Requests For Assistance Research Articles

Abstract 50: Virtual Care via Mobile Application Using a Patient Electronic Health Record Portal is Feasible and Increases Stroke Patient Engagement - A Pilot Study

Introduction: Improving patient engagement in post-acute stroke cohort is challenging. Additional tools are necessary to help patients take an active role their health. Care Companion is an interactive patient engagement tool embedded within a patient’s EHR portal that can provide disease-specific education, symptom monitoring, medication reminders and patient self-reported outcomes. The application was created for patients within the existing Stroke Care Model who are followed for 90 days post-acute. As the first organization to pilot EPIC Care Companion for acute stroke patients, we aimed to evaluate the feasibility of a mobile application and its impact on patient engagement. Methods: We developed stroke specific content for Care Companion including automated alert parameters. Patients were selected based on co-morbidities, willingness and ability to participate and access to a mobile device. Individualized content was electronically sent to the patient via mobile device notifications at predetermined intervals. Patients responded to questionnaires, and input individualized data including blood pressure readings, exercise logs, glucose levels, and nicotine consumption. Patients were able to contact all members of the care team and request assistance to manage risk factors. Participants completed a Likert scale impact survey at day 90. We compared total number of patient-nurse navigator interactions between Care Companion users versus non-users with a t-test. Results: Since January 2020, 406 patients were enrolled in the Stroke Care Model and completed 90 days of follow up. We enrolled 39 patients in the pilot. Patient reported impact surveys were returned in 25 out of 39 patients (64% response rate). Most patients reported that it was easy to enroll in Care Companion (100%) and complete assigned tasks (96%). Patients found the educational content useful (91%) and made lifestyle changes based on the information (90%). Patients enrolled in Care Companion had significantly more interactions with their care team compared to non-enrolled patients (6.6 ± 4.6 vs 3.1 ± 1.9), p<.0001. Conclusion: Implementation of Stroke Care Companion was feasible and increased patient engagement with the stroke care team.

Why Do Countries Request Assistance from International Monetary Fund? An Empirical Analysis

This paper investigates the determinants behind persistent and prolonged stays under the International Monetary Fund (IMF) program and its effectiveness, using panel data consisting of 70 countries that have requested IMF support multiple times, during the period 1980–2018. By employing panel survival analysis, we conclude that weak economic indicators, e.g., current account deficit, high debt service ratio, low GDP, are the main reasons that force a country to reach out to the IMF support program. We further extend our analysis to investigate the effectiveness of the IMF program by dividing our sample into two groups, based on income level. To overcome the issue of endogeneity, we implement the panel instrumental two-stage least squares (2SLS) fixed-effect model. In the light of our analysis, we find a contemporaneous positive impact of the IMF fund program on the economic growth of upper middle-income countries, while, for low-income countries, its contemporaneous impact is insignificant, but becomes visible over time.

Italian civilian victims of war: assistance, legislation and war pensions from Fascism to Republic

ABSTRACT Between 1940 and 1945 Italy experienced all the trials of total war. Subsequently, Italian historiography has focused on reconstructing the causes of civilian losses during the conflict. Much less attention has been paid to official recognition of, and assistance to, the members of the civil population who survived the conflict. This article will show how the inadequate legislative preparations made by the Fascist regime for total war had an adverse impact on requests for assistance from survivors. It will also reveal how the continuity between Fascism and the early Republican years as regards welfare and legislation continued to hamper victims’ access to support and assistance. Finally, it explores how personal judicial battles conducted by individual victims shifted the paradigm of legislation and opened the way for a broader recognition of victims’ rights by the state.

When Fieldwork Ends: Navigating Ongoing Contact with Former Insurgents

ABSTRACT In research on terrorism and political violence, “fieldwork” now means many things. Scholars conduct interviews online, meet former extremists in urban centers, and travel across the globe to interview ex-combatants. But in this world of social media and constant connectivity, it is no longer possible to fully leave the “field.” Complicating matters is that researchers often do not speak openly about the ethical dilemmas they face—both during and after fieldwork—fearing it might damage their credibility. While various scholars have explored the ethical complexities of fieldwork in conflict-affected areas, there has been little discussion in political science on ethical challenges after fieldwork, and even less on how these post-fieldwork experiences are often highly gendered. Once fieldwork is over, what challenges do researchers face, what are researchers’ obligations to participants, and what types of regulations guide this behavior—especially when participants are former violent actors? What are the power dynamics between researchers and participants, how does gender affect these dynamics, and how do these relationships guide future interactions? For example, how do researchers deal with post-fieldwork requests for money or assistance? And how do scholars decide what to publish, and when, if they have received threats, or if threats to their participants change? Based on my experiences conducting over hundred interviews across Colombia, this paper argues that ethical review processes lack adequate consideration of ongoing ethical issues after fieldwork in conflict-affected environments, especially regarding contact with former insurgents. In addition, I argue that the tension between demands for transparency and adequately protecting both participants and researchers creates a disincentive to have open conversations about these dilemmas—especially among junior scholars.

