Virtual Group Research Articles

‘This has given me the peace of mind I needed’: ethnographic insights into Barrett’s oesophagus screening using the capsule sponge test

In 2021 and 2022, researchers carried out an implementation trial that considered how the capsule sponge test might be used to screen for Barrett’s oesophagus using a mobile clinic in...

Comparison of Mannequin-Based Simulation Training Method with Virtual Training Method on Nursing Students' Learning Cardiopulmonary Resuscitation: A Controlled Randomized Parallel Trial.

The use of different educational methods and programs, such as simulation and virtual training, plays an important role in effective Cardiopulmonary Resuscitation (CPR) learning for nursing students. This study was conducted with the aim of comparing mannequin-based simulation training with virtual training on CPR learning among nursing students. This parallel randomized controlled trial was conducted in 2022. We selected 73 nursing undergraduate students and randomly assigned them to two groups: mannequin-based simulation and virtual training groups. The knowledge, attitude, and performance of CPR in both groups were evaluated and compared before, immediately after, and 1 month after the intervention. Data analysis was performed using independent t-test and the repeated-measure analysis of variance (ANOVA) using the Statistical Package for Social Sciences (SPSS) software. Within-group differences were significant in both mannequin-based simulation and virtual training groups in terms of knowledge, attitude, and CPR performance before and after training, as well as between before and 1 month after training (p < 0.001). In addition, the mean performance of simulation group students was significantly higher than the virtual group (p < 0.001), but no significant difference was observed between the two groups in terms of knowledge and attitude dimensions before training, after training, and 1 month after training. Both mannequin-based simulation and virtual training methods increase CPR learning. Considering that students' knowledge and attitude increase significantly using both training methods and the performance of students in the simulation group is better than in the virtual group, the use of a multimodal approach is recommended for CPR training of nursing students.

Popularity at first sight: Dominant behaviours mediate the link between extraversion and popularity in face-to-face and virtual group interactions.

Although there is robust evidence that being more extraverted is related to higher popularity, only few studies have examined which actual behaviours (e.g., verbal content, body language) might explain this association. The current study examined whether observer-rated dominant behaviours (nonverbal, paraverbal, verbal, and general cues) mediate the relationship between self-rated extraversion and its facets (assertiveness, sociability, and activity) and other-rated popularity in zero-acquaintance settings. In two studies, we analysed data from face-to-face (Study 1, N = 124) and virtual (Study 2, N = 291) group interactions where participants were videotaped while performing a task and subsequently rated each other on popularity. Across studies, extraversion and the facets assertiveness and sociability were consistently associated with higher popularity, while the role of dominant behaviours differed. In Study 1, only two nonverbal behaviours, dominant gestures and upright posture, mediated the association between extraversion and popularity. In Study 2, all four types of behavioural cues mediated the association between extraversion (facets) and popularity. We discuss how these findings provide insights into the mechanisms of attaining popularity at zero acquaintance in diverse social settings.

Evaluation of a psychoeducation group for children presenting with functional tic-like behaviours.

We describe the implementation and evaluation of an online psychoeducation group for young people experiencing functional tic-like behaviours (FTLBs) - a type of functional neurological disorder (FND). Across six groups, 50 participants completed pre- and post-group goal-based outcomes (GBOs) and 36 participants completed service-user feedback, which gathered qualitative and quantitative data about participants experiences of the group. Young people and their parents reported significant improvement in their GBOs following the group and increased knowledge and confidence in managing FTLBs. The findings highlight that virtual psychoeducation group intervention is an acceptable and effective first step in treatment of young people with FTLBs. We discuss implications for future intervention development.

Parents' Perspectives on Early Relational Health: A Qualitative Study.

