Support Strategies Research Articles

The role of self-efficacy and tangible support in managing depression in fibromyalgia: Expanding social support strategies

The role of self-efficacy and tangible support in managing depression in fibromyalgia: Expanding social support strategies

Evaluation of childbirth readiness and its associated factors and consequences in pregnant women referring to health centers in Tabriz, Iran and providing strategies to promote childbirth readiness: a sequential explanatory mixed method study protocol.

Childbirth readiness encompasses interventions conducted during pregnancy that encourage pregnant women, their families and communities to plan for a healthy pregnancy, childbirth and postpartum period. It enhances women's childbirth experience and diminishes maternal mortality rates. This study seeks to assess the level of childbirth readiness, relevant factors and outcomes among pregnant women who have completed 37 or more weeks of gestational age and are attending health centres in Tabriz, Iran. The objective is to offer strategies for enhancing childbirth readiness. This sequential explanatory mixed-method study comprises three phases. The initial quantitative phase involves a descriptive-analytical longitudinal study focusing on pregnant women at 37 weeks of gestation or beyond. The quantitative data will be gathered by the sociodemographic and obstetric information questionnaire, the childbirth readiness scale, the pregnancy experience scale, the Wijma delivery expectancy/experience questionnaire (version A) (W-DEQ-Version A), the childbirth experience questionnaire-2, the childbirth outcome checklist, the Edinburgh's postnatal depression scale (EPDS), the postpartum specific anxiety scale research short-form, the next pregnancy desire questionnaire and the exclusive breastfeeding checklist. In the subsequent qualitative phase, purposive sampling will be employed, and data will be collected through individual, in-depth and semi-structured interviews featuring open-ended questions. Data analysis will be conducted using conventional content analysis techniques. In the final mixed-method phase, strategies to enhance childbirth readiness will be formulated by integrating findings from the quantitative and qualitative studies, a comprehensive literature review, and employing the Delphi method. This study has received approval from the Ethics Committee of Tabriz University of Medical Sciences in Tabriz, Iran (code number: IR.TBZMED.REC.1401.557). All participants will provide written informed consent before taking part in the study. The outcomes will be shared through articles published in journals, presentations at medical conferences, the validation of a reliable scale for assessing the level of childbirth readiness in pregnant women and the development of a policy brief outlining supportive strategies to improve childbirth readiness. These resources will be valuable for healthcare providers.

Application of metabolic phase-specific modified nutrition risk in critically ill score: a prospective observational study in critically ill patients.

The prevalence of malnutrition in intensive care units (ICU) is high and can be caused by poor intake or absorption of nutrients in the digestive track, as well as disease-related inflammation. As strong catabolism restricts nutrient supply and potentially leads to subsequent malnutrition, appropriate nutrition should be provided based on the metabolic status. However, nutritional support strategies for considering the metabolic phase are not well established. Therefore, this study aimed to establish a strategy for nutritional support in each phase by implementing a phase-specific modified Nutrition Risk in Critically Ill (mNUTRIC) score. This prospective observational study was conducted on all adult patients admitted to the medical ICU for at least 36 h at Seoul National University Bundang Hospital between September 2020 and September 2022. Patient nutrition assessment (mNUTRIC score), clinical information, and nutritional supply (calories and proteins) were measured twice, in the acute phase (measured at 2 days) and late phase (measured at 7 days). The relationship between nutritional supply and 28-day mortality was analyzed using multiple logistic regression according to the mNUTRIC score in the acute and late phases. Risk factors related to 28-day mortality were analyzed using univariate and multivariate Cox proportional hazards regressions. Of the 631 patients admitted to the ICU during the study period, 613 were included in the acute phase and 361 patients were included in the late phase. Nutritional supply was associated with 28-day mortality, with high mNUTRIC scores in both the acute and late phases. Cox proportional hazards regression analysis demonstrated that a high mNUTRIC score [hazard ratio (HR) 3.20 and 2.52, respectively], lactate >2.5 mg/dL were independent risk factors in both the acute and late phases. In addition, Albumin <2.5 mg/dL, the presence of neoplasm, and the need for dialysis in the acute phase, calorie adequacy <0.7 in the late phase (HR, 2.19) were identified as additional risk factors. The mNUTRIC score is a suitable tool for identifying critically ill patients who benefit from nutritional support. Nutritional supply should be considered for patients with high mNUTRIC scores in both the acute and late phases; however, careful supply should be provided in the acute phase and sufficient supply should be provided in the late phase.

