The use of motivational interviewing skills for patient counselling in an interprofessional education learning simulation

Objective: Healthcare training has increasingly focused on interprofessional education (IPE) to provide students opportunities to gain competencies and learn accountability. IPE was incorporated into the curriculum by creating a course for all health science. Motivational interviewing (MI) training was added to enhance the IPE process. The purpose of this study was to determine the effectiveness of MI training in patient counselling simulations. Methods: A cohort of students enrolled in an IPE course were evaluated on MI skills before and after receiving training. MI performance was coded using the Motivational Interviewing Treatment Integrity (MITI) 4.2.1 scoring system. A student perception survey was also administered. Results: A total of 210 students were included in the study. Results from the MITI indicate an improvement in the four global ratings after MI training in individual and group cohorts. For example, for the Cultivating global score, 0% reached at least a fair benchmark in the pre-training groups while 90% (individual) and 50% (group) reached the benchmark post-training. Student perceptions of IPE improved following MI training with more students strongly agreeing that working together was better for patients post-training (66.2% vs 75.5%). Conclusion: The use of MI training in the setting of IPE setting appears to be beneficial. MI gives students a common language and approach to working with patients in an interprofessional setting.

Mental health prevalence and predictors among university students in nine countries during the COVID-19 pandemic: a cross-national study

The student population has been highly vulnerable to the risk of mental health deterioration during the coronavirus disease (COVID-19) pandemic. This study aimed to reveal the prevalence and predictors of mental health among students in Poland, Slovenia, Czechia, Ukraine, Russia, Germany, Turkey, Israel, and Colombia in a socioeconomic context during the COVID-19 pandemic. The study was conducted among 2349 students (69% women) from May–July 2020. Data were collected by means of the Generalized Anxiety Disorder (GAD-7), Patient Health Questionnaire (PHQ-8), Perceived Stress Scale (PSS-10), Gender Inequality Index (GII), Standard & Poor's Global Ratings, the Oxford COVID-19 Government Response Tracker (OxCGRT), and a sociodemographic survey. Descriptive statistics and Bayesian multilevel skew-normal regression analyses were conducted. The prevalence of high stress, depression, and generalized anxiety symptoms in the total sample was 61.30%, 40.3%, and 30%, respectively. The multilevel Bayesian model showed that female sex was a credible predictor of PSS-10, GAD-7, and PHQ-8 scores. In addition, place of residence (town) and educational level (first-cycle studies) were risk factors for the PHQ-8. This study showed that mental health issues are alarming in the student population. Regular psychological support should be provided to students by universities.

The Effects of Practice on Navigation Performance and Mental Workload with a Mirror-In-The-Sky Map

Some previous research using a new augmented reality map display called Mirror-in-the-Sky (MitS) showed that performance was worse and mental workload (MWL) greater with MitS relative to a track-up map for navigation and wayfinding tasks. The purpose of the current study was to determine—for both MitS and track-up map—how much performance improves and MWL decreases with practice in a simple navigation task. We conducted a three-session experiment in which twenty participants completed a route following task in a virtual environment. Task completion times and collisions decreased, subjective MWL decreased, and secondary task performance improved with practice. The NASA-TLX Global ratings and Detection Response Task Hit Rates showed a larger decrease in MWL with MitS than the track-up map. Additionally, means for performance and workload measures showed that differences between the MitS and track-up map decreased in the first session. In later sessions the differences between the MitS and track-up map were negligible. As such, with practice performance and MWL may be comparable to a traditional track-up map.

