Low-level Support Research Articles

Post-diagnostic support for adults diagnosed with autism in adulthood in the UK: A systematic review with narrative synthesis.

More adults than ever before are seeking an autism diagnosis in adulthood. While receiving a diagnosis may be beneficial, many autistic people struggle to navigate their new diagnosis, and require support. This study conducted a systematic review of previous research on the support available after diagnosis (post-diagnostic support) for autistic adults without intellectual disability who were diagnosed in adulthood in the UK. A systematic review is a pre-planned method of searching for all relevant studies, before combining these to answer a larger question. The study aimed to investigate the availability of such support and its effectiveness, and to explore autistic adults' experiences of accessing support. We also used publicly available information to create a map of the post-diagnostic support services currently available across the UK. A systematic search of seven databases was conducted, to identify UK-based studies published after 2012. Nineteen studies were eligible to be included in the study. Although some form of post-diagnostic support is available across most areas in the UK, this mostly consists of providing information and 'signposting' the person to other services. These options may not meet the needs of autistic people, who want services such as psychoeducation (therapy whereby an individual receives education about their diagnosis to improve understanding and self-management), and peer support. Findings highlight the need for adequate support to alleviate the post-diagnostic challenges autistic adults face. The study could not evaluate the effectiveness of support options in the UK due to a lack of information about this in published research. Research shows that autistic adults would like low-level support services, psychoeducation, and peer support, and may also prefer autistic-led support. Further research is required to develop and evaluate post-diagnostic support programmes which include these elements.

Public support for the cordon sanitaire: Descriptive evidence from Spain

Reactions to the rise of far-right parties that advocate democratic backsliding, and the dilution of socially liberal democratic norms present a dilemma for existing political parties. How should existing political parties respond to this challenge? A commonly adopted strategy is to apply a cordon sanitaire which excludes radical right-wing challengers from the government-forming process. Do voters support this policy? Leveraging data from Spain – where the mainstream right has accommodated the radical right-wing party, VOX, via numerous governing coalitions – I rely on individual citizens’ views on how parties should respond to rise of the far-right party, to answer this question. Empirically, the results show very low-level support for the cordon sanitaire in Spain. Indeed, the modal position of the electorate, regardless of their ideological position, is to treat the party just like any other. These results are not conditioned by the propensity of individuals to identify VOX as indeed being a “radical right” party. These descriptive findings suggest that whilst radical right-wing parties may present an inimical threat to democratic norms, citizens do not necessarily view the means of squashing this threat to be one of strategic exclusion. This likely explains why the mainstream right has been able to institutionalise VOX as a political ally: where strategic exclusion is not expected, the mainstream right need not fear violating an expectation that does not exist.

Addressing Challenges in Residential Facilities: Promoting Human Rights and Recovery While Pursuing Functional Autonomy.

Italian residential facilities (RFs) aim to promote human rights and recovery for individuals with severe mental disorders. Italian RFs can be distinguished into five main types: high-intensity rehabilitation (RF1), medium-intensity rehabilitation (RF2), medium-level support (RF3.1), high-level support (RF3.2), low-level support (RF3.3). This study aimed to assess the effectiveness of Italian RFs in achieving functional autonomy while upholding human rights and recovery. Data on socio-demographics, clinical information, patient and staff assessments of functional autonomy, types of interventions, and RF performance in various domains were collected in a pilot study with a cross-sectional design. Descriptive and inferential analyses were conducted. Twelve RFs and 113 patients participated, with varying proportions in each RF type. RF1 patients were the oldest (p<0.001) with the lowest functional autonomy (p<0.001), while RF2 patients were the youngest (p<0.001) with the lowest hospitalization rate (p<0.001). RF3.1 patients had the highest employment rate (p=0.024), while RF3.2 had the lowest employment rate (p=0.024) and the longest service contact (p<0.001). RF3.3 users had the highest functional autonomy (p<0.001). The highest functional autonomy was in self-care which received the highest focus in objectives and interventions. Patients rated their functional autonomy higher than professionals (p<0.001). RFs excelled in the "human rights" and "social interface" domains but performed poorly in "recovery-based practice," with RF1 having the lowest performance and RF3.3 the highest. This pilot study suggests that Italian RFs generally aligne with their mission and human rights principles, but personalizing interventions and implementing recovery-oriented practices face challenges.

