Team Of Service Providers Research Articles

Prescribed safer supply during dual public health emergencies: a qualitative study examining service providers perspectives on early implementation

BackgroundWithin North America and worldwide, drug related overdoses have increased dramatically over the past decade. COVID-19 escalated the need for a safer supply to replace unregulated substances and to reduce toxicity and overdoses. Service providers play an integral role in the delivery of safer supply but there is little empirical evidence that conceptualizes effective safer supply from their perspectives. This study explored early implementation and impacts of a safer supply program, capturing the perspectives of an interdisciplinary team of service providers on tensions and issues encountered in the development of the SAFER program.MethodsUsing a community-based participatory approach, we conducted individual interviews with program providers (n = 9). The research team was composed of researchers from a local drug user organization, a local harm reduction organization, and academic researchers. The Consolidated Framework for Implementation Research (CFIR) informed the interview guide. Data was analyzed using thematic analysis.ResultsThere are six themes describing early implementation: (1) risk mitigation prescribing as context for early implementation; (2) developing SAFER specific clinical protocols; (3) accessibility challenges and program innovations; (4) interdisciplinary team and wraparound care; (5) program tensions between addiction medicine and harm reduction; (6) the successes of safer supply and future visions.ConclusionEarly implementation issues and tensions included prescriber concerns about safer supply prescribing in a highly politicized environment, accessibility challenges for service users such as stigma, encampment displacement, OAT requirements, program capacity and costs, and tensions between addiction medicine and harm reduction. Navigating these tensions included development of clinical protocols, innovations to reduce accessibility challenges such as outreach, wraparound care, program coverage of medication costs and prescribing safer supply with/without OAT. These findings contribute important insights for the development of prescribed safer supply programs.

Managed-Pressure Cementing Implemented in an Exploratory Ultradeepwater Well

This article, written by JPT Technology Editor Chris Carpenter, contains highlights of paper OTC 30481, “Successful Managed-Pressure Cementing on an Exploratory Well Operation in Ultradeep Waters of Mexico,” by Raul Bermudez, Juan Jose Ferro, and Cyril Szakolczai, Total, et al., prepared for the 2020 Offshore Technology Conference, originally scheduled to be held in Houston, 4–7 May. The paper has not been peer reviewed. Copyright 2020 Offshore Technology Conference. Reproduced by permission. The focus of the complete paper is the planning and execution of an ultradeepwater managed-pressure-cementing (MPC) job in the Gulf of Mexico. From the onset of planning, the base case was to integrate a managed-pressure system into the drilling program to mitigate predicted pore-pressure (PP) uncertainty, pressure ramp increase, and narrow PP/fracture-gradient (FG) window operations, including drilling, tripping, and running casing. Although MPC was not originally in the scope of work, it was required because of the tight drilling window and was successfully executed. Introduction The well is in Mexican waters at a depth of 10,748 ft. Given the exploratory nature of the well, a pressure ramp was predicted that would demand an excessive number of casing strings if a conventional approach were used. During the drilling phase—taking advantage of the ability to adjust the bottomhole pressure instantaneously—dynamic PP tests were performed to conclude that the expected pressure ramp was not aggressive but was leading to a narrow window that would not allow conventional cementing of the 13⅜-in. casing. Strategic planning and close collaboration between the operator’s engineering and operations teams, the cementing service provider, the managed-pressure-drilling (MPD) consultant, and the MPD service provider team was required. The uncertainty about the actual size of the hole led to an even more challenging MPC engineering analysis. The result of this cementing job was a success with no fluid losses, resulting in good zonal isolation. The specific objective for the MPC application was to set a 13⅜-in. casing to isolate the critical formation and safely continue drilling further stages of the well with an improved leakoff test at the shoe. Planning and design of the MPC application is detailed in the complete paper. This job represented the greatest water depth, and first from a drillship, for an MPC job performed by both operator and MPD service provider. In addition to performing a critical cementing operation using the managed-pressure approach, reaching well-construction objectives using MPD also was achieved while avoiding the use of a contingency liner, which saved significant expense. The base case was to integrate an MPD system into the drilling program to assist with PP uncertainty, pressure-ramp increase, and narrow PP/FG window operations, including drilling and tripping. The main objective for using the managed-pressure system during cementing was to ensure that the equivalent mud weight (EMW) at both total depth (TD) and the previous casing shoe did not fall below set limits throughout the job. The secondary objective was to reduce or eliminate losses during this process.

