Support Team Research Articles

Adherence and Compliance with Oral Pre-Exposure Prophylaxis (PrEP) for HIV Prevention

Introduction: Men who have sex with men (MSM), transgender people, sex workers, people who inject drugs, individuals in prisons and other closed settings have been considered key populations because they are at high risk of contracting HIV. The World Health Organization (WHO) has recommended Oral Pre-Exposure Prophylaxis (PrEP) because of its protective effect against HIV in this population. This study aims to analyze the factors that influence adherence and compliance with oral PrEP for HIV prevention. Methods: This systematic review was conducted the databases used were the PubMed, CINAHL Complete, and EMBASE. For search keywords, MeSH, CINAHL Subjects, and Emtree terms were combined with AND and OR Boolean operators. Studies selected encompassed quantitative, qualitative, mixed, and multimethod designs, between from 2015 to 2022, in English, Spanish, and Portuguese language. All references were imported and exported through EndNote for data collection. Methodological quality was evaluated using the MMAT checklist. We used deductive thematic analysis based on Taylor there are six categories that influence adherence and compliance to oral PrEP. Results: Out of 526 articles retrieved, 314 duplicates were eliminated and 26 were incorporated. Various factors affect adherence and compliance with oral PrEP. Conclusions: Based on the findings, PrEP's effectiveness and the perceived high risk of HIV infection served as motivators for PrEP utilization, while negative sentiments regarding PrEP, side effects, and stigma acted as hurdles to its use. Readiness facilitated PrEP adoption. Healthcare team support was viewed as an effective attribute for those administering oral PrEP.

'We're taught green is good': Perspectives on time in range and time in tight range from youth with type 1 diabetes, and parents of youth with type 1 diabetes.

Continuous glucose monitoring (CGM) systems are standard of care for youth with type 1 diabetes with the goal of spending >70% time in range (TIR; 70-180 mg/dL, 3.9-10 mmol/L). We aimed to understand paediatric CGM user experiences with TIR metrics considering recent discussion of shifting to time in tight range (TITR; >50% time between 70 and 140 mg/dL, 3.9 and 7.8 mmol/L). Semi-structured interviews and focus groups with adolescents with type 1 diabetes and parents of youth with type 1 diabetes focused on experiences with TIR goals and reactions to TITR. Groups and interviews were audio-recorded, transcribed and analysed using content analysis. Thirty participants (N = 19 parents: age 43.6 ± 5.3 years, 79% female, 47% non-Hispanic White, 20 ± 5 months since child's diagnosis; N = 11 adolescents: age 15.3 ± 2 years, 55% female, 55% non-Hispanic White, 16 ± 3 months since diagnosis) attended. Participants had varying levels of understanding of TIR. Some developed personally preferred glucose ranges. Parents often aimed to surpass 70% TIR. Many described feelings of stress and disappointment when they did not meet a TIR goal. Concerns about TITR included increased stress and burden; risk of hypoglycaemia; and family conflict. Some participants said TITR would not change their daily lives; others said it would improve their diabetes management. Families requested care team support and a clear scientific rationale for TITR. The wealth of CGM data creates frequent opportunities for assessing diabetes management and carries implications for management burden. Input from people with type 1 diabetes and their families will be critical in considering a shift in glycaemic goals and targets.

Evaluation of the Patients with Placenta Praevia in Mymensingh Medical College Hospital, Bangladesh