The American Academy of Pediatrics endorses a paradigm shift toward promoting early relational health (ERH) in pediatrics. Pediatric clinicians have a unique opportunity to promote ERH, yet little work has sought parents' perspectives on how clinicians can do so effectively. We sought to understand diverse parents' perspectives on ERH and the role of pediatric clinicians in supporting it. We conducted virtual focus groups using a guide prepared with input from community partners and parent advisors. We purposively sampled a diverse group of parents of children aged ≤7 years. Focus groups were recorded and transcribed verbatim. We analyzed data as it was collected and identified themes using an inductive and iterative process. Thirty-seven parents participated in 8 focus groups (median parent age: 36.0 years; 43.2% Asian, 18.9% Black/African-American; 32.4% Hispanic/Latino; 78.4% mothers). We identified 3 organizing themes: (1) Time, attention, and open communication with children lay a foundation for ERH; (2) Pediatric clinicians have an opportunity to promote ERH, but disconnected parent-clinician relationships are a major barrier; and (3) Enhanced communication and careful attention to child development and family well-being represent key opportunities to strengthen parent-clinician relationships. Parents identified time, attention, and open communication as essential to ERH. Although participants expressed openness to clinicians addressing ERH, such work is contingent on strong parent-clinician relationships. Policymakers and clinicians seeking to address ERH in pediatric settings must also be prepared to address potential barriers through strategies like providing adequate time to facilitate relationship-building and careful attention to address this critical topic.

Augmenting Virtual Mindfulness Group With a Mindfulness App in Integrated Primary Care: Development, Feasibility, and Acceptability

As the body of support for the usefulness of mindfulness-based practices within therapeutic intervention has grown, so has demand. To increase access to this evidence-based care, skill-building groups as well as mobile apps that deliver mindfulness training have been developed. However, evaluations of app-augmented group mindfulness interventions are lacking. This pilot study developed and implemented a protocol augmenting a virtual Veterans Affairs–Compassionate Awareness Learning Module (VA-CALM) group with the Mindfulness Coach app in a Mid-Atlantic VA health system. The 6-week app-augmented group was implemented across four cycles (n = 18) within the system’s Integrated Primary Care setting. Qualitative feedback was collected and used to improve the integrative protocol iteratively across group cycles. Feedback indicated participants found the app supported skill growth and that the group context enhanced app engagement, while others found it difficult to navigate the app and build new habits. Quantitative outcomes indicated improvements in stress, health-related quality of life, and the mindfulness skill of nonreactivity. App usage among group members ranged from none to frequent. Groups in combination with apps may be a feasible and acceptable way to support mindfulness skill growth and application to daily life for some veterans. Further study should focus on patient-level factors that are relevant to engagement and efficacy of app-augmented protocols, as well as whether engagement predicts clinical improvement.

Taking ACTion for anxiety and depression: A pilot study of a brief virtual Acceptance and commitment therapy group in primary care

Brief Acceptance and Commitment Therapy (ACT) interventions are well-suited to facilitate timely access to effective treatment for patients experiencing common mental health concerns. This study piloted a 4-session virtual ACT group for primary care patients experiencing symptoms of depression and anxiety (n = 21). Changes in symptoms of depression and anxiety, psychological flexibility, and quality of life (QoL) were examined at post-treatment and at 1- and 3-month follow-up. At a group level, there were significant reductions in symptoms of depression for all time points and symptoms of anxiety were significantly reduced at 1- and 3-month follow-up. Measures of psychological flexibility and QoL were significantly improved at 1- and 3-month follow-up. Reliable change index scores revealed high proportions of individual improvement for depression and anxiety symptoms (56–83% across time points). Proportions of reliable change ranged from 25 to 50% for measures of psychological flexibility and QoL at 1- and 3-month follow-up. Overall, these results are comparable with previously reported rates of improvement for empirically supported treatments and provide preliminary evidence for the effectiveness of this brief ACT intervention delivered in a community setting.

Virtual Bereavement Support Program in a Children’s Hospice Care Center During COVID-19 Pandemic and Beyond

In light of the COVID-19 pandemic, a pediatric hospice in Ottawa, Ontario, implemented a Virtual Bereavement Group Program, necessitating a reorganization of care delivery during the global crisis. This paper outlines the program and assesses the feedback of families who participated in the program following the death of a child or grandchild. Participants expressed high levels of satisfaction, indicating its potential as an effective approach for pediatric bereavement care beyond the pandemic.

