Support Program Research Articles

Relatives’ and Intensive Care Unit Personnel’s Perspectives of Care in Organ Donation: Protocol for a Multiple Methods Study

Background In organ donation from deceased donors, the interaction between the donor’s relatives and intensive care personnel is an important factor. The organ donation (OD) process is complex, and patients’ relatives play a vital role. Intensive care professionals need knowledge about how relatives perceive and experience the process to create a caring environment and support them throughout. Therefore, this collaborative project aims to explore both relatives’ and intensive care personnel’s perspectives of care in deceased organ donation in Scandinavia. Objective This study aims to (1) investigate donor relatives’ satisfaction and ICU personnel’s perception of their own professional competence and (2) explore donor relatives’ and ICU personnel’s experiences in the OD process to design for care and support in OD. Methods This protocol outlines a Scandinavian (Norway, Sweden, and Denmark) project, including 4 work packages. Work package 1 started in 2023 with the translation and validation of the Family Satisfaction in the Intensive Care Unit questionnaire into a Danish version and the translation of the Professional Competence in Organ Donation Questionnaire into a Swedish and Danish version. A cross-sectional survey measuring Scandinavian relatives’ perception of support in and satisfaction with the organ donation process and a cross-sectional survey measuring Scandinavian intensive care personnel’s competence in organ donation are the foundation for work package 2 (2024). The data from both surveys will be analyzed using descriptive and comparative analysis. The results will inform the interview guides in qualitative studies (work packages 3 and 4). Participants in the quantitative study will be invited to participate in in-depth interviews. In work package 3, in-depth interviews will be conducted to illuminate relatives’ experiences in the organ donation process. The interviews will be analyzed using thematic analysis, according to Braun and Clarke. In work package 4 (2025-2026), 1 qualitative design study will be conducted to illuminate ICU personnel’s experiences. Furthermore, the results from work packages 2 and 3 will inform the development of specific programs for care, support, and communication in the organ donation process. Results The project was funded by the Norwegian Organ Donor Foundation in 2022 and Scandiatransplant in 2023. The Norwegian Nurses Organisation supports the project by funding a PhD student. The PhD student was employed by the University in Agder in May 2024. Conclusions This project will provide new knowledge that will assist us in designing and establishing programs for care, support, and donor relatives’ involvement in OD processes. International Registered Report Identifier (IRRID) PRR1-10.2196/55643

Emotional resilience and sense of danger among doctors in hospitals during periods of heightened tensions and warfare in Israel

Abstract Background The “Iron Swords” War beginning in October 2023 led to unprecedented levels of shock and trauma across Israel, significantly impacting the Israeli population and medical personnel. This study aimed to evaluate and compare the perceived personal resilience and sense of danger among physicians in hospitals located in different conflict zone proximities in Israel during this period. Methods A quantitative, cross-sectional study was conducted from March to August 2024, during an active phase of the war, using a structured anonymous questionnaire. Participants were 161 physicians from three hospitals: one in southern Israel near the Gaza Strip, another in northern Israel near the borders with Lebanon, Syria, and Jordan, and a third in central Israel near Tel Aviv. The survey measured personal resilience using the Connor-Davidson Resilience Scale (CD-RISC-10) and sense of danger using the Solomon & Prager scale. Statistical analyses included Kruskal-Wallis H test, multiple linear regression, two-way analysis of variance (ANOVA), and Sobel test for mediation effects. Results The final sample included 161 physicians (54 southern, 56 central, 51 northern). The mean resilience score was 31.14 ± 5.77, and the mean sense of danger score was 8.36 ± 4.15 (scales 0–40 and 0–20, respectively). Physicians in the southern hospital reported significantly higher sense of danger scores (p = 0.005). A trend towards lower resilience scores was noted among southern hospital physicians (p = 0.068) (p = 0.068). Two-way ANOVA revealed significant main effects of hospital location and gender on resilience (p = 0.046 and p = 0.003, respectively) and sense of danger (p = 0.005 and p = 0.062, respectively). Multiple regression analysis identified hospital location (β = -0.178, p = 0.023) and gender (β = 0.229, p = 0.004) as significant predictors of resilience. Mediation analysis indicated that personal resilience partially mediated the relationship between hospital location and sense of danger (indirect effect = 0.2896, p < 0.001). Conclusions Physicians working near conflict zones report higher levels of perceived danger, though their resilience is comparable to peers in less threatened regions. Enhancing personal resilience is crucial to mitigate the heightened sense of danger. This could include regular resilience training, psychological support, and specific programs for single and childless physicians to improve safety perceptions. Additionally, fostering a supportive community with clear communication and robust emergency protocols is essential for enhancing staff resilience and safety in hospitals.

