Finding Goal Focus With People With Severe Traumatic Brain Injury in a Person-Centered Multi-Component Community Connection Program (M-ComConnect)

Background and Objectives: Loss of social connections in the community is a common consequence of severe traumatic brain injury (TBI), resulting in reduced well-being and quality of life. M-ComConnect is an individualized multi-component community connection intervention with the key objectives of increasing social activity, developing social relationships, and supporting community participation following severe TBI. As part of the M-ComConnect approach, semi-structured initial interviews were conducted to develop a holistic understanding of each participant and their goal focus for the project. In this paper we describe how clinicians worked with participants to identify a desired community-based social activity in which to participate.Method: Transcripts of initial interviews between participant and clinician were analyzed using the phases of reflexive thematic analysis developed by Braun and Clarke. Participants were ten individuals aged between 24 and 75 with severe TBI. All were living in the community and reported reduced social connections since their TBI. The aim of the analysis was to evaluate the skills and strategies used by clinicians in their interactions with participants to derive goal focus for the program.Results: Thematic analysis of initial interview data revealed three main categories and fourteen sub-categories of clinical strategies. These were: (1) Humanizing (curiosity; demonstrating respect and empathy; providing compliments and affirmations; simple reflections; revealing aspects of self; and humor and laughter), (2) Empowering (emphasizing choice and control; highlighting strengths; identifying roadblocks and reframing to reveal opportunities; and collaborative problem solving), and (3) Focusing (making suggestions; identifying preferences; working with ideas; and negotiating). These strategies aligned with the program's relational approach and supported the core processes of the goal-focussing framework, namely understanding and connecting with you, building a relationship, and working together with you to find focus.Conclusion: The goal-focusing framework and clinical strategies outlined provide guidance for clinicians working with people with TBI in the community and is a promising way to engage clients when focusing on individualized social activity-based goals.

Immersion: Digital Collaborative Environments

<p>This thesis investigates the potential of Virtual Reality (VR) to solve established clashes in order to improve collaboration between industry professionals, while reducing spatial confusion. Industry professionals and academics state that it is collaboration itself that is one of the most critical factors in ensuring that a construction project is successful. In recent years people have investigated VR as a tool to provide a better environment for design due to its immersive properties and training potential. Current research is primarily focussed on the technology itself, but there are few studies conducted on the people using the technology and what they need in order to do so effectively. While it is essential to further the knowledge in the technological aspect, it is also vital to ensure that people can use it to its full potential. The aim of this study is to explore the relationship between advanced technology being developed and the way that people will be using it, alongside VR’s applicability as a collaborative tool for architecture and construction projects The focus of this study. While there are companies using VR in different stages of a project, it is unknown how productive people are when using this medium and what they require in order to use the technology effectively. Initial interviews with professionals have shown that there are problems in both peoples understanding of the technology used on projects as well as the methods of Building Information Modelling (BIM). The second part of this study involved multiple experiments in which users were put in different scenarios to solve clashes in a digital model using VR and Computer Assisted Design (CAD). This was performed in groups to investigate how they used the technology as well as how they collaborated within the digital environments. Initial experiments were run in Unity without a VR headset, and the final experiment was run using a VR headset (HTC Vive) for the full immersive experience. From these interviews and multiple experiments, the results produced insight into current user issues surrounding advanced BIM technology and the best way to implement them to make full use of the technologies capability during the design phase of a project. The results provided a framework detailing the information users need when using this technology to solve clashes collaboratively. Considering level of detail within the model alongside navigation tools, and perspectives provided a reliable method for aiding users in all aspects of collaborating in digital environments.</p>