The Efficacy of Probiotics Supplementation on the Quality of Life of Patients with Gastrointestinal Disease: A Systematic Review of Clinical Studies.

Patients with gastrointestinal (GI) disorders might benefit from probiotic supplementation to resolve their bowel symptoms and enhance their quality of life (QoL). This systematic review aimed to evaluate the effects of oral probiotic supplementation on improving QoL. Relevant studies were systematically searched in online databases, including PubMed, Scopus, Embase, ProQuest, and Google Scholar up to September 2022 using relevant keywords. Studies that were conducted on GI patients and presented QoL outcomes were included. The Revised Cochrane Risk of Bias 2 tool and the Risk Of Bias In Non-randomized Studies of Intervention tool were used to assess the risk of bias. Of the 4,555 results found in the systematic search of databases, only 36 studies were eligible for evaluation. According to this systematic review, 24 studies reported improvements, whereas 12 studies reported no improvements on QoL in GI patients supplemented with probiotics. We found that probiotics may improve the QoL of patients with GI diseases and related metabolic complications. Therefore, probiotics can be a useful supportive treatment strategy in these patients.

Exploration of medical students’ approach to progress test preparation

Introduction: Medical students are expected to develop competencies in applying clinical knowledge. Progress testing is an assessment for learning and is intended to assist in knowledge acquisition and to promote ongoing recall. This study explored student preparation for progress tests (PTs), relationships between approach and performance, and patterns that could assist with targeting learning support. Methods: A cross-sectional survey exploring study approach and learning context, comprising multi-choice and open-ended responses, was administered to students during their clinical years (n = 297). Quantitative data was analysed using descriptive statistics and comparative analysis, and qualitative data was categorised. Results: One hundred twenty-nine students responded (43.4%), with most demonstrating a stable PT performance over time. Twenty-two students had dynamic changes in their aggregate grades. Poor early PT performance was associated with developing an improvement strategy (χ2 6.954, p = 0.008). Students never falling below satisfactory were less likely to have a strategy (χ2 10.084, p = 0.001). All poorly performing students were using practice question banks, but this was not true for students who scored satisfactorily. The need for pastoral care was associated with poorer performance (χ2 4.701, p = 0.030). Conclusions: Student approaches to PT preparation are diverse, however there are correlations between preparation factors and performance outcomes. Students with poor early performance demonstrated improved results over time that may be attributed to targeted support and preparation strategies. Widespread use of practice questions may not be sufficient to impact results without additional strategies. External impacts to performance were common, and barriers to accessing pastoral care were evident. The feedback dashboard was underutilised, suggesting a need to improve feedback literacy and ensure this is fit for purpose.

The Power of Thought: The Role of Psychological Attentiveness and Emotional Support in Patient Trajectories.

In modern healthcare, the influence of a patient's mindset on health outcomes is an often neglected yet vital component of holistic care. This review explores the significant impact of positive and negative mindsets on disease progression and recovery, emphasizing the need to integrate mental wellness practices into conventional medical care. Drawing from a wide array of studies, it demonstrates how fostering a positive mindset can enhance patient trajectories across various medical specialties. The article advocates for training healthcare providers to adopt a more empathetic and patient-centered approach, bridging the gap between mind and body. By presenting compelling evidence on the correlation between patient mindset and health outcomes, this review highlights the potential benefits of incorporating psychological support and holistic strategies into standard care protocols. Practical strategies for implementing mindset-focused interventions are also proposed, including training programs for healthcare professionals and the development of interdisciplinary treatment plans. Ultimately, this article underscores the need for a paradigm shift in medical practice, advocating for a comprehensive approach that recognizes the power of thought in promoting patient wellness.