Placenta praevia is a life-threatening condition both for mother and foetus and defines high risk pregnancy. A cross-sectional, observational study was conducted from July to December of 2021 in the Department of Obstetrics & Gynaecology of Mymensingh Medical College Hospital, Mymensingh, Bangladesh, to assess the relationship between previous Caesarean scar and subsequent development of placenta praevia. A total of 48 women of placenta parevia were taken in this study as diagnosed through ultrasonogram. In age distribution of these patients, peak incidence was found in the 26-35 years age group (54.10%) and the oldest was at her 42 years. Most of the patients (35.41%) did not take any antenatal check-up before their admission into hospital. The majority patients (64.58%) had history of previous Caesarean scar than vaginal delivery (35.41%) and previous two scars (51.61%) were most common. Ultrasonographically, partial variety was more (29.10%) common than others. Most pregnancies were (78.08%) delivered abdominally. In fetal outcome, 22.91% of babies were premature but did not need any NICU support, whereas 22.83% needed admission into NICU. Primary postpartum haemorrhage was the most common among complications (37.50%). This study suggests identifying the risk factors for placenta praevia. Early diagnosis, creating awareness and organizing a strong supportive surgical skilled team are needed to reduce maternal and foetal morbidity and mortality in such cases. CBMJ 2024 July: vol. 13 no. 02 P: 135-140

Initiatives to the Global Representation of Scientific Collections

Ensuring that all global scientific collections become accessible online is a challenge. The Global Biodiversity Information Facility (GBIF) maintains a Global Registry of Scientific Collections (GRSciColl) but as of May 2023, 58% of the collections included in the registry were from institutions based in Europe or North America. This shows a low representation of organizations from other regions. GBIF is addressing the bias with the help of its participant network and regional support teams. The GBIF participant network is actively encouraging institutions in its regions to register and describe their collection data through GBIF and GRSciColl. To complement this effort, the regional support teams based in Africa, Asia, Latin America and the Caribbean, and Europe are engaged in mobilizing new collections and updating existing ones (Fig. 1). In addition, a community of editors review changes proposed via a user suggestion system and keeps the entries in GRSciColl updated. The work of the regional support teams involves reviewing institutional web pages or other available online sources to update GRSciColl entries. In cases where the data are not accessible on the web, contacts from the institutions are invited to suggest changes to their GRSciColl pages. As a next step, institutions are contacted to inquire about their interest and plan for sharing open access data. If the response is positive, technical support is offered to help the institutions mobilize and publish the collection data through GBIF. The regional support teams have contacted a number of institutions and several institutions have shown interest in publishing collections on GBIF. Some organizations have already started digitizing and publishing their collection(s). With the training and technical support from the regional support teams, the following institutions have started to share data on GBIF: Instituto de Biodiversidad de Venezuela - INBIO has published data on 23,414 herbarium specimens. Natural History Museum, Tribhuvan University, Nepal has started digitizing its collections and has published eight datasets constituting 1,776 specimens. National Museum of Natural History at the Bulgarian Academy of Sciences has started digitizing 31 out of its 32 collections, of which they have published two herbarium collections represented as two datasets consisting of over 6,357 specimens. Instituto de Biodiversidad de Venezuela - INBIO has published data on 23,414 herbarium specimens. Natural History Museum, Tribhuvan University, Nepal has started digitizing its collections and has published eight datasets constituting 1,776 specimens. National Museum of Natural History at the Bulgarian Academy of Sciences has started digitizing 31 out of its 32 collections, of which they have published two herbarium collections represented as two datasets consisting of over 6,357 specimens. This presentation will highlight the data mobilization activities of the institutions, the progress of the GBIF regional support teams (Fig. 2), and the opportunities and challenges experienced in the mobilization effort.

Evaluating the Impact of Opioid-free Anesthesia Protocol on Provider Utilization: A Pilot Study at 2 Southeastern US Hospitals