Immersion: Digital Collaborative Environments

<p>This thesis investigates the potential of Virtual Reality (VR) to solve established clashes in order to improve collaboration between industry professionals, while reducing spatial confusion. Industry professionals and academics state that it is collaboration itself that is one of the most critical factors in ensuring that a construction project is successful. In recent years people have investigated VR as a tool to provide a better environment for design due to its immersive properties and training potential. Current research is primarily focussed on the technology itself, but there are few studies conducted on the people using the technology and what they need in order to do so effectively. While it is essential to further the knowledge in the technological aspect, it is also vital to ensure that people can use it to its full potential. The aim of this study is to explore the relationship between advanced technology being developed and the way that people will be using it, alongside VR’s applicability as a collaborative tool for architecture and construction projects The focus of this study. While there are companies using VR in different stages of a project, it is unknown how productive people are when using this medium and what they require in order to use the technology effectively. Initial interviews with professionals have shown that there are problems in both peoples understanding of the technology used on projects as well as the methods of Building Information Modelling (BIM). The second part of this study involved multiple experiments in which users were put in different scenarios to solve clashes in a digital model using VR and Computer Assisted Design (CAD). This was performed in groups to investigate how they used the technology as well as how they collaborated within the digital environments. Initial experiments were run in Unity without a VR headset, and the final experiment was run using a VR headset (HTC Vive) for the full immersive experience. From these interviews and multiple experiments, the results produced insight into current user issues surrounding advanced BIM technology and the best way to implement them to make full use of the technologies capability during the design phase of a project. The results provided a framework detailing the information users need when using this technology to solve clashes collaboratively. Considering level of detail within the model alongside navigation tools, and perspectives provided a reliable method for aiding users in all aspects of collaborating in digital environments.</p>

PP215 An Evaluation Of The Scottish Medicine Consortium Detailed Advice Document

IntroductionThe Scottish Medicines Consortium (SMC) conducts early health technology assessment (HTA) of new medicines. The advice is implemented at the local level by 14 Health Board Area Drug and Therapeutics Committees (ADTCs). The primary output is a published document, the Detailed Advice Document (DAD), which aims to describe the strengths and weaknesses of the evidence considered and the rationale for the decision. We examined how the DAD is being used to determine areas for improvement.MethodsWe conducted semi-structured interviews with a purposive sample of SMC and ADTC members and formulary pharmacists, who are one of the key audiences. Interviews were recorded and transcribed using Microsoft Teams and coded in NVivo. The results were assessed via thematic analysis, which included major themes such as the structure and content of the DAD and its usefulness in supporting implementation of the advice from an ADTC perspective.ResultsFollowing initial interviews (n = 7), some early themes have emerged. The DAD is a valued tool describing the assessment of a medicine's clinical and cost effectiveness. The current length of the DADs and the technical language used can limit the accessibility of information, and there have been suggestions on how to improve the structure and content. Additional interviews are still being completed and full interview results (available early 2021) will be analyzed to identify key themes.ConclusionsThe DAD is the primary output of SMC's HTA process, which includes decisions on whether a medicine can be routinely prescribed in the National Health Service Scotland. DADs have increased in length over the years, reflecting the increasing complexity of new medicines and a corresponding increase in the size of pharmaceutical company submissions. The interviews conducted to date suggest that the DADs are highly regarded and support implementation of new medicines advice by the ADTC. The findings of this evaluation will lead to an action plan for improvement.