Ten-year trajectories of postpartum depression of Japanese mothers and fathers

BackgroundPerinatal depression is a significant concern affecting both women and men during pregnancy and postpartum periods. While maternal postpartum depression has been extensively studied, paternal depression remains under-researched despite its prevalence and impact on family well-being. This study aimed to estimate the trajectories of perinatal and postpartum depression in Japanese parents over ten years and to determine the details of the symptoms of postpartum depression for each trajectory group, considering reciprocal effects between maternal and paternal depression. MethodsA total of 789 couples used the Edinburgh Postnatal Depression Scale to rate their depressive symptoms prenatally; at 5 weeks, 3 months, 6 months, and 1 year postpartum; and then yearly thereafter until the 10th year. Parallel-process latent class growth analysis was used to group participants according to their longitudinal patterns of depressive symptoms. ResultsFor both mothers and fathers, four depressive symptom trajectories fit the data best and were most informative (escalating: 6.5 %; mothers low and fathers moderate: 17.2 %; mothers high and fathers low: 17.9 %; low: 58.4 %). A variance analysis showed significant class-parent interactions across anhedonia, anxiety, and depression subscales, indicating distinct patterns of depressive symptomatology. DiscussionTailored mental health programs and universal screening using the Edinburgh Postnatal Depression Scale are recommended to address the specific needs of each trajectory class. This study contributes to the understanding of long-term depressive symptom trajectories in parents and emphasizes the necessity of comprehensive support strategies to enhance family well-being and resilience.

Understanding the impact of domestic violence on children's mental health and exploring effective intervention strategies

Exposure to domestic violence in the home can have profound and long-lasting effects on children's mental health and development. An extensive body of research has demonstrated the links between witnessing domestic abuse and increased risks of psychological disorders such as anxiety, depression, and post-traumatic stress disorder in affected children. However, not all children exposed to violence experience negative outcomes, and interventions can help mitigate harm. This research aims to synthesize what is known about the multifaceted psychological consequences of domestic violence exposure for children and identify effective support strategies. A comprehensive literature review was undertaken to understand prevalence rates, forms of abuse, and potential moderating and mediating factors. Key findings indicate that while abuse types, including physical, emotional, verbal, and financial violence, can all impact children's mental health, factors like age, gender, resilience characteristics, and social support networks influence outcomes. Trauma-focused therapies, parent-child interaction programs, play-based interventions, and school-based supports show promise as evidence-based approaches. Recommendations target collaboration between policymakers, practitioners, and researchers to strengthen legislation, implement multidisciplinary treatment, and conduct further longitudinal studies. The goal is to illuminate this critical issue and guide the development and evaluation of integrated systems of care focused on child wellness and family violence prevention.

The Impact of Exemplars On The Academic Outcomes For Master’s In Education Online Graduate Students

Annotated exemplars have recently been scrutinized as an academic support strategy in the context of Higher Education Institutes (HEIs). The idea is that using exemplars may front-load the system regarding student academic performance through the provision of meaningful feedback and task-specific comments before formal student submissions. More specifically, The Scholarship of Teaching and Learning (SoTL) research regarding exemplar use has called for the investigation of these exemplars on academic performance for the online graduate student. The purpose of this quantitative, quasi-experimental study was to determine if and to what extent the integration of annotated exemplars impacted the academic outcomes for Masters in Education online graduate students. Academic outcomes were designated as assessment grades and overall course grades. The study methodology and design were quantitative quasi-experimental using traditional pre-/post- techniques regarding this exemplar implementation with a convenience sample. The sample size of the experimental group is n = 17. The control group ranges from n = 25 to n = 27. The objective stated explicitly is to investigate if and to what extent the use of annotated exemplars impacts overarching student outcomes for graduate students at a university in the southwestern United States. The results showed no statistically significant difference between the control group and the experimental group for assignment grades, resulting in a retention of the null hypothesis. The results also indicated that there was a statistically significant difference between the control group and the experimental group for overall course grades, resulting in a rejection of the null hypothesis. Potential areas of future research might include brick-and-mortar settings, larger sample sizes, other student populations, or a qualitative examination of student perceptions about exemplars.