Harnessing peer mentorship as a tool to turn human resource for health brain drain into brain gain: a case study of a Nigerian peer-mentored research group

BackgroundPeer mentorship can be a potential tool to reduce the disparities in health research capacity between high- and low- and middle-income countries. This case study describes the potential of peer mentorship to tackle two critical issues: bridging health research capacity of doctors from low- and middle-income countries (LMICs) and the transformation of human resource for health brain drain into "brain gain".Case presentationIn 2021, a virtual peer mentorship group was established by 16 alumni of the University of Benin College of Medical Sciences' 2008 graduating class, residing across three continents. This program aimed to facilitate research collaboration and skill development among colleagues with diverse research experience levels, fostering a supportive environment for career development in research. The group relied heavily on digital technology to carry out its activities due to the different geographical locations of the group members. Led by experienced peer leaders, the group fostered a collaborative learning environment where members leveraged each other's expertise. Within 18 months, we published two research papers in high-impact peer-reviewed global health journals, launched a mixed-methods research study, and conducted training sessions on research design and implementation. Findings from our work were presented at conferences and workshops. However, logistical hurdles, competing priorities, structural constraints, and uneven participation presented challenges.ConclusionThe peer mentorship collaboration has achieved some successes so far, and this model can be emulated by other cohorts of medical professionals across LMICs. Despite the group's success at a micro- or individual level, there remain significant structural barriers to research capacity building in LMICs that can only be addressed at the meso- and macro-levels by institutions and government, respectively. A systems-level approach is required to develop and support research capacity building and foster global research collaboration and effectively turn brain drain into brain gain.

Affective Contact in Autism: A Phenomenological Study of the Emotional Experiences of Autistic Adults.

Since the first descriptions of autism, difficulties with affective contact (e.g., interpersonal exchanges of feelings between individuals) have been considered a common feature of autism spectrum disorder, and these difficulties frequently manifest in occupational therapy interventions. To (1) explore how autistic young adults describe their emotions and (2) suggest ways to improve the affective contact between autistic clients and their therapists. Virtual focus group interviews. Online (Qualtrics) survey and Zoom focus groups. Autistic adults (N = 24) who met the following inclusion criteria: self-reported diagnosis of autism spectrum disorder or Asperger syndrome, age 18-35 yr, able to understand English, and able to participate in a focus group or individual interview using verbal or written communication. Two themes were noted and are presented in this article: (1) Autistic people experience complex emotions and (2) autistic people's emotions are often (mis)measured and (mis)understood. The findings indicate that autistic people experience diverse, complex, and intense emotions and that these are connected to occupation. This suggests that occupational therapists must be attuned to the emotional dimension of occupation when working with autistic clients and that autistic clients may benefit from the use of embodied language to reference their emotions. Occupational therapists can help autistic clients recognize their bodily changes when experiencing emotions and to better identify and regulate their emotions. The results also show that there were many cases nonautistic people misinterpreted the emotions of autistic people on the basis of their facial expressions or words. Plain-Language Summary: This article provides information about the emotional experiences of autistic people. The study found that autistic people experience complex emotions and that those emotions are often misinterpreted or misunderstood. The author provides information on how occupational therapists can use a neurodiversity-affirming and person-centered approach to support the emotional experiences of people in the autism community. Positionality Statement: In this article, identity-first language is used when referring to autistic adults. This deliberate choice aligns with the principles of the neurodiversity-affirming movement. Autistic self-advocates have indicated a preference for this style of language over person-first language. The author would also like to acknowledge their positionality. As both a neurodivergent researcher and a self-advocate for the disabled community, this style of language aligns with their own experiences of and beliefs about their disability.

Content validation of a Facebook HPV vaccination promotion intervention (#HPVvaxtalks) created for young Black adults (18-26 years old).

