Support For Programs Research Articles

Remote support of an external quality assessment program in 10 laboratories in Bhutan, Uganda, and Malawi: Pathologists Overseas experience between 2009 and 2017.

This article describes Pathologists Overseas (PO) experience supporting external quality assessment (EQA) programs in 10 clinical laboratories across 3 countries between 2009 and 2017. Laboratories were enrolled in the condensed chemical pathology EQA program provided by the Royal College of Pathologists of Australasia Quality Assurance Program. Participants were given an initial 2- to 4-day in-person training, followed by 1 year of active feedback on performance via emails or phone calls by a PO volunteer. There were 2 performance metrics: percentage of reported results as a measure of compliance and percentage of acceptable reported results as a measure of accuracy. Laboratories demonstrated high compliance with result reporting, with medians of 69.9%, 71.7%, and 81.3% before, during, and after feedback, respectively. Concomitant medians for the percentage of acceptable reported results were 41.2%, 57.3%, and 53.5%, respectively. Six laboratories had low performance in terms of accuracy at baseline (<60%). Active feedback improved the percentage of acceptable reported results for these lower-performing laboratories. External quality assessment programs can be successfully adopted long term by laboratories in low-resource settings. Active feedback requires significant time and effort but could be especially beneficial for laboratories with poor baseline performance.

Trust in and Building of Sustainable Local Health and Well-Being Programs in the United States

The U.S. healthcare system is by far the most expensive per capita in the world and does not deliver the best outcomes. The literature shows that the U.S. population is distressed about what it is paying for and is especially distressed about people and companies that it perceives as sacrificing the public good for personal profit. Nevertheless, studies show high levels of trust in nurses, pharmacists, personal physicians, fire and security officers, engineers, and other practitioners who provide services at the local scale. Artificial intelligence (AI) poses an opportunity to reduce healthcare costs, yet it concerns the public because its misuse may violate personal boundaries, spread inaccurate data, and lead to other undesirable outcomes. The literature illustrates the benefits of cooperative relationships between community groups, local governments, and experts using new AI tools in support of local public health and well-being programs. One important example is preventing and reducing the consequences of acute hazard events. Overall, this review makes a case that focusing on the community scale represents an opportunity to improve health and well-being outcomes by establishing trusted and sustainable relationships.

Redistributive policy and redistribution preferences: the effects of the Moscow redevelopment program

ABSTRACT How does inclusion in social policy programs strengthen individuals’ support for redistribution, and lead to spillovers in support for future social policy programs? We study a unique dataset of 1,300 Moscow residents to estimate the effect of participating in a government-sponsored redevelopment program on preferences for redistributive social policy. Our design exploits features of the program designed to foster institutional trust by engaging citizens in the policy design process. We report a positive effect: individuals in buildings slated for redevelopment are more likely to agree that the government should reduce income differences between rich and poor, provide for the unemployed, and provide public housing. Our findings suggest that increased trust in the government is a channel through which program participation affects redistribution preferences, show how programs can be used strategically to promote a redistributive agenda, and suggest a pathway for the co-persistence of redistribution preferences and redistributive state policies.

Balancing Acts: Exploring the Intersection of Cultural Understanding and Technical Support in Local Government Strategies for Immigrant Micro-Financing

This paper explores the relationship between cultural competency training for local government employees and technical support for micro-financing programs targeting immigrants. Utilizing a combination of literature review, theoretical framework, hypothesis testing, data analysis, and interpretation, the study examines the complexities surrounding the public sector's approach to immigrant support. The research reveals a general preference for cultural competency initiatives over technical support for micro-financing among local government employees. Statistical analysis indicates a significant, albeit complex, association between attitudes towards cultural competency training and support for technical assistance in micro-financing. A multinomial logistic regression suggests a negative relationship between support for cultural competency training and the likelihood of supporting micro-financing programs, highlighting a potential disconnect between cultural understanding and financial support for immigrants. The study discusses the implications of these findings for policy-making, program design, and future research, emphasizing the need for a balanced approach that integrates cultural sensitivity with economic support. The limitations of the study, including sample representation and the challenge of establishing causation, are acknowledged, underlining the necessity for cautious interpretation of the results and further research in this area. The paper concludes by highlighting the importance of considering both the cultural and economic needs of immigrant communities in public administration and support programs.

