Support Services Research Articles

Changes in Specialty Crisis Services Offered Before and After the Launch of the 988 Suicide and Crisis Lifeline.

The launch of the 988 Suicide and Crisis Lifeline (988) in July 2022 aimed to enhance access to crisis mental health services by replacing the National Suicide Prevention Lifeline with a more memorable number and expanding the Lifeline scope beyond suicide. However, 988's success relies on the availability of community crisis services. To examine whether the launch of 988 was associated with the availability of crisis services. This cohort study characterized trends in crisis services offered by US mental health treatment facilities (MHTFs) from November 1, 2021, through June 30, 2023. Longitudinal data were from the Mental Health and Addiction Treatment Tracking Repository, which contains daily instances from the Substance Abuse and Mental Health Services Administration's Behavioral Health Treatment Locator. The analysis includes licensed MHTFs that completed the National Substance Use and Mental Health Services Survey. Proportions of facilities offering 4 specific crisis services were calculated nationally and at the state level. Mixed-effects logistic regression was used to assess changes in availability of each crisis service after the launch of 988, controlling for MHTF characteristics. Launch of 988 in July 2022. Outcomes were the availability of mobile crisis response services, psychiatric emergency walk-in services, suicide prevention services, or peer support services. Across 15 623 MHTFs (184 769 observations; 79 268 before and 105 501 after the 988 launch), the largest changes were observed for availability of peer support services, which increased from 39% (n = 31 170) before to 42% (n = 44 630) after the 988 launch (P < .001), and emergency psychiatric walk-in services, which decreased from 32% (n = 25 684) before to 29% (n = 30 300) after the 988 launch (P < .001). When controlling for MHTF characteristics, after the 988 launch, the odds of peer support availability increased 1.3% per month (odds ratio, 1.013; 95% CI, 1.009-1.018), and the odds of emergency psychiatric walk-in service availability decreased by 0.6% per month (odds ratio, 0.994; 95% CI, 0.989-0.999). Availability of other service types also decreased at the national level, with mobile crisis response decreasing from 22% (n = 17 071) before to 21% (n = 22 023) after the 988 launch and suicide prevention decreasing from 69% (n = 54 933) before to 68% (n = 71 905) after the 988 launch. Significant variation across states was observed in service availability trends before and after the 988 launch. This study found that the launch of 988 did not coincide with significant and equitable growth in the availability of most crisis services except for a small increase in peer support services. These findings suggest that strategies are needed to boost the financing and availability of crisis services to reduce disparities and increase 988's likelihood of success.

Developing an Intervention to Enhance Aging in Place for Older Veterans Living in Permanent Supportive Housing.

The Housing and Urban Development-Veterans Affairs Supported Housing (HUD-VASH) program provides rental subsidies, case management, and supportive services to Veterans who are currently or formerly homeless, 77% of whom are ages ≥50. Few interventions have been developed to address the needs of older Veterans in HUD-VASH. We conducted a 2-stage study to inform the development of an intervention to promote aging in place in HUD-VASH. First, we completed qualitative interviews with 21 older Veterans in HUD-VASH and focus groups with 13 staff members to identify unmet needs for supporting aging in place. Second, we used a modified Delphi process with nine staff and one Veteran to prioritize 66 intervention elements based on perceived feasibility and importance. We identified four main themes: need for services to support aging in place; expanding the HUD-VASH workforce; focus on home delivery; importance of trust. The top-rated intervention elements spanned 5 categories: (1) staffing (by social workers, primary care providers, nurses, home health aides); (2) focus (on geriatric needs, mental health needs, dementia care, medication management); (3) modality (in the home or medical center); (4) timing (delivery of the intervention when Veterans have functional impairment, memory impairment, mental health problems, trouble caring for themselves, or are new to HUD-VASH); and (5) duration (regularly scheduled or ongoing as needed). Veterans and staff members identified key intervention elements which can help inform VA efforts to develop and implement interventions to enhance aging in place in HUD-VASH.

