Program Team Research Articles

Is access to crisis teams associated with changes in behavioral health mortality?

Abstract Behavioral health-related mortality – deaths from suicide, drug overdose, and acute alcohol injury - are leading causes of death among US adults. Crisis teams, trained behavioral health professionals who serve as first responders to assess and stabilize clients in crisis, as well as refer to treatment as necessary, have been shown to reduce psychiatric hospitalizations, but whether crisis teams reduce behavioral health mortality has not been studied. We assessed the association between changes in access to crisis team programs and changes in county-level suicide, drug overdose, and acute alcohol injury mortality from 2014-2019. We found that 250 (9%) of counties experienced crisis team program entry and another 237 (9%) experienced crisis team program closure. Access to crisis team programs was associated with significant changes in county-level drug overdose deaths, but not suicide or acute alcohol injury. Compared to counties with no change in access, crisis team program entry was associated with a 7% reduction in county-level drug overdose death rates, and crisis team program closure was associated with a 13% increase in drug overdose death rates. These findings may support the use of crisis teams as one intervention to address substance use disorder treatment gaps in the US.

All on the Same Team: Simulated Learning to Introduce Pediatric Residents to Interprofessional Collaboration with Individualized Education Program Teams.

Our study sought to determine if participation in a simulated Individualized Education Program (IEP) meeting improved pediatric medical residents' attitudes toward the IEP team as an interprofessional health care team. Pediatric medical residents on the Developmental-Behavioral and Advocacy rotations at an urban medical center participated in a simulated IEP eligibility meeting for a case of a fourth grader with a specific learning disability. Standardized actors portrayed the child's parent, principal, school psychologist, and classroom teacher. Residents were instructed to participate as members of the team. After participation, changes in the residents' readiness to participate on the IEP team were measured by the Interprofessional Socialization and Valuing Scale 9A (presimulation) and 9B (postsimulation). Sixty-six pediatric residents participated over 24 months. The mean scores of the aggregate pre- (4.92, SD = 0.83) and postsurveys (5.75, SD = 0.74) illustrated residents' improvement in 3 areas of interprofessional practice: understanding their role as a member of an IEP team; appreciation of an IEP team as an interprofessional health care team; and comfort and confidence in working as a member of an IEP team (Z = -6.37; p < 0.001; r = 0.78). Comparison of disaggregated data illustrated improvement for post-graduate year 1 (Z = -4.95; p < 0.001; r = 0.85) and categorical pediatric residents (Z = -5.86; p < 0.001; r = 0.83). Simulated IEP meetings help pediatric residents reconceptualize their role in the school health of children with disabilities to include participation in and understanding of the IEP process.

Teacher Competency Improvement: Training and Assistance in Mapping Learning Outcomes, Learning Objectives, Flow of Learning Objectives for the Merdeka Curriculum

The quality of teaching in elementary schools is a crucial factor that influences the early development of students. Training and mentoring for elementary school teachers are expected to strengthen teacher capacity in terms of mapping learning outcomes, learning objectives, and learning objective flows. Community service activities are carried out using the Participatory Action Research (PAR) method. The stages of activities that will be carried out by the community service program team are as follows: (1) giving an initial test (pre-test); (2) implementing offline community service; (3) online mentoring; (4) evaluation and reflection; and (5) giving a final test (post-test). The pre-test score with 20 participants obtained an average of 51.75, while the post-test score obtained an average of 90, so that the N-Gain score was 0.79. This value represents an interpretation of a high improvement category. Overall, this community service activity was able to improve the knowledge and understanding of elementary school teachers in Prabumulih City in mapping CP, TP, and ATP in accordance with the independent curriculum.