Enhancing Personalized Rehabilitation: Integrating Assist-as-Needed System With Real-Time Feedback

Abstract Conventional rehabilitation programs often lack precise real-time feedback, leading to varied training results at different centers. To address this, personalized rehabilitation strategies have been developed using robotic technologies and exoskeletons with assist-as-needed (AAN) controllers to improve recovery rates for individuals with stroke and neuromuscular disorders. This research introduces an automated therapy approach with a patient-specific AAN support strategy that provides immediate feedback, enhancing the rehabilitation process. The system uses minimal data to create effective personalized models and integrates sensors and algorithms for continuous monitoring, improving the efficacy of therapy. Initial trials with an exoskeleton that focused on elbow movements showed promising results in adjusting support in real-time and providing personalized interventions through torque-controlled motors. This system assesses impairment levels, visualizes motor energy needs, and helps design customized rehabilitation programs, significantly enhancing therapeutic results.

Long Term Care As An Outcome Of Community Integrated Care Team Intervention: A Review

Abstract Background Over 65’s occupy over 55% of inpatient hospital bed days. Assessment of average length of stay for patients awaiting long term care (LTC) in the acute hospital setting was found to be 122 days. My aim is to assess the number of patients transferred to long term care (LTC) from the community post referral to an Integrated Care for Older Persons (ICPOP) service, therefore bypassing inpatient admission. Methods Retrospective analysis of patients notes managed by the ICPOP team from January 2023- January 2024. Comprehensive geriatric assessment data as to frailty markers, plus duration of engagement with service and over all discharge destination were assessed. Patients were identified based on unique identifying number but also using date of birth and name to avoid missing cases. Results 59 patients were discharged to a nursing home from the ICPOP service, mean age 80. Sex differentiation 56% female. On average at least 3 out of 8 possible frailty indicators were identified per patient. Most prevalent -67% polypharmacy, 47% memory impairment and 45% carer stress were identified as key concerns on initial assessment. 96% of cases were initially referred for complex case assessment/admission avoidance. Average length of engagement with service 5 weeks. Conclusion The ICPOP service is highly effective at managing complex cases in the community. The multidisciplinary nature of the team facilitates comprehensive assessment and patient centred care which enables a smooth transition through supportive strategies available to the patient and their family. In total 7198 bed days were saved due to direct transfer to nursing home from the community setting. If the patients care needs warrant LTC the ICPOP service is an invaluable tool which could further reduce pressure on hospitals and facilitate appropriate transfers to nursing home care.

Research on Teacher Support Strategies in Project-based Learning in Kindergarten

Teacher professional support is key to children's in-depth project exploration, significantly impacting their overall learning and development. This article first analyzes the concept of project-based learning and then discusses specific support strategies within project-based learning. Teachers should conduct comprehensive project design and meticulous planning in advance, providing essential emotional, methodological, and resource support to children, while enhancing their observational and evaluative abilities. By fostering a supportive environment, educators can encourage creativity, critical thinking, and collaboration among students, ultimately leading to a richer educational experience.

Predicting the following support strategy during the emotional support dialogue by integrating the dialogue history and supporter features

Predicting the following support strategy during the emotional support dialogue by integrating the dialogue history and supporter features

Mind matters: decoding mental health in medical students

This review synthesises current research on the prevalence and determinants of depressive and anxiety symptoms among medical students. It highlights significant mental health challenges faced by this group, emphasising the influence of various factors such as academic pressures, personality traits, and reluctance to seek professional help. The analysis also delves into the roles of gender and geographical variation, revealing how these factors contribute to differing rates of mental health issues among medical students globally. The findings reveal a concerning prevalence of depression and anxiety, with variation observed across different regions and genders, indicating the influence of cultural and societal norms on mental health. This review underscores the urgent need for enhanced mental health support and intervention strategies within medical education systems. The importance of incorporating psychological support programmes and mental health education into curricula is highlighted. By addressing these issues, there is a potential to significantly improve the well-being and academic success of medical students, ultimately contributing to their overall mental health and resilience in their future professional lives. The paper advocates for a multifaceted approach in tackling these challenges, suggesting that medical institutions should not only focus on academic excellence but also prioritise the mental health of their students, ensuring a more supportive and nurturing educational environment.