The prevalence of trimester-specific dietary supplements and associated factors during pregnancy: An observational study.

Objectives: This study aimed to assess the prevalence of trimester-specific dietary supplements (DS)s use and their possible correlates during pregnancy. Method: Pregnant women were convenience sampled and recruited from a comprehensive obstetric care center in Shanghai, China. Data relating to the use of DS during pregnancy, social support and other social-demographic and obstetric data were collected. Trimester-specific DS use and factors related DS were explored. Results: Of the 2803 women participating in this study, 94.8%, 96.2%, 93.8%, and 94.4% reported the use of at least one DS during pregnancy (all trimesters) and in the first, second, and third trimesters of pregnancy, respectively. Significant differences were noted in the use of DS containing folic acid, calcium, iron, vitamins, and docosahexaenoic acid (DHA), during the three trimesters of pregnancy. A higher proportion of DS use was negatively associated with certain categories of pregnant woman, including unemployed/housewife, low education level, obese, and low social support. A positive association was identified with gestational age. Conclusion for practice: Considering the high prevalence of DS use during pregnancy, future studies are needed to evaluate the accuracy and suitability of DS usage during pregnancy.

From whom do people seek what type of support? A regulatory scope perspective.

From whom do people seek what type of support? Although people regularly seek support from close and distant others, little work has systematically investigated when and why people approach different people in their support network for different types of support. The present research introduces a novel distinction of social support and explores its relationship to the scope or range of support providers people would consider asking for support. Based on a recent extension of construal level theory (Trope et al., 2021), five experiments tested the bidirectional relation between levels of support and scope-the latter assessed by the social distance of potential support providers. Experiment 1 demonstrated that people can categorize supportive behaviors into low-level support (i.e., addressing the effect of a problem) and high-level support (i.e., addressing the cause of a problem). Experiments 2 and 4 showed that being prompted to seek low-level (vs. high-level) support-oriented people toward support providers who are socially proximal (vs. distal). In Experiment 3, thinking about interacting with a socially proximal (vs. distal) support provider led to a greater focus on receiving low-level (vs. high-level) support. Testing the implication of the link between levels of support and scope, Experiment 5 demonstrated that support recipients reported they would feel more gratitude when they imagined receiving low-level (vs. high-level) support from socially proximal (vs. distal) support providers. Broader implications for social support, interpersonal relationships, and construal level theory research are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

RADseq Data Suggest Occasional Hybridization between Microcebus murinus and M. ravelobensis in Northwestern Madagascar.

The occurrence of natural hybridization has been reported in a wide range of organisms, including primates. The present study focuses on the endemic lemurs of Madagascar, primates for which only a few species occur in sympatry or parapatry with congeners, thereby creating limited opportunity for natural hybridization. This study examines RADseq data from 480 individuals to investigate whether the recent expansion of Microcebus murinus towards the northwest and subsequent secondary contact with Microcebus ravelobensis has resulted in the occurrence of hybridization between the two species. Admixture analysis identified one individual with 26% of nuclear admixture, which may correspond to an F2- or F3-hybrid. A composite-likelihood approach was subsequently used to test the fit of alternative phylogeographic scenarios to the genomic data and to date introgression. The simulations yielded support for low levels of gene flow (2Nm0 = 0.063) between the two species starting before the Last Glacial Maximum (between 54 and 142 kyr). Since M. murinus most likely colonized northwestern Madagascar during the Late Pleistocene, the rather recent secondary contact with M. ravelobensis has likely created the opportunity for occasional hybridization. Although reproductive isolation between these distantly related congeners is not complete, it is effective in maintaining species boundaries.

The Impact of the COVID-19 Pandemic on Health, Quality of Life and Intrafamilial Relations - A Population-Based Survey in Germany.

