Personal Support Research Articles

Quality Improvement Intervention Using Social Prescribing at Discharge in a University Hospital in France: Quasi-Experimental Study.

Social prescription is seen as a public health intervention tool with the potential to mitigate social determinants of health. On one side, social prescription is not yet well developed in France, where social workers usually attend to social needs, and historically, there is a deep divide between the health and social sectors. On the other side, discharge coordination is gaining attention in France as a critical tool to improve the quality of care, assessed indirectly using unplanned rehospitalization rates. This study aims to combine social prescription and discharge coordination to assess the need for social prescription and its effect on unplanned rehospitalization rates. We conducted a quasi-experimental study in two departments of medicine in a French university hospital in a disadvantaged suburb of Paris over 2 years (October 2019-October 2021). A discharge coordinator screened patients for social prescribing needs and provided services on the spot or referred the patient to the appropriate service when needed. The primary outcome was the description of the services delivered by the discharge coordinator and of its process, as well as the characteristics of the patients in terms of social needs. The secondary outcome was the comparison of unplanned rehospitalization rates after data chaining. A total of 223 patients were included in the intervention arm, with recruitment being disrupted by the COVID-19 pandemic. More than two-thirds of patients (n=154, 69.1%) needed help understanding discharge information. Slightly less than half of the patients (n=98, 43.9%) seen by the discharge coordinator needed social prescribing, encompassing language, housing, health literacy, and financial issues. The social prescribing covered a large range of services, categorized into finding a general practitioner or private sector nurse, including language-matching; referral to a social worker; referral to nongovernmental organization or group activities; support for transportation issues; support for health-related administrative procedures; and support for additional appointments with nonmedical clinicians. All supports were delivered in a highly personalized way. Ethnic data collection was not legally permitted, but for 81% (n=182) of the patients, French was not the mother tongue. After data chaining, rehospitalization rates were compared between 203 patients who received the intervention (n=5, 3.1%) versus 2095 patients who did not (n=51, 2.6%), and there was no statistical difference. First, our study revealed the breadth of patient's unmet social needs in our university hospital, which caters to an area where the immigrant population is high. The study also revealed the complexity of the discharge coordinator's work, who provided highly personalized support and managed to gain trust. Hospital discharge could be used in France as an opportunity in disadvantaged settings. Eventually, indicators other than the rehospitalization rate should be devised to evaluate the effect of social prescribing and discharge coordination.

Recipes for institutional adoption of a teacher-driven learning analytics tool

The changing landscape of higher education is putting increasing strain on educators, leading to a diminishing ability to provide pedagogical and pastoral support to ballooning and diversifying cohorts. Learning analytics promises solutions to these challenges for educators, including by personalising learning support and experiences, streamlining data capture and analyses, and providing teachers with new, efficient teaching approaches. However, reports of these impacts, or widespread adoption of learning analytics, or even examples of cross-institutional collaboration are sparse. We argue that this may be because of a lack of educator-driven learning analytics tools that meet their felt needs, and present case studies from three Australian universities that have collaborated to implement such a tool. This tool, the Student Relationship Engagement System (SRES), empowers educators to collect, collate, analyse, and use student engagement and success data that they consider meaningful for their particular contexts. Developed by unfunded educators and widely adopted through collegiate recommendations, the SRES enables personalisation and targeting of student learning and support using relevant data, fostering positive student-teacher relationships and enhancing student engagement. Using the three case studies as a backdrop, we present a revised learning analytics adoption framework focussing on strategy, structure, support, and impact, and use this framework to systematically evaluate the implementation of the SRES at the three institutions to derive ‘recipes’ for adopting an educator-focussed learning analytics platform. We also discuss three core themes emerging from the case studies, around the needs of academics, the role of academic and educational developers, and flexible and agile information technology practices.