What lurks beneath the symptom? Why more basic scientists are needed in cancer supportive care and survivorship research.

With a growing population of people living with and beyond cancer, a larger portion of cancer research has shifted to ensuring that these people not only survive but survive well, and so supportive oncology has emerged as a critical component of modern cancer care. However, research and advancements in supportive care strategies have largely centered around symptom management, without an appreciation for the physiological mechanisms underlying the symptom. By placing a greater emphasis on understanding the pathophysiological mechanisms that lurk beneath the symptom in supportive care and survivorship research, superior symptom control and greater improvements to quality of life, through the development of targeted interventions, can be achieved.

The effectiveness of personalized technology-enhanced learning in higher education: A meta-analysis with association rule mining

Personalized technology-enhanced learning (TEL) has emerged as a prominent tool used by universities to cater to students' diverse individual needs. Many higher education researchers and educators have explored the adoption of personalized TEL as an important tool to foster student learning outcomes from diverse perspectives. However, despite its significance and the substantial body of existing research, a notable gap exists in systematically evaluating the effectiveness of personalized TEL with meta-analysis approach within the higher education. To address the research gap, we investigated the effectiveness of personalized TEL in developing students' cognitive skills and non-cognitive characteristics in higher education context by utilizing the methods of meta-analysis and association rule mining. Our study reveals that the cognitive skills are reported more than non-cognitive characteristics as the learning outcomes of adopting personalized TEL. Overall, utilizing personalized TEL can improve students' cognitive skills and non-cognitive characteristics at the medium level effect size. Factors of research settings, mean of delivery, and modelled characteristics can influence students’ non-cognitive characteristics while using personalized TEL. Based on our rule mining findings, future teachers, researchers, and instructional designers can consider combining the modelling of learners' skills/knowledge or preferences with adaptive learning support strategies, such as recommending materials and scaffolding, to achieve positive effects, particularly in the fields of Social Sciences and Engineering.

Abuse and neglect as indicators of unhealthy behaviours among 15-year-old schoolchildren in Albania

ObjectiveWe assessed the independent associations of lifetime child abuse and neglect indices with behavioural characteristics of children. Study designA cross-sectional study was conducted in Albania in 2022. MethodsParticipants consisted of a nationwide representative sample of 1877 schoolchildren aged 15 years (55 % girls; response: 96 %). Data on lifetime child abuse and neglect were collected, along with behavioural factors and sociodemographic characteristics. Binary logistic regression was used to assess the independent associations of child abuse and neglect with behavioural factors of schoolchildren. ResultsIrrespective of sociodemographic characteristics, lifetime physical abuse was positively related to lifetime smoking (OR = 1.8, 95%CI = 1.4–2.3), lifetime alcohol consumption (OR = 2.4, 95%CI = 1.9–2.9), and breakfast skipping (OR = 1.3, 95%CI = 1.0–1.6). Furthermore, positive independent factors associated with emotional abuse included lifetime alcohol intake (OR = 1.7, 95%CI = 1.3–2.1) and breakfast skipping (OR = 1.4, 95%CI = 1.0–1.8). Additionally, positive factors associated with lifetime emotional neglect consisted of lifetime smoking (OR = 2.2, 95%CI = 1.6–3.0) and alcohol intake (OR = 2.0, 95%CI = 1.5–2.6), and a lower fruit consumption (OR = 1.7, 95%CI = 1.3–2.3). Positive factors associated with lifetime sexual abuse included lifetime alcohol consumption (OR = 2.4, 95%CI = 1.4–4.1) and especially smoking (OR = 4.3, 95%CI = 2.6–7.3). Also, lifetime witnessing of family violence was positively related to lifetime smoking (OR = 2.7, 95%CI = 1.8–4.1) and alcohol intake (OR = 1.7, 95%CI = 1.2–2.6). ConclusionsWe evidenced strong and consistent links between child maltreatment indices and unhealthy behavioural practices among 15-year-old children in Albania. These findings underscore the potential impact of early trauma on developmental trajectories. The association between child abuse and the adoption of detrimental behaviours highlights the urgent need for comprehensive support and intervention strategies to break the cycle of harm.