Flags for seeking help: making supervisor expectations of general practice trainee help-seeking explicit

ABSTRACT Timely supervisor input into patient care plays a key role in ensuring the safety of patients under the care of general practice trainees. Current models of clinical supervision for trainees in both hospital and general practice training have, however, been criticised for placing too much onus on the trainee to request assistance, despite the many known barriers for trainees to do so. An important barrier to general practice trainee help-seeking is trainee uncertainty about when and how their clinical supervisor expects them to seek this assistance. We introduce a tool, ‘Flags for Seeking Help’, which was modified from an existing checklist, to assist supervisors to tailor their input to the care of their trainee’s patients. The tool aims to make supervisor expectations of trainees explicit, including when trainees should request assistance during consultations (rather than defer this until more convenient opportunities) and when this assistance should be face-to-face (rather than by phone or messaging systems). Our aim is to reduce the barriers for trainees to request in-consultation and face-to-face supervision, in particular, when it is indicated. We outline the evidence which informed the development of the tool, and present some preliminary findings from a pilot in Australian general practice training.

Getting good help: a guide for reflection, debriefing and feedback conversations about in-consultation supervision

ABSTRACT Timely supervisor input to the care of their trainees’ patients plays a key role in ensuring the safety of patients under the care of general practice trainees. Supervisor responses to trainee calls for assistance are also important for trainee learning and professional identity formation. The in-consultation supervisory encounter in general practice training is, however, a complex social space with multiple trainee, supervisor and patient agendas. Trainee requests for assistance during their consultations are known to present general practitioner supervisors with a number of challenges. From the trainee’s perspective, a safe learning environment is essential during these supervisory interactions. A number of factors may act as barriers to, or reduce the usefulness of, in-consultation assistance in particular, resulting in trainees being less likely to seek such assistance on future occasions. It is therefore important to improve both trainee and supervisor skills in safe, effective and efficient in-consultation supervision. Making time for trainee and supervisor conversations about their help-seeking and help provision may uncover opportunities for improving skills, aligning agendas and enhancing outcomes. Finding time for debriefing, reflection and effective feedback conversations may be challenging, however, and opportunities for trainees to provide feedback to their supervisors are known to be particularly limited. We introduce a Debriefing, Reflection and Feedback Guide which is designed to prompt reflection, and structure effective and efficient debriefing and reciprocal feedback conversations. We outline the evidence which informed the development of the Guides, and present some preliminary findings from a pilot in Australian general practice training.

Le rôle médiateur de la pleine conscience dans l’effet d’un programme de prévention sur l’anxiété et le perfectionnisme des étudiants collégiaux

Les étudiants collégiaux rapportent vivre de l’anxiété qui affecte leur rendement scolaire, et les demandes d’aide psychologique chez ces étudiants sont en hausse. Cette étude a pour objectif d’évaluer les effets du volet ciblé indiqué d’un programme de prévention sur la diminution de l’anxiété et du perfectionnisme ainsi que le rôle médiateur de la pleine conscience sur l’anxiété et le perfectionnisme des étudiants suite à leur participation au programme. Les résultats montrent que les participants au programme (n = 22) rapportent moins d’anxiété relativement au groupe de comparaison (n = 19) et que ces effets sont maintenus dans le temps. Les effets sur la pleine conscience, sur le perfectionnisme, ainsi que le rôle médiateur de la pleine conscience ne sont pas confirmés. Bien que cette étude confirme l’effet du programme sur l’anxiété, la pleine conscience n’a pu être identifiée comme une composante essentielle du programme. Les limites quant à la difficulté à mesurer la pleine conscience sont discutées.

