Pivoting an MCI Empowerment Program to Online Engagement

In the Spring of 2020, closures and safe distancing orders swept much of the United States due to the COVID-19 pandemic. This paper presents a case study of pivoting an in-person empowerment program focused on lifestyle interventions for people newly diagnosed with Mild Cognitive Impairment (MCI) to an online program. Working as rapidly as possible to sustain participant engagement, our design decisions and subsequent iterations point to initial constraints in telehealth capabilities, as well as learning on the fly as new capabilities and requirements emerged. We present the discovery of emergent practices by family members and healthcare providers to meet the new requirements for successful online engagement. For some participants, the online program led to greater opportunities for empowerment while others were hampered by the lack of in-person program support. Providers experienced a sharp learning curve and likewise missed the benefits of in-person interaction, but also discovered new benefits of online collaboration. This work lends insights and potential new avenues for understanding how lifestyle interventions can empower people with MCI and the role of technology in that process.

“Dying with a Smile, Just Knowing that Somebody’s Listened to Me”: End-Of-Life Care and Medical Assistance in Dying in Canadian Prisons

Medical assistance in dying (MAiD) has been legal in Canada since 2016 and some incarcerated patients who are at the end of their lives are eligible for the procedure. Interviews with nine incarcerated men at a federal penitentiary in Canada provide insight into some of the ways that people who are navigating aging and end-of-life in prison think about MAiD. Interview themes are organized around: experience with death and dying; possibilities and barriers related to applications for release from prison at end-of-life; experiences of peer-caregiving in a prison palliative care program; support for MAiD and the expansion of eligibility criteria; what a good death looks like. Themes are contextualized alongside federal guidelines related to end-of-life care (EOLC) and MAiD for prisoners, highlighting that sound policy requires both generalizable principles and attention to nuance. MAiD rests on patient voluntariness, and thus autonomy over EOLC decisions is paramount for prisoners.

Psychosocial Assistance Through a Support Group Program as a Strategy for Handling Adolescent Social Problems in the Village of Merak Belantung, South Lampung

Tujuan dari kegiatan pengabdian kepada masyarakat ini adalah membantu meningkatkan kesadaran remaja tentang pentingnya sehat secara sosial serta membantu pemerintah Daerah Lampung Selatan mengurangi permasalahan-permasalahan sosial khususnya masalah sosial remaja. Masa remaja merupakan masa transisi dari masa anak-anak ke masa dewasa. Dianggap dewasa belum, dianggap anak-anak juga bukan. Oleh karenanya remaja perlu didampingi secara psikososial supaya remaja bisa berkembang secara baik dan sesuai yang diharapkan oleh orang tua. Salah satu permasalahan remaja adalah masalah pencarian jati diri. Melihat situasai seperti ini timbul keiginan untuk mendampingi remaja dan bekerjasama dengan para tokoh masyarakat di Desa Merak Belantung Lampung Selatan untuk memberikan bimbingan dan penyuluhan serta pendampingan kepada para remaja warga di desa tersebut. Hal itu dilakukan supaya warga sadar akan pentingnya sehat secara sosial dan membantu pemerintah mengatasi masalah sosial remaja. Metode kegiatan untuk pengabdian kepada masyarakat ini menggunakan program Support Group, yang didalamnya akan ada kegiatan bimbingan, penyuluhan dan pendampingan psikososial kepada remaja di Desa Merak Belantung Lampung Selatan. Jika ini terealisir maka insyaalah permasalahan sosial remaja di Desa Merak Belantung Lampung Selatan akan teratasi. Salah satu kebanggaan kota Desa Merak Belantung adalah memiliki banyak tempat wisata yang ramai dikunjungi oleh para wisatawan baik lokal maupun domestik bahkan internasional. Keberadaan pariwisata tersebut idealnya memberi kontribusi kepada masyarakat khususnya remaja untuk berfikir dan bertindak sesuai norma-norma sosial masyarakat Desa Merak Belantung Lampung Selatan. Kenyataannya para remaja malah terpengaruh dengan lingkungan wisata yang relatif bebas tersebut. Disinilah urgensi pengabdian kepada masyarakat ini dilakukan. Keberadaan tempat wisata seharusnya tidak mengurangi untuk menjadi remaja yang sholeh secara pribadi, sosial dan spiritual. Kesimpulan dari pengabdian ini adalah (1) Support group therapy yang diberikan membuat informan mengenali dirinya, memahami bahwa setiap orang memiliki kelebihan dan kekurangan dan juga sejarah masing-masing, serta bisa menerima dirinya; (2) Support group therapy yang telah dilaksanakan mampu memberikan fungsi terapeutiknya terhadap kelompok, yaitu sebagai faktor dukungan (supportive factors), faktor keterbukaan diri dan katarsis, faktor belajar kebijaksanaan atau kearifan dari anggota kelompok lainnya, serta faktor-faktor psikologis yang berkaitan dengan bagaimana menjalin hubungan dengan orang lain dan bagaimana memahami diri sendiri.