Perspectives of community and facility stakeholders on community health workers in rural Malawi.

Community health workers (CHWs) bridge the primary health care (PHC) system and communities by providing care in the household. In Malawi, few studies have examined the perspective of users of household-level CHW services, in remote areas, to understand CHW's role in community-based PHC. To explore perspectives of community and facility stakeholders on the enablers and challenges of the CHW role in community-based PHC in Neno District. The study was conducted in the Neno District health facilities, namely, Ligowe, Dambe, Chifunga, and Zalewa. We conducted eight focus group discussions (FGDs) with purposively sampled community members and conveniently sampled facility stakeholders. Data were transcribed and analysed thematically through an adapted COM-B model of behaviour change. Three main themes of perceived behaviour change within the CHW role were identified: (1) capacity - the CHW programme aids health education and promotion within the community; (2) opportunity - the CHW programme facilitates community-based PHC and linkage to the facility; and (3) motivation - the CHW programme enablers and challenges in providing community-based PHC. Community health workers enrich community-based PHC delivery through health education, timely access to care, and linking communities to the facility. Optimising workload and programme support is critical for the help of CHWs. Further studies are required to address programme and cultural challenges to enhance positive health-seeking behaviours.Contribution: This study provides contextual knowledge for further research on bringing together spiritual and formal health practices and considering the cultural background when planning for health interventions in remote areas.

Expanding Outcomes in Cancer Screening Safety Net Programs: Promoting Sustainability and Policy Reform.

Community-engaged patient navigation safety net programs are established as an evidence-based approach to address cancer prevention and early detection efforts, but barriers to expand and sustain such programs persist. In addition, few studies describe how these programs impact buy-in among communities and policy change within health care systems and government. We describe how we used the Capacity for Sustainability Framework to guide efforts for program sustainability and community, institutional, and policy level change in a breast cancer screening and patient navigation safety net program. The nine domains of the Capacity for Sustainability Framework were used to develop program logic models, to inform program implementation and quality improvement agendas, and to guide multi-level partner and stakeholder engagement, outreach, and dissemination of outcomes. The program is currently in its seventh year and continues to be annually funded by a city public health department. In 2021, additional 5-year renewable funding from a state public health department was secured. In addition, institutional program support was expanded for patients diagnosed with breast cancer. Program leaders worked with policymakers to draft legislation to support training certification and third-payor reimbursement for patient navigators and community health workers. The program is well-known and trusted among community members, community-based organizations, and providers. Community, organizational, and policy-level outcomes demonstrate that community-engaged patient navigation safety net programs can influence more than individual and interpersonal outcomes and can be sustained over time.

General support of physical exercise programs in pediatric oncology but differences in perception by childhood cancer care professionals at European and North-African/Arab centers

PurposeTo explore the perception of physical exercise programs for pediatric oncology patients among childhood cancer care professionals. We also aimed at comparing such perceptions between cultures. Healthcare professionals’ endorsement may be essential for initiating and promoting such programs. MethodsAn anonymous survey was designed and administered voluntarily to childhood cancer care professionals (including pediatric oncologists, nurses, and physiotherapists) in European, North-African and Arab pediatric oncology centers. ResultsFive-hundred-and twenty-eight professionals from 14 sites answered the survey. Most respondents considered physical exercise programs as a suitable therapeutic approach for pediatric cancer patients with a potential positive contribution to survival (81%), wellbeing (82%), quality of life (80%), and self-esteem (75%). 91% of respondents would also support the future introduction of physical exercise programs into standard pediatric oncological care. There was a comparatively higher appreciation of physical exercise programs among European centers compared to North-African / Arab centers. ConclusionWe registered a broad acceptance of physical exercise programs among all European and North-African / Arab childhood cancer care professionals. The positive perception was independent of any pre-existing experience with such programs and seems therefore representative. This finding may encourage the further promotion of physical exercise programs in pediatric oncology.

Developing an Inclusive Training Environment: Accommodations in Physical Medicine and Rehabilitation Residency Training for Residents With a Disability.