A mixed-method approach on the glass cliff phenomenon: a case of public sector service organizations in Iran

PurposeThis study aims to develop and test a model of the antecedents, mediators and consequences of the glass cliff phenomenon through public sector service organizations in Iran to explore more insights on gender inequality in managerial positions.Design/methodology/approachThe current research was conducted based on a mixed-method approach, using both qualitative and quantitative research designs. First, the qualitative method includes content analysis by conducting semi-structured interviews with 20 university professors and expert managers working in public sector service organizations in Iran. The outcomes of the qualitative phase lead to designing the conceptual framework and research hypothesis. Then, through a quantitative phase, 384 female managers working in public sector service organizations in Iran are selected using stratified random sampling and fill out the research questionnaire. The exploratory factor analysis was used to verify the model. Moreover, structural equation modeling, using AMOS 24, was used to test the research hypothesis.FindingsThe findings of the qualitative phase were represented in three categories including antecedents (e.g. the characteristics of women’s leadership, the selection of women based on meritocracy criteria, women’s preferences and organizational factors), mediation effect (e.g. succession planning, personal development planning and support networks) and consequences of the glass cliff phenomenon (e.g. positive and negative consequences). The results of the exploratory factor analysis show there are ten components, explaining 88.5% of variances. Moreover, the test of the structural model supports the direct effect of antecedents on the glass cliff phenomenon. The results also show the effect of the glass cliff phenomenon on consequences through mediation effects.Research limitations/implicationsThere are some limitations that can be addressed by other researchers. Accordingly, the limited number of female managers in Iran prevented larger quantitative research. Moreover, the current research only found casual and mediation consequences of the glass cliff phenomenon, and potential moderators were not considered in this study.Originality/valueThe present study’s innovations may include using a mixed-method approach to investigate the antecedents, mediators and consequences of the glass cliff phenomenon in this study and examining the model constructs in some public sector service organizations. This research may provide a deep understanding of the antecedents, mediators and consequences of the glass cliff phenomenon by finding new factors using a mixed-method approach.

The impact of early intervention psychosis services on hospitalisation experiences: a qualitative study with young people and their carers

BackgroundWhile a core aim of early intervention psychosis services (EIPS) is to prevent hospitalisation, many with a first episode of psychosis (FEP) will require inpatient care. We explored young people’s (YP) and their carers’ hospitalisation experiences prior to and during EIPS engagement and how factors across these services influenced these experiences.MethodsUsing purposive sampling, we recruited twenty-seven YP, all of whom had been involved with the hospital system at some stage, and twelve support persons (parents and partners of YP) from state and federally funded EIPS in Australia with different models of care and integration with secondary mental health care. Audio-recorded interviews were conducted face-to-face or via phone. A diverse research team (including lived experience, clinician, and academic researchers) used an inductive thematic analysis process.ResultsFour key themes were identified as influential in shaping participant’s hospital experiences and provide ideas for an approach to care that is improved by the effective coordination of that care, and includes this care being delivered in a trauma informed manner: (1) A two-way street: EIPS affected how participants experienced hospitalisation, and vice versa; (2) It’s about people: the quality and continuity of relationships participants had with staff, in hospital and at their EIPS, was central to their experience; (3) A gradual feeling of agency: participants viewed EIPS as both reducing involuntary care and supporting their self-management; and (4) Care coordination as navigation for the healthcare system: great when it works; frustrating when it breaks down.ConclusionsHospitalisation was viewed as a stressful and frequently traumatic event, but a approach to care founded on trust, transparency, and collaboration that is trauma-informed ameliorated this negative experience. Consistent EIPS care coordination was reported as essential in assisting YP and carers navigate the hospital system; conversely, discontinuity in EIPS staff and lack of integration of EIPS with hospital care undermined the positive impact of the EIPS care coordinator during hospitalisation. Care coordinator involvement as a facilitator, information provider, and collaborator in inpatient treatment decisions may improve the usefulness and meaningfulness of hospital interventions.

Profiles of executive functions in middle childhood and prediction of later self-regulation.