Despite the expansion in human papillomavirus (HPV) vaccination recommendations, vaccine uptake and completion remain low among Black individuals. An 8-week Facebook intervention (#HPVvaxtalks) was developed to increase knowledge and awareness of HPV risk factors, risk perceptions, and vaccination intention and uptake. This article details the formative phase of experts' feedback and participants' satisfaction on the components of the #HPVvaxtalks for content useability, acceptability, relevance, and visual appeal to inform further refinements. A convenience sample of 5 experts and 13 young Black adults were invited to provide feedback on #HPVvaxtalks intervention content. The experts reviewed and provided feedback via a survey and open-ended questions. After incorporating suggestions from experts' feedback, 13 participants viewed #HPVvaxtalks posts, took part in a virtual focus group, and completed a survey. Qualitative data were thematically analyzed and integrated with survey results. Experts and participants mean age were 41.9±2.3 and 21.2±1.9 years, respectively. Experts and participants reported positive ratings for intervention posts, including useability, acceptability, relevance, and visual appeal. Data provided areas for improvements of #HPVvaxtalks. CONCLUSION: Experts indicated strong content validity and participants showed satisfaction with #HPVvaxtalks content. Ensuring acceptability, relevance, and appeal of the intervention for the target population is an integral part of intervention development.

On the codimension-two cohomology of [formula omitted]

Borel–Serre proved that SLn(Z) is a virtual duality group of dimension (n2) and the Steinberg module Stn(Q) is its dualizing module. This module is the top-dimensional homology group of the Tits building associated to SLn(Q). We determine the “relations among the relations” of this Steinberg module. That is, we construct an explicit partial resolution of length two of the SLn(Z)-module Stn(Q). We use this partial resolution to show the codimension-2 rational cohomology group H(n2)−2(SLn(Z);Q) of SLn(Z) vanishes for n≥3. This resolves a case of a conjecture of Church–Farb–Putman. We also produce lower bounds for the codimension-1 cohomology of certain congruence subgroups of SLn(Z).

Understanding Successful Mentor-Mentee Relationships in New Faculty Scholars Program.

Mentorship is critical for the career development of health care professionals and educators. Facilitating successful mentorship is valuable in supporting future leaders and educators in family medicine. Since 1988, the Society of Teachers of Family Medicine's New Faculty Scholars (NFS) program has provided 1-year mentorship opportunities for new faculty. This qualitative study used group concept mapping to identify the characteristics of successful mentorship relationships within the NFS program. Eight New Faculty Scholars (five mentors, three mentees) from 2015 to 2021 participated in a virtual 90-minute group concept-mapping and pattern-matching session. Participants generated statements in response to a prompt about successful features of mentorship relationships. Participants categorized responses by similarity and rated each statement on a numerical scale from 1 to 5 (1 indicating lowest, 5 indicating highest) according to importance, current presence within the program, and feasibility. Statements generated by participants were grouped into seven common themes. Categories rated most important included interpersonal skills, mentor soft skills, and mentor preparation. Structured processes and goal setting, mentor soft skills, and mentor preparation were rated most feasible in terms of future improvement. Interpersonal skills, mentor soft skills, and mentor preparation were the most highly rated by participants, but also displayed the largest disparity when compared to ratings on current presence. Future efforts to improve interpersonal communication and mentor training can potentially lead to greater satisfaction with the NFS program. The most highly rated categories indicated the primary benefit of the relational components of mentorship.

Exploring the perceptions of faculty members about research courses in undergraduate pharmacy curriculum: A qualitative study.

