Support Resources Research Articles

"Due to These Restrictions, Girls Think of Themselves as Nothing": A Qualitative and Quantitative Description of Menstrual Restrictions and Stigma Among Adolescent Girls Across Religious and Other Sociocultural Contexts.

Girls in Tanzania often experience menstrual restrictions (i.e., expectations about behaviors prohibited during menstruation) and menstrual stigma (i.e., negative attitudes toward people who menstruate). A better understanding of sociocultural contexts contributing to menstrual stigma and restrictions is needed. In 2018, two conceptually linked quantitative and qualitative studies were conducted to describe menstrual restrictions and stigma among girls in Tanzania, examine how sociocultural contexts influence menstrual restrictions and stigma, and investigate the relationship between menstrual restrictions and stigma. A cross-sectional survey of 509 post-menarche girls from five schools assessed associations between religion, religion-based menstrual restrictions, and menstrual stigma while controlling for differences between schools. In-depth interviews with 10 adolescent girls and 10 adult key informants explored broader menstrual experiences. We analyzed themes pertaining to sociocultural contexts and other mechanisms that shape menstrual restrictions and stigma, their impacts on girls, and opportunities for intervention. In the surveys, 52% of Christian girls and 76% of Muslim girls experienced religion-based menstrual restrictions. Some restrictions, such as prohibitions against praying during menstruation, were more common among Muslim girls, who also had higher menstrual stigma. Menstrual stigma differed by school. Although menstrual restrictions did not show an association with stigma in the surveys, interview participants described how menstrual restrictions contribute to stigma and indicated that religion, tribe, education, family support, and menstrual resources influence menstrual restrictions and stigma. Sociocultural contexts influence menstrual restrictions and stigma. Working with religious, school, and family leaders may provide opportunities to implement interventions to reduce menstrual stigma.

Machine-learning-based cost prediction models for inpatients with mental disorders in China

BackgroundMental disorders are increasingly prevalent, leading to increased medical expenditures. To refine the reimbursement of medical costs for inpatients with mental disorders by health insurance, an accurate prediction model is essential. Per-diem payment is a common internationally implemented payment method for medical insurance of inpatients with mental disorders, necessitating the exploration of advanced machine learning methods for predicting the average daily hospitalization costs (ADHC) based on the characteristics of inpatients with mental disorders.MethodsWe used data including demographic information, clinical/functional characteristics, institutional features, and cost information of 5070 hospitalized patients with mental disorders in Jinhua, China, and employed six algorithms to predict ADHC. Performance of these six algorithms was evaluated through 5- old cross-validation combined with bootstrap method to select the most suitable algorithm and identify key factors influencing ADHC.ResultsThe random forest (RF) model demonstrated better performance (R-squared (R2) = 0.6417 (95% CI, 0.6236–0.6611), root-mean-square error (RMSE) = 0.2398 (95% CI, 0.2252–0.2553), mean-absolute error (MAE) = 0.1677 (95% CI, 0.1626–0.1735), mean-absolute-percentage error (MAPE) = 0.0295 (95% CI, 0.0287–0.0304)). According to feature importance ranking, models incorporating top 11 factors (> 0.01) demonstrated comparable performance to those encompassing all variables. Top four factors (> 0.05) were level of medical institution, age, functional classification, and cognitive classification. Notably, level of medical institutions was the most significant factor across all primary models. Higher medical institutions level, patients below 20 and above 75 years old, lower functional classification, and lower cognitive classification are associated with increased ADHC.ConclusionsMachine learning algorithms, particularly RF algorithm, enhance accuracy of predicting ADHC for mental health patients. The findings of this study provide evidence for setting up more reasonable insurance payment standards for inpatients with mental disorders and support resource allocation in clinical practice.