This study examines the challenges and accommodations for medical residents with disabilities within physical medicine and rehabilitation training programs. Medical residency presents unique stressors and responsibilities, with the potential for added complexities for residents with disabilities. Few data exist regarding the prevalence and experiences of people with disabilities as medical trainees and the limited studies available highlight an underrepresentation of individuals with disability in medical training and practice. Through cross-sectional surveys administered to physical medicine and rehabilitation residents, this research assesses disability prevalence, characterizations, barriers to training, and accommodations provided. Of 140 respondents, 9.3% identified as having disabilities, with varying prevalence among genders and disability types. Results revealed distinct challenges for residents with mobility and nonmobility disabilities, spanning learning environments, standardized testing, procedural skills, and accessibility. Self-provided accommodations exceeded program-provided ones, indicating room for improvement in program support. These findings underscore the need for proactive dialog between residents and leadership to address barriers, enhance accommodations, and create an inclusive training environment. The study's insights emphasize the importance of advocating for equal opportunities and cultivating supportive conditions to enable individuals with disabilities to thrive in medical residency programs, ultimately contributing to more diverse and inclusive medical communities.

Sibling influence on migration pathways from the French overseas to mainland France

Abstract Research shows that economic, political and social factors all drive migration, but we still know little about their interaction, especially the interplay between increasingly selective migration policies and family relations. Studies stress the role played by social capital in responding to migration restrictions and the importance of intermediaries in encouraging access to institutional resources, but we lack systematic analyses linking migrant networks and recourse to migration-facilitating programs. This paper fills this gap by investigating how siblings’ influence and migration programs combine in shaping migration from the French Overseas departments (DOM). Using a survey with detailed information on DOM families’ migration histories (MFV, INED, 2010), it assesses whether individuals stay, migrate with or without the support of migration programs, depending on their siblings’ past trajectories. A longitudinal approach and the nesting of individuals within families allow controlling for unobserved heterogeneity. Siblings migrating without the programs’ support decrease the chances of migration with it and increase the chances of migration without it. Siblings migrating with the programs’ support increase the chances of migration with it and decrease the chances of migration without it. This work shows how DOM populations engage with selective pro-migration policies, stressing the role of family relations in driving cumulative patterns of migration. It contributes to uncovering the way social and political factors interact in contexts of high migration prevalence with increased selectivity of migration and especially pro-migration policies.

CaRE@ELLICSR: Effects of a clinically integrated, group-based, multidimensional cancer rehabilitation program.

Although oncology clinical practice guidelines recognize the need and benefits of exercise, the implementation of these services into cancer care delivery remains limited. We developed and evaluated the impact of a clinically integrated 8-week exercise and education program (CaRE@ELLICSR). We conducted a mixed methods, prospective cohort study to examine the effects of the program. Each week, participants attended a 1-h exercise class, followed by a 1.5-h education session. Questionnaires, 6-min walk tests (6MWT), and grip strength were completed at baseline (T0), 8 weeks (T1), and 20 weeks (T2). Semi-structured interviews were conducted with a sub-sample of participants about their experience with the program. Between September 2017 and February 2020, 277 patients enrolled in the program and 210 consented to participate in the research study. The mean age of participants was 55 years. Participants were mostly female (78%), white/Caucasian (55%) and half had breast cancer (50%). Participants experienced statistical and clinically meaninful improvements from T0 to T1 in disability, 6MWT, grip strength, physical activity, and several cancer-related symptoms. These outcomes were maintained 3 months after program completion (T2). Qualitative interviews supported these findings and three themes emerged from the interviews: (1) empowerment and control, (2) supervision and internal program support, and (3) external program support. This study demonstrates the impact of overcoming common organizational barriers to deliver exercise and rehabilitation as part of routine care. CaRE@ELLICSR demonstrated clinically meaningful improvements in patient-reported and functional outcomes and was considered beneficial and important by participants for their recovery and wellbeing.