The use of outpatient support services: Differences between people with mild cognitive impairment and people with mild to moderate dementia.

Little is known about the utilization of outpatient support services by people with mild cognitive impairment (MCI). This study aimed to analyze the use of support services by people with MCI compared to people with mild to moderate dementia. The data basis is the multicenter, prospective register study 'Digital Dementia Register Bavaria - digiDEM Bayern'. The sample consists of 913 people with cognitive impairment, including 389 with MCI and 524 with mild to moderate dementia. Classification into 'MCI' and 'mild to moderate dementia' is based on the Mini-Mental State Examination and Montreal Cognitive Assessment. The use of support services was surveyed using the Dementia Assessment of Service Needs. Fisher's exact test and multiple linear regression were conducted to analyze for group differences. Four out of thirteen support services are used less frequently by people with MCI than by people with mild to moderate dementia: 'Outpatient care' (p < 0.001, φ = -0.199), 'Acquisition of aids' (p = 0.004, φ = -0.096), 'Adult daycare' (p < 0.001, φ = -0.290), and 'Respite care' (p = 0.029, φ = -0.095). Even the overall utilization rate is lower for people with MCI (b = -0.18, p = 0.027), although other factors such as a care level (b = 1.01, p < 0.001) are more strongly related. There are differences in utilization between people with MCI and people with mild to moderate dementia, but these are small. Therefore, access to support services should be provided at the first signs of cognitive impairment.

Exploring experiences of dementia post-diagnosis support and ideas for improving practice: A co-produced study.

It takes time to adjust to a diagnosis of dementia. Post-diagnosis support has an important part to play in navigating this transition. However, it is often scarce and variable according to location. This co-produced study explored experiences of support across the UK. The project was co-designed and implemented with people living with dementia. Five focus groups were attended by 18 people with dementia and 10 spouses from across the UK. The aim was to find out what support people currently received, what aspects they valued, and what they would like to see done differently. Most participants reported feeling abandoned after diagnosis, with little continuity of care. Many felt the burden of navigating post-diagnosis life was on them and their loved ones, with a perceived scarcity of support, and difficulties navigating the benefits system. Peer/voluntary support was seen as vital in promoting confidence, a source of relational support, and finding out crucial information relating to benefits, healthcare, and management of symptoms. Participants felt dementia was stigmatised, receiving less support than other medical conditions. Participants identified aspects of post-diagnosis support they valued, and collaborated on ideas for support structures and services they would like to see introduced. In concluding this study, we argue that post-diagnosis support services could be improved with the input of people living with dementia. This could reduce the burden on those receiving the diagnosis to find advice and support outside of health and social care systems. For future research, the financial implications of a dementia diagnosis have rarely been discussed and warrants further exploration.

Recovery support services as part of the continuum of care for alcohol or drug use disorders.

The definition of 'recovery' has evolved beyond merely control of problem substance use to include other aspects of health and wellbeing (known as 'recovery capital') which are important to prevent relapse to problematic alcohol or other drug (AOD) use. Developing a Recovery Oriented System of Care (ROSC) requires consideration of interventions or services (Recovery Support Services, RSS) designed to build recovery capital which are often delivered alongside established treatment structures. Lived experience and its application to the process of engaging people, changing behaviour and relapse prevention is an essential part of these services. To map out the evidence base for RSS as part of guidance for commissioners of addiction services in each of the 152 local authorities in England. The authors updated the findings of a 2017 systematic review of RSS through a further rapid scoping review, aiming to map out the extent, range and nature of research under six headings: (1) Peer-based recovery support services (P-BRSS); (2) Employment support approaches; (3) Recovery housing; (4) Continuing care and recovery check-ups; (5) Recovery community centres (RCC); and (6) Recovery support services in educational settings. A systematic search of the PubMed, Embase, CINAHL, CENTRAL and PsychINFO databases was conducted. The abstracts of all articles published since 2017 were reviewed by two of the authors, and the full text versions of all relevant articles were obtained and relevant data extracted. A narrative review of the findings was then prepared, mapping them on to the ROSC continuum of care. The review was restricted to adults (over 18 years), but all substances and available outcomes were included. Four of the six forms of RSS were well supported by evidence. RCTs of interventions to increase levels of employment demonstrated large effect sizes, and continuing care interventions that extend treatment intervention into the early recovery phase have shown small but significant benefit. Peer-delivered interventions to link people to ongoing support were associated with decreased rates of relapse and re-admission, increased engagement, and increased social support for change. However, the variability in the design of these studies means that further work is required to clarify the effective components of the intervention. Studies of recovery housing have also shown positive results, including significant differences from standard care. No controlled studies exist to support RCCs or RSS in educational settings, but the complexity of these interventions and the wide range of potential outcome measures mean that other study designs may be more relevant. This monograph provides a structure to help policy makers, commissioners and service providers describe and understand an emerging field of research. Recovery Support Services (RSS) are proving to have clinical, public health and cost utility. A rational social and fiscal response to endemic alcohol or other drug challenges should therefore include the more intensive acute care clinical services linked with more extensive community-based RSS.