The occurrence of the novel severe acute respiratory syndrome coronavirus-2 (COVID-19) at the end of 2019 comes along with many challenges. Besides worry for one’s own health and the well-being of the family, all measures applied to limit the spread of the coronavirus affected daily life. School closures, economic shutdown and contact restrictions have led to high levels of stress. The impact on health and families has been widely discussed. However, population-based data are scarce. Here, we have assessed health, quality of life and intrafamilial relations depending on the COVID-19 pandemic. Using a three-step random-route approach, a population-based sample of 2,515 persons (52.6% female, average age of 50.3 years) was recruited during the second COVID-19 wave in Germany in winter 2020/21. While the majority of participants reported no change in their health status and the relationship with their partner and children, more than half of participants reported a decreased quality of life since the beginning of the pandemic. Female gender, age above 60 years, a low household income, not living with a partner and the experience of childhood adversity were associated with a higher risk for a worsening of health, quality of life and intrafamilial relations. These had already been well-established risk factors ahead of the pandemic. In order to avoid further increase of inequality in our society and more devastating impact of the pandemic on health and intrafamilial relations, low-level support and intervention programs are urgently needed.

Donation Levels in Cause-Related Marketing (CRM): The Impact of Donation levels, Consumer Support and Self-Expressive Cues on Perceived Benefits and Perceived Monetary Sacrifice

In this study, we examine the extent to which donation level is perceived as a concept of benefit and monetary sacrifice to consumers, as well as that the extent to which it is moderated by consumer support for cause domains. In addition, we investigate the influence of self-expressive cues as a means of increasing consumers’ intention of participating in cause-related marketing (CRM) by lowering perceived monetary sacrifice. As a result of Study 1, consumers with high-level cause support perceived the donation level as a benefit, resulting in a positive effect on their intentions to participate in CRM. Conversely, consumers with low-level support perceived the donation level as monetary sacrifice. Thus, donation level had a negative effect on their participation intentions. Study 2 showed that self-expressive cues dilute the interaction effect of donation levels and consumer support. We conclude by discussing the academic and practical implications of this study.

Supporting Mental Health During the COVID-19 Pandemic Using a Digital Behavior Change Intervention: An Open-Label, Single-Arm, Pre-Post Intervention Study.

BackgroundThe COVID-19 pandemic is taking a toll on people’s mental health, particularly as people are advised to adhere to social distancing, self-isolation measures, and government-imposed national lockdowns. Digital health technologies have an important role to play in keeping people connected and in supporting their mental health and well-being. Even before the COVID-19 pandemic, mental health and social services were already strained.ObjectiveOur objective was to evaluate the 12-week outcomes of the digitally delivered Gro Health intervention, a holistic digital behavior change app designed for self-management of mental well-being, sleep, activity, and nutrition.MethodsThe study used a quasi-experimental research design consisting of an open-label, single-arm, pre-post intervention engagement using a convenience sample. Adults who had joined the Gro Health app (intervention) and had a complete baseline dataset (ie, 7-item Generalized Anxiety Disorder scale, Perceived Stress Scale, and 9-item Patient Health Questionnaire) were followed up at 12 weeks (n=273), including 33 (12.1%) app users who reported a positive COVID-19 diagnosis during the study period. User engagement with the Gro Health platform was tracked by measuring total minutes of app engagement. Paired t tests were used to compare pre-post intervention scores. Linear regression analysis was performed to assess the relationship between minutes of active engagement with the Gro Health app and changes in scores across the different mental health measures.ResultsOf the 347 study participants, 273 (78.67%) completed both the baseline and follow-up surveys. Changes in scores for anxiety, perceived stress, and depression were predicted by app engagement, with the strongest effect observed for changes in perceived stress score (F1,271=251.397; R2=0.479; P<.001).ConclusionsA digital behavior change platform that provides remote mental well-being support can be effective in managing depression, anxiety, and perceived stress during times of crisis such as the current COVID-19 pandemic. The outcomes of this study may also support the implementation of remote digital health apps supporting behavior change and providing support for low levels of mental health within the community.