Pendampingan Petani Padi Melalui KKN Pembelajaran Pemberdayaan Masyarakat Desa Piasa Kulon Kabupaten Banyumas

The Ngudi Mratani Farmers Group in Piasa Kulon Village is one of the producers of healthy rice that is cultivated organically, but there are several obstacles in providing fertilizers, biopesticides and marketing the rice produced. The objectives of this activity are 1) providing technology transfer in organic rice cultivation by utilizing rabbit urinee as liquid organic fertilizer (POC) 2) Providing training on the manufacture of Local Micro Organisms (MOL) and biopesticides 3) providing assistance related to marketing organic rice. This activity was carried out in July - August 2017 by KKN-PPM students of Jenderal Soedirman University accompanied by a team of service providers from the Faculty of Agriculture as field supervisors. The method used is Rural Appraisal Participation (PRA), which is the active involvement of all parties involved in activities. The stages of the activity were direct field surveys, interviews, training discussions and mentoring on organic rice cultivation techniques, post-harvest handling and marketing. The results of this activity were an increase in farmer understanding by 35%, farmer skills in making MOL, POC rabbit urinee and vegetable pesticides to support organic rice production by 50%. The existence of attractive post-harvest handling and product packaging that increases the quality and selling power of the organic rice produced.

Practising critical resilience as an advanced peer support worker in London: A qualitative evaluation of a peer-led hepatitis C intervention amongst people experiencing homelessness who inject drugs

BackgroundPeer support has been used as a mechanism to facilitate active engagement with healthcare amongst underserved populations. The HepCare project upskilled experienced peer support workers (PSWs) to become equal members of a service provider team, taking on advanced clinical roles normally carried out by medical or nursing specialists. MethodA participatory case study approach was taken to the study following the methodological guidance of Merriam (1998). The subject of the case in our study is the advanced peer support workers (APSWs) functioning in the HepCare project as service providers. The object of the case is an exploration of their transition to service provider in the HCV screening and treatment support service. Five peer led in-depth interviews with APSWs were supplemented by a survey of health professionals, interviews with service users, documentary evidence in the form of job descriptions, observational notes and a blog from the field. Thematic analysis of the data was conducted, refined and finalised in a workshop with the research team and APSW participants. ResultsThree themes were generated from the data that explore the peer support worker's transition to APSW in the programme: Transition to Integration, Retaining ‘Peerness’, and Practising Critical Resilience. The advocacy and support enacted by the APSWs through the HepCare project, offer purpose and meaning alongside integration into a new social group. This is buffered by the supportive context of the programme and facilitates a motivating sense of worth. ConclusionThe programme offers policy guidance for the structured career development of APSWs and a platform for enactment of critical resilience as they transition to their advanced role, in the healthcare provider team.

Responding to health and social needs of aging Latinos in new-growth communities: a qualitative study

BackgroundThe development of new-growth communities of Latino immigrants in southern states has challenged the traditional health and social service infrastructure. An interprofessional team of service providers, Latino leaders, and university faculty partnered to establish linkages with the Latino community and providers serving aging adults and to explore the health and social needs of aging Latinos residing in a rural region.MethodsA qualitative descriptive study was conducted through a community-university partnership, the Aging Latino Research Team (ALRT). Data were generated from nine focus groups and 15 key informant interviews with Latino and non-Latino community members and service providers in rural, eastern North Carolina (ENC).ResultsThematic analysis was used to identify common patterns and form recommendations for future research and programs. Themes common to Latino participants were: “We are put off to one side”; “If I can't work, I can't survive”; and “Without documents, you are no one.” Themes common to non-Latino participants were: “Older Latinos are not well served”; “Older Latinos are invisible”; “Older Latinos are undocumented and afraid”; and “Older Latinos are wandering the highway”.ConclusionA major finding of this research was the extent to which discrepancies in perceptions between Latino participants and non-Latino participants exist. These discrepancies revealed ethnic stereotyping and cultural insensitivity as major barriers in access to care.

Contemporary Formulation-based Assessment and Treatment: A Framework for Clinical Discourse

With the relentless push for efficient and effective mental health treatment, service delivery has evolved from inpatient and outpatient therapy to multi-component interventions provided collaboratively across a continuum of treatment settings by a range of disparate disciplines, including mental health providers, medical providers, case managers, social workers, residential and social service providers, and managed care stakeholders. This new paradigm for mental health treatment calls for a need to modify traditional psychodynamic case formulation approaches, which have focused primarily on synthesizing clinical data to inform predominantly long term psychodynamic therapy. This paper details a new approach to clinical formulation that allows for the provision of targeted, optimal, efficient, and effective care by linking a biopsychosocialspiritual understanding to a biopsychosocialspiritual suite of interventions executed by a coordinated, multidisciplinary team of service providers. Finally, the paper concludes with a discussion of strategies for implementing formulation-based assessments and treatment plans.