Objective: Perioperative opioid medications are implicated as contributors to the opioid crisis and associated with significant negative side effects that complicate recovery, leading to increased hospitalization and healthcare costs. Implementation of opioid-free anesthesia (OFA) hospital protocols may be an effective strategy to familiarize healthcare providers with non-opioid strategies for treating perioperative pain. Methods: An exploratory, descriptive pilot study was conducted at 2 Southeastern US Hospitals with a preexisting OFA policy. An electronic survey was developed and distributed to the anesthesia departments with an OFA protocol for bariatric surgical procedures. The responses (n=14) were analyzed, and the qualitative data thematically categorized. Results: Two major and one minor theme emerged. Theme 1: utilizing an OFA protocol led to increased familiarity and a desire to utilize OFA in other surgical populations. Theme 2: implementation of regional anesthesia into a multimodal OFA plan improves pain management and perioperative team support. Minor Theme: opioid sparing may be preferable to OFA techniques among a minority of anesthesia providers. Conclusion: OFA protocol promoted familiarity and favorable attitude towards OFA techniques. Participants reported an increased willingness to utilize OFA beyond protocol requirements. Therefore, hospital protocol may be a useful tool to drive evidence-based anesthesia and pain management practice change.

Exploring staff experiences of remote working in a new community rehabilitation team

Background/Aims Health services required significant adaptation during the COVID-19 pandemic. The remote community enhanced rehabilitation team was created during the pandemic in response to faster discharges. This service evaluation aimed to explore staff experiences of remote working when implementing this new community rehabilitation team. Methods Six members of the community enhanced rehabilitation team, including nursing and psychology staff, completed qualitative semi-structured interviews about staff experiences. The interviews explored experiences of delivering clinical care, providing and receiving team support and personal impacts of remote working. Data were analysed using thematic analysis via a critical-realist approach. Results Thematic analysis from the interview transcripts revealed five main themes: anxiety related to remote working practices during a global pandemic, work–life balance, developing relationships, limits to remote working and working towards a hybrid model. Conclusions Challenges and benefits of remote working were identified along with some mitigations. Moving forward, a hybrid working model would likely benefit both service users and staff.

Intensive Care Unit Management of Right Heart Failure and Lung Transplantation for Pulmonary Hypertension

: Pulmonary hypertension is associated with worse outcomes across systemic and cardiopulmonary conditions. Right ventricular (RV) dysfunction often leads to poor outcomes due to a progressive increase in RV afterload. Recognition and management of RV dysfunction are important to circumvent hospitalization and improve patient outcomes. Early recognition of patients at risk for RV failure is important to ensure that medical therapy is optimized and, where appropriate, referral for lung transplant assessment is undertaken. Patients initiated on parenteral prostanoids and those with persistent intermediate to high risk for poor outcomes should be referred. For patients with RV failure, identifying reversible causes should be a priority in conjunction with efforts to optimize RV preload and strategies to reduce RV afterload. Admission to a monitored environment where vasoactive medications can treat RV failure and its sequelae, such as renal dysfunction, is essential in patients with severe RV failure. Exit strategies need to be identified early on, with consideration and implementation of extracorporeal support for those in whom recovery or transplantation are viable options. Enlisting the skills and support of a palliative care team may improve the quality of life for patients with limited options and those with ongoing symptoms from heart failure in the face of medical treatments.

Sexual activity (re-)engagement following spinal cord injury: Identifying behavior change targets for intervention development.

This study used the behavior change wheel to identify the priority behavioral factors for a tailored intervention to support (re-)engagement in sexual activity following a spinal cord injury (SCI). Forty-eight semistructured interviews were conducted with participants from three outpatient/carer/clinician populations in the United Kingdom: people living with SCI, their partners/spouses, and healthcare professionals working in SCI rehabilitation. To identify potential strategies to facilitate (re-)engagement in sexual activity, the behavior change wheel (BCW) and behavior change technique taxonomy Version 1 were applied to code behavior change techniques (BCTs) present in interview transcripts. Six intervention functions, three policy categories, and 21 BCTs were identified as primary targets for interventions to support sexual (re-)engagement post-SCI. Increasing physical-related skills and training would promote physical capability, while sex-related knowledge and the understanding of sex-related health consequences would elevate psychological capability. A supportive healthcare team, alongside peer support and targeted environmental resources about sexual activity/well-being facilitate physical and social opportunities for sex. Motivation to (re-)engage in sexual activity comprised goal-driven reflective motivation to enhance beliefs about capabilities, and automatic motivation via emotional support and reward-based reinforcement. This study outlines the key BCW and theoretically-derived intervention targets which now provide the foundation for innovative future interventions in SCI and sexual activity. Targeting these highly specific BCTs increases the likelihood that sexual satisfaction can become universally accessible after SCI. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Prognostic Equations and Accuracy of a Total Score of Functional Independence Measure at Discharge for Different Diseases in a Convalescent Rehabilitation Ward.

