Developing a self-directed career guidance intervention for South African high school learners amidst severe COVID-19 restrictions

Background: South African schools have been severely impacted by the coronavirus disease 2019 (COVID-19) pandemic in 2020. State-imposed restrictions to mitigate the spread of the infection have significantly limited direct interpersonal contact, curtailing the existing career guidance and counselling activities in schools. Crucially, in low-income settings, the social distancing regulations implied that in a year of increasing anxiety and uncertainty, many high school learners would have had to make important career-related decisions with limited or no tacit career guidance.Objectives: In response to these challenges, this study developed a self-directed career guidance intervention to provide continued career guidance support for Grade 9 learners amidst the unfolding global pandemic.Method: A cross-sectional mixed-methods design was employed to evaluate feasibility and acceptability of the intervention amongst a sample of 498 learners across eight high schools in the Cape Winelands district, Western Cape province, South Africa.Results: Favourable quantitative results were obtained assessing learners’ experiences of participating in the intervention and on the perceived impact of the intervention on their career preparedness. Participants reported a mean score of 41.25 (out of 50) for acceptability of the intervention. In addition, they reported a mean score of 17.1 (out of 20) for perceived impact of the intervention on their career preparedness. In terms of feasibility, qualitative findings revealed that the intervention improved learners’ self-knowledge and career directionality.Conclusion: The mixed-methods results confirm the feasibility and utility of implementing a self-directed career guidance intervention amongst secondary school learners. Whilst learners reported positive evaluations of the self-directed career guidance booklet, they also expressed the need for one-on-one or group engagement with the intervention content.

Il ruolo dell’orientamento universitario in itinere per la prevenzione del drop-out e la promozione del successo formativo. Una rassegna di studi empirici recenti

Guidance activities are considered as a valid support for the individual along his or her entire educational path, from the first years of school until the transition to the job market; in particular, the crucial function of this type of activity has been pointed out in the first phase of university studies. This paper presents a reasoned review of the literature on the main ongoing university guidance interventions, with particular attention to the prevention of drop-out and the promotion of academic success. Previous studies highlighted the role that ongoing guidance can play in the prosecution of studies and in reducing drop-out rates, as well as in favouring the integration of the subject in the academic context and raising awareness of his or her goals. Nonetheless, in the literature there is no univocal consensus regarding the fundamental characteristics of an effective guidance intervention. Starting from a critical analysis of some recent results, the main methodological issues of guidance research are illustrated, with particular reference to the strategies for evaluating the efficacy of interventions. In line with the main previous reviews, the need to conduct systematic studies guided by empirical evidence is emphasised, using rigorous research designs to identify the factors involved in the effectiveness of ongoing university guidance.

524 Anaesthetic Use and Packing in Subcutaneous Abscess Management: A Retrospective Before and After Analysis Within A Two-Cycle Audit

Introduction In the United Kingdom, there are no widely used guidelines within the management of subcutaneous abscesses by incision and drainage (I&D) to direct the use of local anaesthesia (LA) vs genal anaesthesia (GA); or the use of wound packing vs no packing. Method Two cohorts of patients undergoing I&D procedures were retrospectively identified from attendance records over a 3.5-month period. The first cohort was between 16th October 2018 to 31st January 2019. The second cohort of patients was during the COVID-19 pandemic following the introduction of new RCS guidance (intervention) between 29th March 2020 and 15th June 2020. Results Seventy-one patients before and 63 after the intervention were included. There were significantly more procedures performed under LA after the introduction of the intervention (n = 52; 82.5%) vs before (n = 4; 5.6%) p < 0.0001. The incidence of wound packing decreased after the intervention (n = 43; 68.3% vs n = 62; 87.3%) p = 0.00452. Conclusions The results demonstrate that during the pandemic, change in practice resulted in more subcutaneous abscesses being treated with LA. The majority of abscesses were packed in both cohorts although the incidence declined after the intervention. Future research should explore the patient satisfaction regarding pain management and the abscess recurrence rate.

Interactive Guidance Intervention to Address Sustained Social Withdrawal in Preterm Infants in Chile: Protocol for a Randomized Controlled Trial