Informing the development of an online self-management program for men living with HIV: a needs assessment.

BackgroundThe aim of this mixed methods study was to conduct a multifaceted needs assessment to inform the development of an online self-management program for men living with HIV. The objectives were to describe the health-related quality of life for men living with HIV, the impact of living with HIV, and the perceived problem areas and service and support needs of these men. The needs assessment was conducted in accordance with the PRECEDE model for health promotion program planning.MethodsA survey assessing the quality of life of men living with HIV (n = 72) was conducted and results were compared to Australian normative data. Focus groups were also undertaken with men living with HIV (n = 11) and a multidisciplinary team of service providers working in the area of HIV (n = 11). Focus groups enabled an in-depth description of the impact of HIV on quality of life and perceived problem areas in daily life.ResultsHIV-positive men experience significantly lower quality of life when compared with Australian normative data, particularly in those domains concerned with social and emotional aspects of quality of life. Qualitative focus groups yielded an overarching theme ‘The psychosocial impact of HIV’ which contained three sub-themes; (1) Life before and after HIV – a changed identity and its repercussions; (2) Resilience and the importance of social support; (3) Negotiating the practicalities – intimate relationships and disclosure.ConclusionsThe findings from this needs assessment highlight the need to target socio-emotional contexts of HIV positive men’s daily lives to improve quality of life and well-being. Intervention priorities for the proposed online self-management program include: (1) managing the emotional impact of HIV; (2) disclosing HIV status to family and friends; (3) maintaining social connectedness; (4) managing HIV within intimate relationships; and (5) disclosure of HIV status to intimate partners.

The Uses of Humour in Case Management with High-Risk Children and their Families

While humour is prevalent in social services, discussions of humour are rare in social work journals. The present article discusses the uses of humour among a team of service providers in a child and family service agency where the families are among the most high-risk in the county that the agency serves. We viewed humour as the amusement at incongruity, which appears to be its essential feature, and recognised that humour can foster effectiveness but also can be cruel (Morreall, 2010). The present research provides case examples of situations a team of service providers found amusing. We found that case managers use humour to regulate negative emotions, to express frustration that led to tension relief and then to creative problem solving, to diffuse anxiety and to express liking and admiration for service users. This article contributes to practice and policy by highlighting the potential advantages of humour in highstress service situations and by recommending that the use of humour be evaluated in terms of the ethical imperative of doing no harm.

The Influence of Work Motivation on Emotional Intelligence and Team Effectiveness Relationship

Empirical evidence on the role of Emotional Intelligence (EI) in service providers' team role effectiveness is inconclusive despite the obvious conceptual link. The purpose of this paper is to look into the moderating effect of work motivation on the relationship between EI factors (Self Emotional Appraisal, Others' Emotion Appraisal, Regulation of Emotion, and Use of Emotion) and team role effectiveness. Analyses of 167 responses from service providers and their superiors revealed that the interactions between work motivation and Self Emotional Appraisal (SEA) and between work motivation and Others' Emotional Appraisal (OEA) have significant affect on service providers' team role effectiveness. The effect of SEA on team role effectiveness is positive for those with low work motivation while for the high work motivation group, the effect is initially positive but turns negative at high SEA levels. The effect of OEA on team role effectiveness is higher for low work motivation group and for both low and high motivation groups, the moderation effect is positive at the low to moderate levels of OEA but becomes negative at high levels of OEA. The findings indicate that the effect of SEA and OEA on service provider's team role effectiveness is moderated by work motivation, the effect is complex and counter-intuitive. Implications for managerial practices and future research are discussed.

Basilar Invagination Managed with Electroacupuncture and Chinese Herbal Medicine: The Report of a Rare Case in a Pediatric Patient

A 13-year-old girl who suffered from basilar invagination managed with electroacupuncture and Chinese Herbal medicine is presented in this report. This is a rare disease. The condition was misdiagnosed by many biomedical specialists over a period of 5 years. There has been no literature ever recorded in Traditional Chinese Medicine (TCM) history for the treatment of this rare condition. The patient has a secondary condition, hydrocephalus, which was categorized as Jie Lu from a Chinese Medicine perspective. Jie Lu has also been used to form the rational base of the TCM treatment. This patient's condition stabilized for a period of 3 years. As bone growth continued, the severity of the patient's symptoms increased. The patient has turned 19; her symptoms have become more severe and she is unable to walk for a short distance. Finally, a diagnosis of basilar invagination was confirmed by a private health service provider team separate from several public hospitals' specialist teams.