Most research on the development of executive functions (EF) has applied variable-oriented approaches, neglecting the potential inter- and intraindividual interplay of these capacities. In a person-oriented approach, the present study identified varying profiles of performance for three cool EF facets: inhibition, working-memory updating, and cognitive flexibility, as well as two hot EF facets: affective decision-making and delay of gratification, in a community sample of 1,657 children (T1; age: 6-11 years, M = 8.36 years, 52.1% female) via latent profile analysis. The best-fitting model allowed for partial dependence across the three cool EF and included four profiles: all-average (69.4% of the children), low-delay (19.0%), regulated-decision-making (7.0%), and low-inhibition (4.6%). Age, binary sex, socio-economic status, multilingualism, and processing speed were identified as significant characteristics of EF profile membership. Longitudinally, a higher probability of belonging to the low-inhibition profile predicted lower rates of the self-regulatory outcome of inhibitory control 1 year later, while belonging to the regulated-decision-making profile predicted lower rates of the ability to plan and organize 3 years later. These results not only demonstrate the existence of subgroups with different concurrent within-person expressions of EF performance, but also identify related characteristics and longitudinal outcomes of subgroup membership. In turn, these conclusions stress the importance of person-oriented research to inform on differing weaknesses or strengths in EF performance for varying individuals, thereby providing valuable insight for educational and clinical research into the design of effective personalized support or interventions during middle childhood.

Socially Responsible Human Resource Management Practices and Job Satisfaction of Public Servants with Disabilities in South-West Nigeria

Overt ill-treatments from management and co-workers have often led to job dissatisfaction and discouraged other persons with disabilities keen and able to join the workforce. Persons with disabilities continue to suffer employment-related and other forms of discrimination, resulting in low job satisfaction and job discontentment. These conditions accentuate the need for socially responsible human resource management practices in organisations. This study examined socially responsible human resource management practices and job satisfaction of public servants with disabilities in South-West Nigeria. Survey research design was adopted for this study. The study’s sample size of 422 public servants and leaders was determined using total enumeration sampling technique. A structured and validated questionnaire and semi-structured interview were used to obtain quantitative and qualitative data. Cronbach’s alpha reliability coefficients for the constructs ranged between 0.69 and 0.84. The response rate was 95%. Data were analysed using descriptive and inferential (multiple linear regression and hierarchical regression) statistics. The study found that SRHRM had a statistically significant effect on job satisfaction (Adj.R2 = 0.53, F(5, 410) = 92.07, p < 0.05). The interviews indicated that only two of five States had a deliberate strategy driving recruitment of persons with disabilities. A vast majority were employed as teachers in special schools, and diverse administrative roles across government ministries, departments and agencies. All States provided varying degrees of basic support and benefits, and stated that the employment of persons with disabilities was influenced by its leadership and affected organisational reputation. The study concluded that SRHRM affects job satisfaction of public servants with disabilities in South-West Nigeria. The study recommended that the government, in conjunction with institutional stakeholders and advocacy groups, should facilitate the adoption of SRHRM practices in South-West Nigeria. In addition, the involvement of the private sector and provision of financial grants and subsidies for employers would enhance wider employment, inclusion and quality organisational support for persons with disabilities.

Implementation of the principle of awareness in the process of mastering educational knowledge by students with special educational needs in the conditions of the New Ukrainian School

Relevance. The examination of the principle of awareness in the process of teaching students with special educational needs in the framework of the New Ukrainian School is necessary since this principle is responsible for the transition to personality-oriented learning. For students with special educational needs, awareness of their own learning is key to understanding their strengths and weaknesses and solve individual problems. Purpose. The main purpose of this study is to analyse the main aspects of implementing the mindfulness principle in inclusive education within the New Ukrainian School. Methodology. The study employed categorical analysis and generalisation to address key aspects and challenges of inclusive education within international pedagogical theory. It also utilised legal document analysis and the method of systematisation. Results. Inclusive education, a key aspect of problem solving, has different definitions, but all focus on accessibility for all children. It is recorded that awareness in the process of learning by students is a pedagogical approach that emphasises the importance of self-awareness and active understanding of the learning process on the part of students. Four principles of inclusive education in the New Ukrainian School are identified, which contribute to the awareness of educational material by students with special educational needs. Conclusions. Inclusive education in Ukraine is supported by a robust legislative framework, ensuring equal access to education for individuals with special needs with the emphasis on interactive learning, practical application of educational material, social integration, and personalized support. The main practical substantial aspect of this study is to inform teachers about the legislative and programmematic nuances of inclusive education, aimed at maximising its effectiveness. Keywords: inclusion; competence; interactive learning; practicality; social integration; personal support