Prognosisand goal setting from admission in the convalescent rehabilitation ward, supported by a multidisciplinary team, enhance rehabilitation and discharge support. Predicting functional independence measure (FIM) outcomes can further optimize these processes. This study aimed to develop prognostic equations for the motor FIMat discharge for stroke, hip fracture (HF), vertebral compression fractures (VCFs), and total knee arthroplasty (TKA), which are common diseases in patients admitted to convalescent rehabilitation wards, using multiple regression analysis, and to clarify the difference in the accuracy of the predicted motor FIM according to the disease. This study included 965 patients admitted to our hospital. The objective variable consists of the motor FIM at discharge, and the explanatory variables were age, sex, days from onset to admission, total admission motor FIM, and total admission cognitive FIM. A stepwise multiple regression analysis was performed. The analysis of the difference in the accuracy of predicted motor FIM by disease used the absolute value of the residuals. The total motor FIM and cognitive FIM at admission were extracted for all four diseases included in this study. The absolute value of the residuals appeared to be more accurate for TKA, HF, stroke, and VCF in that order. Although differences in the accuracy of the prediction equation were observed by disease, this prediction equation can be used as an approach to review the details of rehabilitation and discharge and can be tailored to each case.

A Discount Approach to Reducing Nursing Alert Burden.

Numerous programs have arisen to address interruptive clinical decision support (CDS) with the goals of reducing alert burden and alert fatigue. These programs often have standing committees with broad stakeholder representation, significant governance efforts, and substantial analyst hours to achieve reductions in alert burden which can be difficult for hospital systems to replicate. This study aimed to reduce nursing alert burden with a primary nurse informaticist and small support team through a quality-improvement approach focusing on high-volume alerts. Target alerts were identified from the period of January 2022 to April 2022 and four of the highest firing alerts were chosen initially, which accounted for 43% of all interruptive nursing alerts and an estimated 86 hours per month of time across all nurses occupied resolving these alerts per month. Work was done concurrently for each alert with design changes based on the Five Rights of CDS and following a quality-improvement framework. Priority for work was based on operational engagement for design review and approval. Once initial design changes were approved, alerts were taken for in situ usability testing and additional changes were made as needed. Final designs were presented to stakeholders for approval prior to implementation. The total number of interruptive nursing alert firings decreased by 58% from preintervention period (1 January 2022-30 June 2022) to postintervention period (July 1, 2022-December 31, 2022). Action taken on alerts increased from 8.1 to 17.3%. The estimated time spent resolving interruptive alerts summed across all nurses in the system decreased from 197 hours/month to 114 hours/month. While CDS may improve use of evidence-based practices, implementation without a clear framework for evaluation and monitoring often results in alert burden and fatigue without clear benefits. An alert burden reduction effort spearheaded by a single empowered nurse informaticist efficiently reduced nursing alert burden substantially.