A critical appraisal of education policy practices ensuring free and compulsory school education: Insights from Nepal

Education policy plays a pivotal role in ensuring access to free and compulsory education for all children, fostering national development and reducing social disparities. This critical appraisal examined the school education policy practices in Nepal that aimed at achieving the goal of free and compulsory school education at basic level. For this, descriptive and analytical research designs were applied for analyzing the education policy provisions. The education policies practices were observed through a field survey in which the information was gathered from schools through the distribution of questionnaires to students, teachers, and guardians, as well as interviews with head teachers and focus group discussions among policy experts and local leaders. The investigation led to the provision of free and compulsory education in basic education. While there was good achievement in teacher training and development, there was insufficient support for teachers-guardians interaction programs. The research also offers suggestions for preparing detailed policy implementation guidelines, including an education plan for policy execution. Nepal has made significant progress in school education in terms of providing free and compulsory school education. This paper has provided a critical appraisal of these policies and practices drawing on evidence from Nepal. By analyzing the evidence and outcomes, this study evaluates the effectiveness, challenges and potential areas for improvement in the Nepalese education system.

Knowledge, practice and attitudes regarding substance use disorder treatment and harm reduction strategies among pharmacists: a scoping review protocol

IntroductionPharmacists provide a spectrum of services and comprehensive medication management for patients with substance use disorders (SUDs) with many providing timely and increased access to care for patients. Prior studies...

Abstract HUP4: Can A Remote Telehealth-based Program Support Survivors With Varying Social Needs Post-stroke?

Introduction: There are significant and longstanding inequities in stroke prevalence and care as well as outcomes. Social determinants of health (SDOH) are known to be a risk factor in post-stroke recovery. SDOH also put individuals at higher risk for 90-day mortality. Social determinants are a significant contributor to disparities in health and specifically addressing SDOH needs may improve the health and outcomes of stroke survivors. Methods: An app-based, virtual care model was used to impact survivor quality of life and outcomes for stroke survivors and their care partners. As a part of program onboarding, the clinical navigator utilized the CMS Accountable Health Communities Health-Related Social Needs Screening Tool to assess survivor needs in five core domains including housing instability, food insecurity, transportation problems, utility needs, and interpersonal safety. As needs were identified, they were cross-walked to pre-populated community resource maps to aid the survivor in their recovery and support subsequent stroke prevention. Results: Of the (n=50) stroke survivors (median age of 62) that completed the 12-week survivor-led Navigator support program, 35% had one SDOH need, 16% had 2 SDOH needs, 16% had 3 SDOH needs, 3% had 4 SDOH needs and 28% had 5 or more SDOH needs. The most regularly identified areas of social need in the cohort were mental health (20%), financial strain (15.7%), employment (13.6%) and transportation (12.9%). These SDOH were addressed throughout the 90-day program based on individual access considerations. The 30- and 90-day all-cause readmission rates for survivors were 5% and 10%, respectively, superior to recent publications reporting 30-day unplanned readmission rates after stroke ranging from 8.7%-12.5%, and 90-day readmissions ranging from 18.9% to 20.7%. Conclusion: By assessing SDOH and providing specifically tailored post-acute resources to meet those needs, a tech-enabled platform with clinical navigator support can improve outcomes for stroke survivors with a variety of SDOH needs. Additional post-acute stroke care and targeted programming are needed to address the ongoing inequalities in the healthcare system as they relate to post-stroke care and recovery in populations with high SDOH needs.

Abstract NS4: Can a Remote Telehealth-Based Program Support Survivors With Varying Social Needs Post-Stroke?

Introduction: There are significant and longstanding inequities in stroke prevalence and care as well as outcomes. Social determinants of health (SDOH) are known to be a risk factor in post-stroke recovery. SDOH also put individuals at higher risk for 90-day mortality. Social determinants are a significant contributor to disparities in health and specifically addressing SDOH needs may improve the health and outcomes of stroke survivors. Methods: An app-based, virtual care model was used to impact survivor quality of life and outcomes for stroke survivors and their care partners. As a part of program onboarding, the clinical navigator utilized the CMS Accountable Health Communities Health-Related Social Needs Screening Tool to assess survivor needs in five core domains including housing instability, food insecurity, transportation problems, utility needs, and interpersonal safety. As needs were identified, they were cross-walked to pre-populated community resource maps to aid the survivor in their recovery and support subsequent stroke prevention. Results: Of the (n=50) stroke survivors (median age of 62) that completed the 12-week survivor-led Navigator support program, 35% had one SDOH need, 16% had 2 SDOH needs, 16% had 3 SDOH needs, 3% had 4 SDOH needs and 28% had 5 or more SDOH needs. The most regularly identified areas of social need in the cohort were mental health (20%), financial strain (15.7%), employment (13.6%) and transportation (12.9%). These SDOH were addressed throughout the 90-day program based on individual access considerations. The 30- and 90-day all-cause readmission rates for survivors were 5% and 10%, respectively, superior to recent publications reporting 30-day unplanned readmission rates after stroke ranging from 8.7%-12.5%, and 90-day readmissions ranging from 18.9% to 20.7%. Conclusion: By assessing SDOH and providing specifically tailored post-acute resources to meet those needs, a tech-enabled platform with clinical navigator support can improve outcomes for stroke survivors with a variety of SDOH needs. Additional post-acute stroke care and targeted programming are needed to address the ongoing inequalities in the healthcare system as they relate to post-stroke care and recovery in populations with high SDOH needs.