Impact of COVID-19 Restrictions on the Implementation of the Ward-based Outreach Team Program in Gauteng Province

Background The epidemic Coronavirus 2019 (COVID-19) has led to changes in healthcare delivery systems globally, affecting the Ward-based Outreach Team (WBOT) program. Objective This study aimed to explore the impact of COVID-19 restrictions on the implementation of the ward-based outreach team program by Community Health Workers (CHWs). Methods A qualitative design was adopted to conduct In-depth Interviews (IDIs) with CHWs implementing the WBOT program in the northern subdistrict of Ekurhuleni. A purpose-oriented sampling technique was used to select participants for IDIs. Results The study included nine health facilities linked to 47 wards. The findings of the study revealed four main themes: fear and denied access during COVID-19, the impact of COVID-19 on CHW's role, psychological impact, and perceived socioeconomic impact as a result of COVID-19. The results of this study showed the perception of CHWs of the displaced community during the COVID-19 outbreak and the impact of the lockdown on their role. Conclusion The results of this qualitative study showed the impact of the outbreak on the role of CHWs, the fear of COVID-19 in the communities, stress and fear of the disease, and the perception of CHWs of the displaced community by the disease. Despite the challenges posed by the outbreak, the ward-based outreach program has continued to play a vital role in delivering essential healthcare services to communities. These findings can be used as an input for decision-making when developing strategies to optimize CHWs implementation.

Difficult Airway Response Team Outcomes in an Academic Emergency Department: A Prospective, Multidisciplinary Airway Management Cohort Study

Background Successful first-attempt intubation minimizes the risk of hypoxemia, hypoventilation, and hypoperfusion. However, few data exist on outcomes of team-based difficult airway management in the Emergency Department (ED) for patients with deteriorating respiratory status. Objective To investigate the outcomes of an ED Difficult Airway Response Team (DART) program. Methods A prospective observational cohort study of DART implementation was conducted in the ED of an academic, tertiary care institution over a five-year period. An activation protocol was established, and the DART team included emergency physicians, other physicians (anesthesiologists, otolaryngologists, and trauma surgeons), respiratory therapists, nurses, and staff. Patients 18 years or older managed by the DART in the ED were included. Outcome measures included first-attempt intubation success, intubation techniques, and need for surgical airway. Results Across 98 DART activations, 73 patients were managed in ED, nine patients were transported directly to the operating room, and 16 were transported to the operating room after an unsuccessful attempt at airway securement. Advanced airway techniques (fiberoptic bronchoscopy or videolaryngoscopy) accounted for 76% of first-attempt success with airway securement versus 24% for direct laryngoscopy (p&lt;.01). Difficulty with bag-mask ventilation, need for cardiopulmonary resuscitation, and underlying illness predicted lower first attempt success rates (all p &lt;.01). Surgical interventions were required in 17 patients, and 6 patients underwent cricothyroidotomy. There were no airway-related mortalities. Airway anatomy, difficult airway history, and context were associated with equipment selection, transport to operating room, and need for surgical airway. Conclusion In this DART implementation, the first attempt intubation success was associated with use of advanced airway techniques and favorable patient characteristics.

A Unique Case of Pretonamid Resistance on MDR TB Patient: A Case Report

&amp;lt;i&amp;gt;Background&amp;lt;/i&amp;gt;: Pretomanid is a novel medication that belongs to the class of nitroimid-azooxazines. The development of resistance to this novel agent not only complicates clinical management but also poses a threat to public health efforts aimed at controlling TB. This case report highlights the clinical presentation, laboratory findings, and therapeutic implications associated with a patient exhibiting pretonamid resistance. Through this examination, we aim to enhance understanding of resistance mechanisms, underscore the importance of ongoing surveillance, and advocate for refined treatment strategies in the context of MDR-TB management understanding the mechanism of this resistance is crucial for developing effective treatment strategy and improving patient outcome. &amp;lt;i&amp;gt;Case presentation&amp;lt;/i&amp;gt;: a sixteen-year-old male patient diagnosed with rifampicin-resistant PTB (RR-PTB) after he presented with a cough of two weeks duration and he is on treatment for RR-PTB, and he is on BpaLM regimen. The third-month second-line phenotypic DST result revealed pretomanid (Pa) resistance. [Stm, INH, RIF, EMB, Pa are resistant, and Bdq, Clf, Dlm, Lfx, Lzd, and Mfx are sensitive]. &amp;lt;i&amp;gt;Clinical Discussion&amp;lt;/i&amp;gt;: Following the hospital’s clinical panel team and national TB program expert’s discussion we changed the regimen to individualized (Lfx, Cs, Bdq, Dlm, Cfz and Lzd). &amp;lt;i&amp;gt;Conclusion&amp;lt;/i&amp;gt;: Pretomanid resistance in humans reveals a low prevalence but highlight the need for vigilance. And since it’s the incorporated in BPaL regimine and its among the backbone of the regimen we should have to follow the resistance pattern. While facing Pretomanid resistance Consult experts, engage a physician experienced in drug-resistant TB for treatment planning and management, monitor adverse effects closely observe patients for signs of myelosuppression, peripheral neuropathy, and hepatotoxicity during treatment with the BPaL regimen. And also ensure timely susceptibility testing for all components of the BPaL regimen to guide effective treatment adjustments then go for alternative regimen.