Pencegahan Penyebaran Covid-19 di Desa Melalui APBDesa

Tujuan dari pengabdian ini adalah untuk melakukan pencegahan pennyebaran Covid-19 di Desa Melalui APBDdesa. Metode pendekatan yang digunakan adalah melalui metode wawancara bersama pihak-pihak terkait yang mana diawali dengan wawancara awal lalu penentuan TSO. Penentuan TSO ini dilakukan dengan cara analisis permasalahan utama dari Desa yang mana berdasarkan hasil wawancara adalah permasalahan covid di desa. Fokus pengabdian meliputi refocusing APBDesa tahun 2020 dan pencegahan Penyebaran/Penularan Covid-19 di desa. Pengebdian ini dilaksanakan di Propinsi Kalimantan Timur dengan 10 Kabupaten/Kota yang menjadi populasi yang terdiri atas tiga Kota dan tujuh kabupaten. Hasil dari pengabdian ini adalah kebijakan re-focusing yang cepat dan tepat telah berhasil menghambat penyebaran covid-19 di desa yang ditandai dengan rendahnya kasus terpapar dan kasus meninggal di desa kecuali desa yang berada dipinggir kota. Proses perubahan anggaran dan pihak yang terlibat dalam menentukan perubahan berbeda dibeberapa desa sehingga perlu dipersiapkan mekanisme yang baku baik proses maupun pihak yang terlibat dalam menentukan re-focusing segingga anggaran yang dihasilkan melalui proses yang sama disemua desa. The purpose of this service is to prevent the spread of Covid-19 in the village through the village budget. The approach method used is through interviews with related parties which begins with initial interviews and then determines the TSO. The determination of this TSO is done by analyzing the main problems from the village, which based on the results of the interview are the covid problems in the village. The focus of service includes refocusing on the 2020 APBDesa and preventing the spread/contagion of Covid-19 in the village. This service is carried out in East Kalimantan Province with 10 regencies/cities which make up the population consisting of three cities and seven regencies. The result of this service is that a fast and appropriate re-focusing policy has succeeded in inhibiting the spread of covid-19 in villages which is marked by low cases of exposure and cases of death in villages except for villages that are on the outskirts of the city. The process of changing the budget and the parties involved in determining changes are different in several villages, so it is necessary to prepare a standard mechanism, both the process and the parties involved in determining re-focusing so that the resulting budget goes through the same process in all villages

Assessment of Psychological Distress and Peer Relations among Trans Adolescents—An Examination of the Use of Gender Norms and Parent–Child Congruence of the YSR-R/CBCL-R among a Treatment-Seeking Sample

Among trans adolescents, increased psychological distress is reported in the literature. The goal of this study was to examine psychological distress, associated peer relations and parent report congruence among the treatment-seeking sample of the Gender Identity Special Consultation (GISC) for youth at the Charité Berlin. Further, differences between the instruments’ binary gender norms were investigated. Retrospectively, we analyzed clinical data derived from the GISC. By initial interviews and using the Youth Self-Report and Child Behavior Checklist, n = 50 trans adolescents aged 12–18 years (M = 15.5) were examined for psychological problems and peer relations. Congruence between self and parent report was analyzed by correlations. Half of the sample reported suicidality, self-harm and bullying. Trans adolescents showed significantly higher internalizing and total problems than the German norm population. The congruence between self and parent report proved to be moderate to high. The level of congruence and poor peer relations were identified as predictors of internalizing problems. Significant differences between the female vs. male gender norms emerged regarding mean scores and the number of clinically significant cases. Data provide valuable implications for intervention on a peer and family level. There are limitations to the suitability of questionnaires that use binary gender norms, and further research on adequate instruments and assessment is needed.

Needs of Spouses of Patients with Substance Use Disorder: A Qualitative Study

Background: The skill of adjusting and regulating the needs and adaptation are the most fundamental abilities of family members. Since substance use related disorders create serious health threats and cost burdens for family, it is important to investigate the needs of spouses of these patients. Regarding the wide spectrum of needs based on previous researches, the psychiatric needs were the focus in this study. By evaluating the needs, the executives of social services can better determine the basic needs of patients and their family members. Methods: This is a qualitative study applying a content analysis approach. Based on the objectives of this research, purposeful sampling was done and continued until information saturation. In total, 16 spouses of patients using substance were interviewed. Initial interviews began with guiding questions and the probing questions were applied in the following interviews. Participants’ emotions were coded and codes with similar concepts were placed together in one category and subcategories were created. Results: After conducting 16 in-depth interviews, 38 initial codes were obtained and categorized into 6 key concepts (Neglecting the reciprocal roles and rights, lack of responsibility, lack of motivation, psychiatric changes due to substance use, feelings of insecurity, and defective communication). Conclusion: The present study paves the way in better understanding of the needs of the spouses of patients with substance use disorder, and enables the specialists in this area to adjust the treatment according to each individual patient and evaluate emerging patient related issues and challenges as well. Substance dependence, in addition to making problems for the individual and the society, leads to unsatisfied needs of close family members and acquaintances. In other words, treatment will be more effective if each patient is recognized individually, the family is educated, and family-level interventions are provided.

