Supporting Communication Between Individuals With Disabilities and First Responders: A Preliminary Case-Based Interview Study

Purpose: During a crisis, an individual with a communication disability or difference is at risk of communication breakdowns that could unintentionally escalate the crisis. The goal of this preliminary study was to identify how first responders from various organizations may respond given scenarios presenting potential interactions with an individual with a communication impairment or difference. Method: Three adult participants currently serving as first responders completed semistructured interviews. Participants were asked how they would react in different hypothetical scenarios, all incorporating aspects of communication disorders and differences that could be misinterpreted. Data analysis consisted of transcribing the responses to each scenario and identifying the themes. Results: Participants across organizations receive general communication and disability training, rely on established procedures, problem-solving, open-mindedness, and use of departmental resources in their interactions. Conclusions: This preliminary study illustrates awareness of existing protocols and organizational supports that may support interactions with individuals with communication disorders and differences. Potential areas for additional resources and training include the use of augmentative and alternative communication and disability-specific education.

Where’S the “Everyday Black Woman”? an Intersectional Qualitative Analysis of Black Women’S Decision-Making Regarding HIV Pre-Exposure Prophylaxis (PrEP) in Mississippi

Background Black cisgender women in the U.S. South bear a disproportionate burden of HIV compared to cisgender women in other racial and ethnic groups and in any other part of the US. Critical to decreasing new HIV infections is the improved delivery of pre-exposure prophylaxis (PrEP) for Black cisgender women as it remains underutilized in 2021. Informed by intersectionality, the study sought to characterize the sociostructural influences on Black cisgender women’s deliberations about PrEP within the context of interlocking systems of oppression including racism, sexism, and classism. Methods Six focus groups were conducted with 37 Black women residing in Jackson, Mississippi. This sample was purposively recruited to include Black cisgender women who were eligible for PrEP but had never received a PrEP prescription. Results Six themes were identified as obstacles during PrEP deliberation among Black women: 1) limited PrEP awareness, 2) low perceived HIV risk, 3) concerns about side effects, 4) concerns about costs, 5) limited marketing, and 6) distrust in the healthcare system. Three themes were identified as facilitators during PrEP deliberations: 1) women’s empowerment and advocacy, 2) need for increased PrEP-specific education, and 3) the positive influence of PrEP-engaged women’s testimonials. Black women shared a limited awareness of PrEP exacerbated by the lack of Black women-specific marketing. Opportunities to support Black women-specific social marketing could increase awareness and knowledge regarding PrEP’s benefits and costs. Black women also shared their concerns about discrimination in healthcare and distrust, but they felt that these barriers may be addressed by patient testimonials from PrEP-engaged Black women, empowerment strategies, and directly addressing provider biases. Conclusions An effective response to PrEP implementation among Black women in the South requires developing programs to center the needs of Black women and carry out active strategies that prioritize peer advocacy while reinforcing positive and mitigating negative influences from broader social and historical contexts.

Developing islamic values-based biology smart cards for the eleventh-grade students of special school

Students with special needs require specific education services different from other students in general. This research aims to develop Islamic value-based biology smart cards media for students with hearing and visual impairments. Furthermore, this research also seeks to determine the feasibility and effectiveness of the developed learning media in improving students' learning motivation. This research employed the research and development method (R & D) with the development procedure proposed by Borg and Gall, which consists of nine stages. The research involved three experts in validating the product: a media expert, a material expert, and a language expert. Ten students with hearing impairment and ten students with visual impairment were selected as the research subjects. The validation findings from media experts are 98.5 percent, material experts' validation results are 97.32 percent, and linguists' validation results are 98.12 percent. The findings of the paired sample t-test were 0.00 < 0.05. As a result of the product trial, it can be determined that the developed Islamic value-based biology smart card media are feasible and effective in enhancing eleventh-grade special school students' motivation with hearing and visual impairments.

Formalisation of agricultural research

As an independent component of modern research in natural sciences, branch research developed as a result of the accumulation of knowledge from three spheres of public activity – agriculture, branch-specific education, and agricultural research – under the influence of a complex interaction of many external factors. The purpose of this study is to investigate the initial stage of formalization of agricultural research as a branch of natural sciences with the development of corresponding sign-symbolic systems and terminology. Based on the study of printed and archival research of the Imperial Free Economic Society (IFES), adjustments were made to the scientific periodization of the history of research as a branch of knowledge, considering the personalized contribution of its luminaries. Forgotten or little-known studies of pioneers of Ukrainian research – the IFES members: Swiss mathematician L. Euler; Russian scientist of Swedish origin, botanist and chemist E.G. Laxman; a native of Chernihiv Region, Professor of agriculture V. P. Prokopovich, and others were introduced into scientific discourse. The present paper analyses the areas of diverse research activities in agriculture, which were conducted by IFES figures at the early stages of the first scientific and economic association in the Russian Empire.