The commitment of pharmacy graduates to patient care and research is crucial to advancing pharmaceutical science and practice. Consequently, the value of involving undergraduate pharmacy students in research has been increasingly recognized. Given that the College of Pharmacy at Qatar University offers two undergraduate pharmacy research courses, it is relevant to explore the perception of faculty members of the delivery, impact, facilitators, barriers, and suggested improvements in these courses. This exploration will help to improve the existing curriculum and to highlight the prospective impact of student involvement in undergraduate pharmacy research courses on the personal and professional growth of students, as well as on the progressive evolution of the pharmacy profession. A qualitative exploratory case study was performed in which five virtual focus groups were conducted. All eligible faculty members from the clinical pharmacy and pharmaceutical science departments with experience supervising students who had taken one or two undergraduate pharmacy research courses were invited to participate. The focus group questions were based on the Theoretical domain framework of behavioral determinants. Verbatim transcription was performed, and the collected data were thematically analyzed using the computer-assisted coding software NVivo®. Of the 26 eligible faculty members, 21 participated in this study. Five deductive themes were identified: social professional role and influences, beliefs about capabilities, skills, beliefs about consequences and goals, and environmental resources and behavioral regulations. Overall, faculty members identified themselves as assessors and mentors. Participants expected students to possess independence, responsibility, and motivation. They believed that students generally required more practical research skills. Several benefits of incorporating students into undergraduate research have been highlighted, including increased publication productivity and quality. However, several hurdles to undergraduate research in pharmacy have been identified, including limited resources, limited timeframes, and sometimes delayed ethical approval. Faculty members expressed optimism regarding the undergraduate research courses. However, some logistical concerns, including the lengthy ethical approval process and resource availability, must be addressed to optimize the effectiveness of these courses.

In Their Own Words: LGBTQIA+ Stigma in Secondary School

LGBTQIA+ youth often face stigma from society as they develop their personal identities. In the United States, legislation has recently been focusing on reducing protections in schools for queer youth and limiting access to resources like gender affirming healthcare. Youth have increasingly been targeted for identifying as queer and have experienced verbal and physical violence for expressing their gender identities. Research links stigmatization with increased mental health and substance use problems. However, there is limited information on how stigma experienced during adolescence may continue to impact young adults over time. Using a qualitative retrospective framework, LGBTQIA+-identified undergraduates (N = 8) at a 4-year university participated in one-hour virtual focus groups. Data were recorded and anonymized using individual participant codes with names of people or places removed from transcripts. Students were asked to reflect on their experiences as queer youth in secondary school including access to resources; interactions with teachers, staff, and peers; recommendations for supporting LGBTQIA+ students; and personal coping skills. The researchers used a thematic analysis to examine key issues students raised. Results provide insight into the challenges LGBTQIA+ youth face and highlight the strengths of these college-age young adults.

Identifying and Measuring Administrative Harms Experienced by Hospitalists and Administrative Leaders

Administrative harm (AH), defined as the adverse consequences of administrative decisions within health care that impact work structure, processes, and programs, is pervasive in medicine, yet poorly understood and described. To explore common AHs experienced by hospitalist clinicians and administrative leaders, understand the challenges that exist in identifying and measuring AH, and identify potential approaches to mitigate AH. A qualitative study using a mixed-methods approach with a 12-question survey and semistructured virtual focus groups was held on June 13 and August 11, 2023. Rapid qualitative methods including templated summaries and matrix analysis were applied. The participants included 2 consortiums comprising hospitalist clinicians, researchers, administrative leaders, and members of a patient and family advisory council. Quantitative data from the survey on specific aspects of experiences related to AH were collected. Focus groups were conducted using a semistructured focus group guide. Themes and subthemes were identified. Forty-one individuals from 32 different organizations participated in the focus groups, with 32 participants (78%) responding to a brief survey. Survey participants included physicians (91%), administrative professionals (6%), an advanced practice clinician (3%), and those in leadership roles (44%), with participants able to select more than one role. Only 6% of participants were familiar with the term administrative harm to a great extent, 100% felt that collaboration between administrators and clinicians is crucial for reducing AH, and 81% had personally participated in a decision that led to AH to some degree. Three main themes were identified: (1) AH is pervasive and comes from all levels of leadership, and the phenomenon was felt to be widespread and arose from multiple sources within health care systems; (2) organizations lack mechanisms for identification, measurement, and feedback, and these challenges stem from a lack of psychological safety, workplace cultures, and ambiguity in who owns a decision; and (3) organizational pressures were recognized as contributors to AHs. Many ideas were proposed as solutions. The findings of this study suggest that AH is widespread with wide-reaching impact, yet organizations do not have mechanisms to identify or address it.