Instilling pedagogy through the Shepherding process

Research on sessional teachers in legal education is underrepresented in the literature (Blackham, 2020). In law schools, sessional teachers are employed to develop and deliver bespoke intensive-based subjects at postgraduate level and are often classifiable as ‘outside industry experts’ (OIEs); this cohort has been described as atypical of sessional academics across the sector in many ways (Cowley, 2010). This poster presentation seeks to add to this area of knowledge, by presenting something of an auto-ethnographic snapshot of a ‘shepherding process’, implemented at MLS, from Educational Designers’ point of view. ‘Shepherding’ is a collaborative initiative for new subjects proposed to be taught at the MLS, enhancing curriculum design outcomes and pedagogical capabilities of new subject coordinators (most of whom lack formal training in teaching), as well as facilitating connection to the wider teaching and learning community and support services. When a new subject is proposed, would-be lecturers are usually not yet employed by the school. Having pitched an idea for a subject with the school, they work with an Educational Designer to refine a new subject proposal to be reviewed by a curriculum committee. As such, the shepherding process and the final deliverable of the new subject proposal form also forms part of the candidature process for prospective subject coordinators. Grounded in co-design principles, shepherding facilitates the integration of instructional design theories, particularly constructive alignment and backwards design, into the subject development workflow from the outset. The educational designer’s role is central to shepherding and begins with the collaborative formulation of subject intended learning outcomes (SILOs), development of an assessment regime and comprehensive subject mapping, with the aim to establish constructive alignment. Additionally, the shepherding process includes guidance on designing course content within the LMS, providing a structured and accessible online environment for students. In helping guide a new subject through to acceptance and by being a singular point of contact with new lecturers, the educational designer forms an ongoing relationship which can also help with ensuing curriculum development. Hitch et al. (2017) and Hattam et al. (2024) have both argued that sustainable and targeted professional development of sessional staff is a critical factor for increasing engagement and feelings of connection with their institution and to their roles, and that where this is lacking the consistency and quality of student educational experience can be undermined. Cowley (2010) argues for the creation of school-level programs of support for law schools, specifically aimed at OIEs, in lieu of one-size-fits-all programs at the institutional level. Because of the nature of the OIE cohort and subject delivery timelines, there is a limited window of opportunity to work towards ‘acculturating casual staff to the new student-focused learning agendas’ (Kift, 2003 cited in Cowley, 2010), towards improving student learning outcomes. By providing targeted support for OIE teaching staff, the shepherding process has represented a significant advance in MLS’s instructional design and curriculum development process, enhancing the alignment, consistency and quality of subject design. By aligning teaching practices with established instructional design theories, the process enhances the educational experience for both instructors and students.

A comparative study of home and host country effects on the academic performance of Chinese students in transnational education

ABSTRACT This study examines the impact of intercultural learning, from the perspective of home versus host country, on the academic performance of Chinese students in an Australian university’s transnational education program. It integrates transformative learning theory and cognitive load theory as the conceptual framework and compares the academic performance of students who remained in China with those who went to Australia to complete the same Australian university degree. Using a difference-in-differences approach, our analysis revealed a significant performance difference between the Australia-based and China-based groups by year level after controlling for academic ability. The findings have practical and policy implications for student support and transnational education program management in Australian universities. The study highlights the need for tailored support to help Chinese (and possibly other international) students during their first year of arrival in Australia. It also calls for embedding intercultural learning into discipline-specific programs.