Organisational factors associated with burnout among emergency and internal medicine physicians: a qualitative study

ObjectiveTo identify physician perspectives on factors associated with physician burnout, protective factors against burnout, and to seek potential solutions for this pervasive problem.DesignA qualitative study with semistructured focus group interviews...

The relationship between access to peer support programs and quality of life among people living with HIV in Australia

ABSTRACT Peer support services for people living with HIV (PLHIV) serve varying functions and are a unique resource for support. Peer support programs are considered an important strategy for achieving better quality of life (QoL) for PLHIV and there has been substantial investment in provision of such programs. The present study asks whether being connected to other PLHIV is associated with better QoL for PLHIV in Australia and; whether involvement in formal peer support programs is associated with QoL among people newly diagnosed with HIV. A sample of 816 PLHIV participated in a nationwide survey. Regression analyses showed that having a friend living with HIV who they could talk to about HIV was significantly associated with better QoL. However, a multiple regression analysis showed that use of peer advice/support and peer navigator programs was associated with lower QoL among PLHIV who had been living with HIV for more than five years. This suggests that people experiencing poorer QoL are more likely to access these programs long after diagnosis. It is therefore critical that peer support continue to be available and accessible to PLHIV beyond initial diagnosis and treatment as a means of ongoing HIV-related care.

Navigating barriers and embracing facilitators of connection: insights from peer recovery specialists working with individuals with substance use disorder and criminal justice involvement: a qualitative analysis

BackgroundSubstance use disorder affects over half of incarcerated individuals, with 23% experiencing opioid use disorder specifically. Addressing opioid use disorder in jails is crucial due to its association with increased recidivism and overdose. This study investigates the experiences of peer recovery specialists working with individuals with opioid use disorder and criminal justice involvement, focusing on barriers and facilitators to client connections. Qualitative interviews were conducted and thematically analyzed using a hybrid inductive and deductive coding approach. The sample involved five peer recovery specialists, who were interviewed multiple times, across three sites in Virginia between August 2022 to December 2023.ResultsThis analysis categorized findings into two main domains: barriers to connection and facilitators of connection. Within the barriers to connection, six themes emerged: jail specific restrictions, client in withdrawal, social determinants of health insecurities, lack of client engagement, disconnection, and adverse peer recovery experience. Jail-specific restrictions was the most common barrier to connection with 91.30% of transcripts referencing at least one code for jail-specific restrictions; 73.91% of all transcripts indicated social determinants of health insecurities; 56.52% of all peer recovery specialist transcripts experienced clients in withdrawal; 52.17% of all transcripts identified lack of client engagement; 43.48% of all transcripts identified disconnection as a barrier; and 34.78% of all transcripts indicated adverse peer recovery specialist experiences. Three themes were identified as facilitators of connection: peer communication skills, connection to services, and positive peer recovery specialist experience. Peer communication skills were by far the most prominent, with 100% of all transcripts indicating a code related to peer communication skills; 60.87% of all transcripts indicated positive peer recovery specialist experience; and 56.52% of all transcripts identified connection to services as a facilitator. Notable discrepancies in code frequency were observed across different sites, suggesting site specific challenges.ConclusionThis study offers valuable insights into enhancing peer-based support programs within the justice system for individuals with opioid use disorder. Barriers such as jail specific restrictions, client withdrawal, and social determinants of health insecurities pose significant challenges, while effective communication emerges as a critical facilitator. Findings emphasize the need for collaborative efforts between justice and recovery partners to optimize the impact of peer-based support services.