Abstract TP45: A Nurse-Driven Pre-hospital Telemedicine Program Supports Care of Patients With Suspected Stroke

Background: Because of the time-sensitive nature of stroke treatment, extensive efforts focus on reducing treatment time in the hospital and prehospital setting. Recent studies exploring the use of telemedicine within the ambulance setting report positive results. Non-recordable paramedic-assisted videos allowed patients to be examined by an ED physician while in route to the receiving hospital, improving stroke treatment times. Ambulance teleconsultations are reported to be reliable and a good method to aide emergency triage facilitating accurate diagnosis. To the best of our knowledge, these studies have used EMS tele-health services to connect with a physician. In this study we assessed the treatment benefits of a nurse-driven pre-hospital telemedicine program in a community comprehensive stroke center (CSC). Methods: Telemedicine services was installed in 4 ambulance units. A tablet was supplied to highly specialized stroke nurses. Using the current dispatch notification system, the stroke nurse was alerted to an incoming suspected stroke patient and prepared to receive the telemedicine video connection. During the telemedicine video call a paramedic-assisted assessment occurred, patient history, contact information, and pre-thrombolytic consent was obtained. Upon arrival, the stroke alert proceeded as normal. Telemedicine data was retrospectively matched with data extracted from the medical record to evaluate treatment volume (thrombolytics (TNK), endovascular procedure (EP), or both), treatment times [door to CT(D2CT), door to needle (D2N), door to puncture(D2P), door to device(D2D)], and coded stroke volume for all EMS-telemedicine cases between Jan 2020-May 2022. Results: Over the course of the pilot, 41 cases were successfully matched, and pre-hospital video assessments occurred for 17 (41%) cases. Treatment rates were 20% (n=8), 15% (n=6), and 10% (n=4) for TNK, EP, and both respectfully. Median times were 7 min (4-21), 20min (12-32), 58min (48-124), and 82 min (64-140) for D2CT, D2N, D2P, D2D respectively. Lastly, 71% (n=29) received a stroke diagnosis. Conclusion: This study shows that a nurse-driven prehospital telemedicine system can be successfully implemented in a community CRC with excellent treatment time metrics.

Effectiveness of the Introduction Capital Market Activities to the Younger Generation Through the Support of Internship Programmes

Stock trading on the capital market is one of the investment activities. The capital market has become one of the places where transactions on securities can be carried out. Given the importance of expertise in this field, there is an internship for students to apply the knowledge previously acquired from the Capital Market School. The highly expected output of the internship activity is that students are able to read stock price movements, where they understand when it is time to buy stocks and when it was time to sell stocks, to be able to make a profit. Participants who take part in this internship will have skills in Opening Stock Account Administration up to the release of RDN, Selling Buy Stock Practices, Analysis of Stock Price Movement Transaction Graphs, and Knowledge of Advanced Material for BPPE Certification.