Correlational Study on Burnout among University Teachers in Hunan, China

Education is a cornerstone of national development in China, essential for fostering scientific self-reliance and social progress. The 20th National Congress of the Communist Party of China aims to transform the country into a global education powerhouse by 2035, with higher education as its focal point. In this context, Hunan Province, home to various big university in the country, must look into reforms to enhance its educational infrastructure and teacher quality, however, numerous issues also exist including job burnout among teachers. This study investigates burnout among university teachers in Hunan, exploring its prevalence and the factors contributing to it. Utilizing a descriptive-comparative-correlational research design, the study surveyed 300 faculty members across different universities, gathering quantitative data on their demographic profiles, levels of burnout, and perceptions of its causes.This research underscores the urgency of addressing burnout to maintain educational quality and advance Hunan’s educational objectives as findings reveal apparent levels of emotional exhaustion, depersonalization, and decreased personal fulfillment among respondents, with burnout intensity influenced by years of working experience. While no substantial differences in burnout were noted based on profile, perceptions of burnout factors varied by job title and experience, suggesting that institutional roles significantly affect burnout experiences. The study highlights a critical need for targeted interventions to mitigate burnout and enhance faculty well-being, emphasizing the importance of supportive management systems, fair compensation, and robust interpersonal relationships. Recommendations include implementing tailored support programs, improving job satisfaction through clearer feedback and emotional support, and fostering a collaborative work environment to promote professional development.

Effects of Teen Childbearing on the Family Socio-Economic Wellbeing in Ruiru, Kiambu County, Kenya

Purpose: The purpose of the study was to investigate the impact of teenage childbearing on family socio-economic well-being in Ruiru, Kiambu County, Kenya, focusing on financial strain, educational disruption, post-partum experiences, and family support. Methodology: Using family stress, human capital, and social support theories, the study adopted descriptive survey design targeted 378 teenage mothers, with a sample of 195 selected using Yamane’s formula. Data collection involved semi-structured questionnaires and interviews, analyzed quantitatively through descriptive statistics and regression, and qualitatively through thematic analysis. Findings: The findings reveal that 85.5% of respondents faced financial difficulties within six months, and 55% reported disrupted high school education, leading to long-term setbacks. Emotional and health challenges characterized post-partum experiences, and 61.1% of respondents found family support insufficient to meet socio-economic needs. The study concludes that teenage childbearing significantly disrupts family well-being, recommending comprehensive support programs, including financial aid, childcare, healthcare, and community initiatives, to better assist teenage mothers and reduce their socio-economic burdens. Unique Contribution to Theory, Policy and Practice: This research uniquely contributes to theory, policy, and practice by creating a comprehensive model that integrates empirical findings and qualitative insights, thereby enriching existing theories. Additionally, it provides practical recommendations for targeted support programs that guide policymakers in alleviating socio-economic burdens and enhancing family well-being.

Navigating Barriers to Success for Community College Science Students: A Review of Transfer Challenges

This paper examines the challenges community college students encounter when transferring to four-year higher-education institutions, focusing on the gap between their transfer aspirations and actual success. Despite the availability of substantial financial aid in higher education, transfer students continue to face numerous challenges that impede their integration and success at new institutions. These obstacles arise from a combination of institutional factors and individual student characteristics. Utilizing Pascarella’s model, this study underscores the importance of support programs in raising institutional awareness of the diverse challenges transfer students face and the necessity for tailored strategies to facilitate their successful transition and retention.