Feasibility of Delivering Pediatric-to-Adult Transition Education during Annual Comprehensive Clinic Appointments and Patient-Reported Outcomes: A Quality Improvement Study

Individuals with bleeding disorder diagnoses require developmentally sensitive care across the lifespan, particularly as they gain knowledge and skills necessary to successfully tackle their illness-specific needs as independent adults (Breakey et al., 2010). The current study describes one phase of a larger quality improvement (QI) initiative aimed at improving transition from pediatric to adult care (TAC) at one US Hemophilia and Thrombosis Center (HTC). Our aim was to assess the feasibility of delivering transition specific education to youth-caregiver dyads during youth annual multidisciplinary clinic appointments. Youth-caregiver dyads were selected given previous research revealing that both patients and their parents express worries about related to TAC (Geerts et al., 2008). Education included discussion of the knowledge and skills necessary for autonomous management of one's bleeding disorder (e.g., illness basics, treatment, communication, and healthy living). During an 8-month period, 101 youth-caregiver dyads were approached. Patients were between the ages of 12 and 25 (M age = 17.66, SD = 3.45). Approximately half of patients were diagnosed with hemophilia A (53.5%) and 16.8% were female. Of the 101 patients approached, 90 completed the transition education discussion. On average, these discussions took 12.80 minutes (SD = 8.49) and ranged from 5 to 50 minutes. Social work delivered the bulk of these discussions (78.7%) and spent an average of 10.61 minutes (SD = 5.76) with youth and caregivers. While the intention was to deliver transition education to youth-caregiver dyads, this only occurred in 37 discussions. Other discussions included the patient only (n = 31), caregiver only (n = 20), or had missing data (n = 1). In instances when a youth-caregiver dyad was approached, but a discussion did not take place, barriers to completing the discussion were identified. "Provider" was listed most frequently (n = 5) as a barrier (e.g., youth sent home by medical team prior to transition discussion occurring; miscommunication between members of multidisciplinary team; low staffing of those trained to deliver transition discussion). Even in instances when a transition discussion did take place, barriers to having the discussion were identified. "Patient" barriers were the most frequently listed (n = 13), followed by barriers related to "Time" (n = 11), and barriers related to "Clinic" (n = 3). At the end of the transition discussion, youth and/or caregivers were encouraged to identify a goal for improving their skills or knowledge in one of the four areas discussed during their appointment. Of those having transition discussions, 72 created a transition goal. The majority of participants reported goals related to Treatment (e.g., infusion skills; n = 36) followed by goals related to Communication (n = 18), Healthy Living (n = 11), and Bleeding Disorder Basics (n = 7). There was a statistically significant difference in the type of goal of expressed by youth and/or caregivers when the patient was 17 years old or younger vs those older than 18, X 2 (3, N = 72) = 9.49, p = 0.024. Generally, more youth reported goals related to Treatment (e.g., infusion skills) than predicted by chance in both age groups. Patients or patient caregivers were contacted via phone between 5 and 14 months following their transition discussion. Approximately 1/3 of the patients who completed transition discussion, responded and provided ratings on progress toward meeting their transition goal. Ratings (M = 4.24, SD = 2.63) were made on a Likert-type scale ranging from 1 (no progress made) to 10 (maximum progress made). The information gleaned from this QI initiative revealed that delivery of transition-specific education within the CU-HTC annual multidisciplinary appointments is feasible and in some cases, served as the impetus necessary for accomplishing transition-specific goals. The results from this initiative have been instrumental in subsequent transition-related efforts related to: (a) fostering full engagement across the multidisciplinary team in TAC efforts utilizing HEMO-Milestones Tool (Croteau et al., 2016); (b) adopting specific materials developed to assess TAC in individuals with bleeding disorder diagnoses (i.e., American Society of Hematology Hemophilia Transition Readiness Assessment); and (c) reducing time between patient goal-setting and follow-up from the HTC. Disclosures Wang: Novo Nordisk: Consultancy, Other: Clinical trial investigator; Bioverativ: Consultancy, Other: Clinical trial investigator; Bayer: Consultancy, Other: Clinical trial investigator; Octapharma: Other; uniQure: Consultancy, Other: Clinical trial investigator; Pfizer/Spark: Other: clinical trial investigator; Genentech: Consultancy, Other: Clinical trial investigator; BioMarin: Consultancy, Other: Clinical trial investigator; CSL Behring: Consultancy, Other: Clinical trial investigator; Takeda: Consultancy, Other: Clinical trial investigator; Hema Biologics: Consultancy, Other: Clinical trial investigator. Buckner: CSL Behring: Honoraria; Tremeau Pharmaceuticals: Consultancy, Honoraria; Genetech: Honoraria; Bayer: Honoraria; Spark: Honoraria; Sanofi: Honoraria; Novo Nordisk: Honoraria; Pfizer: Honoraria; BioMarin: Consultancy, Honoraria; Takeda: Honoraria; American Thrombosis: Membership on an entity's Board of Directors or advisory committees; Hemostasis Network: Membership on an entity's Board of Directors or advisory committees; uniQure: Consultancy, Honoraria.