대학 핵심역량기반 학습역량 측정도구 개발 및 효과 탐색

Objectives This study aims to develop a scale to measure a set of learning competence elements based on the core college competencies by extracting them and investigating their effects by applying an extracurricular pro-gram to reinforce the competence of low performers in learning.&#x0D; Methods For these purposes, the investigator tested the scale for its content validity with two Delphi surveys based on previous studies, selecting 176 items after the first survey and six components and 51 preliminary items after the second one. The main study carried out a confirmatory factor analysis to test the items by the component in fitness, reliability, and validity with students who participated in the extracurricular program and tested the model for fitness based on discriminant and convergent validity with AMOS 21.0.&#x0D; Results Based on the results, the study developed a scale to measure learning competence with six components and 35 items. To investigate its effects, the extracurricular program to reinforce learning competence was applied to ten low performers in learning in two semesters with changes to their learning competence measurements analyzed. The analysis results show that there were significant outcomes for learning motives, self-directed, cre-ative convergence, learning strategies, and community spirit under the six components and no significant out-comes for learning affection.&#x0D; Conclusions Based on these findings, the study offers some objective ground data helpful for each college and university to develop a custom scale to measure learning competence based on the core competencies, measure the degree of competence cultivation based on the characteristics of learners, and assess outcomes with custom extracurricular program supports, thus holding its research implications. Furthermore, we aim to lay the founda-tion for practicing and strengthening core competency education.

Diving into paclitaxel: isolation and screening content from Taxus sumatrana at Singgalang Conservation Center, West Sumatra

The report features the first isolation of paclitaxel from wood of conservated Taxus sumatrana. The T. sumatrana is a nationally protected endemic plant that has been successfully cultivated outside its natural habitat at the Singgalang Conservation Centre in West Sumatra. The paclitaxel was utilised as a reference standard for evaluating its presence in different parts of T. sumatrana. This analysis exhibits that the acetone extract from T. sumatrana bark contained the highest paclitaxel concentration, measuring about 0.473 ± 0.031 ppm. The isolated paclitaxel demonstrated potent cytotoxic activity against A549, HeLa, and MCF7 cancer cells, by IC50 values of 3.26 ± 0.334, 2.85 ± 0.257, and 3.81 ± 0.013 μM, respectively. This outcome provides scientific support for conservation programs and campaigns for the community to engage in conservation efforts.

The ‘woeful’ state of administrative support for online programmes: A critical discourse analysis

AbstractThis study used critical discourse analysis to explore how higher education administrators in the United States talk about how they assess and support online programmes. Specifically, we hoped to analyse administrators' perceptions of their responsibilities over online programmes, faculty and students, to attain where they may need more training. Therefore, we explored the perspectives of 11 administrators at both the mid‐level administrative and campus senior administrative levels who oversee online programmes in U.S. higher education. Our findings suggest that mid‐level administrators hold pivotal roles in communicating needs, administrators are not viewing their online faculty holistically, current online programmes assessment is insufficient and concern for student engagement is often neglected. Implications for research and practice include additional investigation of the online faculty experience and the development of administrative training specifically focused on the needs of online programming and online faculty support.

Vaccination coverage against COVID-19 according to country of birth, and underlying risk of severe clinical course

Support for the COVID-19 vaccination programme has been high in Norway throughout the pandemic, but previous studies have observed variation based on country of birth. If the unvaccinated are young and healthy, the risk and consequences for the individual and for the health service will be less than if the unvaccinated have underlying risk of severe COVID-19. The purpose of the study was to examine the degree to which vaccination coverage varied by country of birth in persons with and without underlying risk. We used the Norwegian emergency preparedness register Beredt C19 to link vaccination coverage to demographic and health variables. Using Poisson regression, we estimated the relative likelihood of being vaccinated for foreign-born individuals compared to Norwegian-born individuals, for those with and without underlying risk of severe COVID-19, adjusted for sex, age, level of education, household income and county. The study population was 4304249, which included 768312 people who were born outside Norway. The vaccination coverage varied in total from 47 to 94% between countries of birth. The variation between countries of birth was less in the group with underlying risk, ranging from 63 to 96%. The difference between persons with and without an underlying risk was most pronounced among those born in Poland (RR 0.71 and 0.55) and Lithuania (RR 0.69 and 0.61). In absolute numbers, this corresponded to a difference in relative risk of 0.16 and 0.08, respectively. Higher vaccination coverage against COVID-19 among persons with an underlying risk means that the variation between countries of birth may have had less serious implications in terms of severe clinical course and healthcare needs than previously assumed.