Support for pharmacy professionals returning to (clinical) practice after a break: a cross-sectional survey

Abstract Introduction The continuing expansion of clinical roles for pharmacists, combined with National Health Service workforce shortages and the COVID-19 pandemic, have significantly increased pressure on pharmacy professionals.1 These pressures have heightened stress levels, causing many to consider leaving the field.2 Addressing workforce shortages and retension is crucial, with a particular focus on the reintegration of professionals returning to practice after a break. However, those returning after extended breaks often face challenges such as decreased skills and confidence. Nevertheless, research on the effectiveness of reintegration programmes to help pharmacy professionals return remains limited. Aim To explore participants’ reasons for leaving and returning and to assess the effectiveness of the Centre for Pharmacy Postgraduate Education (CPPE)’s Return to practice (RTP) and Return to the register (RTTR) programmes in helping individuals return to pharmacy practice in England. Methods CPPE emailed an anonymous link to an online survey, with two reminders, in December 2023 and January 2024, to individuals who participated in the RTP and/or RTTR programme(s) before March 2023 (n=701) and had given consent to be contacted for evaluation purposes. The survey employed closed, Likert-type and free-text questions. Quantitative data were analysed using the Statistical Package for Social Sciences (SPSS), with inferential statistics for subgroup comparisons and thematic analysis for qualitative comments (statistical significance p≤0.05).3 Using the university’s ethical approval tool, this study did not require approval due to not collecting personal, confidentical or sensitive information, with no vulnerable groups included, or risk of disclosure. Results The valid response rate was 15% (n=106). Most respondents were female (n=67, 79.8%), aged 35 and older (n=82, 97.6%), and pharmacists (n=77, 85.6%) or pharmacy technicians (n=8, 8.9%). The primary reasons for leaving included family responsibilities, career transition, and relocation, while the main motivations for returning were career reconnection, relocation, and other personal reasons. Participants reported a high degree of satisfaction with both programmes; those who perceived high content relevance reported significantly higher satisfaction (8.90±1.47 for RTP and 8.75±1.58 for RTTR on a 10-point scale). Overall, 70.8% (n=75) successfully returned to pharmacy practice and/or the GPhC register after completing the programme(s). Of those who returned, 68.1% (n=47) took less than 6 months. It was found that those who were more satisfied and more likely to recommend the programme(s), had been off the register for less than 10 years (n=41, 78.8%), and completed the programme(s) before 2020, prior to the shift to online delivery due to COVID-19 (n=41, 83.7% for RTP and n=16, 88.90% for RTTR), were more likely to have returned. Discussion/Conclusion The CPPE RTP and RTTR programmes supported participants effectively in returning to pharmacy practice. Increasing the number of pharmacy professionals returning to practice using reintegration course(s) positively impacts workforce shortages and addresses skill gaps after a break. One study limitation is the lack of information about those who did not use or are unaware of these support programmes. Further research could explore the support needs of all those wishing to return to practice or the GPhC register.

Enhancing healthcare outcomes and cost efficiency through patient support programs: a comprehensive analysis

Abstract Introduction Treatment retention is crucial for patients with chronic diseases, impacting both clinical outcomes and healthcare costs. Patient Support Programs (PSP), often sponsored by pharmaceutical companies as a wraparound support service for new and innovative medicines, have been shown to be a viable tool in supporting treatment retention and adherence1. Utilizing tools like Patient Activation Measure (PAM®) equips healthcare providers with a means to evaluate the impact of these PSPs on patients' activation and their potential to adhere to medication. The PAM is a behavioural concept focusing on a patient’s understanding of their role in their healthcare, and how competent they feel to fulfil that role. Crucially, there is substantial evidence indicating a strong association between higher PAM scores and improved clinical outcomes2. Aim This study objectives are to evaluate the effectiveness of PSP in reducing treatment drop-off; to investigate the impact of PSP on patient activation/PAM levels; and to analyse potential cost savings from patient activation through PSP participation. Methods The study population includes patients (n= 97795) diagnosed with chronic diseases receiving one of three services from a Clinical Homecare company: (1) Direct-to-patient medication delivery (DD); (2) DD plus self-administration training and (3) DD, self-administration training and PAM-based PSP. Patient “drop-off” from treatment was analysed across all three services and defined as discontinuation of medication due to unwillingness to engage, non-response to engagement attempts, or requests to put the service on hold. Additionally, change in PAM level/activation for patients who completed baseline and follow-up PAM surveys between October 2020 and March 2024 (n=1880) was considered. Finally, expected cost saving was examined, both as a result of the observed change in activation for PSP patients as well as in a hypothetical scenario where patients in DD and self-administration training are redirected to PSP. Ethical approval was not required because the study does not involve any patient interaction/intervention whatsoever. It was a retrospective data analytical study, using existing and fully anonymised patient data from routine clinical care. Results Fewer patients drop off from treatment when they are on the PSP (1.1%) compared to those that are on self-administration training (2.1%) or DD (2.8%). Participation in PSP also positively impacted PAM scores across all therapies, with average improvements ranging from 1 to 8.1 points per patient. Patients in the lower two activation levels (typically at the greatest risk of non-adherence) experienced the most substantial gains (ranging from 8.4 to 17.4 points) emphasizing the significance of intervention. These improvements in PAM scores by PSP translated to substantial cost savings for the health system, amounting to £1,028,669. Finally, where the same treatment drop-off rate and PAM performance ratio are applied to a hypothetical scenario involving the redirection of patients from DD and self-administration training to PSP, there is a further potential cost savings of £4,298,277. Conclusion Participation in PSP improves patient activation and the potential to adhere to prescribed medication, while producing significant financial benefits. Further research is needed to understand how these benefits may vary across different therapy areas and within primary, secondary, and homecare settings.