The early-stage comprehensive costs of routine PrEP implementation and scale-up in Zambia

Introduction: Pre-exposure prophylaxis (PrEP) is effective at preventing HIV infection, but PrEP cost-effectiveness is sensitive to PrEP implementation and program costs. Preliminary studies indicate that, in addition to direct delivery cost, PrEP provision requires substantial demand creation and user support to encourage PrEP initiation and persistence. We estimated the cost of providing PrEP in Zambia through different PrEP delivery models. Methods: Taking a guidelines-based approach for visits, labs and drugs assuming fidelity to the expanded 2018 Zambian PrEP guidelines, we estimated the annual cost of providing PrEP per client for five delivery models: one focused on key populations (men-who-have-sex-with-men (MSM) and female sex workers (FSW), one on adolescent girls and young women (AGYW), and three integrated programs (operated within the HIV counselling and testing service at primary healthcare centres). Program start-up, provider, and user support costs were based on program expenditure data and number of PrEP sites and clients in 2018. PrEP clinic visit costs were based on micro-costing at two PrEP delivery sites (in 2018 USD). Results: The annual cost per PrEP client varied greatly by program type, from $394 (AGYW) to $760 in an integrated program. Cost differences were driven largely by volume (i.e. the number of clients initiated/model/site) which impacted the relative costs of program support and technical assistance assigned to each PrEP client. Direct service delivery costs, including staff and overheads, labs and monitoring, drugs and consumables ranged narrowly from $208-217/PrEP-user. Service delivery costs were a key component in the cost of PrEP, representing 36-65% of total costs. Reductions in service delivery costs per PrEP client are expected with further scale-up. Conclusions: The results show that, even when integrated into full service delivery models, accessing vulnerable, marginalised populations at substantial risk of HIV infection is likely to cost more than previously estimated due to the programmatic costs involved in community sensitization and user support. Improved data on individual client resource usage (e.g. drugs, labs, visits) and outcomes (e.g. initiation, persistence) is required to get a better understanding of the true resource utilization, cost and expected outcomes and annual costs of different PrEP programs in Zambia.

Academic Advising and International Collaboration Agreements

The purpose of this quantitative study was to examine and compare the retention and graduation rates of students in a doctoral program in Education that holds collaboration agreements with institutions in Colombia, Mexico, and the Dominican Republic. Results reveal that the number of years to graduate from the program averaged 7.7 years. Seventy-five percent of the participants from Colombia graduated within four years, whereas 75% of participants in the Dominican Republic graduated within 6.7 years. Findings also highlight the importance of program support from academic advising personnel to assist doctoral students in completing their degrees on time.