Revolutionizing Higher Education Admissions: A Holistic Solution Integrating Machine Learning and Chatbot Technology

In the dynamic landscape of higher education admissions, traditional processes encounter inefficiencies and limitations in providing personalized support to prospective students. This research proposes a comprehensive solution that merges advanced machine learning methodologies with AI-driven chatbot technology to redefine the admission journey. By addressing the challenges faced by both applicants and institutions, this innovative approach aims to streamline the admissions process while nurturing a supportive ecosystem for students. Through predictive modeling and educational chatbots, the integrated system enhances efficiency and provides tailored guidance, facilitating a smoother transition into higher education. This paper explores the potential of this integrated solution, emphasizing its implications for predictive modeling, college prediction, and the overall improvement of the admission experience.

Integrating NLP Chatbot into Career Guidance Web Application

Artificial Intelligence (AI) is the development of computer systems that can perform tasks that typically require human intelligence. The development of an advanced web-based chatbot system involves the integration of various technologies and methodologies to create a seamless conversational interface. Leveraging HTML, CSS, and JavaScript for frontend development, alongside Python Flask framework for backend functionality, the project aims to deliver a robust and intuitive user experience. Key to the system's operation is the incorporation of PyTorch for machine learning, allowing for the implementation of sophisticated natural language processing (NLP) techniques. Through tokenization and stemming using NLTK (Natural Language Toolkit), the system enhances its understanding of user queries, enabling it to provide relevant and contextually appropriate responses. At the core of the system lies a supervised learning model trained on a custom dataset compiled from user interactions. This model utilizes bag-of-words representations and neural network architectures to predict responses based on input text. By continuously refining its predictions through feedback mechanisms, the system improves its accuracy and responsiveness over time, ensuring a more tailored and effective user experience. Voice input functionality, facilitated by speech recognition technology, further enhances user interaction by allowing users to communicate with the chatbot using spoken commands. This feature expands the accessibility and convenience of the system, catering to a broader range of users with varying preferences and abilities. In addition to its conversational capabilities, the system prioritizes security and privacy, implementing robust user authentication mechanisms and secure data storage practices. By adhering to industry best practices and standards, the project aims to instill trust and confidence in users regarding the confidentiality and integrity of their data.User interface design and usability are also key considerations in the development process, with careful attention given to creating an intuitive and visually appealing interface. Through thoughtful design choices and user feedback, the system seeks to optimize the user experience and streamline the interaction flow, ensuring that users can easily navigate and utilize its features. Overall, the project endeavors to create an intelligent and user-friendly chatbot system that enhances communication and interaction between users and technology. By leveraging advanced technologies and methodologies, the system aims to provide personalized assistance and support to users, ultimately improving productivity, efficiency, and satisfaction in various domains and applications

Abstract PO5-10-02: Neighborhood deprivation index and time to initiation in patients with metastatic breast cancer