Anxiety among Ukrainian academic staff during wartime

The ongoing war in Ukraine has significantly impacted the mental health of academic staff, with anxiety emerging as a predominant issue. This study aimed to assess the prevalence and severity of generalized anxiety disorder (GAD) among Ukrainian academic staff and determine the influence of sociodemographic factors, such as gender, age, migration status, scientific degree, and job title, on anxiety levels. The research was conducted using a cross-sectional online survey between December 2023 and February 2024. The sample included 429 participants from various Ukrainian universities, representing both male and female academic staff, holding job positions such as assistants, senior lecturers, associate professors, and full professors. The findings revealed that 44.3% of participants experienced moderately severe to severe anxiety, with migration due to the full-scale war being a significant predictor of higher anxiety levels. Notably, male academic staff exhibited higher anxiety levels than their female counterparts, contrary to typical peacetime trends, suggesting that wartime responsibilities and societal expectations may play a crucial role. The data underscore the need for targeted mental health support, particularly for displaced academic staff, and highlight the importance of developing gender-specific interventions. These insights are vital for informing policies and support programs to enhance academic staff’s mental health and productivity in conflict zones, ensuring the continuity and quality of scientific research during and after the war.

The Buddy Program: High school students inform the design of a school-based peer support program for concussion

ABSTRACT Prior research provides little guidance on how to support return to school post-concussion. Peer support may be one strategy to enable adolescents to return to school post-concussion. The purpose of this study was to explore what high school students preferred in a school-based peer support program post-concussion. We conducted a qualitative instrumental case study in one high school in Calgary, Canada. Seven semi-structured focus groups were conducted with 53 high school students (16 boys, 36 girls, 1 preferring not to disclose gender; median age = 16 years, range = 15-18 years). All adolescents were enrolled in a sport medicine course and had either a history of concussion (n = 20) or were interested in supporting peers who had sustained a concussion (n = 33). Focus group questions aimed to solicit which factors the adolescents believed should be considered in the development of a post-concussion peer support program. We analyzed the focus group transcriptions using content analysis. Adolescents preferred a one-on-one Buddy Program. A one-on-one environment would provide a trusting and confidential relationship between the student with a concussion and their buddy. Peer support could include social support, advocacy support for academic accommodations, tutoring support, and concussion education. In future, the Buddy Program should be piloted in high schools.

Starting a surgical prehabilitation program: results from a pragmatic nonrandomized feasibility study.