Doctors’ Satisfaction with the Rehabilitation System for Anti-Terrorist Operation Participants: A Factor Analysis

A war has a catastrophic effect on veterans' health. However, there is a knowledge gap about the veterans' rehabilitation system, requirements, and the satisfaction of doctor-organizers. The present study aims to assess the level of satisfaction of the doctor-organizers of health care with the existing rehabilitation system for anti-terrorist operation (ATO) veterans in Ukraine. A cross-sectional design was conducted during the ATO in March-April 2020. A total of 25 organizing doctors from healthcare institutions filled out the form. The questionnaire consisted of three blocks: 1) Main characteristics of the existing system of rehabilitation of ATO veterans (14 items); 2) Strengths of the existing system of rehabilitation of ATO veterans (11 items); and 3) Weaknesses of the existing system of rehabilitation of ATO veterans (8 items). Evaluation of the rehabilitation system was carried out using factor analysis. The main features of the system were accessibility, financing of rehabilitation programs, and commitment to the rehabilitation of ATO veterans. The advantages of the system included 1) doctors and organizers identifying the regulatory and legal provision of medical and social protection for the rehabilitation of veterans, 2) access to experienced personnel to carry it out, 3) respectful attitude towards veterans, and 4) comprehensive rehabilitation. In addition, disadvantages inherent in the system included: 1) violation of the integral principle, 2) insufficient material, technical support, and financial resources for rehabilitation programs, and 3) legislative and regulatory gaps necessary to provide rehabilitation to ATO veterans. The findings provided healthcare organizers with information on the main features, advantages, and disadvantages of the rehabilitation of ATO veterans. These insights can aid in optimizing the current rehabilitation system in Ukraine.

Exploring the association between hearing status and suicidal ideation among U.S. adults: An observational study.

Suicidal ideation is a critical public health concern, and its relationship with hearing status has garnered increasing attention. This study aimed to investigate the association between hearing status and suicidal ideation in a nationally representative sample of U.S. adults. Data were analyzed from 8095 participants in the 2015-2018 National Health and Nutrition Examination Survey (NHANES). Weighted logistic regression models, along with restricted cubic spline (RCS) analyses, explored the relationship between hearing status and suicidal ideation, adjusting for potential confounders. Subgroup analyses by sex, race, education level, marital status, family monthly poverty level, vision trouble, mobility trouble, smoking, hypertension, diabetes, coronary heart disease, stroke, and cancer were conducted. A Zero-Inflated Poisson (ZIP) regression model was applied to explore the association between hearing status and the level of suicidal ideation. Participants with more difficulty hearing showed a higher likelihood of experiencing suicidal ideation (P<0.05 for all). Further analysis using RCS regression confirmed a linear relationship between hearing status and suicidal ideation risk (Pnonlinear>0.05). Subgroup analyses revealed no significant interactions across different stratifications (P>0.05 for all). The ZIP analysis revealed that individuals with moderate hearing trouble or those identified as deaf or hard of hearing exhibited higher frequencies of suicidal ideation. This study identifies an association between hearing status and suicidal ideation among U.S. adults. Factors such as discrimination, social isolation, environmental inaccessibility, and communication barriers may underlie this relationship. Interventions aimed at reducing suicidal ideation should focus on addressing these underlying factors, improving access to supportive resources, and promoting inclusive and accommodating environments for individuals with hearing difficulties.

RESEARCH ROADBLOCKS: INVESTIGATING THE CHALLENGES ENCOUNTERED BY THE DEPED PERSONNEL IN RESEARCH WRITING

This study investigates the pervasive challenges faced by Department of Education (DepEd) personnel in various aspects of research writing. Through a comprehensive assessment, it was found that educators encounter significant difficulties across all dimensions of research writing, ranging from time management to the formulation of conclusions and recommendations. These challenges, consistently rated as "Very Much Challenging," underscore the urgent need for targeted interventions and supportive resources to enhance educators' proficiency and improve the quality and rigor of research outcomes within the educational context. Furthermore, the study highlights the critical importance of providing targeted support and resources to address these challenges, fostering a culture of research excellence among educators, and ultimately leading to informed decision-making and improved educational practices. Finally, the culmination of the study prompted the creation of a Research Guidebook tailored for DepEd personnel, designed to assist them in navigating the complexities of research writing.

HOW DOES AWARENESS OF SOCIAL SERVICES PLAY A ROLE IN THE RELATIONSHIP BETWEEN RELATIONAL RESOURCES AND THE AIP?