Abstract Background Cyclin-dependent kinase 4 and 6 inhibitors (CDKi) are first-line therapy for patients with estrogen-positive (ER+) metastatic breast cancer (MBC). The accessibility, usability, and outcomes according to demographic factors have not been well studied in real world practice. Methods Retrospective review of patients with ER+ MBC prescribed first line CDKi therapy at a large NCI-designated cancer center from January 2015 through December 2022. Patient records were abstracted for outcomes including 1) time from CDKi prescription to drug initiation (TTI), 3) time from CDKi initiation to progression, and 3) time from CDKi initiation to death/or 6/30/2022. Patient variables collected were: patient age (continuous), race (patient self-report – Black, White, Other), partner status (Married, Not married), Insurance type (Medicare, Medicaid, Private); Mean BMI; Number of comorbidities (5 categories). Neighborhood deprivation index (NDI) was determined from the patient’s address with higher scores indicating more deprivation. Descriptive, comparative, and correlational statistics were used. Results A total of 173 patients were included in the analysis. Mean age – 63.1, (SD 12.7, range 24-94); race – White n=157, Black n=16; marital status – Married n=102, Not married n=71; mean NDI – 61.0 (SD 23.7, range 6-100); mean BMI – 28.9 (SD 6.9, range 16-48); number of comorbidities – 0 n=35, 1-2 n= 35, 3-4 n = 55, 5-6 n = 20, 7+ n = 28; insurance type – Medicare n = 115, Medicaid n = 21, Private n = 37. TTI: the median TTI was 14 days. There were no statistically significant differences in TTI based on age, race, NDI, or other demographic variables. Time to progression: in the multivariate model, younger age at diagnosis and Medicaid insurance were associated with shorter time to progression. Overall survival: not married, younger age at diagnosis, and Medicaid insurance were associated with shorter overall survival. Discussion Demographic factors are associated with diverse outcomes of MBC therapy, not attributed to delay in CDKi treatment initiation. Personalization of support during MBC illness according to risk factors for worse outcomes may help to equalize incomes. Citation Format: Sneha Rajendran, Dianxu Ren, Marina Petruzzi, Margaret Rosenzweig. Neighborhood deprivation index and time to initiation in patients with metastatic breast cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-10-02.

The Covid-19 resilience journey of vulnerable young South Africans

Resilience, the ability to adapt well to adversity, is a critical factor in the well-being and success of young individuals. This study explored the multifaceted nature of resilience among South African youth challenged by COVID-related stressors and structural disadvantage. Specifically, this paper reports a follow-up qualitative leg of a sequential mixed-method design. Thirty-eight young adults (average age 24), all of whom reported high risk exposure but low depression symptoms, took part in semi-structured interviews to learn more about their resilience journey. Qualitative content analysis was employed to identify prominent themes. The study’s findings emphasize the dynamic nature of youth resilience, with individuals being buoyed by social network support (especially family); personal agency, structural support, and resource combinations. The qualitative findings contribute to the growing attention to the need for comprehensive policies and programs that recognize and enhance multisystemic sources of support, enabling young individuals to navigate challenges and thrive in their transition into adulthood.

Applying simulation learning theory to identify instructional strategies for Generation Z emergency medicine residency education

AbstractIntroductionGeneration Z learners are entering emergency medicine (EM) residency training, bringing unique learning preferences that influence their engagement with residency education. To optimally teach and motivate this incoming generation of learners, EM educators must understand and adapt to the changing instructional landscape.MethodologyThe Simulation Leaders Advancing the Next Generation in Emergency Medicine (SLANG‐EM) Workgroup was created to identify effective educational strategies for Generation Z learners entering EM. Members were faculty in the Society for Academic Emergency Medicine (SAEM) Simulation Academy, well versed in learning theory supporting simulation‐based education (SBE) and actively involved in EM residency education.Unique treatment/analysisThrough primary and secondary literature searches, the SLANG‐EM Workgroup identified four distinctive learning preferences of Generation Z learners: (1) individualized and self‐paced learning, (2) engaging and visual learning environments, (3) immediate and actionable feedback, and (4) combined personal and academic support. Workgroup members evaluated these learning preferences using a novel conceptual framework informed by the theoretical principles underpinning SBE, recommending instructional strategies for Generation Z EM residency learners across multiple educational environments.Implications for educatorsInstructional strategies were described for the didactic, simulation, and clinical learning environments. In the didactic environment, identified instructional strategies included meaningful asynchronous education, interactive small‐group learning, and improved multimedia design. In the simulation environment, educational innovations particularly suitable for Generation Z learners included learner‐centered debriefing, rapid‐cycle deliberate practice, and virtual simulation. In the clinical environment, described instructional strategies involved setting learner‐centered goals and delivering facilitative feedback in the context of an educational alliance. Overall, these instructional strategies were clustered around themes of student‐centered education and the educator as facilitator, which align well with Generation Z learning preferences. These findings were synthesized and presented as an advanced workshop, “Delivering Effective Education to the Next Generation,” at the 2023 SAEM Annual Meeting.