We sought to assess the feasibility and estimate the effects on outcomes of a multimodal prehabilitation service implemented as an ancillary surgical service. We conducted a pragmatic, nonrandomized feasibility study of surgical prehabilitation. Patients were eligible if they were ≥ 18yr of age, fluent in English, and referred by a health professional for prehabilitation. Participants received an individualized program of preoperative exercise, nutrition, psychological, and/or smoking cessation support. The primary outcome was operational feasibility, including referral volume, enrolment rate, prehabilitation window, engagement, completion rate, and safety. Secondary outcomes included surgical complications, length of hospital stay, readmission, quality of life, and physical and mental health. Qualitative data related to intervention feasibility and acceptability. We compared intervention participants with patients who were referred for, but declined, prehabilitation. One hundred and sixteen patients were referred for prehabilitation. The mean age of referred patients was 71yr and 55% were male. Over 90% of referrals were from surgical oncology, and the most common indication for referral was frailty (46%). Of the 116 referred patients, 83 consented to participate in the study. Patient-reported and objectively measured outcomes improved by a clinically important margin from baseline to presurgery, and returned to presurgery levels by 90days postoperatively. Qualitative findings suggest that the prehabilitation intervention was well received. Multimodal surgical prehabilitation is feasible as an integrated clinical service and may be effective for improving physical and psychological outcomes. Further evaluations of clinically integrated prehabilitation programs in Canada are needed to confirm these findings.

Impact Findings From a Randomized Controlled Trial of a Supportive Housing Demonstration Programme for Homeless, Child Welfare–Involved Families

ABSTRACTA “Housing First” approach to homelessness, showing promise for single adults, might also be effective for families whose homelessness combined with other challenges bring them to the attention of the child welfare system. This paper reports impact findings from the evaluation of a randomized, controlled trial in San Francisco that tested the effectiveness of an intervention designed to provide permanent housing and supportive services to such families, with the goal of safely reducing the use of foster care. Compared with families in the control group (33 families with 60 children), we found no significant impact on the likelihood of out‐of‐home placement up to 2 years after randomization. For families whose children were already in foster care, children in the treatment group (43 families with 63 children) reunified faster than those in the control group (42 families with 68 children), although nearly always before being housed. There was no difference between groups in time to case closure or likelihood of subsequent child welfare involvement. We discuss these findings in the context of important implementation challenges that have implications for further testing this intervention in tight housing markets.

From jobs to careers: drivers and barriers to career development in emerging labor markets

IntroductionThis study aims to reveal the intrinsic and extrinsic drivers of career development in emerging labor markets and to explore the impact of these drivers and barriers on career development. With the rapid transformation of global industrial structure, career development in emerging industries such as artificial intelligence, big data, new energy and e-commerce is gradually attracting attention.MethodsThis study utilizes a mixed research method of questionnaires and in-depth interviews. The research team distributed a total of 700 questionnaires to practitioners in China, the United States, Japan, Germany and India, and collected interview data from 20 industry practitioners. These data were analyzed from both quantitative and qualitative perspectives to analyze the drivers and barriers to career development, and structural equation modeling was used to analyze the relationship between career motivation, barriers, social networks, and career satisfaction.ResultsThe results indicate that career development motivation significantly and positively influences career satisfaction, while individuals with high career satisfaction perceive fewer career barriers. In addition, career barriers significantly influenced individuals’ perceptions of career discrimination. The study also found that social networks play an important supportive role in career development, and that extensive social networks increase career satisfaction. Individuals with high motivation were more resilient in the face of external barriers and were willing to retrain to improve their occupational skills.DiscussionTo promote career development in emerging industries, labor market policies should optimize and create fair and inclusive work environments for emerging industries. By eliminating gender, age, and racial discrimination and providing employee support programs, career development satisfaction and opportunities can be effectively enhanced.ConclusionRapid technological updates, high work pressure, and cross-cultural barriers in emerging industries are the main challenges to career development today. This study suggests that governments and enterprises should jointly provide flexible vocational training and support policies to help practitioners adapt to the rapidly changing occupational environment.

Educational Challenges Affecting Girls’ Academic Achievement in Public Secondary Schools in Burao, Somaliland

The study explores Educational Challenges Affecting Girls’ Academic Achievement in Public Secondary Schools in Burao, Somaliland. It utilizes both quantitative and qualitative research methods to gain a comprehensive understanding of the obstacles faced by girls in their educational pursuits. The study reveals that socioeconomic factors, cultural traditions, and insufficient school infrastructure significantly hinder girls’ education, with financial constraints, early marriage, and gender-biased cultural practices identified as significant barriers. The recommendations of this study, if effectively implemented, have the potential to bring about substantial positive change. These recommendations include the implementation of financial support programs, raising community awareness, improving school infrastructure, and providing career guidance and skills training.