WORK-CENTERED LIFE AND EMPLOYEE PERFORMANCE AT GEOTHERMAL DEVELOPMENT COMPANY IN NAIROBI CITY COUNTY, KENYA

Work-life balance entails to the working arrangements that ensure an employee's personal and professional duties are balanced. Poor work-life balance is a key risk that jeopardizes employee well-being, performance, and organizational effectiveness. Most employees find it difficult to strike a balance between their personal lives and their work obligations. Work-life balance is linked to the stability between the time and effort employees devote to work and also attend personal responsibilities to maintain an overall sense of synchronization in life. State corporations such as Geothermal Development Company are currently operating in an extremely competitive environment. This demand for more responsiveness and efficiency of employees that is brought about by Work-life balance as adopted in private organizations. The main objective of this study was to investigate the influence of work-centred life and employee performance at Geothermal Development Company. The anchor theory of the study was Spill-over Theory that was reinforced by Compensation Theory. The study adopted a descriptive research design. Data was collected using structured questionnaires from the senior management, middle management, and lower-level support staffs of Geothermal Development Company. The target population of the study was 341 and the study’s sample size was 102. The study used stratified random sampling. The researcher conducted a pilot study using 10% of the respondents before the questionnaires were distributed for data collection. Pre-testing and expert opinion were used to examine the instrument's validity. The instrument's dependability was tested using the Cronbach’s alpha reliability test. The qualitative data was analyzed with the aid of SPSS version 26.0. Inferential statistics (correlations and regression analysis) was used by the researcher to show the relationship between independent and dependent variables. Pearson correlation helped in envisaging and defining the relationship between the variables. Data was presented on tables and figures. Pearson correlation helped in envisaging and defining the relationship between the variables. The study established that work-centred life had a significant influence on employee performance. The study concluded that work-centered life had significant influence on employee performance. The researcher recommends that the management of GDC should enhance their policies on work-centred life by formulation and implementation of modern policies, and this should be cascaded down to departmental level. The Human Resource department at GDC should reconsider its policies on flexi working arrangements, organization wellness programmes, job sharing as well as employee health as way of motivating employees to improve their performance. &#x0D; &#x0D; &lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt; Article visualizations:&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;img src="/-counters-/edu_01/0876/a.php" alt="Hit counter" /&gt;&lt;/p&gt;

The Impact of COVID-19 Outbreak on the Mental Health of the Pregnant Women: A Systematic Review

Background It is reported that pregnant women have shown different behaviors during the outbreak of COVID-19. The present study aimed to review existing studies concerning pregnant women’s mental health during the COVID-19 outbreak. Materials and Methods: In this systematic review, two independent researchers reviewed the impact of COVID-19 on health mental in databases, including Scopus, EMBASE, Cochrane, Web of Science, and Medline, without time and language restrictions from inception up to June 10, 2020. The searches were performed using the following keywords: (Pregnant OR Pregnancy) AND (COVID-19 OR SARS-COV 2) AND (anxiety OR Anxiety). Results: The following risk factors affect the pregnant women’s anxiety levels: underweight during pregnancy, employment, primigravida, lower than 35 years old, low family level and social support, and low physical activity. Women’s psychological responses during the COVID-19 outbreak include anxiety, depression, fear, and stress. Besides, pregnant women in the COVID-19 pandemic have refused to receive prenatal care and have preferred social isolation. Generally, women’s levels of anxiety and depression had an ascending order. Moreover, findings concerning the relationship between age and pregnancy and levels of anxiety were contradictory. Moreover, anxiety levels had a relationship with the race as levels of anxiety, and the symptoms of psychological tensions were higher in Arab women than Jewish women. Conclusion The anxiety and depression levels among pregnant women during the COVID-19 outbreak have been reported as average to high. It is required for women to be under social support and encourage pregnant women to have more physical activities.