Learn to Like Your ­Students

This department provides a space for current and past PK-12 teachers of mathematics to connect with other teachers of mathematics through their stories that lend personal and professional support.

Evaluating TeamBirth's Effect on Autonomy for Minoritized Populations in Labor [ID 2683585

INTRODUCTION: Prioritization of maternal autonomy and communication can greatly affect obstetric care experiences. We implemented TeamBirth—an initiative designed to center the patient, their preferences, and autonomy through standardized team communication in labor. We sought to understand how TeamBirth affected obstetric care experiences, through self-reported autonomy, for minority populations. METHODS: TeamBirth “huddles” in labor included patients, labor support persons, physicians, and nursing team members participating in standardized communication approaches, supplemented with whiteboard and decision-support guides. From May 2021 to May 2022, surveys administered postpartum inpatient were collected from birthing persons. We used the Mother’s Autonomy in Decision Making Scale (MADM) to measure autonomy. MADM scores in the highest quartile (scores ranged 34–42) were considered as having high autonomy. RESULTS: Over one-third (36.4%) of the 762 respondents were of minoritized populations (eg, Black, Hispanic) versus White (63.3%). When considering race/ethnicity, high autonomy was not related to minoritized group (P=.944). The majority (86%) of high autonomy respondents had one or more huddles, compared to 71% with low autonomy (P<.001). When evaluating the relationship of number of huddles to high autonomy, the minority group was not different compared to White patients (interaction P=.915). CONCLUSION: Patients who experienced huddles during intrapartum care reported higher autonomy regardless of minority status. Use of the TeamBirth initiative has potential to increase autonomy and improve obstetric experiences. Early data indicate that patient experiences of minoritized populations can be improved with TeamBirth; additional investigation is indicated.

Health Management Service Models for the Elderly with Visual Impairment: A Scoping Review.

The incidence of visual impairment(VI) in older people is gradually increasing. This review aimed to summarise the evidence on existing health management models and strategies for older adults with VI to improve health-related and vision-related quality of life (QoL) in older people. Based on the framework of the scoping review methodology of Arksey and O'Malley (2005), a comprehensive literature search of relevant literature published between January 2010 and June 2022 in PubMed, CINAHL, EMBASE, Web of Science, Cochrane Library, CNKI, VIP, Wanfang database, Sinomed and the grey literature. Finally, 31 articles were included. The health management model had a multidisciplinary team low vision rehabilitation model, medical consortium two-way management model, low vision community comprehensive rehabilitation model, medical consortium-family contract service model, screening-referral-follow-up model, and three-level low vision care model. The health management strategy covers nine aspects, the combination of multi-element strategies is feasible, and network information technology has also shown positive results. In the future, under the Internet and hierarchical management model, we should provide demand-based personalized support to rationalize and scientifically achieve hierarchical management and improve resource utilization efficiency and eye health outcomes.

Acceptability and feasibility of FAMS-T1D mHealth intervention to optimize self- and social regulation for emerging adults with type 1 diabetes