Abstract The process of ‘Aging in Place (AIP)’ encompasses a variety of declines in physical capabilities, adaptability to environmental changes, and the breadth of interpersonal relationships. The AIP is not just about staying in the community; it also involves the availability of requisite resources to address the needs that emerge throughout the AIP journey. In this context, relational resources such as an individual’s social capital, may serve as a significant asset. Nonetheless, the availability of relational resources is not uniform among older adults, and it might be risky to solely rely on relational resources, potentially resulting in an excessive burden on the enhancement of AIP sustainability. Instead, social services can act as supportive resources. The purpose of this study is to examine the moderating role of perceived awareness of social services in the relationship between relational resources and the intention to AIP. Logistic regression was conducted using data from the 2020 National Survey of Older Koreans (n=10,097). The results show that older adults who have more relational resources are likely to have more intention to AIP and specifically, the association is stronger at a higher awareness of services. The findings show that there is a need for a range of social engagement programs to provide more opportunities to build relational resources in later life, thus increasing the likelihood of AIP. Policy efforts are also needed to increase awareness of social services among older adults and so, they can plan their AIP with the assurance of various available supports.

The Enlightenment and Reference of Finland’s Special Education Financial Model to China

This study aims to investigate the financial system of special education in Finland and explore the implications of Finland’s experience for China. The research methods include literature review and statistical data analysis. The main issues include allocating special education funds, management models, and their effects between the two countries. This article compares the financial background and current situation of special education in China and Finland, pointing out challenges such as insufficient funding, uneven resource allocation, and shortage of professional personnel in China. By comparison, Finland adopts an inclusive education fiscal system that emphasizes fairness and efficiency. Through centralized financial support and flexible resource allocation, it has achieved high-quality development of special education. China can learn from Finland’s experience in rational planning of financial investment and improvement of policy support, to enhance the quality and equity of its special education and improve China’s national policy on special education. Summarizing Finland’s experience and providing insights for China, it is recommended that China learn from Finland’s successful practices in funding, resource allocation, audit evaluation, and professional training to optimize the use of special education resources and enhance educational equity and quality.

TikTok as a Resource for Fertility Information and Support: A Patient Survey

Objective: TikTok is a rapidly growing social media platform with over 800 million users worldwide. Many patients access fertility-related content across social media platforms, however, this has never been studied related to TikTok. This study aimed to describe patient perspectives and experiences using TikTok for fertility-related content. Materials and methods: We conducted a cross-sectional web-based survey from April 1st 2023 to October 1st 2023 at a large fertility center in Toronto, Canada. Patients were eligible for inclusion if they self-identified that they use TikTok for fertility-related content and had pursued any form of fertility care. Results of the survey were described with descriptive statistics and thematic analysis. Results: A total of 23 patients with a mean age of 36.74±6.67 years participated in the online survey. Fertility-related TikTok content included lived experiences of fertility journeys descriptions of fertility treatments or procedures, live-streaming of fertility treatments or procedures, interactive questions and answers, and educational videos. Creators of fertility-related TikTok content include patients undergoing fertility treatments, physicians, naturopaths, counselors, and patient advocates. The most common reasons for liking TikTok for fertility content included empathy or shared experiences, stress relief, and self-education. Reasons for disliking TikTok for fertility information included misinformation, commercialization or advertisements, and negative emotions of stress, anxiety, or emotional upset. Misconceptions seen on TikTok included misinformation about complications and success rates for assisted reproductive therapy, as well as nutritional advice. Conclusion: Fertility providers should have a growing awareness of information available on TikTok for patients accessing fertility care and assisted reproductive technology.

‘Is anyone else’s husband trying to undermine them all the time?’: A reflexive thematic analysis of online support forum discussions about bariatric surgery saboteurs

Online support forums (OSFs) are an increasingly utilised social support resource for bariatric surgery (BS) patients. OSFs could permit patients to discuss sensitive topics, such as being sabotaged post-BS. This study aimed to explore the phenomenon of BS saboteurs via BS-specific OSFs. Two internet search engines were used to identify BS-specific OSFs. The eligible OSF(s) was searched to identify relevant threads. Thread data were analysed using reflexive thematic analysis. One OSF was eligible. The final dataset included 18 threads ( N replies = 569). Three themes were identified: Feeder Behaviours, Negative Reactions to Bariatric Surgery-Induced Weight Loss and Strategies to Avoid and/or Manage Bariatric Surgery Saboteurs. Transcending these was the notion of The Online Support Forum as a Source of Substituted Social Support and Place of Solace. In lieu of the limited social support received in real life, BS patients use OSFs as a form of social support when being sabotaged.