Negotiating safety and vulnerability in everyday life: perspectives of UK older people from participative research

ABSTRACT This article reports on a participative study that began to explore what safety and vulnerability mean to older people and the resources they draw on to keep themselves safe. The methodology was designed in collaboration with an independent advocacy organisation and 10 of its older members, who were also research participants. It involved focus groups and repeated visits to five participants to discuss their daily lives. The findings indicate that ‘safety’ and ‘vulnerability’ have subjective, experiential dimensions, which are situated in particular relationships, environments and experiences over time. Participants reported drawing on their own strengths and the strengths of others in their families, communities and local services to achieve an acceptable level of felt safety for themselves. However, this sense of safety could not be disentangled from, nor always prioritised over, wider aspects of living well including maintaining reciprocal relationships, preserving self-identity and contributing to the well-being of families and other social groups of which they felt themselves a part. Implications are considered in light of UK and wider European policy aspirations to support both autonomy and safety: specifically, the need to foster supportive communities, to offer low-level support and to pay attention to what safety means to each individual.

Inpatient COVID-19 outcomes in solid organ transplant recipients compared to non-solid organ transplant patients: A retrospective cohort.

Immunosuppression and comorbidities might place solid organ transplant (SOT) recipients at higher risk from COVID-19, as suggested by recent case series. We compared 45 SOT vs. 2427 non-SOT patients who were admitted with COVID-19 to our health-care system (March 1, 2020 - August 21, 2020), evaluating hospital length-of-stay and inpatient mortality using competing-risks regression. We compared trajectories of WHO COVID-19 severity scale using mixed-effects ordinal logistic regression, adjusting for severity score at admission. SOT and non-SOT patients had comparable age, sex, and race, but SOT recipients were more likely to have diabetes (60% vs. 34%, p<.001), hypertension (69% vs. 44%, p=.001), HIV (7% vs. 1.4%, p=.024), and peripheral vascular disorders (19% vs. 8%, p=.018). There were no statistically significant differences between SOT and non-SOT in maximum illness severity score (p=.13), length-of-stay (sHR: 0.9 1.11.4 , p=.5), or mortality (sHR: 0.1 0.41.6 , p=.19), although the severity score on admission was slightly lower for SOT (median [IQR] 3 [3, 4]) than for non-SOT (median [IQR] 4 [3-4]) (p=.042) Despite a higher risk profile, SOT recipients had a faster decline in disease severity over time (OR = 0.76 0.810.86 , p<.001) compared with non-SOT patients. These findings have implications for transplant decision-making during the COVID-19 pandemic, and insights about the impact of SARS-CoV-2 on immunosuppressed patients.

Clinical experience of high-flow nasal cannula oxygen therapy in severe COVID-19 patients

Acute respiratory failure due to acute hypoxemia is the major manifestation in severe coronavirus disease 2019 (COVID-19). Rational and effective respiratory support is crucial in the management of COVID-19 patients. High-flow nasal cannula (HFNC) has been utilized widely due to its superiority over other non-invasive respiratory support techniques. To avoid HFNC failure and intubation delay, the key issues are proper patients, timely application and improving compliance. It should be noted that elder patients are vulnerable for failed HFNC. We applied HFNC for oxygen therapy in severe and critical ill COVID-19 patients and summarized the following experiences. Firstly, to select the proper size of nasal catheter, to locate it at suitable place, and to confirm the nose and the upper respiratory airway unobstructed. Secondly, an initial ow of 60 L/min and 37℃ should be given immediately for patients with obvious respiratory distress or weak cough ability; otherwise, low-level support should be given first and the level gradually increased. Thirdly, to avoid hypoxia or hypoxemia, the treatment goal of HFNC should be maintained the oxygen saturation (SpO2) above 95% for patients without chronic pulmonary disease. Finally, patients should wear a surgical mask during HFNC treatment to reduce the risk of virus transmission through droplets or aerosols.

Brokers on the Ward

Abstract This paper is based on an ethnographic study conducted in a public hospital in Bangladesh. The study shows how the social dynamics necessary to deal with the structural realities of the hospital give this cosmopolitan institution a local character. In this paper, we describe this local character by focusing on the lower-level hospital staff, such as ward boys, cleaners, and gatemen. Social inequality and exclusion are rampant in Bangladeshi public hospitals. Doctors and nurses are unwilling to communicate with patients and their relatives, while the latter are unable to approach the former for specific help or information. Our research, shows how low-level support workers fill the void between the two “factions” and act as brokers transporting information and activities between these factions. By doing so they do not only make a crucial contribution to the functioning of the ward, but also gain considerable influence in spite of their low position.