BackgroundAmong emerging adults with type 1 diabetes (T1D), self-regulation and social regulation skills can help avoid high A1c and diabetes distress. FAMS (Family/friend Activation to Motivate Self-care) is mobile phone-delivered intervention that supports development of these skills and is efficacious among adults with type 2 diabetes. However, the acceptability and feasibility of the FAMS intervention among emerging adults with T1D are unknown.MethodsTherefore, we adapted FAMS for in a new disease context and developmental stage and then conducted a 3-month mixed-methods pre-post pilot study. Participants were emerging adults with T1D and a friend/family member enrolled as a support person (optional). Feasibility/acceptability outcomes and associated progression thresholds were recruitment (≥ 70% eligible emerging adults), retention (≥ 85%), intervention engagement (≥ 70%), and satisfaction (≥ 70%). We also collected qualitative feedback to determine if the intervention addressed relevant needs and explored changes in outcomes of interest (family/friend involvement, self-efficacy, self-management, distress, A1c).ResultsRecruitment rates indicate recruitment of emerging adults with T1D (n = 30) and their support persons (n = 20) is feasible — 79% of emerging adults who screened as eligible enrolled and 70% of enrolled emerging adults invited a support person. Emerging adults completed 98% of coaching sessions, and response rates to automated text messages were median 85% IQR [68%, 90%]. Changes in selected measures for outcomes of interest were in expected directions suggesting sensitivity to changes occasioned by the intervention in a future evaluative trial. Emerging adults said FAMS-T1D helped with setting realistic goals, motivated them to prioritize diabetes goals, and increased support, indicating acceptability of the intervention in this new disease and developmental context.ConclusionsFindings suggest potential for FAMS-T1D to engage emerging adults and their support persons and feasibility for an evaluative trial examining effects on self-regulation (self-efficacy, self-management), social regulation (family/friend involvement), and outcomes (diabetes distress, A1c).Trial registrationWe did not register this study on ClinicalTrials.gov because the purpose of the study was to assess the feasibility and acceptability of the intervention and study procedures and measures in preparation for a future trial. The purpose of that future trial will be to evaluate the effect of the intervention on health-related biomedical and behavioral outcomes, and that trial will be registered accordingly.

Best Practices for Managing Patients with Unresectable Metastatic Gastric and Gastroesophageal Junction Cancer in Canada.

Gastric cancer (GC) is one of the most common types of cancer and is associated with relatively low survival rates. Despite its considerable burden, there is limited guidance for Canadian clinicians on the management of unresectable metastatic GC and gastroesophageal junction cancer (GEJC). Therefore, we aimed to discuss best practices and provide expert recommendations for patient management within the current Canadian unresectable GC and GEJC landscape. A multidisciplinary group of Canadian healthcare practitioners was assembled to develop expert recommendations via a working group. The often-rapid progression of unresectable GC and GEJC and the associated malnutrition have a significant impact on the patient's quality of life and ability to tolerate treatment. Hence, recommendations include early diagnosis, identification of relevant biomarkers to improve personalized treatment, and relevant support to manage comorbidities. A multidisciplinary approach including early access to registered dietitians, personal support networks, and palliative care services, is needed to optimize possible outcomes for patients. Where possible, patients with unresectable GC and GEJC would benefit from access to clinical trials and innovative treatments.

Impact of Multimodal Intervention on Empathy Levels in Medical Students: A Questionnaire-Based Study.

Background Empathy is essential for effective doctor-patient communication. It enables doctors to understand patients' emotions and concerns, facilitating personalized care and support. Empathy can be cultivated through various methods and training programs. Objective The study aims to assess the effectiveness of a multimodal intervention involving interactive lectures, peer role-play, and guided reflection in enhancing empathy levels among second-year medical undergraduate students in India. Methods This study utilized a questionnaire-based, pre- and post-test interventional design. Seventy-nine second-year medical students were included after obtaining their informed consent. The students received the intervention through an interactive lecture on communication skills, role-play on selected case studies, and guided reflection. The empathy levels were assessed using the Toronto Empathy Questionnaire (TEQ) before and after the intervention. The Mann-Whitney U test was utilized to compare pre-test and post-test TEQ scores. A univariate analysis of variance was conducted to explore the relationship between demographic variables and post-test TEQ scores. Statistical significance was considered at p ≤ 0.05. Results The TEQ score improved significantly (p=0.009) after the intervention. The univariate analysis indicated that gender, style of education, and place of residence did not have a statistically significant impact on post-test scores. Conclusion The study demonstrates that a multimodal intervention significantly enhances the empathy level of medical students, highlighting the potential of focused interventions to reduce gender disparities in empathy levels. There were no significant differences in empathy scores based on gender, place of residence, or schooling, suggesting the intervention's benefits may apply to all medical students.