Implementation of a referral and expert advice call Center for Maternal and Newborn Care in the resource constrained health system context of the Greater Accra region of Ghana

BackgroundReferral and clinical decision-making support are important for reducing delays in reaching and receiving appropriate and quality care. This paper presents analysis of the use of a pilot referral and decision making support call center for mothers and newborns in the Greater Accra region of Ghana, and challenges encountered in implementing such an intervention.MethodsWe analyzed longitudinal time series data from routine records of the call center over the first 33 months of its operation in Excel.ResultsDuring the first seventeen months of operation, the Information Communication Technology (ICT) platform was provided by the private telecommunication network MTN. The focus of the referral system was on maternal and newborn care. In this first phase, a total of 372 calls were handled by the center. 93% of the calls were requests for referral assistance (87% obstetric and 6% neonatal). The most frequent clinical reasons for maternal referral were prolonged labor (25%), hypertensive diseases in pregnancy (17%) and post-partum hemorrhage (7%). Birth asphyxia (58%) was the most common reason for neonatal referral. Inadequate bed space in referral facilities resulted in only 81% of referrals securing beds. The national ambulance service was able to handle only 61% of the requests for assistance with transportation because of its resource challenges. Resources could only be mobilized for the recurrent cost of running the center for 12 h (8.00 pm – 8.00 am) daily. During the second phase of the intervention we switched the use of the ICT platform to a free government platform operated by the National Security. In the next sixteen-month period when the focus was expanded to include all clinical cases, 390 calls were received with 51% being for medical emergency referrals and 30% for obstetrics and gynaecology emergencies. Request for bed space was honoured in 69% of cases.ConclusionsThe call center is a potentially useful and viable M-Health intervention to support referral and clinical decision making in the LMIC context of this study. However, health systems challenges such inadequacy of human resources, unavailability of referral beds, poor health infrastructure, lack of recurrent financing and emergency transportation need to be addressed for optimal functioning.

Welfare Commissioners’ Assistance Requests at Comprehensive Community Support Centers for Older Adults with Suspected Dementia, Related Knowledge of Dementia, and Attitudes Toward People with Dementia

Welfare Commissioners’ Assistance Requests at Comprehensive Community Support Centers for Older Adults with Suspected Dementia, Related Knowledge of Dementia, and Attitudes Toward People with Dementia

A Feasibility Study of an Individualized Voiding Program in Japan to Improve the Sense of Control in Older People with Functional Urinary Incontinence

Purpose: This study intended to assess the feasibility of an individualized voiding program in Japan aimed at improving the sense of micturition control in older people with functional urinary incontinence. Method: Following the interview guide, FGIs were conducted in two groups (4 - 6 participants) consisting of nurses and care workers with more than 5 years of experience as practitioners of urination care. Data were analyzed using a qualitative descriptive approach. Results: We determined that the program purpose is to “enable caregivers to work as a well-coordinated team to humanely facilitate excretion independence in older people, which is essential for living with dignity”, as this confirmed the importance of maintaining the sense of micturition control in older people for their well-being. In the program outline, we extracted the following five categories: 1) setting selection criteria for recipients considering the status of micturition induction, 2) careful collection of information and assessment of lower urinary tract symptoms in older people in case of environmental changes, 3) examination of methods used for assessing lower urinary tract symptoms according to the facility environment, 4) confirmation of the recipient’s micturition habits and request for assistance, and 5) conducting necessary examination for setting the intervention period and evaluation period according to the target condition. The feedback on the program guide was summarized in the statement—specific successful cases help frame and implement the micturition induction plan. Conclusion: We confirmed the feasibility of the micturition induction plan for improving the sense of control in older people with functional urinary incontinence. Upon evaluating the program guide, we deemed that referring to specific successful cases helps frame and implement the micturition induction plan. It is extremely important to verify the effectiveness of the program going forward.

Electronic Documentation and Digital, IT Technology in Pre-Hospital Emergency Care

In recent years Hungarian healthcare including outpatient and inpatient medical institutions and the Emergency Medical Services providing emergency care have undergone numerous IT improvements. In addition to patient health documentation, electronic digital technology provides a telemedicine opportunity for at-the-scene care, helping and supporting care, diagnosis and patient path- related decisions. The National Emergency Services are involved in the development and implementation of mobile applications that assist at-the-scene first aid provided by non-professionals in cases where early intervention can be life-saving for the patient. By providing the possibility of requesting direct assistance in unexpected situations, not only can the request for assistance be made easier and simpler, but the scene of the medical emergency or injury can also be precisely determined without the assistance of the person who reports the emergency case.