INTERNATIONAL RATINGS AND VOLUMES OF FOREIGN DIRECT INVESTMENT: THE RELATIONSHIP BETWEEN INDICATORS

The purpose of the study is to identify the relationship between the values of major international rankings and the volume of foreign direct investment for 20 leading countries in involvement FDI. The following rankings were examined: the index of ease of doing business, international and global ratings of competitiveness, the index of economic freedom, tolerance for corruption. Analysis of the places occupied by Ukraine in the relevant rankings. The statistical processing of information on 20 leading countries in terms of foreign direct investment and the corresponding place of these countries in the main international rankings, the use of the correlation method to identify the relationship between these indicators, methods of analysis and synthesis, comparing the level of foreign direct investment with the corresponding values of known international indices. In addition, countries were classified into three different groups depending on the relationship between the values of the main international ratings and of foreign direct investment. Another research method was the abstract-logical method to find new additional factors that determine the investment attractiveness of countries. The analysis of the relationship between the inflow of foreign direct investment and the corresponding place of the studied countries in the main international rankings did not show a significant dependence. At the same time, it was found that a number of countries that hold leading positions in attracting the highest volumes of foreign direct investment have correspondingly high-ranking positions in international indices. However, this sample of countries turned out to be the smallest. The largest number was the sample of countries, it was half of the list of countries for which there is no correlation between the volume of foreign direct investment and the rating values in major international indices. The analysis showed a fairly close relationship between the volume of foreign direct investment, on the one hand, and the size of the country, which is characterized by GDP and population, on the other hand. However, in our opinion, international ratings should not be ignored in general: achieving high places in international rankings to some extent forms a positive investment image of the country, and ignoring the results of ratings can lead to financial isolation of the country. At the same time, the study of new factors that cause the desire to make foreign direct investment in a country is a very interesting object of further research.

Depression, anxiety and PTSD symptoms before and during the COVID-19 pandemic in the UK

Background: The COVID-19 pandemic is a novel population-level stressor. As such, it is important to examine pandemic-related changes in mental health and to identify which individuals are at greatest risk of worsening symptoms.Methods: Online questionnaires were administered to 34,465 individuals in the UK, recruited from existing cohorts or via social media. Around one third (n = 12,718) with prior diagnoses of depression or anxiety completed pre-pandemic mental health assessments, allowing prospective investigation of symptom change. We examined changes in depression, anxiety and PTSD symptoms using prospective, retrospective and global ratings of change assessments. We also examined the effect of key risk factors on changes in symptoms.Outcomes: Prospective analyses showed small decreases in depression (PHQ-9: - .43 points) and anxiety symptoms (GAD-7: -.33 points), and increases in PTSD symptoms (PCL-6: .22 points). Conversely, retrospective analyses demonstrated large significant increases in depression (2.40 points) and anxiety symptoms (1.97 points) and 55% reported worsening mental health since the beginning of the pandemic on a global change rating. Using both prospective and retrospective symptom measures, regression analyses demonstrated that worsening depression, anxiety and PTSD symptoms were associated with i) prior mental health diagnoses, ii) female gender; iii) young age, and iv) unemployed or student status.Interpretation: We highlight the effect of prior mental health diagnoses on worsening mental health during the pandemic and confirm previously-reported sociodemographic risk factors. Discrepancies between prospective and retrospective measures of changes in mental health may be related to recall bias underestimating prior symptom severity.

Multilevel Influences on Black Cancer Patient Experiences With Care: A Qualitative Analysis

PURPOSE: Black patients with cancer report worse experiences with health care compared with White patients; however, little is known about what influences these ratings. The objective of this study is to explore the multilevel factors that influence global ratings of care for Black cancer survivors. METHODS: We conducted semistructured in-depth interviews with 18 Black cancer survivors. We assessed the global ratings of their personal doctor, specialist, health plan, prescription drug plan, and overall health care, and asked patients to elaborate on their rating. We analyzed the interviews with a deductive grounded theory approach using the socioecologic model to identify the individual, interpersonal, organizational, and environmental influences on Black cancer patient experiences with global ratings of care. We used an inductive constant comparison approach to identify additional themes that emerged. Two coauthors separately coded a set of transcripts and met to refine the codebook. RESULTS: On average, participants reported the highest mean rating for their specialist (9.39/10) and the lowest mean rating for their personal doctor (7.33/10). Emerging themes that influenced patient ratings were perceptions about their interaction with medical providers, physician communication, the doctor's expertise, and aspects of the physical facilities. Global ratings of care measures were widely influenced by patient interactions with their providers that were empathetic, nondiscriminatory, and where the doctors addressed all concerns. CONCLUSION: This grounded theory study identifies multiple aspects of health care that intervention researchers, health care administrators, and providers may target to improve Black cancer patient experiences with care.