Prioritizing educational technologies for children with intellectual disabilities under fuzzy MCDM perspective

Objectives: Children with intellectual disabilities struggled to perform basic tasks in the educational platform due to their deferred learning pace and individual challenges. To assist such needs, the child’s individual education program (IEP) team, spearheaded by the school administrators, continues to offer supplementary educational technologies. However, selecting an appropriate technology does not follow an objective system, making the decision process tedious and unreliable. Therefore, this paper provides a new perspective on analyzing the educational technologies for children with intellectual disabilities with respect to design factors that also constitute the technical specifications and ergonomic principles of technology design. Method: To analyze the educational technologies, fuzzy best-worst method (BWM) and fuzzy technique for order of preference by similarity to ideal solution (TOPSIS) method are employed in a case study in the Philippines. Impact: Results reveal that user perception is the most important design factor to be considered when selecting educational technology for children with disabilities. Furthermore, the adaptive educational platform has been found to best fit the needs of children with autism.

Understanding the career experiences and reflections of Special Olympics Canada’s National Team Program coaches

ABSTRACT The most prominent competition for athletes with intellectual disabilities is the Special Olympics; however, there is surprisingly little research focusing on what it means to be an effective Special Olympics coach. The purpose of this study was to explore the career experiences and reflections of Special Olympics Canada’s National Team Program coaches. Thirteen Special Olympic coaches participated in individual semi-structured interviews. Guided by narrative inquiry, we analysed our data with a thematic narrative analysis; and using creative non-fiction, presented our findings in three composite vignettes. The first vignette illustrates Coach Sarah as head coach of the Canadian national team managing the complexities and stressors of athlete travel, medications, emotions, and behaviours. The second vignette is from Coach Jennifer who balances the demands of being a volunteer coach and parent of a child with an intellectual disability, and reflects on the creativity and patience required to coach in this setting. The final vignette is from Coach Michael, who reflects on how to improve coach learning and development for upcoming coaches in the Special Olympics, including providing formal mentorship and improving coach education for this setting. Using narrative inquiry as a theoretical and methodological framework, we were able to support the use of creative non-fiction as a learning tool for disability sport coaches. With accessibility in mind, these vignettes are readily available to be translated into coach education to provide Special Olympics coaches with common coaching experiences that can prepare and inform coaches of athletes with intellectual disabilities.

Effectiveness of a Multidisciplinary Expertise Team in the reduction of restrictive measures in sheltered care homes for people with an intellectual disability.

Background: Minimizing restrictive measures is an important lever to promote self-determination for people with intellectual disabilities. Aims: This study assesses the efficacy of the Multidisciplinary Expertise Team (MDET) program in reducing such measures within Dutch sheltered care homes for people with intellectual disabilities. Methods and Procedures: A clustered randomized trial encompassed 30 residential units, reporting 428 measures on 107 residents through an organization-wide registration system. Units were randomly assigned to the MDET program or care-as-usual. Outcomes and Results: Units assigned to the MDET-program reported a significant stronger reduction in restrictive measures compared to the care-as-usual units (40% versus 20%). Conclusions and Implications: The MDET program shows promise in decreasing restrictive measures by enhancing awareness and sharing expertise across disciplines at staff and resident levels.