EP.TU.414Development and introduction of a multi-modal Major Trauma Ward nursing course

Introduction In 2018, the National Major Trauma Nursing Group (NMTNG), published a set of competencies for nurses working on Major Trauma Wards (MTW). They recommended that nurses evidence their knowledge and skills to this framework and that local education packages are created to support this. Methods Nurses working on the MTW completed a survey to self-assess their competency and level of knowledge against the NMTNG framework. An intensive, in-house, 2-day pilot course was designed for nurses, incorporating lecture-based teaching, practical skills and simulation. The content was fully mapped against the NMTNG key competencies, and also addressed the survey responses and local policy. Nurses were then asked to repeat the survey following the course. Results 5 nurses and 2 student nurses attended the pilot course. The majority of attendees (4/7) had been working on the major trauma ward for over 6 months and none had previously completed any nationally accredited major trauma training. Following the course, an improvement in self-assessed knowledge was recorded across all aspects of the competency framework. The highest percentage increase in knowledge was 76% in maxillo-facial trauma and the mean increase across all areas was 48% (range 20-76%). Conclusion Attendance at the course significantly increased the nurses self-perceived knowledge and competency in all key areas. Feedback will be used to further develop the course and an associated mentorship scheme, ensuring all nurses working within Major Trauma will have access to ward-based, major trauma specific education.

Two Sides of a Coin: Parental Disease-Specific Training as Seen by Health Care Practitioners and Parents in Pediatric Liver Transplantation

In the absence of widely accepted education standards for parents of children after liver transplantation (LTx), the content and structure of parental training are influenced by health care practitioners’ (HCP) individual knowledge and assessment of the relevance of its contents. This study examines the hypothesis that expectations towards training differ between HCPs and parents, and that the quality of parental training affects the job-satisfaction of HCPs. Attitudes towards disease-specific education were assessed by tailor-made questionnaires in HCPs (n = 20) and parents of children with chronic liver disease or after LTx (n = 113). These were supplemented by focused interviews in n = 7 HCPs and n = 16 parents. Parents were more satisfied with current counseling than HCP. Language barriers and low parental educational background were perceived as obstacles by 43% of HCPs. The quality of parental knowledge was felt to have a strong influence on HCPs job satisfaction. The expectations towards the content of disease-specific education largely overlap but are not synonymous. HCP and parents agreed with regards to the importance of medication knowledge. Parents rated the importance about the meaning of laboratory values and diagnostic procedures significantly higher (3.50 vs. 2.85, p < 0.001 and 3.42 vs. 2.80, p < 0.001) than HCPs. Parents and HCPs would prefer a structured framework with sufficient staff resources for disease-specific counseling.

Differences in management of telemedicine alerts on weekdays and public holidays: Results from the OptiLink heart failure trial

Background In the OptiLink heart failure study, timely and appropriate reactions to telemedicine alerts improved clinical outcomes in heart failure patients. This analysis investigates the relation between the weekday of alert transmission and the subsequent patient contact. Methods In patients enrolled in the intervention arm of the OptiLink heart failure study ( n = 505, age 66.1 ± 10.1, 77.2% male, left-ventricular ejection fraction 26.7% ± 6.1%), fluid index threshold crossing alerts were analysed according to the weekday of the transmission. Transmissions on Mondays–Thursdays were categorized as TD1, Fridays–Sundays as well as public holidays as TD2. Results Of 1365 transmitted alerts, 867 (63.5%) were categorized as TD1 and 498 (36.5%) as TD2. Same day telephone contacts were more frequent in TD1 (46.2%) than in TD2 (18.3%; p < 0.001). Accordingly, the median time to contact was significantly longer in TD2 compared with TD1 (2(1–3) vs 0(0–1) days; p < 0.001). Rates of no telephone contact were no different between the groups (12.1% vs 12.4%; p = 0.866). Although signs of worsening heart failure were prevalent in 32.4% in TD1 versus 32.1% in TD2 ( p = 0.996), initiation of a pharmacological intervention occurred more likely in TD1 compared with TD2 (27.9% vs 22.9%; p = 0.041). No differences existed concerning hospitalization for heart failure within 30 days after alert transmission (3.9% vs 3.4%; p = 0.636). Conclusion Alert transmissions during weekends and public holidays were less likely associated with timely patient contacts and initiation of pharmacological interventions than during the week. Telemedical centres providing 24/7 remote monitoring service and specific education programmes for physicians might help to optimize patient care.

Factors influencing intention to intervene in elder abuse among nursing students

Purpose This study aimed to identify the factors influencing the intention to intervene in elder abuse among nursing students. Methods A descriptive survey design was used, and questionnaires were completed by 182 nursing students. Statistical analysis was performed on the data collected, using SPSS 25.0, χ2-test, t-test, correlation, and regression analysis to confirm predictors of intention to intervene in elder abuse. Results Awareness of abuse, legal and institutional knowledge, and attitude were positively correlated with the intention to intervene in elder abuse. Factors influencing the intention to intervene by nursing students were education courses about elder abuse, awareness of elder abuse, legal and institutional knowledge, and attitude. Conclusion The findings suggest that it is necessary to provide educational protocols for nursing students to improve their awareness and knowledge of elder abuse. Based on the findings of this study, there is a need for specific education programs and guidelines to increase the assessment of, and intervention in, elder abuse.