Clinical Utilization of Point-of-care Ultrasound After Training: A Prospective Study

Background: This study aimed to investigate the clinical utilization of PoCUS of the first post-graduate year residents after a PoCUS curriculum. Methods: It was conducted at the emergency department of the National Taiwan University Hospital between July 2015 and October 2017. Every resident had one-month ED training and a curriculum was implemented during the first week. The post-training objective structured clinical examination (OSCE) global ratings were obtained, as well as the sonographic examinations by the residents. The participants were categorized into 4 groups: group 1 performed PoCUS before and after the curriculum; group 2 performed only after the curriculum; group 3 performed only before the curriculum; the last did not perform any examinations. Results: Two hundred and thirty-nine residents participated. The median global rating was 4 (interquartile ranges, 4-5). A significantly increasing number of residents integrated PoCUS into patient care (64 vs. 170, p=0.037) with acceptable image quality after the curriculum. Nearly 30% of residents did not use PoCUS although no differences existed in the OSCE global ratings. Group 1 performed more cases with better image quality and using ≥2 ultrasound applications (8/100 vs. 82/359, p=0.0009) after the curriculum. Group 1 performed more cases with better image quality than group 2 after the curriculum. In groups 3 and 4, “no suitable cases” (25/69), and “choosing other imaging priorities” (43/69) were the main feedbacks for not performing PoCUS. Conclusions: A focused training had a substantial positive impact on the utilization of PoCUS of the residents. The global ratings could not predict whether to integrate PoCUS into clinical practice. Further studies would be needed for the sustained effects of the curriculum and how to encourage these residents in groups 3 and 4 to use PoCUS.Clinical trial registration: NCT03738033.

Responsiveness of PROMIS and Patient Health Questionnaire (PHQ) Depression Scales in three clinical trials

Background The PROMIS depression scales are reliable and valid measures that have extensive normative data in general population samples. However, less is known about how responsive they are to detect change in clinical settings and how their responsiveness compares to legacy measures. The purpose of this study was to assess and compare the responsiveness of the PROMIS and Patient Health Questionnaire (PHQ) depression scales in three separate samples. Methods We used data from three clinical trials (two in patients with chronic pain and one in stroke survivors) totaling 651 participants. At both baseline and follow-up, participants completed four PROMIS depression fixed-length scales as well as legacy measures: Patient Health Questionnaire 9-item and 2-item scales (PHQ-9 and PHQ-2) and the SF-36 Mental Health scale. We measured global ratings of depression change, both prospectively and retrospectively, as anchors to classify patients as improved, unchanged, or worsened. Responsiveness was assessed with standardized response means, statistical tests comparing change groups, and area-under-curve analysis. Results The PROMIS depression and legacy scales had generally comparable responsiveness. Moreover, the four PROMIS depression scales of varying lengths were similarly responsive. In general, measures performed better in detecting depression improvement than depression worsening. For all measures, responsiveness varied based on the study sample and on whether depression improved or worsened. Conclusions Both PROMIS and PHQ depression scales are brief public domain measures that are responsive (i.e., sensitive to change) and thus appropriate as outcome measures in research as well as for monitoring treatment in clinical practice. Trial registration ClinicalTrials.gov ID: NCT01236521, NCT01583985, NCT01507688

Personality and Workstation Type Predict Task Focus and Happiness in the Workplace

Employee personality traits have long been studied in the context of workplace outcomes, and drawbacks of certain workstation types have become regularly debated in the last decade. However, very little is known at the intersection of these two areas of interest. This study of 231 federal office workers explored how personality levels interacted with workstation type (open bench seating, cubicle, private office) on-task focus and happiness. Momentary assessment and global, one-time survey methods were used to capture a more ecologically valid understanding of such interactions. While global ratings of task focus were higher for those in private offices than those in cubicles and open bench seating, there were no differences between workstation types in momentary assessments of focus. Several personality trait-workstation type interactions were found, including support for the idea that certain affordances of open bench seating are more beneficial to momentary focus and happiness for employees high in extraversion, while detrimental to momentary focus for those high on neuroticism. Taken together, these findings suggest that a consideration of individual differences is critical to advance the workstation design conversation in order to best support the most valuable asset of an organization: the employee. Concern for the employee is especially important in the current context of the global pandemic that is driving a rapid evolution in approaches to both short and long-term strategies for workplace design and policy.