The Learning Hub – Empowering Remote Rural Communities across India through Blended Learning

This case study explores The Learning Hub, an initiative of the Aga Khan Foundation (AKF), which hosts, among many other learning assets, a three-strand learning programme to enhance the quality of life in rural India through innovative blended learning strategies. The programme, delivered by the Aga Khan Rural Support Programme India (AKRSPI), addresses critical issues such as water sanitation, sustainable agriculture, and governance by delivering courses through a combination of video-based online content and in-person facilitation. The study provides a brief analysis of AKF's blended learning approach, and its impact on community resilience, economic development, and social equity.

Examining the Relationship Between Social Vulnerability and Animal Shelter Intakes and Outcomes: Patterns and Implications

(1) Background: This study investigates the impact of social vulnerability, as quantified by the Social Vulnerability Index (SVI), on animal shelter intakes and adoptions, and the flow of animals between SVI groups at seven shelters within the United States. Understanding how social vulnerability influences these factors is crucial for developing targeted interventions to improve shelter outcomes and community support programs. (2) Methods: The research analyzed intake and adoption data from multiple animal shelters to assess the relationship between the social vulnerability at intake and adoption locations based on Census Tract obtained from addresses, focusing on comparison across strays, seized animals, and owner surrenders. Effect sizes were calculated to determine the magnitude and practical implications of these relationships. The study also examined the distribution of outcomes and reasons for animal surrender in relation to SVI levels. (3) Results: The analysis found that animals tended to enter shelters from areas of higher vulnerability while being adopted out to homes from all levels of vulnerability. Stray animals and those seized by authorities were more likely to come from high-SVI areas and showed a stronger disparity between intake and adoption SVI levels than owner surrenders. Racial/ethnic minority status and socioeconomic status were the components of the SVI that produced the strongest differences between intake and adoption vulnerability levels. Adoptions, however, were evenly distributed across different SVI levels, suggesting equitable access to adoption services. The study also identified that animals from high-SVI areas were not euthanized at higher rates compared to those from lower-SVI areas. (4) Conclusions: The findings highlight the need for further investigation into the high numbers of stray adult dogs in areas of communities that are most socially vulnerable as well as programs to address the volume of young animals originating from these areas. The equitable distribution of adoptions across SVI levels suggests that shelters are effectively engaging with socioeconomically and racially/ethnically diverse communities. Future research should focus on exploring the dynamics of stray animal intakes and enforcement patterns to enhance community and animal welfare initiatives.

Challenges for social cohesion after de-occupation: social and political reintegration and attitudes toward residents of temporarily occupied territories

The future reintegration of the temporarily occupied territories of Ukraine requires social cohesion in Ukrainian society: both for those who survived the occupation and those who lived in the governmentcontrolled territories. This article aims to determine the attitudes of residents of the government-controlled territories toward those who remain under occupation and to identify to what extent the issues of elections and (un)restriction of voting rights, the economic and cultural support programs, and the recognition of education certificates obtained in the occupied territories may hinder social cohesion after de-occupation. The study is based on the results of two waves of a nationwide survey conducted in October 2023 and March 2024. The paper analyses the survey results using descriptive statistics methods, and the linear regression analysis is conducted to test the hypothesis regarding the relations between the attitudes toward residents of occupied territories and having close relatives there. The study shows that Ukrainians’ attitudes toward the residents of the temporarily occupied territories are rather neutral than positive, which may indicate future lines of social tension. The support for reintegration policies varies depending on the duration of the occupation and the policy area. If the benefits and resources the policy addresses are perceived as scarce, the support for such policy is lower, as is the case of special university admission programs for school graduates from occupied territories. Also, Ukrainians’ positions differ in scenarios for restoration of local governance after de-occupation depending on the territories in question. Immediate restoration is a preferred scenario for territories occupied in 2022, while for territories occupied since 2014, the intermediate period of five years is envisioned.