Green Startup Policy in Vietnam: Current Status and Challenges for Sustainable Development

In the context of globalization and increasing awareness of climate change, green and sustainable economic development has become an inevitable trend for nations worldwide. With a strong commitment to reducing greenhouse gas emissions and achieving the Sustainable Development Goals (SDGs), Vietnam is striving to promote green startup initiatives to maximize economic potential while protecting the environment and natural resources. Policies supporting green startups play a crucial role in creating a favorable environment, fostering creativity and innovation, and enhancing the competitiveness of domestic green enterprises. However, the implementation of these policies in Vietnam still faces many challenges, including an inconsistent legal framework, fragmented support resources, and barriers in accessing capital and markets. This article aims to analyze the current state of green startup support policies in Vietnam and highlight key issues to consider during the policy formulation and implementation process.

SUPPORT SYSTEM AS A PREREQUISITE FOR THE SUCCESSFUL ADAPTATION OF NOVICE TEACHERS

The process of adaptation of any person to the new place of work is an important stage that contributes to the further motivation both to stay in a particular place of work and to continue to be a representative of the chosen profession. Encouraging novice teachers to remain in their chosen profession is the actuality of the modern educational space. It is therefore important to evaluate all possible support tools and resources for the adaptation of novice teachers, as well as to identify opportunities for their useful, meaningful and targeted use. Thus, the questions become relevant: "What factors contribute to the adaptation of a novice teacher in a general education school?" and "What support system is needed for the successful adaptation of novice teachers in general education schools?".This article, without excluding other possibilities and probabilities, will examine the factors contributing to and hindering the successful adaptation process of novice teachers who started working in general education schools, the offer of support measures from both a historical and contemporary perspective, choosing the situation of the Latvian state as the basis for the study. The importance of the support system for the successful adaptation of novice teachers will also be highlighted. The research is based on the study of theoretical literature and the personal experience of the author of the publication (as a novice teacher).The aim of the article is to study the offer of existing support systems for novice teachers, based on periodicals, various scientific publications, legislative regulations, OECD and other educational studies, as well as the content analysis of other historical sources, and to identify elements of the model of successful adaptation of novice teachers. This will become the basis for further empirical research, the result of which will be the development of an adaptation model for novice teachers. The research method: theoretical analysis of scientific literature and sources. As a result of theoretical research, based on the content analysis of various historical sources and international research, the following elements of the support system have been identified as the most important: participation in mentoring introductory programmes, the attraction of a teacher-mentor from an educational institution, introductory training, opportunities for self-expression, the quality of mutual relations in the school team. More on these and other aspects of the adaptation of novice teachers in the main part of the article.It should be noted that the study was conducted within the framework of the educational situation in Latvia, therefore, further research would be necessary to confirm the results in the international educational context.

Alzheimer's Association's funding portfolio: Insights from the International Alzheimer's and Related Dementias Research Portfolio (IADRP).

Alzheimer's disease (AD) and related dementias (ADRD) present significant health challenges. Understanding their underlying biology, advancing existing and new therapies, and enhancing care for patients and caregivers are critical priorities. This article utilizes data from the International Alzheimer's and Related Dementias Research Portfolio (IADRP) to analyze funding patterns from the Alzheimer's Association over the past decade. As the largest nonprofit funder of AD/ADRD research globally, the Alzheimer's Association has committed over $430 million, supporting a diverse range of studies across the entire spectrum of dementia-related science. The funding landscape has evolved, reflecting new areas of investigation and collaboration with broader research initiatives. This article highlights the dynamic nature of the Association's funding strategies and ongoing efforts to connect funding with additional supportive resources, thereby enhancing the overall research ecosystem Highlights As the world's largest nonprofit funder of Alzheimer's disease and dementia science, the Alzheimer's Association's funding activities are strategically designed in partnership with the global research community to address scientific gaps in our knowledge to advance research. A large part of the Association's funding portfolio depends on key partnerships and collaborations. From 2019 to 2023, the Alzheimer's Association has allocated funding for more than 850 new research studies. The diversity of areas funded is clear across the Association's portfolio. Beyond the Association's strong emphasis on supporting research through grant funding, there are also efforts to ensure the necessary ecosystem to support the career development of researchers and clinicians, maintaining ongoing support for current and future awardees, including convening and the Alzheimer's Association International Society to Advance Alzheimer's Research and Treatment (ISTAART).