Antecedents of Risk Information Sharing & Processing Mechanism in Supply Chain: A social and technical Perspective

This paper emphasizes Supply Chain Risk Management (SCRM), whose execution can boost an organization's resilience and operating performance. Drawing on quantitative data from 231 supply chain professionals in various industries, the results highlight that subcomponents of SCRM—specifically strategy alignment and technology usage—significantly influence risk information sharing, analysis, and evaluation. Abstract Surprisingly, an SCRM-oriented culture does not significantly affect the exchange of risk information or the amount of risk partnership. At the same time, team support has insignificant effects on risk analysis and assessment. From these insights, it is evident that although having a culture of SCRM in place and some team involvement is beneficial, they could not, altogether, pave the way toward the organizational capability of evaluating and disseminating risk-related information. In its place, the emphasis on aligned SCRM strategy and technological advancement in the supply chain sector becomes a critical factor for risk mitigation. This suggests an absolute imperative for managers: to facilitate a technological-enabled SCRM approach that is collaborative, in line with the strategy, and allows integrated information processing. Fortifying these domains can help minimize weaknesses, increase response, and streamline the supply chain performance; continuous monitoring and improvement of information dissemination processes are essential, as they facilitate better risk management across the supply chain network.

Nursing managers' perceptions of teamwork and collaboration in mining primary healthcare clinics in Gauteng.

Teamwork and collaboration among nursing managers, nurses, doctors and peripheral hospitals treating mining patients is pivotal. A case study of specific mining primary healthcare clinics revealed a lack of teamwork among the doctors and nursing managers, even on decisions that show productivity. The aim of this study was to explore and describe nursing managers' perceptions of teamwork and collaboration in mining primary healthcare clinics in Gauteng. A qualitative, exploratory, descriptive and contextual research design was adopted to conduct this study. Data were collected by conducting semi-structured individual interviews with 10 participants and thematically analysed. Data saturation was reached by the seventh participant and confirmed with three more interviews. Trustworthiness measures and ethical considerations were preserved as protocols because of the nature of the study. Three themes emanated from the study: (1) team coordination and support improve teamwork and collaboration in primary healthcare clinics, (2) there is a lack of involvement from the nursing team, negatively influencing teamwork and collaboration and (3) collaboration can improve the quality of healthcare services rendered in mining primary healthcare clinics. All mining primary healthcare clinic team members should be involved in operational activities to foster teamwork and collaboration.Contribution:This study revealed that teamwork and collaboration should be facilitated to improve the quality of healthcare service in mining primary healthcare clinics.

A Novel Machine-Learning Algorithm to Predict the Early Termination of Nutrition Support Team Follow-Up in Hospitalized Adults: A Retrospective Cohort Study.

For hospitalized adults, it is important to initiate the early reintroduction of oral food in accordance with nutrition support team guidelines. The aim of this study was to develop and validate a machine learning-based algorithm that predicts the early termination of medical nutritional therapy (the transition to oral feeding). This retrospective cohort study included consecutive adult patients admitted to the Hacettepe hospital (from 1 January 2018 to 31 December 2022). The outcome of the study was the prediction of an early transition to adequate oral feeding before discharge. The dataset was randomly (70/30) divided into training and test datasets. We used six ML algorithms with multiple features to construct prediction models. ML model performance was measured according to the accuracy, area under the receiver operating characteristic curve, and F1 score. We used the Boruta Method to determine the important features and interpret the selected features. A total of 2298 adult inpatients who were followed by a nutrition support team for medical nutritional therapy were included. Patients received parenteral nutrition (1471/2298, 64.01%), enteral nutrition (717/2298, 31.2%), or supplemental parenteral nutrition (110/2298, 4.79%). The median (interquartile range) Nutritional Risk Screening (NRS-2002) score was 5 (1). Six prediction algorithms were used, and the artificial neural network and elastic net models achieved the greatest area under the ROC in all outcomes (AUC = 0.770). Ranked by z-value, the 10 most important features in predicting an early transition to oral feeding in the artificial neural network and elastic net algorithms were parenteral nutrition, surgical wards, surgical outcomes, enteral nutrition, age, supplemental parenteral nutrition, digestive system diseases, gastrointestinal complications, NRS-2002, and impaired consciousness. We developed machine learning models for the prediction of an early transition to oral feeding before discharge. Overall, there was no discernible superiority among the models. Nevertheless, the artificial neural network and elastic net methods provided the highest AUC values. Since the machine learning model is interpretable, it can enable clinicians to better comprehend the features underlying the outcomes. Our study could support personalized treatment and nutritional follow-up strategies in clinical decision making for the prediction of an early transition to oral feeding in hospitalized adult patients.