Using a Participatory Culture-Specific Intervention Model to Develop a Peer Victimization Intervention

SUMMARY The purpose of the Peer Victimization Intervention (PVI) was to develop and implement a culture-specific pilot intervention to address the effects of bullying on middle school students who are victims utilizing the Participatory Culture-Specific Intervention Model (PCSIM; Nastasi, Moore, & Varjas, 2004). The involvement of participants who serve as cultural brokers in the system and/or stakeholders was used to encourage acceptability, integrity, ecological validity, sustainability, and institutionalization of the intervention. The pilot intervention was conducted in an urban, multiethnic school system and implemented during the school day by a multidisciplinary team of service providers. Twenty-eight students (11 sixth graders, 13 seventh graders, 4 eighth graders) participated in a 6-session pilot intervention group. Qualitative and quantitative data were collected from the students and cofacilitators of each group to assess acceptability, integrity, and efficacy. Quantitative pilot data indicated that levels of post-traumatic stress symptoms decreased from pre-test to post-test. Qualitative data provided information about students' perceptions of reasons for bullying, characteristics of bullies and victims, student and adult responses to bullying, and places where bullying incidents occur. Qualitative findings also indicated a high degree of intervention acceptability and integrity.

Issues in IT Service-Oriented Requirements Engineering

Corporate information technology (IT) management is increasingly service-oriented, offering continuous evaluation and improvement of application, communication, delivery and support services to internal and external customers. Service-oriented requirements engineering (SoRE) plays a significant role in identifying and specifying service requirements, formally defined through service-level agreements (SLAs). However, the new frameworks and approaches emerging to guide these developments have not yet addressed how requirements for such services can be effectively developed, nor identified the diverse issues involved. We report a case study of a web services team development of requirements for an internal Service Desk service. The study revealed five main issues of concern when developing service provider requirements: service roles, responsibilities and accountability; service performance metrics; resolution of conflicting stakeholder service requirements; customer acceptance of service change; and service provider team structure. This study suggests that in the new IT services era, new techniques and approaches are needed for eliciting and determining provider and customer requirements that involve key stakeholder groups equitably and more closely negotiate the sometimes-conflicting provider and customer needs.

Community Exchange and Training in the Suid Bokkeveld: A UNCCD Pilot Project to Enhance Livelihoods and Natural Resource Management

Community knowledge exchanges have played a key role in developmental processes in the Suid Bokkeveld community of South Africa. Two exchange visits were undertaken with the support of the Department of Agriculture and an NGO, the Environmental Monitoring Group, which have led to local economic development and enhanced capacity to manage natural resources in a sustainable manner. These pilot projects were undertaken within the framework of the Community Exchange and Training Programme of the Global Mechanism of the United Nations Convention to Combat Desertification (UNCCD). The methodology applied included facilitation to develop a community-based vision for development, in terms of which the community exchange process was designed. A Facilitation Team of service providers conducted preparatory workshops, and identified potential partner communities. Two exchange visits were carried out, one focused on Rooibos production and marketing, and the other on community-based eco-tourism. Following report-back and planning workshops, emerging community-driven initiatives were supported through their formative stages. The initiatives have not only resulted in enhanced livelihoods, but the methodology has also been applied widely in a number of different contexts.

Disseminating evidence-based mental health practices

Why do people working in mental health fail to use evidence-based practices? A review of the literature suggests two main barriers to staff dissemination: 1) individual service providers lack the...

Evaluation of a Case Management Program: Summary and Integration of Findings

1. Occupational health nurses can advocate for fair and equitable policies for both workers and employers. Assisting workers to understand and negotiate through the workers compensation system can minimize suspicion among workers and service providers, and can increase the effectiveness and efficiency of service provision. 2. Occupational health nurses can work with the team of service providers and the injured worker to develop appropriate and realistic goals for service provision. Make sure there is clarity related to the roles and responsibilities of all persons on the team (including the injured worker) is essential. Consistency and continuity of services throughout the life of the case is crucial. 3. The injury and its sequelae have personal meaning to the worker that may profoundly affect the outcome of their case. The OHN/CM must be sensitive and responsive to the worker's issues and concerns, and respectful of their views. Workers must be assisted to identify and tap into their social support systems. 4. Occupational health nurse/case managers should take an active role in developing and advocating for strategies that will assure effective and meaningful communication among all parties involved in a case.

The geriatric worker in a community-based out-patient geropsychiatry clinic: a conceptual model.

This paper describes the role of the geriatric worker as a member of the service provider team in a community-based geropsychiatry out-patient program using the bio-psycho-social model. Three major components are identified: the functional role, the affective role, and the community-integrative role. The contribution of the worker is shown to be significant in the attainment of the goal of outpatient geropsychiatry: that being the resocialization and maintenance of the elderly person with special needs in the community.