“Since you live in two worlds, it is not always easy to tell them apart”

Online Sámi language education experiences a booming interest, not least as large groups of Sámi live in diasporic communities outside the traditional area of Sápmi where Sámi language teachers are hard to find. Therefore, for many, online education is the only available educational option. From a philosophical perspective, this paper aims to contribute knowledge about online Sámi language education contextualised to the Swedish and Norwegian side of Sápmi. Information from conversations with six online 1-9 Sámi language teachers revealed that they operate within a colonial matrix underpinned by dominant perspectives expressed through legislation, policies, financial incentives etc. Within the matrix, teachers work hard at counteracting colonial consequences, such as pupils with a wide array of pre-knowledge leading to conflicting expectations, and a disconnection to land, animals and people. One consequence might also be embodied colonialism manifesting in different ways. The teachers’ work of applying Sámi philosophical and pedagogical perspectives is done with hardly any outside support and poor financial resources to the best of their ability. There is a need to digitally transform the practice to, amongst other reasons, counteract potential spatial limitations, as teachers need support structures to make the most of the epistemic space created through this mode of education. If Sweden and Norway continue to frame online education within the compulsory school system as a second-best option that should be avoided, if possible, it is unlikely that enough resources will be allocated without political pressure.

Evidence-Based Leadership in Nursing: An Evolutionary Concept Analysis.

To conduct a concept analysis of evidence-based leadership in a nursing context. Rodgers' evolutionary method was employed to identify attributes, antecedents, consequences, definitions and surrogate and related terms. We systematically searched three databases (PubMed, Cumulative Index to Nursing and Allied Health Literature and Scopus) for relevant publications. The databases were searched from their inception to 4 February 2024. We included 12 papers published between 2005 and 2022. The attributes include leadership attributes (personality, developing common goals and visions and influencing others) and evidence-based attributes (valuing evidence-based practice, integrating evidence and adapting evidence). The antecedents include individual internal factors (commitment to growth and proficiency in implementation science) and individual external factors (growing need for evidence-based practice, training support and available resources), while the consequences are personal growth, organisational benefit and disciplinary development. Based on the concept analysis, evidence-based leadership can be defined as a process whereby individuals, based on their personality and values towards evidence-based practices, integrate the best evidence into practice, adapt the evidence integration process based on evaluations and influence others towards achieving a common goal and vision. This concept analysis enhances our understanding of evidence-based leadership, guiding nurses to integrate evidence into their leadership practices to achieve specific goals and visions within the healthcare context. Future studies could consider developing instruments to evaluate evidence-based leadership based on this refined concept, ultimately promoting nurses' leadership competencies in real-world settings. This concept analysis not only raises awareness of the responsibilities of nurses as healthcare professionals, including the provision of evidence-based practice, but also facilitates their effective execution of these responsibilities. Empowering nurses to actively incorporate evidence into their leadership practices can further enhance the quality of healthcare delivery. Not applicable. Not applicable.