MENTAL HEALTH IN THE CONTEXT OF CLIMATE CHANGE

Climate change has intensified in recent decades, generating devastating consequences for the environment and, consequently, for human health. Mental health has emerged as a critical area of concern, since extreme weather events such as natural disasters, droughts and floods directly impact the psychological well-being of vulnerable populations. This study aims to analyze how climate change influences mental health, focusing on the psychological effects these changes have on communities in situations of vulnerability. The aim of this analysis is to explore how climate change impacts the mental health of vulnerable populations, discussing the main risk factors involved and addressing strategies that can be adopted to minimize these effects. This discussion is relevant because recognizing the emotional consequences of the climate crisis creates a basis for developing public health practices and psychosocial approaches that promote resilience and adaptation. By focusing on the psychological impact of climate change, we aim to contribute to a more comprehensive and inclusive response to the challenges of a changing world. This is a literature review, based on a qualitative approach, using the Scielo, Google Scholar and PubMed databases. To enhance the research, the health descriptors “climate change”, “mental health”, “psychological impacts” and “solastalgia” were used, with a time frame between 2007 and 2020. The methodology adopted for this analysis consists of a comprehensive literature review, using academic sources and reports from health and environmental organizations. The study addresses how extreme weather events, food insecurity and forced displacement affect mental health, leading to an increase in disorders such as anxiety, depression and post-traumatic stress disorder (PTSD). In addition, the social inequalities that aggravate these impacts are discussed, considering that populations with less access to health resources and services are more susceptible to the adverse effects of climate change. It is concluded that climate change poses a significant threat to mental health, especially for vulnerable populations already facing socio-economic challenges. It is essential that public health policies integrate mental health considerations into climate change adaptation and mitigation strategies. Promoting psychological support programs and implementing targeted interventions can help minimize the negative impacts on mental health, strengthening the resilience of affected communities and promoting a more effective response to climate crises.

Factors influencing the ability of family caregivers of Alzheimer’s patients within Iranian families to continue and persist in their caregiving roles: a qualitative study

BackgroundUnderstanding the motivations driving family members to continue caring for individuals with Alzheimer’s disease is crucial for enhancing social support programs within community health systems. This study specifically explores the factors influencing Iranian family caregivers’ ability to persist in their caregiving roles.MethodsThis qualitative study was conducted using conventional content analysis with 22 participants in 2022 in Babol (a city in northern Iran). The inclusion criteria for the study included caregivers of Alzheimer’s patients who had been the primary caregivers for at least one year for patients with a confirmed diagnosis of Alzheimer’s disease. The sampling method was purposive, ensuring maximum variation in social position, demographic status, and stages of Alzheimer’s disease after the onset of symptoms. In this research, data were collected from caregivers of Alzheimer’s patients through semi-structured interviews and in-depth individual interviews. The data were analyzed using MAXQDA software.ResultsOne category and four subcategories were identified to explain the continuity of the caring role in family caregivers of Alzheimer’s patients. The category was “on the Fence of the Caring Role.” The subcategories included Commitment to Care (Being Determined, Being Indebted, Feeling Dutiful), Coercion to Care (Giving in to the Caring Role Due to Family Requirements, Patient Care Due to Financial Problems), Socio-Cultural Beliefs and Concerns (Spiritual and Religious Tendencies, Social Stigma and Social Fears), and Attachment and Love for the Patient (Feeling Pity, Feeling Nostalgia for Kinship).ConclusionFamily caregivers are deeply engaged in their roles, often feeling trapped by various pressures. Recognizing these dimensions can inform policymakers and health practitioners in developing targeted interventions, such as respite care programs, financial support, and community resources, aimed at alleviating caregiver burden and enhancing the quality of care for patients. By addressing the complexities of the caregiver experience, effective strategies can be implemented to support both patients and their caregivers, ultimately improving health outcomes within the community.