Addressing Conflicts and Role Responsibilities in the Special Education Service Delivery Process: Adult Sibling Involvement and Facilitation as Cultural and Linguistic Brokers

This case study explores the role of adult siblings in bridging and brokering cultural and linguistic gaps in special education on behalf of their sibling with a disability. Focusing on the Le family, the study explores how Eunice Le, an adult sibling, is navigating communication between their Vietnamese-speaking family and the school, and advocating for their brother Kai, a culturally and linguistically diverse (CLD) student with autism. The case is premised on two key provisions within the Individuals with Disabilities Education Act (IDEA) that center on the Individualized Education Program (IEP) team configuration and parent participation. This case reveals the difficulties that arise when schools and families have divergent approaches to supporting students with disabilities and their extended families from racialized and minoritized communities.

Community Partnership Empowerment: Optimizing the Teaching Profession Through Omohage Application Based e-Modules Preparation Training

This service activity was carried out against the background of the facts: (1) the gap in the quality of education in rural and urban areas; (2) the need for Information and Communication Technology (ICT)-based learning to face the demands of the 21st century, the industrial revolution 4.0, and the digital era; and (3) teachers have difficulty in preparing IT-based learning tools. The Community Partnership Programme team from DRTPM offers a solution by implementing training activities for preparing e-modules to implement spatial imaginative learning models through the omohage (Online Handbook Web-based) application. The participants were all teachers of SDIT AL Kautsar and PAUD AL Kautsar, Kebonduren village, Ponggok sub-district, Blitar district, East Java. Training activities were carried out using the method of discussion, lecture, and practice of handbook preparation by participants. The stages of the activity were: (1) preparation stage, (2) implementation stage, and (3) evaluation stage. The results of the activities are: (1) teachers' understanding of the use of the omohage application; (2) increased teacher skills in preparing learning tools assisted by the omohage application; and (3) published teacher handbook products online.

Importance-Performance Analysis (IPA) in Researching the Satisfaction of Simulation

Students are the customers of higher education, and their satisfaction directly influences service quality in the tertiary sector. It is essential, therefore, to research students' views. This can be done by applying important-performance analysis (IPA), an effective tool for achieving satisfaction. The study described in this article focuses on data obtained from research into the Programme and Project Management major which is a Master's program in the United Kingdom. The course, Managing the multi-project and programme environment (MMPE), combines theory with practice through offline-business simulation. The program focuses on imparting skills to graduate students in the management field. The performance and importance of thirteen items were connected to motivation and teamwork. The results revealed that not all student respondents are satisfied with the simulation. Utilizing IPA, the research suggests that tutors should prioritize improving communication and relationships among both the programme and project teams, specifying accountability and work allocations, motivating students to achieve goals, and refining feedback methods. These recommendations could be applied to other business simulations that aim to improve student satisfaction.

RePAIRing the student nurse journey: empowering interrupted students through innovative support strategies.

This article reports on a study that evaluated an innovative 6-week summer returners' programme, part of the Health Education England RePAIR project, designed to support nursing students who have interrupted their studies. Held from May to July 2022, the programme addressed diverse needs through academic guidance, mental health and resilience workshops, creative arts, professional identity development, and practical nursing skills training. The programme ran alongside support from the programme team, student engagement services, and ongoing communication via phone and email. Despite non-mandatory sessions leading to varying attendance, the combined efforts facilitated the return of 67 out of 135 interrupted students. Thematic analysis identified four key themes: anticipation and fear, making contact and reaching out, preparing for return, and psychological wellbeing. The programme's effectiveness underscores the necessity of tailored support strategies to enhance retention and wellbeing. This innovative approach highlights the importance of personalised support in aiding nursing students' return to education and addressing nursing workforce shortages.

Antibiotic spectrum coverage scoring as a potential metric for evaluating the antimicrobial stewardship team activity: a single-center study.