Language mediation during consultations between deaf patients and health care providers at Chivhu Hospital, Zimbabwe

This study examines the extent to which the Covid-19 pandemic exacerbated language barriers between the Deaf community and healthcare providers. Virtual interviews and focus group discussions (FGDs) with Deaf merchants and other Deaf people living in Chivhu, Zimbabwe, were used to gather data for the study. Observation and document analysis were also utilized to supplement these two approaches of data acquisition. The study used critical theory as its theoretical framework in order to better understand the communication difficulties between Deaf and Healthcare practitioners. According to the study's findings, Covid-19 had a significant impact on how Deaf people and healthcare workers interacted, which helped the Deaf population receive health services. In addition, the lack of qualified Sign Language interpreters to close the communication gap between Deaf patients and healthcare professionals made it more difficult for Deaf people to access healthcare facilities. The study suggests, among other initiatives, that during emergency crisis situations like those brought on by the Covid-19 pandemic, the Government of Zimbabwe, the health system, and various stakeholders should provide accessible information and language mediators for the Deaf.

Clinical phenotype and management of sound-induced pain: Insights from adults with pain hyperacusis.

Pain hyperacusis, also known as noxacusis, causes physical pain in response to everyday sounds that do not bother most people. How sound causes excruciating pain that can last for weeks or months in otherwise healthy individuals is not well understood, resulting in a lack of effective treatments. To address this gap, we identified the most salient physical and psychosocial consequences of debilitating sound-induced pain and reviewed the interventions that sufferers have sought for pain relief to gain insights into the underlying mechanisms of the condition. Adults (n = 32) with pain hyperacusis attended a virtual focus group to describe their sound-induced pain. They completed three surveys to identify common symptoms and themes that defined their condition and to describe their use of pharmaceutical and non-pharmaceutical therapies for pain relief. All participants endorsed negative effects of pain hyperacusis on psychosocial and physical function. Most reported sound-induced burning (80.77%), stabbing (76.92%), throbbing (73.08%), and pinching (53.85%) that occurs either in the ear or elsewhere in the body (i.e., referred pain). Participants reported using numerous pharmaceutical and non-pharmaceutical interventions to alleviate their pain with varying degrees of pain relief. Benzodiazepines and nerve blockers emerged as the most effective analgesic options while non-pharmaceutical therapies were largely ineffective. Symptoms of pain hyperacusis and therapeutic approaches are largely consistent with peripheral mechanistic theories of pain hyperacusis (e.g., trigeminal nerve involvement). An interdisciplinary approach to clinical studies and the development of animal models is needed to identify, validate, and treat the pathological mechanisms of pain hyperacusis.

Feasibility and Effectiveness of Virtual Group Advance Care Planning Visits During the COVID-19 Pandemic.

The COVID-19 pandemic necessitated the transition from in person to virtual advance care planning (ACP) engagement efforts. This pilot initiative evaluated virtual group visits (GVs) and in-person GVs for ACP to determine their feasibility and effectiveness. Participants included patients in a Geriatric Medicine clinic who were referred by their primary care physician to an ACP GVs intervention. The ACP GVs had 2 sessions, led by clinicians with ACP expertise who facilitated a discussion on patients' values, goals, and preferences. Participants were provided with technical assistance to support use of the virtual platform. Evaluation included an ACP readiness survey, post-session feedback, GV observations, and electronic health record review at baseline and a 6month follow-up for goals of care documentation and advance directives. Seventy patients attended 46 ACP GVs from August 2019 to February 2022, including 16 in-person GVs and 54 virtual GVs. At a 6month follow-up, for virtual GVs participants (n = 54), goals of care documentation increased from 31% to 93%, and advance directives increased from 22% to 30%. For in-person GVs participants (n = 16), goals of care documentation increased from 25% to 100%, and advance directives increased from 69% to 75%. All surveyed patients in both formats would recommend ACP GVs. ACP GVs are feasible and effective for supporting ACP, demonstrating an increase in both goals of care conversations and advance directives completion.

Histopathology reporting of temporal artery biopsy specimens for giant cell arteritis: results of a modified Delphi study

The temporal artery biopsy (TAB) is regarded as the gold-standard test in the diagnosis of giant cell arteritis (GCA). There is a lack of agreement among experienced pathologists regarding the...