LEVERAGING AI IN CASE MANAGEMENT FOR VULNERABLE MIGRANTS: A PATH TOWARD ENHANCED RESILIENCE

The concept paper explores the potential of artificial intelligence (AI) in improving case management for vulnerable migrants. With the increasing challenges faced by migrants, including displacement, exploitation, and lack of access to services, there is a growing need for innovative solutions to support their well-being and resilience. The paper begins by providing an overview of the current landscape of migration and the challenges faced by vulnerable migrants. It highlights the limitations of traditional case management approaches, including resource constraints, lack of data-driven decision-making, and difficulty in tracking and monitoring cases effectively. The paper then delves into the potential of AI in transforming case management for vulnerable migrants. AI technologies, such as natural language processing (NLP), machine learning (ML), and data analytics, can enable more efficient and effective case management processes. AI can help in automating routine tasks, such as data entry and documentation, allowing case workers to focus more on providing personalized support to migrants. Furthermore, AI can assist in identifying patterns and trends in migration flows and service utilization, enabling more proactive and targeted interventions. By leveraging AI, case workers can make more informed decisions, improve service delivery, and enhance the overall resilience of vulnerable migrants. However, the paper also acknowledges the challenges and ethical considerations associated with the use of AI in case management. These include concerns about data privacy and security, algorithmic bias, and the potential for AI to replace human decision-making entirely. Addressing these challenges will be crucial in ensuring that AI is used responsibly and ethically in supporting vulnerable migrants. In conclusion, the concept paper emphasizes the importance of leveraging AI in case management for vulnerable migrants as a means to enhance resilience and improve outcomes. It calls for a collaborative approach involving policymakers, practitioners, and technology developers to harness the full potential of AI in supporting vulnerable migrants and building more inclusive and resilient communities. Keywords: AI, Case Management, Migrants.

The COVID-19 pandemic, psychologists' professional quality of life and mental health.

Psychologists are at known risk of work-related stress, secondary trauma, and burnout. The COVID-19 pandemic increased stress and anxiety for communities worldwide and corresponded with an increased demand for mental health services. Our study investigated the impact of COVID-19 on psychologists' professional quality of life, psychological symptoms, and work-related stress in Aotearoa, New Zealand (NZ). Ninety-nine registered psychologists were recruited via NZ professional psychology organizations, representing 3% of the total workforce. Survey data collected included symptoms of compassion fatigue and satisfaction, psychological symptoms, COVID-19-related stress and resilience, and professional and personal circumstances during the third year of the pandemic, 2022. Seventy percent reported that their work stress had increased, and 60% reported that their caseload intensity had increased during the COVID-19 pandemic. Psychologists reported receiving little to no additional personal or professional support, while 55% reported increased personal responsibilities during the pandemic (for example, closed childcare and schools during lockdowns). High rates of compassion fatigue (burnout and secondary traumatic stress) and low resilience were reported. We observed that psychological distress was higher than the community averages before the pandemic and comparable with frontline healthcare professionals. Compassion fatigue was associated with COVID-related stress, psychological distress, years in practice, and more frequent supervision, but not with working with at-risk clients, levels of personal support, or having children at home. Despite these difficulties, high Compassion Satisfaction scores were also reported, with over 90% indicating they had no intention of leaving the profession in the foreseeable future. Psychologists' compassion fatigue appears to have worsened during the COVID-19 pandemic, as have their symptoms of psychological distress. Increased workplace and clinical demands, telehealth difficulties, stress relating to the pandemic, inadequate support, and increased personal responsibilities were reported by psychologists. Mental health workforces are not immune to the personal and professional impacts of crises and are at risk of burnout and secondary traumatic stress. We hope that increased awareness and understanding of psychologists' own difficulties during COVID-19 can be used to better tackle future crises and support mental health professionals.