Days of antibiotic spectrum coverage (days of ASC: DASC) is a metric for antibiotic usage calculated by ASC scores for spectrum and addresses limitations of days of therapy (DOT), which does not include spectrum. This study aims to investigate whether ASC-related metrics offer different aspects compared to aggregated DOT for all antibiotics (DOTtotal) and to assess their correlation in evaluating the impact of antimicrobial stewardship team (AST) programs. Retrospective. A single center within an 845-bed hospital. Trends in DOTtotal, DASC, and the DASC/DOT ratio, representing the average spectrum coverage per therapy day, were analyzed pre- and post-AST programs (April 2018) from January 2015 to December 2023, using interrupted time series analysis. Independent of the DASC/DOT, we also advocated ASC-stratified DOT (ASDOT), which facilitates comprehensive evaluation of DOT across ASC scores of <6, 6-10, and >10, representing narrow-, intermediate-, and broad-spectrum antibiotics. Among inpatients, AST programs significantly moderated the increasing trends of these metrics. Specifically, although the rates of increase in DOTtotal and DASC were slowed or plateaued, the DASC/DOT ratio decreased (P < 0.001). ASDOT metrics revealed a decrease and subsequent plateau in DOTtotal for the broad- and intermediate-spectrum antibiotics, with an increase observed for the narrow-spectrum antibiotics (P < 0.001 for each). DASC did not provide additional insights in the outpatient's population. The study demonstrates that ASC-related metrics may yield different and useful conclusions about the effectiveness of AST programs for inpatients.

Assessing the Feasibility of Integrating the Lethality Assessment Program into the Los Angeles Domestic Abuse Response Team

Abstract Purpose The Lethality Assessment Program (LAP) Maryland Model is an evidence-based intervention designed to prevent intimate partner homicide. It includes the lethality assessment screen, a tool used by field practitioners to assess a victim-survivor’s risk of being killed by their partner, and a referral process linking victim-survivors to community-based domestic violence services. This study aimed to evaluate the LAP's alignment with the needs of Los Angeles and its potential integration into the Los Angeles Domestic Abuse Response Team (DART) Program, which operates in all 21 divisions of the Los Angeles Police Department (LAPD). Methods Between January and May 2021, we conducted qualitative interviews with 15 law enforcement officers, domestic violence service providers, and other stakeholders involved with DART to gather information for tailoring the LAP intervention for pilot implementation in three LAPD divisions. Results Participants were positive about the LAP and its integration into the DART program but identified several gaps, such as limited staff, resources, and training. Despite these concerns, there was widespread agreement that the LAP aligned with existing DART operations, with an emphasis on the importance of obtaining buy-in from non-DART LAPD personnel. Conclusions Results suggest that it will be feasible to pilot test the LAP in Los Angeles. These efforts should include fact-based education for officers on the rationale and factors behind the screening procedures to improve acceptance and implementation of evidence-based practices.

STRYV365 peak team and Brain agents: teacher perspectives on school impact of a trauma-informed, social-emotional learning approach for students facing adverse childhood experiences.

Adverse childhood experiences (ACEs) have a profound impact on children's and adolescents' academic performance and overall wellbeing. In contrast, positive childhood experiences help mitigate the negative effects of ACEs on health and wellbeing. Trauma-informed and social-emotional learning (SEL) programs in schools may address these impacts, with school staff playing a pivotal role in ensuring their success and influencing school outcomes. This study aimed to assess the strengths, weaknesses, and areas for improvement in the STRYV365 peak team and Brain Agents programs. The aim was to refine program implementation and determine the preliminary effects on students, teachers, and the broader school environment. To achieve this goal, four focus groups were conducted after the program concluded, involving 17 school leaders, administrators, and teachers from four urban schools serving students in fifth through ninth grades. The audio transcripts were professionally transcribed and analyzed by four co-authors using Dedoose for inductive coding, leading to the identification of major themes and subthemes. Three key themes were identified from transcripts: school-wide perspectives of STRYV365 programs, strengths and impacts of STRVY365 programs, and suggestions for program improvement. School staff noted that the peak team was particularly engaging for students, helping them develop SEL skills and foster both peer-to-coach and peer-to-peer relationships. Additionally, the STRYV365 programs were found to enhance student-teacher relationships and staff relationships. Teachers expressed strong interest in taking a more active role in future programming. Overall, this study highlights the importance of teacher and administrator involvement in maintaining consistent SEL activities for urban youth. The findings also suggest that short-term, 4-week SEL programs can have a positive effect on school culture, as well as on student-teacher relationships and teacher-teacher relationships.