Resilience as a predictor of internet addictive behaviours: a study among Ghanaian and Saudi samples using structural equation modelling approach

This study aimed to examine the relationship between resilience and internet addictive behaviours, focusing on cross-cultural contexts involving tertiary education students in Ghana and Saudi Arabia. Using a cross-sectional survey design, data were collected from 738 students across selected universities in both countries. Structural equation modeling (SEM) techniques were employed to analyse the data. The findings indicated that most respondents exhibited low resilience levels alongside a high prevalence of internet addictive behaviours. A significant positive relationship was identified between resilience levels and various dimensions of internet addiction, as well as the overall composite of internet addictive behaviours. Interestingly, while low resilience levels were found to increase the risk of internet addiction, higher resilience levels also appeared to heighten susceptibility to addictive behaviours. These results suggest the need for targeted interventions to address internet addiction. Programs should focus on enhancing resilience through resilience-building initiatives, promoting digital well-being, and integrating mental health support services. These approaches can help mitigate the risks associated with internet addiction while fostering healthier coping mechanisms in students across diverse cultural settings.

Validation of the Hospital Survey on Patient Safety Culture 2.0 in Italian Hospitals: A Cross-Sectional Study of Healthcare Personnel Perceptions.

To adapt and validate the HSOPS 2 instrument for the Italian context and to describe the current patient safety culture amongst healthcare personnel working in Italian hospitals. Cross-sectional study. We adapted and validated the HSOPS 2 instrument following the COSMIN guidelines: we performed a forward-backward translation, calculated the content validity index, evaluated face validity, acceptability (percentage of participants responding to all items on the questionnaire and to every specific item), construct validity (confirmatory factor analysis), and internal consistency (Cronbach's alpha for each dimension). We then performed a cross-sectional study following the guidelines of the original instrument: we categorised the responses into "positive," "negative," and "midpoints." For each dimension we calculated the average percentage of positive responses. We repeated this process, dividing the responses by various sample characteristics (e.g., profession), and compared them using the chi-square test. Data were collected between April and November 2023. A total of 633 hospital personnel participated in the survey, and 473 completed the questionnaire in its entirety. The dimensions of "teamwork", "supervisor", "manager", or "clinical leader support", and "communication about error" emerged as dimensions with higher percentages of positive responses, while those that received lower percentages were "hospital management support for patient safety", "staffing and work pace", and "response to error". We identified statistically significant differences in many dimensions between gender, profession, and clinical inpatient units. These findings provide a comprehensive overview of challenges and opportunities within the healthcare sector as regards patient safety culture and can inform the development of targeted interventions aimed at improving patient safety across healthcare organisations. Proper assessment of safety culture, one of the main indicators of patient safety, can inform the development of effective strategies and interventions to enhance patient safety. What problem did the study address? To effectively assess patient safety culture, it is essential to use valid and reliable tools. It is crucial to proactively assess patient safety culture in hospital personnel, whether employed in clinical units, in management, or in support services, to develop initiatives aimed at improving patient safety. What were the main findings? The use of the adapted and validated version of the HSOPS 2 will produce valid and reliable evidence on patient safety culture. Perception of patient safety culture differs amongst respondents according to gender, profession, clinical setting. The dimensions of "hospital management support for patient safety", "staffing and work pace", and "response to error" were identified as those with the greatest need for improvement. Where and on whom will the research have an impact? Patient safety heavily impacts care at every level; therefore, this study could have an impact on healthcare organisations as well as healthcare workers, patients, and their families. By making available an instrument that can contribute to a proper assessment of patient safety culture, this study might contribute to the development of appropriate strategies and targeted interventions to improve patient safety, quality of care and satisfaction while decreasing adverse events and related costs. The COSMIN guidelines were used for the validation of the instrument; the STROBE reporting guidelines were used for the cross-sectional study. No patient or public contribution.