FINANCING OF E-GOVERNMENT PROJECTS IN THE EUROPEAN UNION COUNTRIES AND UKRAINE

The article identifies that an important area of sustainable development and public administration reform is an effective e-government process, which should be provided with appropriate funding. The purpose of the article is to determine further opportunities for financing e-government of Ukraine in the framework of projects and public administration reform, taking into account the experience of the European Union to achieve the goals of sustainable development and digitalization of the country. The methodological basis of the study is the analytical data of UNDP Ukraine, the National Agency for Civil Service Affairs of Ukraine, the European Commission, the study of the digital government of the Organization for Economic Cooperation and Development. The key factors of the state in the direction of digital society and sustainable democratic governance are identified (human rights, transparency and integrity, parliamentary reform, civil society and youth work, health care reform and public procurement support, digital transformation). Peculiarities of financing the Public Administration Reform Strategy of Ukraine are analyzed, the largest share of financing of which is the budget program «Support to the implementation of comprehensive public administration reform» and EU budget support. The peculiarities of e-government financing in the EU countries are determined. The necessity of external sources of financing of digital projects in Ukraine due to their insufficient financing is substantiated. The largest donor countries for financing e-government projects in Ukraine (Denmark, Estonia, Great Britain, Sweden, Switzerland, Germany and Poland) have been identified. Based on the study of European experience in financing models of e-government development projects, existing funding instruments for Ukraine (funds of the joint interstate development strategy, grants, charity, public-private partnership) and promising funding instruments have been identified, the use of which will increase openness, transparency and efficiency and ensure the development of open data. Keywords: e-government, project financing, digital transformation, public administration reform. JEL Classification G38 Formulas: 0; fig.: 2; tabl.: 2; bibl.: 14.

Translingual transcultural competence: student agency, teacher guidance, and program support

An increasingly interconnected world requires people to become versatile communicators in a variety of different settings. Language centers have a critical role to play in this process by offering language and culture training in multiple languages to students, professionals and the wider community alike. They may do so from the perspective of developing plurilingual pluricultural competence, translingual transcultural competence or intercultural communicative competence and intercultural citizenship. This paper takes as its framework translingual transcultural competence, which not only reflects the current trend of transnationalism and diasporic communities, but also emphasizes the need to be critically aware, culturally reflective and socially sensitive. In order to better understand affordances and challenges in developing this competence, or set of competences, the author surveyed and interviewed students and teachers at one university-affiliated language center offering 30 languages besides German as the main language of study. Students at all proficiency levels as well as native and non-native teachers of the language taught were included in the study. Whereas the student survey investigated awareness and attitude, identity and community as well as the autonomy and agency of students in the program, teacher interviews provided insights into program parameters, classroom pedagogy and out-of-class projects. Findings from the study indicate a strong foundation in multicompetence thinking with some challenges in developing the transcultural component.

Scaling Access to Contraception for Youth in Urban Slums: The Challenge Initiative's Systems-Based Multi-Pronged Strategy for Youth-Friendly Cities

Introduction: More than half of all adolescents globally live in Asia, with India having the largest adolescent population in the world at 253 million. In sub-Saharan Africa, adolescents make up the greatest proportion of the population, with 23% of the population aged 10–19. And these numbers are predicted to grow rapidly—particularly in urban areas as rural youth migrate to cities for economic opportunities. While adolescents and youth are subject to high sexual and reproductive health risks, few efforts have been documented for addressing these in urban settings, especially in poor settlements.Methods: The Challenge Initiative (TCI) is a demand-driven, family planning platform for sustainable scale and impact that lets city governments—in particular urban slums—lead implementation. It is currently active in 11 countries in Africa and Asia. In June 2018, TCI heightened its focus on adolescent and youth sexual and reproductive health (AYSRH) for youth living in urban slums. It now supports 39 city governments. TCI dedicates technical and program support to married (including first-time parents) and unmarried youth ages 15–24 years. Using an innovative coaching model and an online learning platform (TCI University), TCI supports city governments as they implement AYSRH interventions to accelerate the impact of TCI's model for rapid scale.Results: TCI has been assessing the performance of cities implementing its AYSRH approaches using its RAISE tool and has found considerable improvement over two rounds of assessments through TCI coaching and support for adaptation of its high-impact interventions between the first and second round.Conclusions: TCI's AYSRH approach scaled rapidly to 39 cities and multiple urban slums since 2018, using its evidence-based interventions and coaching model. In the context of universal health coverage, TCI has supported segmented demand generation and improved access to quality and affordable contraceptive as well as youth-friendly health services. It provides a menu of interventions for cities to implement for youth—including such approaches as public-private partnerships with pharmacies and quality assurance using quick checklists—along with an innovative coaching model. This approach has facilitated greater access to contraceptive methods of choice for youth.