Towards an enterprise research model for academics at University of Botswana

We are in an age where there are several societal and scientific challenges that are facing humanity. The academics are not left out of this entire dilemma. The same academic who is expected to be active in research within the university system is also expected to be committed to teaching and service assignments. The research task itself requires a lot of processes scattered around various work, culture, people and structure such as writing proposals, liaising with the research department, looking for materials in the library, learning appropriate applications with the Information Technology (IT) department etc. The aim of this research is to establish the perceived gaps based on the process of academic research in the university. The study is based on a case study of the University of Botswana. It uses the Nadler-Tushman Congruence Framework to perform a gap analysis on the current system. The study is initiated as part of progress towards providing a model to identify opportunities for improvement in research services at the university. The outcome from the study is a proposed model to help align work, culture, people and structure. The blueprint provided by the model will allow one to see the real impact of change, identifying where gaps and opportunities exist, and understand how and where things can be improved for the benefit of all stakeholders. The model provides for a single point through which a researcher can request assistance from the various units of the system. Be-yond the single point of access, the various units should be able to provide support for the entire research process without the researcher necessarily having to leave their desk. It also provides researchers with information to build systems that can improve enterprise flow within the research process. An efficient way of achieving this will be to eliminate or minimize the human factor where necessary. The paper proposes that a more detailed model can be achieved using The Open Group Architecture Framework (TOGAF) architecture model.

P180 Food access challenges and social needs for people with cystic fibrosis

Introduction: The rate of food insecurity (FI) among Americans is 10.5%. A recent U.S. study found 33% of people with cystic fibrosis (PwCF) experience FI. We sought to understand the needs for those seeking assistance with food through Compass and how these needs changed due to COVID-19. CF Foundation Compass is a free, personalised case management service to help with insurance, financial, legal, and other issues PwCF are facing. Methods: We identified Compass calls between January 1, 2019 to December 31, 2020 related to food assistance. We reviewed whether callers had an additional need reported during the call. For 2020 calls, we also determined whether their needs could be met by community resources;2019 referral data was not available. Results: Compass received 174 requests for food assistance. Food requests almost tripled between 2019 (47) and 2020 (127). Of the 174 food requests, 60% of callers had an additional need and 38% had 2 or more additional needs. 75% of the additional needs related to other social factors including utility costs (33%), housing (27%), medical needs (13%), and car issues (5%). In 2020, half of food needs (44%) were not met by community resources. 17% of callers did not follow Compass recommendations. Conclusions: Given the unique caloric needs of PwCF, lack of food is a concern. Food access in the U.S. has been impacted by COVID-19 and community resources are scarce. People facing FI are more likely to have other social needs, such as affordable housing. CF clinicians are uniquely positioned to have sensitive conversations and address these factors to understand the need and improve quality of life for their patients. This can be accomplished by screening for social factors and collecting and evaluating the data. The CF Foundation has enhanced Compass training for responding to food inquiries and put together a Food Security Committee of clinicians and community members focused on research, education, quality improvement, and advocacy.

Some Criminalistic Aspects of International Cooperation in the Sphere of the Criminal Process

In the article, the author made an attempt to consider some of the forensic aspects of international cooperation in the field of criminal procedure, or rather tactical features in the direction and (or) execution of requests for legal assistance in criminal cases, as a result of which the author comes to the appropriate conclusions, which have both theoretical and applied value.

Perceptions of Feedback among Russian Adolescents

Despite the obvious significance of the feedback phenomenon for school practice, there is a lack of valid analysis of students’ perception of feedback. This article explores how Russian adolescents conceptualize and perceive feedback as an educational tool. Descriptive research was conducted using an anonymous survey based on a questionnaire composed of open-ended questions. Seven hundred and three adolescents from large cities of Russia were asked questions about how they understood “feedback”, what kind of feedback they would like to receive, and what kind of feedback they actually received from teachers. This was followed by a field study that involved an overt observation and analysis of feedback manifestations in a secondary school program for gifted students (n = 140). Most senior students understand the range of problems associated with feedback, yet they perceive feedback itself as a resource to be used by the teacher, not by themselves. In their beliefs about feedback, adolescents intuitively rely on either “behavioral” or “existential” perspective. In the former case, feedback is perceived only as an external stimulus and the resulting response. In the latter, students regard feedback as a tool for dialogue, support, engaged communication, relationship development, and direct or indirect request for evaluation or assistance. The more complex interpretation may stem from students’ prior participation in situations of assistance and cooperation as well as their perceived need for a dialogue with the teacher or tutor.Since the sample was unrepresentative, the conclusions made in this study should be deemed preliminary. Nevertheless, they allow designing further research of feedback literaсу in Russia’s school education.