Co-operation and consistency: a global survey of professionals involved in reopening schools during the COVID-19 pandemic

PurposeDuring the 2020 COVID-19 pandemic, schools closed in haste and were expected to create virtual learning opportunities for their students while they waited to see when and how they might re-open. National governments issued reopening guidance at varying speeds. The purpose of this study was to invite health and education professionals to share what was happening in their country about school reopening in terms of the features and implications of the guidance issued.Design/methodology/approachA qualitative study. Initial interviews informed a semi-structured questionnaire distributed through the global community of UNESCO Chair ‘Global Health and Education’ and partner organisations. Its aim was to collect, analyse and share globally relevant knowledge and practices about school reopening.FindingsThere were 192 useable responses from 43 countries and territories and 1 multi-country region. 20 of these, mainly in the Global North, had received reopening guidance, 23 were still waiting and 1 had not closed its schools. Guidance prioritised public health measures like social distancing, with less emphasis on education impacts. Success came from partnerships between schools, families and local authorities, consistent guidance and enough time and resources for implementation. Fear of infection led to significant absenteeism among students and staff. Respondents waiting for guidance, mainly in the Global South, shared similar concerns and expectations.Originality/valueDescribing first-hand practices and perspectives of health and education professionals from diverse countries and territories about reopening schools.

Tsunami evacuation times and routes to safe zones: a GIS-based approach to tsunami evacuation planning on the island of Stromboli, Italy

While a landslide at the volcanic island of Stromboli (Aeolian Islands, Italy) in December 2002 created a tsunami with a run-up of 10.9 m, two paroxysmal eruptions in the summer of 2019 caused a tsunami with an amplitude of 40 to 20 cm. All three events required rapid, spontaneous emergency evacuations of the beach zone as the time between tsunami generation and impact is around 4 min. These conditions thus require a special consideration of the issue of evacuation capabilities on the island in the event of a volcanogenic tsunami. The purpose of this paper is thus to (i) determine pedestrian evacuation times from high-risk coastal areas to safe zones, (ii) to assess building evacuation ease, and (iii) determine emergency evacuation plans (for buildings and coastal zones). For this purpose, we created a GIS-based risk analysis/mapping tool that also allowed macroscopic evacuation modelling. In our case, the high-risk zone to be evacuated involves an area extending to 10 m a.s.l. and involving 123 individual buildings over an area of 0.18 km2. The results show that 33% of the buildings can be evacuated in 4 min, and that a 10-min warning time is required for a complete and well-distributed evacuation whereby the population is evenly distributed between all evacuation exits to avoid the potential for congestion. Initial interviews of residents in the at-risk zone reveal a high level of awareness and a desire for personalized evacuation scenarios.

Collaborative Planning and Team Teaching in a Large Lecture Hall: Modeling Leadership for Change

This paper presents data from initial interviews of instructors collaboratively planning a new course in the Faculty of Education at the University of Alberta. There is a need to investigate the courses we offer in pre-service teacher education in order to understand the best ways to prepare pre-service teachers for teaching in today’s ever changing environments. The interviews were the first part of an action research cycle that follows students and instructors through the initial implementation of the course. The paper discusses the collaborative process and highlights five themes that emerged from the data: fear and risk-taking, control, course content, process, and the possibilities for positive change. Recommendations for pre-service teacher educators and teacher-librarians involved in collaboration are included. Through studying the implementation of this complex course, the research will provide us with information to improve the course and to offer our experiences as models for others involved in such a process.