Feasibility and Acceptability of a Newborn Screening Program Using Targeted Next-Generation Sequencing in One Maternity Hospital in Southern Belgium.

Genomic newborn screening programs are emerging worldwide. With the support of the local pediatric team of Liege, Belgium, we developed a panel of 405 genes that are associated with 165 early-onset, treatable diseases with the goal of creating a newborn screening test using targeted next-generation sequencing for all early-onset, treatable, and serious conditions. A process was developed that informed the future parents about the project and collected their consent during a face-to-face discussion with a trained investigator. The first baby was screened on 1 September 2022. The main objective of the study was to test the feasibility and the acceptability of targeted sequencing at birth as a first-tier newborn screening approach to detect treatable genetic conditions or genetic conditions for which a pre-symptomatic or early symptomatic clinical trial is available. As of 20 June 2024, the parents of 4425 children had been offered the test; 4005 accepted (90.5%) and 420 refused (9.5%). The main reasons for refusal were the research nature of the project and the misunderstanding of what constitutes genetic conditions. These data demonstrate the high acceptability of genomic newborn screening in a properly informed population.

A Computer Laboratory for the Calculation of the Heat Capacity of a Peptide Unfolding Transition

ABSTRACT We present the implementation of a computer simulation laboratory for the calculation of the heat capacity of the folding-unfolding pseudo phase transition of a polyalanine Ala30 α-helix, using molecular dynamics simulations. Unlike conventional calorimetry experiments, which provide a macroscopic interpretation of the heat capacity, the computer laboratory additionally offers a molecular perspective of the energy exchange processes that lead to the peak of the heat capacity at the phase transition, as well as the statistical mechanical interpretation of the phase transition. The exercise is targeted toward 1st- or 2nd-year students of biophysics in the context of an undergraduate physical chemistry course. We use a graphical web interface to overcome the steep learning barriers associated with command line interactions in commonly used molecular dynamics protocols. The web interface (VIKING) also handles communication with computing hardware in the background, so that students with limited or no programming experience can launch and analyze the simulations easily. A collaboration between the VIKING support team and responsible teachers is required to set up VIKING. We also present a solution in which simulations can be launched on students’ own computers, if some command line knowledge can be expected. The laboratory can also be repurposed for students of various backgrounds (physics, chemistry, biology, or engineering) and scholastic levels (undergraduate or graduate).

Impact of nutritional support on immunity, nutrition, inflammation, and outcomes in elderly gastric cancer patients after surgery.

Postoperative rehabilitation of elderly patients with gastric cancer has always been the focus of clinical attention. Whether the intervention by a full-course nutritional support team can have a positive impact on the postoperative immune function, nutritional status, inflammatory response, and clinical outcomes of this special population has not yet been fully verified. To evaluate the impact of full-course nutritional support on postoperative comprehensive symptoms in elderly patients with gastric cancer. This is a retrospective study, including 60 elderly gastric cancer patients aged 70 years and above, divided into a nutritional support group and a control group. The nutritional support group received full postoperative nutritional support, including individualized meal formulation, and intravenous and parenteral nutrition supplementation, and was regularly evaluated and adjusted by a professional nutrition team. The control group received routine postoperative care. After intervention, the proportion of CD4+ lymphocytes (25.3% ± 3.1% vs 21.8% ± 2.9%, P < 0.05) and the level of immunoglobulin G (12.5 G/L ± 2.3 G/L vs 10.2 G/L ± 1.8 G/L, P < 0.01) were significantly higher in the nutritional support group than in the control group; the changes in body weight (-0.5 kg ± 0.8 kg vs -1.8 kg ± 0.9 kg, P < 0.05) and body mass index (-0.2 ± 0.3 vs -0.7 ± 0.4, P < 0.05) were less significant in the nutritional support group than in the control group; and the level of C-reactive protein (1.2 mg/L ± 0.4 mg/L vs 2.5 mg/L ± 0.6 mg/L, P < 0.01) and WBC count (7.2 × 109/L ± 1.5 × 109/L vs 9.8 × 109/L ± 2.0 × 109/L, P < 0.01) were significantly lower in the nutritional support group than in the control group. In addition, patients in the nutritional support group had a shorter hospital stay (10.3 d ± 2.1 d vs 14.8 d ± 3.6 d, P < 0.05) and lower incidence of infection (15% vs 35%, P < 0.05) in those of the control group. The intervention by the nutritional support team has a positive impact on postoperative immune function, nutritional status, inflammatory response, and clinical outcomes in elderly patients with gastric cancer.