A Review of Unsolicited Comments on the CAHPS 5.0 Health Plan Survey.

The CAHPS Health Plan Survey (CAHPS 5.0) collects invaluable information regarding consumer experiences with their health plans, and these data inform healthcare policies at both the state and federal levels. The purpose of this paper was to explore unsolicited comments provided on the CAHPS 5.0 survey of one state's Medicaid program. Secondary data analysis was conducted of unsolicited, written comments received from Medicaid recipients who completed the CAHPS 5.0 adult or child postal survey between 2016 and 2018. The majority of unsolicited comments were moderately or very negative in attitude (or tone) for adult and child surveys. Analysis of unsolicited comments yielded 3 themes: positive experiences with Medicaid, limitations of coverage, and direct requests for assistance. Providing space for Medicaid patients to share comments and receiving further guidance for content analysis would provide valuable context for interpreting overall survey results. Comments may also help Medicaid program administrators respond to the frequently complex and challenging experiences of navigating a continually evolving state health insurance program by the most vulnerable populations.

Practical Challenges in Cross-border Cybercrimes: Prosecutors and Investigators Perspectives

The investigator and prosecutor encounter enormous difficulties and challenges in dealing with the cross-border cyber related crimes. This article intends to show practical difficulties prosecutors and investigators often face when they deal with the cross-border cybercrimes. For example, foreign States often refused to share the information and evidences if the alleged conduct is not amounted to crime under their law. Further, the investigators follow the Mutual Legal Assistance Treaties (MLAT) mechanisms to request assistance and other evidences from a foreign country, which often proved to be time-consuming. Alarmingly, it became very challenging for investigators and prosecutors to identify and locate the actual perpetrator since perpetrators now use modern technologies and methods to hide their identity and location. Thus, this article aims to explore some of the common challenges prosecutors and investigators meets in their day-to-day work.

Los puertos asturianos en el siglo Ilustrado

La España del siglo XVIII asiste al renacimiento de su política naval con la creación de importantes infraestructuras militares (arsenales) e inversión tecnológica (navíos de línea). Sin embargo, por lo que respecta al ámbito costero desde la óptica civil, el análisis de la situación de los puertos que no tenían un estricto interés estratégico y militar, es decir, los comerciales y pesqueros, se aprecia una situación en la que se alternan la destrucción y el deterioro con las reiteradas peticiones de los gremios de marineros para mejorar los muelles, diques y construcciones anexas. Podemos afirmar que la práctica totalidad de las demandas de auxilio serán atendidas administrativamente (elaboración de proyectos, planificación de impuestos para sufragar las obras, frecuentes visitas de los ingenieros militares), lo que no equivale a que se ejecutaran de manera completa, perfecta o siquiera que garantizaran una perdurabilidad en el tiempo que fuera más allá de varios lustros.

RANCANGAN PENGEMBANGAN SEKOLAH BERDASARKAN 8 STANDAR NASIONAL PENDIDIKAN SD N 6 DANGER

ABSTRACT
 This research is a research on school development design based on 8 National Education Standards. The problems examined in this study are about the gaps in SD N 6 Danger and what programs will be carried out after the school development design is carried out. The purpose of this research is that schools can design or plan school development based on 8 SNPs. In addition, the goal to be achieved is for schools to determine programs to develop schools. The method used is descriptive qualitative research with the research subject is SD N 6 Danger. Data collection techniques are interviews, observation and documentation. The result of the research is that there are gaps in schools including the standard of facilities and infrastructure, and also from the standard of financing. The programs to be implemented are training programs for teachers, making printed books and educational aids (APE), and making requests for assistance from the central government.

Good help: a model for providing in-consultation supervision of general practice trainees

ABSTRACT Timely clinical supervision of trainee consultations plays a key role in ensuring the safety of patients under the care of general practice trainees, and in trainee learning and professional development. Trainee requests for assistance during their consultations present supervisors with a number of challenges, however, and a number of factors act as barriers to, or reduce the utility of, this in-consultation assistance from the trainee’s perspective. Face-to-face supervision in the presence of the patient presents particular challenges and opportunities. It is important to address barriers to trainee help-seeking and improve both trainee and supervisor skills in promoting safe, effective and efficient in-consultation supervision. We introduce a model (β-LACTAM) to assist supervisors in planning and delivering their face-to-face in-consultation supervision. The recent evidence which informed the development of this model is outlined, and some preliminary findings from a pilot of β-LACTAM in Australian general practice training are presented.