Psychosocial Correlates of Loneliness and Suicidality in the Taiwanese General Population

ABSTRACTObjectivesTo estimate the prevalence of loneliness and to investigate the associations between loneliness and suicidality among the general population in Taiwan.DesignCross‐sectional analysis of random samples in surveys.SampleDuring 2016 and 2017, 2148 and 2098 participants (N = 4246) from a representative sampling of the Taiwanese population were interviewed via the computer‐assisted telephone system in Taiwan.MeasurementsThe study measured demographics, psychological distress, suicide risk factors, and loneliness status (single‐item measurement). The association between loneliness and psychosocial factors was analyzed using Spearman's correlation. Logistic regression was applied in the association between loneliness and current suicide ideation.ResultsAround 13.1% in the sample perceived feelings of loneliness. Loneliness status was significantly associated with increased psychological distress and suicide risks. The regression model indicated that the three most significant factors linked to loneliness were “no one trustworthy to talk to” (OR = 3.69), substance abuse (OR = 3.43), and depression (OR = 3.07), whereas self‐rated mental health (poor to good) (OR = 4.11), loneliness (OR = 2.59), and depression (OR = 2.09) were associated with current suicide ideation.ConclusionLoneliness was a significant suicide risk factor with multiple underlying psychosocial influences. Establishing support groups or service referrals through early psychosocial assessment could identify or alleviate loneliness and/or reduce suicide risk.

Reels to Remembrance: Attention Partially Mediates the Relationship Between Short-Form Video Addiction and Memory Function Among Youth

Abstract: Background and Purpose: The proliferation of short-form video content on social media platforms has led to increased user engagement but also raised concerns about potential addictive behaviors and cognitive consequences, particularly among youth. This study explored the prevalence of short-form video addiction (SVA) among Jordanian youth, its correlates, and its impact on attention and memory function, with an emphasis on understanding the mediating and moderating role of attention in the relationship between SVA and memory. Methods: Utilizing a cross-sectional survey design, data were collected from 1029 university students across 25 higher-education institutions in Jordan. Results: Half of the participants exhibited moderate to high levels of SVA. The findings indicated a significant increase in SVA scores among female students (p = 0.003), those of a younger age (p = 0.045), those with lower GPAs (p = 0.013), and those who dedicated fewer hours to study (p = 0.006). Notably, there was a significant and large correlation between SVA scores and students’ perceptions of user-generated content (p &lt; 0.001). Attention partially mediated the relationship between SVA and memory function with excellent model fit indices (χ2(12) = 14.11, p = 0.05, RMSEA = 0.03, GFI = 0.99, IFI = 0.99, TLI = 0.98, CFI = 0.99). However, attention did not moderate this relationship, suggesting that the impact of SVA on memory is consistent across varying levels of attention. Discussion: The findings underscore the significant engagement of Jordanian youth with short-form video content and the potential cognitive risks associated with SVA. Interventions to manage attention could mitigate the adverse effects of SVA on cognitive functions. This study calls for a comprehensive approach to address SVA among youth, including the development of digital literacy programs, mental health support services, and policy interventions that promote a balanced digital ecosystem and responsible media consumption.