School counselling key in mental health battle says Children's Commissioner

The children's commissioner wants to see more funding and incentives for in-school counselling and other low-level mental health support

School counselling key in mental health battle

The children's commissioner wants to see more funding and incentives for in-school counselling and other low-level mental health support

Long Chain Omega-3 Fatty Acid Intervention in Ageing Adults at Risk of Dementia Following Repeated Head Trauma. Low-Level Support or an Opportunity for an Unanswered Question?

Emerging evidence of brain injury on risk of neurodegenerative diseases such as Alzheimer's disease (AD) and chronic traumatic encephalopathy (CTE) have resulted in interest in therapeutic potential of omega-3 fatty acids (n-3FA). We conducted a systematic review of n-3FA therapeutic efficacy for ageing adults at risk of AD/CTE following a history of repeated head trauma. Databases for articles between 1980-June 2020 were examined for studies reporting on n-3 FAs in adults (≥ 45 years) with a history of repeated brain injury. Following an initial screen of 175 articles, 12 studies were considered but were eventually rejected, as they did not meet inclusion criteria. Our review could find no evidence to support, or disprove, effectiveness of n-3FA intervention in older adults with a history of head trauma. With animal studies showing neuro-restorative potential of n-3FA following brain injury, this review highlights the urgent need for human research in this area.

Resilience and workplace stress in Australian and New Zealand obstetrics and gynaecology trainees: A cross-sectional survey.

Obstetrics and gynaecology training is a demanding vocation; there is a paucity of data on trainee resilience and well-being in this field. To investigate resilience, support and perceived levels of stress and burnout in Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) trainees. A cross-sectional survey of RANZCOG trainees in Australia and New Zealand (n=638) was distributed electronically in May 2018. Two-hundred and thirty-one (36%) valid responses were received. The mean resilience score was moderate (mean=77; SD=11). Resilience was significantly associated with general health (F=7.5, P=0.007), depression in the last two weeks (F=4.4, P=0.013) and seriously considering leaving the program at some point (F=15.4, P<0.001). Most participants (204; 88%) stated improvements could be made to the level of trainee support; with over half identifying the support they received from RANZCOG to be low or very low (132; 57%). One-third of participants (76; 33%) rated the support from their direct supervisor as low to very low. Over half of all participants identified high to very high responses to: burnout (127; 55%); personal stress (134; 58%); workplace stress (143; 62%) and depression (103; 45%). RANZCOG trainees exhibit moderate resilience levels, yet they report high levels of perceived stress, depression and burnout and low-level support from direct supervisors. This may highlight the need for enhanced support and working conditions to allow trainees to remain resilient and thrive in their careers.

Weakening WebAssembly

WebAssembly (Wasm) is a safe, portable virtual instruction set that can be hosted in a wide range of environments, such as a Web browser. It is a low-level language whose instructions are intended to compile directly to bare hardware. While the initial version of Wasm focussed on single-threaded computation, a recent proposal extends it with low-level support for multiple threads and atomic instructions for synchronised access to shared memory. To support the correct compilation of concurrent programs, it is necessary to give a suitable specification of its memory model. Wasm's language definition is based on a fully formalised specification that carefully avoids undefined behaviour. We present a substantial extension to this semantics, incorporating a relaxed memory model, along with a few proposed extensions. Wasm's memory model is unique in that its linear address space can be dynamically grown during execution, while all accesses are bounds-checked. This leads to the novel problem of specifying how observations about the size of the memory can propagate between threads. We argue that, considering desirable compilation schemes, we cannot give a sequentially consistent semantics to memory growth. We show that our model provides sequential consistency for data-race-free executions (SC-DRF). However, because Wasm is to run on the Web, we must also consider interoperability of its model with that of JavaScript. We show, by counter-example, that JavaScript's memory model is not SC-DRF, in contrast to what is claimed in its specification. We propose two axiomatic conditions that should be added to the JavaScript model to correct this difference. We also describe a prototype SMT-based litmus tool which acts as an oracle for our axiomatic model, visualising its behaviours, including memory resizing.