Background Preterm newborns can be exposed early to significant perinatal stress, and this stress can increase the risk of altered socioemotional development. Sustained social withdrawal in infants is an early indicator of emotional distress which is expressed by low reactivity to the environment, and if persistent, is frequently associated with altered psychological development. Infants born prematurely have a higher probability of developing sustained social withdrawal (adjusted odds ratio 1.84, 95% CI 1.04-3.26) than infants born full term, and there is a correlation between weight at birth and sustained social withdrawal at 12 months of age. Objective The aims of this study are to compare the effect of the interactive guidance intervention to that of routine pediatric care on sustained social withdrawal in infants born moderately or late preterm and to explore the relationship between sustained social withdrawal in these infants and factors such as neonatal intensive care unit hospitalization variables, parental depression, and posttraumatic stress symptoms. Methods This study is designed as a multicenter randomized controlled trial. Moderate and late preterm newborns and their parents were recruited and randomized (1:1 allocation ratio) to control and experimental groups. During neonatal intensive care unit hospitalization, daily duration of skin-to-skin contact, breastfeeding, and parental visits were recorded. Also, a daily score for neonatal pain and painful invasive procedures were recorded. After discharge from neonatal intensive care, for the duration of the study, both groups will attend follow-up consultations with neonatologists at 2, 6, and 12 months of age (corrected for gestational age) and will receive routine pediatric care. Every consultation will be recorded and assessed with the Alarm Distress Baby Scale to detect sustained social withdrawal (indicated by a score of 5 or higher). The neonatologists will perform an interactive guidance intervention if an infant in the intervention group exhibits sustained social withdrawal. In each follow-up consultation, parents will fill out the Edinburgh Postnatal Depression Scale, the modified Perinatal Posttraumatic Stress Disorder Questionnaire, and the Impact of Event Scale–revised. Results Recruitment for this trial started in September 2017. As of May 2020, we have completed enrollment (N=110 infants born moderately or late preterm). We aim to publish the results by mid-2021. Conclusions This is the first randomized controlled trial with a sample of infants born moderately or late preterm infants who will attend pediatric follow-up consultations during their first year (corrected for gestational age at birth) with neonatologists trained in the Alarm Distress Baby Scale and who will receive this interactive guidance intervention. If successful, this early intervention will show significant potential to be implemented in both public and private health care, given its low cost of training staff and that the intervention takes place during routine pediatric follow-up. Trial Registration ClinicalTrials.gov NCT03212547; https://clinicaltrials.gov/ct2/show/NCT03212547. International Registered Report Identifier (IRRID) DERR1-10.2196/17943

Interactive Guidance Intervention to Address Sustained Social Withdrawal in Preterm Infants in Chile: Protocol for a Randomized Controlled Trial (Preprint)

BACKGROUND Preterm newborns can be exposed early to significant perinatal stress, and this stress can increase the risk of altered socioemotional development. Sustained social withdrawal in infants is an early indicator of emotional distress which is expressed by low reactivity to the environment, and if persistent, is frequently associated with altered psychological development. Infants born prematurely have a higher probability of developing sustained social withdrawal (adjusted odds ratio 1.84, 95% CI 1.04-3.26) than infants born full term, and there is a correlation between weight at birth and sustained social withdrawal at 12 months of age. OBJECTIVE The aims of this study are to compare the effect of the interactive guidance intervention to that of routine pediatric care on sustained social withdrawal in infants born moderately or late preterm and to explore the relationship between sustained social withdrawal in these infants and factors such as neonatal intensive care unit hospitalization variables, parental depression, and posttraumatic stress symptoms. METHODS This study is designed as a multicenter randomized controlled trial. Moderate and late preterm newborns and their parents were recruited and randomized (1:1 allocation ratio) to control and experimental groups. During neonatal intensive care unit hospitalization, daily duration of skin-to-skin contact, breastfeeding, and parental visits were recorded. Also, a daily score for neonatal pain and painful invasive procedures were recorded. After discharge from neonatal intensive care, for the duration of the study, both groups will attend follow-up consultations with neonatologists at 2, 6, and 12 months of age (corrected for gestational age) and will receive routine pediatric care. Every consultation will be recorded and assessed with the Alarm Distress Baby Scale to detect sustained social withdrawal (indicated by a score of 5 or higher). The neonatologists will perform an interactive guidance intervention if an infant in the intervention group exhibits sustained social withdrawal. In each follow-up consultation, parents will fill out the Edinburgh Postnatal Depression Scale, the modified Perinatal Posttraumatic Stress Disorder Questionnaire, and the Impact of Event Scale–revised. RESULTS Recruitment for this trial started in September 2017. As of May 2020, we have completed enrollment (N=110 infants born moderately or late preterm). We aim to publish the results by mid-2021. CONCLUSIONS This is the first randomized controlled trial with a sample of infants born moderately or late preterm infants who will attend pediatric follow-up consultations during their first year (corrected for gestational age at birth) with neonatologists trained in the Alarm Distress Baby Scale and who will receive this interactive guidance intervention. If successful, this early intervention will show significant potential to be implemented in both public and private health care, given its low cost of training staff and that the intervention takes place during routine pediatric follow-up. CLINICALTRIAL ClinicalTrials.gov NCT03212547; https://clinicaltrials.gov/ct2/show/NCT03212547. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/17943

Promising Results From a Video-Feedback Interaction Guidance Intervention for Improving Maternal–Infant Interaction Quality of Depressed Mothers: A Feasibility Pilot Study

Background Mothers and infants affected by postpartum depression are known to have (1) reduced quality interactions and (2) elevated cortisol levels, both of which are linked to negative developmental outcomes in children. Parent training promoting sensitive and responsive maternal–infant interactions may help optimize development in children of mothers with postpartum depression. Objectives This pilot study tested a video-feedback interaction guidance intervention designed to improve maternal–infant interaction, depressive symptoms, and cortisol patterns of depressed mothers and their infants. Method An experimental, pre-test, post-test design was employed to randomly assign mothers with postpartum depression to intervention ( n = 6) and control ( n = 6) conditions. Intervention mothers received three video-feedback sessions during home visits, provided at three-week intervals. Control participants received three home visits on the same schedule. Results Significant differences favoring the intervention group were observed in maternal–infant interaction quality, especially maternal sensitivity and cognitive growth fostering activities, and in reduced infant diurnal cortisol. Conclusion Professionally guided video-feedback intervention appears to support improvements in interactions between depressed mothers and their infants and optimizes infants’ diurnal cortisol patterns. The findings from this feasibility pilot study have been used to support a large-scale follow-up exploration.