Exploring the Socio-Economic Challenges and Daily Life of Persons with Disabilities Insights from Mehendiganj Upazila: A Case Study Approach&lt;b&gt;&lt;/b&gt;

This study explores the experiences, challenges, and aspirations of persons with disabilities in Mehendiganj, Barisal, Bangladesh. This study uses a qualitative approach, including in-depth, case-based interviews to gather detailed insights from a group of participants who were persons with disabilities. Key findings of this research show that people with disabilities in a particular region encounter significant barriers, including limited access to financial resources, inadequate access to education and vocational training, and a breakdown of society. A lack of infrastructure and support services exacerbates these challenges. Despite the challenges, the research reflects the core strengths and knowledge of the participants in different fields. Many of them strongly desire to overcome adversity and pursue aspirations of life through better education, employment opportunities, and social acceptance. The research also replicates the importance of the role of family support and social networks in reducing some of the difficulties faced by persons with disabilities. This research highlights the insistent need for comprehensive policies designed to address the unique needs of persons with disabilities. Recommendations include developing vocational and educational programs addressing the need, improving access to public services based on the requirements, and social awareness programs to combat discrimination and create social acceptance. This study will provide valuable insight for policymakers, social activists, and development professionals to create an inclusive and supportive environment for persons with disabilities in Bangladesh.

The fiscal impact of tax abatements on New York’s school districts

ABSTRACT The fiscal impact of economic development tax incentives is not well-understood due mainly to the hitherto lack of jurisdiction-specific revenue cost data. We use relatively new government disclosure data from 2019 to assess the cost burden of property tax exemptions by New York’s 106 industrial development agencies on its 664 school districts (New York City excluded). Regression analyses show that district per-pupil foregone revenue is higher in districts with a higher percentage of historically disadvantaged races but lower percentage of poor students—defined as those eligible for free or reduced-price lunch. Greater abatement cost burden is associated with slower growth in per-pupil spending on support services post-recession. These results suggest that school districts should be given greater consideration in development projects that affect their revenues.

"When People Reach Out that is When They're Desperate": Understanding Informal and Formal Help-Seeking Practices for Gambling among Aboriginal Peoples in the Northern Territory, Australia.

This study provides an in-depth qualitative exploration of Aboriginal peoples' experiences with seeking help for gambling-related issues in the Northern Territory (NT), Australia. Through semi-structured interviews with 29 participants, including regular and occasional gamblers as well as those affected by others' gambling, the research highlights key barriers to seeking formal help. These barriers included the normalisation of gambling within Aboriginal communities, denial of gambling problems, feelings of shame, privacy concerns, and a lack of trust in mainstream services. Additionally, past negative experiences with services, fear of judgment, and logistical challenges, such as long waiting times and transportation difficulties in remote areas, contributed to the low uptake of professional services. Instead, informal support from family and friends was occasionally sought, reflecting the collectivist nature of Aboriginal cultures. Participants also reported employing self-help strategies and offered practical suggestions for minimising gambling harm. This research underscores the complexity of gambling behaviours within Aboriginal communities and the cultural, social, and systemic factors that deter access to formal support services. It calls for the integration of Indigenous knowledge and practices into gambling prevention and intervention programs, which may improve the relevance and effectiveness of these strategies. By addressing both cultural norms and access barriers, such targeted approaches may reduce the need for reactive interventions and better support the health and wellbeing of Aboriginal people affected by gambling in the NT. To improve relevant policies and practices, we also consider these findings to contribute to the broader Indigenous-specific gambling prevention evidence-base contexts nationally and globally.

Support methods and effectiveness to reduce maternal depression and anxiety in Japan: A literature review