The Mediating Role of Social Support between Psychological Distress and Mental Well-Being

Not only can individuals benefit themselves but also their immediate environment and society as a whole when they are mentally healthy. An elevated level of mental health may stimulate positivity. Therefore, it is crucial to thoroughly examine and resolve the issue. Psychological distress is a common experience that individuals encounter at different stages of life. When faced with a challenging situation, individuals can benefit from social support resources. The distress individuals endure influences how they assess their mental health and social support resources. In this context, the present study aims to examine the mediating role of social support in the relationship between psychological distress and mental well-being. For the first time, the relationships between these variables were examined. Data were collected from 434 adult volunteers. The structural equation modelling (SEM) method was employed to analyse the mediation between the concepts. The analyses' results indicated that psychological distress was a predictor of mental well-being, both directly and indirectly through interpersonal support. Individuals who are experiencing distress exhibit diminished levels of mental well-being and perceive less social support. Perceiving more support from their environment and experiencing less distress can enhance individuals' mental health.

Lived Experiences of Bureau of Fire Protection Firefighters in Baguio City Fire Station, Philippines

This study explores the experiences of firefighters at the Bureau of Fire Protection (BFP) in Baguio City, Philippines focusing on their well-being and the challenges they face in their demanding roles. By providing insights into their experiences, the study aims to enhance firefighter morale and inform the Baguio City government and educational institutions about the realities of fire service. Such understanding could encourage future volunteerism in firefighting, fostering a stronger community response to fire emergencies. Using a case study design, qualitative data were collected through semi-structured interviews and observational methods. A purposive sampling method yielded 28 participants. Data collection involved distributing questionnaires at the fire stations following approval from the City Fire Marshal, ensuring a comprehensive exploration of the participants' experiences. The findings reveal that while firefighters enjoy camaraderie and community support, they also encounter significant stress stemming from heavy workloads, interpersonal conflicts, and insufficient resources. Coping strategies employed by firefighters include prayer, peer discussions, and seeking guidance from more experienced colleagues, demonstrating their resourcefulness in managing stress. These insights have broader implications for enhancing firefighter training programs and organizational policies, emphasizing the necessity for improved emotional support systems and resource allocation.

User-Centred Design and Development of a Smartphone Application (OverSight) for Digital Phenotyping in Ophthalmology.

Visual impairment can significantly impact an individual's daily activities. Patients require regular monitoring, typically occurring within hospital eye services. Capacity constraints have necessitated innovative solutions to improve patient care. Existing digital solutions rely on task-based digital home monitoring such as visual acuity testing. These require active involvement from patients and do not typically offer an indication of quality of life. Digital phenotyping refers to the use of personal digital devices to quantify passive behaviour for detecting clinically significant changes in vision and act as biomarkers for disease. Its uniqueness lies in the ability to detect changes passively. The objective was to co-design an accessible smartphone app (OverSight) for the purposes of digital phenotyping in people with sight impairment. Development of OverSight included stakeholder consultations following principles of user-centred design. Apple iOS software frameworks (HealthKit, ResearchKit, and SensorKit) and a SwiftUI developer toolkit were used to enable the collection of active and passive data streams. Accessibility and usability were assessed using the System Usability Scale (SUS) and feedback following a 3-month pilot study. Consultations with patients informed the design of OverSight, including preferred survey scheduling and the relevancy of patient support resources. Twenty visually impaired participants (mean age 42 ± 19 years) were recruited to the pilot study. The average score on the SUS was 76.8 (±8.9), indicating good usability. There was a statistically significant moderate negative correlation between SUS scores and visual acuity in both the better (r = -0.494; p ≤ 0.001) and worse eye (r = -0.421; p ≤ 0.001). OverSight offers promising potential for collecting patient-generated health data for the purposes of digital phenotyping in patients with eye disease. Through further testing and validation, this novel approach to patient care may ultimately provide opportunities for remote monitoring in ophthalmology.

Examining Demographic, Social-Emotional, and Educational Factors Influencing Teaching Motivation among Arab Teachers in Regular and Special Education