In the Shadow of the Pandemic: Examining Therapists' Perceptions of Work-Related Stress in the Late Stages of the COVID-19 Pandemic in Germany.

The previous literature has identified increased work-related stress among healthcare workers (HCWs) during the COVID-19 pandemic. This study analyzes work-related perceived stress experienced by therapists during the COVID-19 pandemic in Germany to identify potential for supporting this crucial group of HCWs in future health crises. Survey data on stress, measured through the Perceived Stress Scale 4, among HCWs (therapists n = 612, nurses n = 501, and doctors n = 461) were analyzed using descriptive statistics, and data from four semi-structured interviews and seven focus group discussions with therapists were analyzed using thematic content analysis. Data were collected from March to September 2022. Therapists reported similar stress levels to other HCWs, with the reporting of perceived stress differing between work contexts. Eight stressors were identified through the thematic analysis: (1) concerns about maintaining the quality of care, (2) uncertainty about the future, (3) workload, (4) interactions with colleagues and patients, (5) PPE, (6) the risk of infection, (7) insufficient information flow, and (8) the lack of public and political recognition. This study emphasizes the distinct challenges that therapists experienced during the COVID-19 pandemic. By identifying the factors that contributed to the stress experienced, the study can inform targeted support strategies which can enhance therapists' work, ultimately contributing to sustaining essential healthcare services during public health crises.

Parental Perspectives on Teachers' Supportive Strategies During the Transition to First Grade

This qualitative study explores the transition to first grade, focusing on parental expectations and the perceived supportiveness of educational staff. The objectives are to identify the primary expectations and needs of parents from teachers, and to evaluate the extent and methods through which parents view educational staff as a source of support and information. Twenty parents participated in semi-structured interviews, revealing their concerns and expectations as their children entered first grade. Thematic analysis identified key themes: the necessity for accessible communication, genuine teacher attentiveness, and comprehensive information transparency. Findings suggest that strengthening communication, teacher responsiveness, and proactive information sharing are crucial to supporting both parents and children. These insights highlight how enhanced teacher training and school policies can better address parental needs, promoting a smoother transition into first grade and improving early educational experiences.

Impact of augmentation strategy variations on the mechanical characteristics of patients with osteoporotic proximal humerus fractures with medial column instability.

Low bone density and lack of medial support are the two most important factors affecting the stability of locking plate fixation for osteoporotic proximal humeral fractures (PHFs). This study aimed to compare the biomechanical characteristics of PHILOS locking plates combined with calcar screws, bone cement, fibular allografts, and medial locking plate support strategies for treating osteoporotic PHFs with medial column instability. A three-part osteoporotic PHF (AO 11-B3.2) model with metaphyseal loss was generated using 40 synthetic humeri and fixed via four distinct medial support strategies. All models were mechanically tested to quantify the mechanical characteristics. Subsequently, finite element models were created for each biomechanical test case. The stress distribution and displacement of the four different fixation structures were analyzed using finite element analysis. The results demonstrated that the PHILOS locking plate combined with the medial locking plate, exhibited the greatest stability when subjected to axial, shear, and torsional loading. Furthermore, the PHILOS locking plate combined with bone cement showed structural stability similar to that of the PHILOS locking plate combined with fibular allograft but with lower stress levels on the fracture surface. In conclusion, the PLP-MLP fixation structure showed superior biomechanical properties under axial, shear, and torsional loading compared to other medial support methods. Repairing the medial support when treating osteoporotic PHFs with medial column instability can enhance the mechanical stability of the fracture end in both the short and long term.