Objectives In Japan, support services are provided to help postpartum women within one year after childbirth. This study conducted a literature review of these support methods and their effectiveness in reducing depression and anxiety among postpartum women.Methods We searched for Japanese and English literature published until August 2023 using the PubMed, Igaku Chuo Zasshi, CiNii Research, and Cochrane Library databases. We included original papers that provided support for postpartum women discharged from delivery facilities within one year of childbirth in Japan and assessed changes in depression and anxiety. The included studies were organized according to study design, number of participants, intervention period, support methods, assessment time, and main outcomes. The support methods and their effectiveness in reducing depression and anxiety were examined.Results This review included 22 studies from PubMed, Igaku Chuo Zasshi, CiNii Research, and Cochrane Library. Regarding support provided after childbirth, the following methods reduced depression and anxiety; support from the childbirth hospital, care services after childbirth, exercise support, and physical contact between the mother and child. For continuous support during pregnancy, the following methods reduced depression and anxiety; continuous support from certain midwives and comprehensive support based on the assessment of the health status and need for support of postpartum women. Concerning other support, the following methods reduced depression and anxiety; health checkups for two weeks after childbirth, coaching based on the assessment of the current status of child-rearing, consultation services using an application, parenting support, and support for Chinese residents in Japan, while focusing on cultural differences and social support. Eight of these support programs were provided through collaborations between various healthcare professionals, such as physicians and nurses.Conclusion This literature review found that some support methods reduced depression and anxiety among postpartum women. Planning based on the assessment of the mother's health condition and needs and multidisciplinary cooperation enhanced the effectiveness of support services for postpartum women.

Proactive Conversational AI: A Comprehensive Survey of Advancements and Opportunities

Dialogue systems are designed to offer human users social support or functional services through natural language interactions. Traditional conversation research has put significant emphasis on a system’s response-ability, including its capacity to understand dialogue context and generate appropriate responses. However, the key element of proactive behavior – a crucial aspect of intelligent conversations – is often overlooked in these studies. Proactivity empowers conversational agents to lead conversations towards achieving pre-defined targets or fulfilling specific goals on the system side. Proactive dialogue systems are equipped with advanced techniques to handle complex tasks, requiring strategic and motivational interactions, thus representing a significant step towards artificial general intelligence. Motivated by the necessity and challenges of building proactive dialogue systems, we provide a comprehensive review of various prominent problems and advanced designs for implementing proactivity into different types of dialogue systems, including open-domain dialogues, task-oriented dialogues, and information-seeking dialogues. We also discuss real-world challenges that require further research attention to meet application needs in the future, such as proactivity in dialogue systems that are based on large language models, proactivity in hybrid dialogues, evaluation protocols and ethical considerations for proactive dialogue systems. By providing a quick access and overall picture of the proactive dialogue systems domain, we aim to inspire new research directions and stimulate further advancements towards achieving the next level of conversational AI capabilities, paving the way for more dynamic and intelligent interactions within various application domains.

Needs Assessment to Guide the Development of a Pediatric Survivorship Program to Promote the Physical and Psychological Well-being of Children After Cancer Treatment.

Studies have provided insights into the major challenges and needs of young children who survive cancer. Many such challenges are related to a lack of support during the patient's transition back to normal life. Survivorship programs are designed to help survivors cope with potential late effects of treatment and to provide psychosocial support. However, there is not yet a survivorship program in Hong Kong that provides young survivors with continuous care. To explore the challenges and needs faced by pediatric cancer survivors during their transition from patient to survivor and to guide the development of the survivorship program. A qualitative descriptive design utilizing purposive sampling was used. Semistructured interviews were conducted with 30 pediatric cancer survivors aged between 9 and 18 years, along with their parents/caregivers, as well as 5 pediatric cancer oncology nurses and 3 pediatric oncologists. The interviews yielded 4 overarching themes: (1) challenges in school reintegration, (2) concerns relating to physical and psychological well-being, (3) lack of social support and adaptation difficulties, and (4) needs for supportive care services. The findings provide insights into the needs of pediatric cancer survivors, their parents, and other key stakeholders. These insights suggest that a pediatric cancer survivorship program should be established in Hong Kong as an essential component of the continuum of cancer care. Survivor clinic care should be enhanced to provide continuous support for children who have completed medical treatment and their caregivers, incorporating the perspectives of all stakeholders.