In recent years, research has increasingly emphasized the emotional, social, and educational aspects of teacher training and professional practices in both regular and special education systems. This study aims to: (a) investigate differences in teaching motivation, socio-emotional learning, perceived social and family support, mental well-being, resilience resources, and situational anxiety across demographic variables (specifically gender, age, academic qualifications, and type of education system) among Arab teachers in northern Israel; and (b) assess the extent to which these socio-emotional and educational factors explain the variance in teaching motivation among these teachers. To achieve these objectives, teachers from both regular and special education settings were asked to provide demographic information and complete self-report measures targeting the specified factors. The results revealed significant differences in socio-emotional and educational factors across the demographic variables of gender, age, academic qualifications, and type of education system (regular or special education). Notably, a significant negative relationship was observed between teaching motivation and situational anxiety, while positive relationships were found between teaching motivation and perceived social and family support, mental well-being, socio-emotional learning, and resilience resources. Moreover, multiple linear regression analysis identified socio-emotional learning, mental well-being, and resilience resources as significant predictors of teaching motivation, accounting for approximately 35.3% of the variance. This study highlights the critical role of socio-emotional factors in shaping teaching motivation, particularly among Arab teachers in northern Israel. Understanding these dynamics can inform targeted interventions and support systems, ultimately enhancing teacher effectiveness and improving student outcomes in both regular and special education settings.

Pediatric Subspecialist Referrals to Peer Support for Families.

Families of children with special health care needs (CSHCN) have reported to benefit from social, emotional, and informational support from other families (peer support) with similarly affected children. Pediatric subspecialists often serve as the primary medical providers for CSHCN, as well as educators for these children's families. The extent to which subspecialists refer families to sources of peer support is unknown. A statewide online survey of California pediatric subspecialists investigated opinions about the potential value and challenges of peer support. Data was obtained on the frequency with which families in their practices were referred to peer support, practice characteristics, and personal demographics. Weighted data, descriptive statistics, and regression models were used to characterize and predict factors affecting referral services. There were 388 respondents, a response rate of 14.5%. Subspecialists were generally unfamiliar with peer support resources in their communities, but many more knew of peer support programs in their institutions. Most (> 85%) held positive views about peer support, though only 40% of practices often referred families for such support. Individual opinions did not predict practice referral processes for peer support which were more influenced by knowledge of resources, and availability of time, staffing, and institutional peer support resources. Offering referral to peer support services is compatible with pediatric subspecialty care. Educating physicians about available resources, assigning responsibility, providing staff time for referring families, and incorporating parent mentors into subspecialty practices can increase access. Future studies of families' referral experiences are needed.

Supporting Nursing Staff During Crises: Impact of Organisational Support Measures and Resources in Job Satisfaction in German Nursing Homes.

The COVID-19 pandemic placed an immense burden on nursing home staff, significantly increasing their workload. How the impact of these challenges on job satisfaction is mitigated by personal and social resources, along with organisational support measures initiated by nursing homes, is investigated in this study. In 2021, a cross-sectional survey was conducted among nursing home staff in Rhineland-Palatinate (n = 373). The questionnaire contained parts of standardised instruments (parts of the Copenhagen Psychosocial Questionnaire (COPSOQ), Brief Resilience Scale) and self-developed questions related to support measures such as training, psychological support and work organisation changes. The association of these support measures, as well as personal and social resources (e.g., resilience, social support, sense of community), with job satisfaction was explored. Descriptive, bivariate and regression analyses were conducted. While various support measures were offered to the nursing home staff, significant gaps remained. Training on hygiene and COVID-19 care was beneficial but not universally available. Similarly, psychological, pastoral and palliative support was lacking for a large portion of nursing home staff. Surprisingly, in the regression analysis, frequent information updates from supervisors were found to be negatively correlated with job satisfaction (p = 0.002). However, some personal and social resources (resilience (p = 0.002), social support (p = 0.001), sense of community at work (p ≤ 0.001), commitment to the workplace (p = 0.019), recognition by management (p ≤ 0.001)), and various support measures (training programmes (p = 0.005), changes in work organisation (p = 0.008), technical measures (p = 0.025)) were positively correlated with job satisfaction. This study highlights that despite the implementation of various support measures for nursing home staff during the COVID-19 pandemic, significant gaps remained. Notably, a substantial portion of staff members lacked access to crucial support services such as psychological, pastoral and palliative care. Furthermore, healthcare facility managers should prioritise the following support measures, especially during crises: comprehensive training, including resilience training; flexible working arrangements; and recognition for nursing staff. Ultimately, healthcare organisations should aim to create a supportive work environment that fosters a sense of community and belonging among their nursing workforce.