Addressing DNS Propagation Challenges with Repurposed STBs, ZeroTier Networking, and Indonesian ISP Integration

PT Transformasi Data Digital (HostData) operates as a web hosting and domain service provider in Indonesia, facing recurring challenges related to DNS propagation. Clients often encounter issues accessing their newly acquired domains or updated DNS records due to a lack of understanding of the propagation process. In response, HostData has developed a DNS Propagation checking system to streamline verification for clients and its support team. This system allows clients to monitor DNS propagation independently, acknowledging variations based on their Internet Service Provider (ISP). Leveraging six local ISPs—Telkomsel, Indosat, XL, Three, Smartfren, and Indihome—the system utilizes repurposed Set Top Boxes (STBs) as mini servers for real-time DNS value verification. These STBs connect via Zerotier to a Virtual Private Server (VPS) with a public IP address, serving as the central control unit. This innovative solution enables clients to confirm domain resolution and serves as an educational tool, offering insights into DNS propagation mechanics.

"Instead, You're Going to a Friend": Evaluation of a Community-Developed, Peer-Delivered Online Crisis Prevention Intervention.

Online communities promote social connection and can be used for formal peer support and crisis intervention. Although some communities have programs to support their members' mental health, few programs have been formally evaluated. The authors present findings from a mixed-methods evaluation of the Stack Up Overwatch Program (StOP), a digital peer support intervention delivered in an online gaming community. Data were collected from members of the Stack Up Discord server between June and October 2020 and included chat messages, survey responses, encounter forms (documenting information from private interactions between users and peer supporters), and interviews with peer support team members. The authors analyzed data on demographic characteristics, mental health and crises, use of and experiences with StOP, and chat posts. Thematic analysis and descriptive statistics were combined in a joint display table, with mixed-methods findings explained in narrative form. The findings show that StOP provides users in crisis with a source of mental health support when other options have been exhausted and that military and veteran users valued the connections and friendships they formed while using it. Participants reported that StOP met needs for support and connection when formal services were inaccessible or did not meet their needs, and volunteer peer supporters detailed how StOP's design facilitates use of the intervention. Volunteering offered members of the peer support team a "family feeling" facilitated by the unique chat room structure. Community-based crisis prevention programs administered through chat rooms may provide valuable support to both users and peer support providers.

Why do consumers buy sports NFTs? – decoding consumer values and needs driving purchase intention