Healing beyond bone: a qualitative study of the core decompression experience of physically active patients with stage II hip avascular necrosis

BackgroundAvascular necrosis (AVN) of the femoral head is a degenerative condition characterized by ischemic bone death, resulting in pain and impaired mobility. Core decompression, a surgical intervention, is widely performed for stage II AVN to alleviate symptoms and delay disease progression. While clinical and radiological outcomes are well-documented, the psychosocial dimensions of recovery remain underexplored. This study aims to understand the experiences of physically active patients diagnosed with stage II AVN who have undergone core decompression surgery during their follow-up period, allowing for a broader evaluation of the experiences of this patient group.MethodsThis study used semi-structured interviews, in-depth follow-up questions, and thematic analysis to explore the experiences of physically active patients who underwent core decompression surgery for stage II AVN of the femoral head. The participants were assessed 1–3 years post-surgery. Conducted in the Orthopaedics and Traumatology outpatient clinic of Adana City Training and Research Hospital, the study included 31 patients who had core decompression surgery between January 2020 and January 2024, with at least one year of follow-up data. Data collection, including demographic and qualitative information, was carried out during the first week of April 2024, followed by the member-checking process in the third week. A thematic analysis checklist and COREQ guidelines were used to ensure analysis reliability.ResultsThe experiences of 31 patients (mean age 37.19 ± 8.21 years, 12 females, 19 males) were summarized into five main themes that emerged from the data analysis process: ‘Expectations and Concerns Before Surgery,’ ‘Postoperative Physical Experiences,’ ‘The Psychological and Emotional Process,’ ‘Social Support and Family Relationships,’ and ‘Health Services and Medical Support.’’ Twelve sub-themes emerged from the main themes.ConclusionsCore decompression offers significant benefits to patients with stage II AVN by improving mobility and reducing pain. However, psychological support, patient education, and robust social networks are essential to address the holistic needs of recovery. These findings highlight the importance of integrating patient-centered approaches into surgical care to optimize outcomes and satisfaction. Further qualitative research is needed to explore the experiences of AVN patients at different stages to inform multidisciplinary care strategies.

The plight of Ukrainian refugees staying in Sweden under EU:s mass refugee directive: a brief trauma-focused, participatory, online intervention as a pilot feasibility study

BackgroundUkrainians staying in Sweden under the EU mass refugee directive may face challenges due to traumas caused by the invasion that started on February 24, 2022. Part of an European Social Fund (ESF) project, our study showed that a brief trauma-focused group intervention onsite helped to increase health and mental-health literacy. The intervention has not yet been adapted online.MethodsThis pilot study during six months aimed to investigate the feasibility, acceptability and outcome in perceived trust, anxiety/stress, and perceived health after this brief trauma-focused group intervention online. A second aim was to observe perceived acceptability of the group intervention with different ways of online intervention. Local coaches, interpreters, the authors, and local experts participated. A mixed-methods design with participatory methodology and evaluation were used. Data was collected with a short questionnaire in Ukrainian. Additionally, at the end of each set, we orally asked about perceived trust and integrity. There were six sets of five group sessions per set, a total of 30 sessions. Each group met online five times for 2 h, a total of 10 h excluding pre- and post-assessment. Breathing exercises sought to reduce stress among the participants.ResultsThe group intervention had both strengths and limitations. Baseline data were obtained from 136 participants, mostly females (75.7%). Answers to pre- and post-questionnaires showed that perceived anxiety/stress was significantly reduced (N = 91, chi-2 20.648, df = 6, p &amp;lt; .02). Perceived health significantly improved between pre- (mean 63.6) and post (77.2) (N = 77, t = −8.08, df = 66, p &amp;lt; .001). Older participants were vulnerable with higher stress and lower mean perceived health after the intervention. Four out of ten needed individual psychosocial support online.The participants' open questions were analyzed with qualitative content analysis, giving five general categories and 25 sub-categories and the theme “Strong efforts to cope with Swedish system”.ConclusionTrust and reduced anxiety level changed after the intervention and a combination online of small, closed group meetings with the possibility of personal acquaintance, trust and individual follow-up psychosocial support for those in need to be paid attention to for future refugee support services, particular an online format.