Factors affecting implementation of a National Clinical Programme for self-harm in hospital emergency departments: a qualitative study

BackgroundA substantial number of people experiencing self-harm or suicidal ideation present to hospital emergency departments (EDs). In 2014, a National Clinical Programme was introduced in EDs in Ireland to standardise...

Usability Evaluation of the Revised Color Me Healthy Symptom Assessment App: Perspectives of Children and Parents.

The Color Me Healthy symptom reporting app was co-designed with school-age children with cancer, their parents, and clinicians. Preliminary studies demonstrated its feasibility and acceptability; however, children and parents identified the need for additional refinements. Guided by the Technology Acceptance Model and principles of user-centered design, this study supported refinements to the Color Me Healthy user interface and evaluation of its usability. As the programming team completed builds of the app, school-age children with cancer and their parents participated in cognitive walkthrough usability evaluations and qualitative interviews. Usability logs documented the completion of key tasks related to reporting pain and review of child-reported data. Parents completed the Technology Acceptance Model Perceived Usefulness Scale (TAM-PUS). Interview responses were analyzed using qualitative content analysis. Fourteen children (median age 8.5 years; range 6-12) and 14 parents (median age 38.5 years; range 34-49) participated in one of three usability evaluation cycles. After the third cycle, children and parents navigated the app and completed key tasks independently. Median TAM-PUS scores were 6 (range 6-8), indicating high perceived usefulness. Qualitative analyses indicated that children regarded the app as easy and fun to use. Parents emphasized the app's developmental relevance for their child and for themselves as the child's caregiver. This study demonstrates the perceived usefulness and perceived ease of use of the revised Color Me Healthy app. Optimizing the usability of the Color Me Healthy app with attention to the user needs of children and parents positions the app for wider-scale clinical implementation.

Strengths, Barriers, and Recommendations for a Wraparound Gang Intervention Program Targeting High Risk Youth

ABSTRACT The Wraparound approach aims to prevent and interrupt gang activity by “wrapping” youth with individualized supports to increase prosocial connections and reduce the risks for gang involvement. The current study examines 38 interviews with program staff and external stakeholders to assess implementation strengths and challenges of a Wraparound program in British Columbia, Canada. Thematic analysis resulted in seven strengths-related themes concerning program structure, team, and youth engagement strategies, and seven challenge-related themes regarding youth interactions, resources, and communication. Findings highlight the benefits of an individualized approach, with consideration of enhanced communication and outreach strategies, resource allocation, and case manager training.

Pelatihan Software Akuntansi untuk Musyawarah Guru Mata Pelajaran Ekonomi Daerah Istimewa Yogyakarta

Economic disruption and changes in corporate operations in the Fourth Industrial Revolution will necessitate the understanding and control of artificial intelligence, or robots. This is a major issue, but it is also important for economic teachers to introduce companies that are already successful and sophisticated. Accounting software may help make bookkeeping, analyzing, reporting, and investigating easier and more precise; this concludes an opportunity in this era. Therefore, educational institutions must develop graduates who are adaptable and have soft skills. The Accounting Program and Financial Accounting Pillar team respond to economic teachers at MGMP in the Special Region of Yogyakarta by organizing a discussion forum and simulation to provide them with knowledge and best practices for using accounting software to manage business activities and achieve effective and efficient business outcomes. These exercises involve a class lecture using an andragogic approach. The discussion results suggest that economic teachers have best practices to offer accounting software to their pupils. On the other hand, it can increase teaching motivation for improving both financial and technology for themselves and the topic itself.