PurposeOver the past years, non-fungible tokens (NFTs) have sparked growing interest in the sport industry. NFTs are unique digital assets verified using blockchain technology. Each NFT has a distinct identifier that sets it apart from other tokens, documenting its uniqueness and ownership. NFTs promise innovative growth opportunities by generating revenue via novel products such as digital collectibles which can be owned and traded on dedicated platforms. Despite this promising outlook, it currently seems unclear how sports NFTs should be designed and which features they should offer to align with consumer values, effectively meet their needs and ultimately drive Purchase Intention. This study will therefore attempt to answer the following research question: Which consumer values and consumer needs have a positive impact on PI of sports NFTs? Based on the results, the study seeks to offer advice on concrete characteristics sports NFTs should possess in order to foster mainstream adoption.Design/methodology/approachTo address the current gap in the literature and provide an answer to the research question, this paper uses structural equation modelling exploring the impact of consumer values and consumer needs or wants on purchase intention regarding sports NFTs.FindingsThe results of this study indicate that social needs or wants (SNW) have the strongest impact on purchase intention, as well as on experiential and functional needs or wants. NFTs should therefore possess characteristics that foster community, interaction and connection with other team or athlete supporters while enhancing the overall consumer experience. Incorporating these elements into future NFTs can help sports organizations tap into the social SNW of consumers by providing opportunities for connection, interaction and collective experiences within supporter communities.Research limitations/implicationsDue to the low response rate of Baby Boomers, the results of the study cannot be applied to this cohort. Additional research, potentially using physical in-stadium surveys and targeted specifically at the BB cohort may shed light on their particular values, needs or wants and impact on sports NFT purchase intention. Moreover, Generation Z respondents may statistically be underrepresented in the sample due to the fact that only respondents aged 18 and older were included in the study. Hence, the part of Generation Z, which was born after March 2006 and had not yet come of age at the time of this research, was explicitly excluded from the survey. Results should be applied carefully to the population of sports team or athlete supporters due to the method of data collection which was based on convenience sampling and may therefore not be representative. Since the survey was exclusively administered online, people with no Internet access are not represented in this research.Practical implicationsSports organizations and marketers can leverage the strong impact of SNW identified in this study to position their NFT portfolio accordingly. Using athletes themselves or other influencers as product ambassadors may trigger purchase intention of consumers. Additionally, it is crucial that socializing agents, such as family, friends, colleagues and other team supporters with a strong influence on consumers own or promote NFTs. Marketers can support this adoption process by encouraging testimonials, reviews and user-generated content that showcase how NFTs have positively impacted others. Reaching a critical mass of adoption among supporters as a first step will ultimately impact consumers’ desire to satisfy ENW and FNW as well. Consumers may then recognize the benefits of using NFTs to enhance their overall consumer experience and to make their lives easier, for instance by using NFTs as season tickets or to collect loyalty points they can redeem later.Originality/valueThis study is the first attempt to determine the relationship between consumer values, consumers’ needs or wants and their impact on purchase intention regarding sports NFTs.

Implementation of trauma-informed care strategies in a comprehensive maternal-fetal care center.

To identify traumatic stress symptoms among expectant parents with a confirmed congenital anomaly and describe the ways in which a maternal-fetal care center, with an embedded multidisciplinary psychosocial support team, provides specific trauma-informed strategies to mitigate psychological distress from the first patient contact throughout prenatal care practice. Traumatic stress symptoms in response to the confirmed congenital anomaly were assessed using the Impact of Events Scale-Revised. With Institutional Review Board approval, a total of 4,391 pregnant parents and 3,570 partners were analyzed based on routine universal screening performed in a single maternal-fetal care center. Exploratory, descriptive analyses examined rates of overall traumatic stress symptoms and subscale scores. 28.7% of pregnant parents and 24.2% of expectant partners reported elevated traumatic stress symptoms in response to their confirmed congenital anomaly, with clinically significant risk endorsed among 16.2% and 13.4%, respectively. Symptoms of intrusion and avoidance were most notable among parents. Methods of trauma-informed care provided by the multidisciplinary care team in collaboration with the psychosocial support team to identify, support, and intervene with high-risk parents are described. Recognizing that expectant parents who receive a prenatal diagnosis of a congenital anomaly are at heightened risk for experiencing traumatic stress symptoms, multidisciplinary care teams should offer trauma-informed strategies and psychosocial support services, including parental mental health screening, psychosocial assessment, and clinical intervention, as part of routine prenatal care to reduce the negative effect of emotional distress in the expectant parents prior to birth. (PsycInfo Database Record (c) 2024 APA, all rights reserved).