Evaluation of the Acceptability of a Prenatal Program for Women With Histories of Childhood Trauma: The Program STEP

Background: Childhood trauma would negatively affect pregnant women's mental health and would have intergenerational repercussions. However, there is a paucity of prenatal interventions specifically designed for women exposed to childhood trauma. The study aims to evaluate the acceptability of STEP, a manualized group intervention designed for pregnant women having experienced early life adversity.Methods: The acceptability of STEP was assessed in four phases. In Phase 1, six experts evaluated whether the program activities were pertinent and trauma sensitive. In Phase 2, three parents read the intervention manuals and evaluated whether they considered each session relevant, interesting, and clear. In Phase 3, the program was briefly presented by phone to 309 pregnant women from the community. Women were inquired about their interest in the program, and the reasons for their lack of interest were assessed. In Phase 4, 30 pregnant women exposed to childhood trauma participated in the program and completed anonymous satisfaction questionnaires after each session. Psychological distress was also measured before and after the program.Results: All activities were rated by independent experts as highly pertinent, adequate, and sufficiently safe to be offered to pregnant women. Parents who read through the intervention manuals also considered that the sessions were relevant, clear, and interesting. About half of the pregnant women from the community showed interest in the program. Participants reported very high levels of satisfaction and a significant decrease in psychological distress during the program.Conclusions: Our findings show a high level of convergence among various indicators of program acceptability.

Data Pattern Aware Reliability Enhancement Scheme for 3D Solid-State Drives

3D charge-trap (CT) NAND flash-based SSD has been used widely for its large capacity, low cost per bit, and high endurance. One-shot program (OSP) scheme, as a variation of incremental step pulse programming (ISPP) scheme, has been employed to program data for CT flash, whose program unit is the Word-Line (WL) instead of the page. The existing program optimization schemes either make trade-offs among program latency and reliability by adjusting the program step voltage on demand; or remap the most error-prone cell states to others by re-encoding programmed data. However, the data pattern, which represents the ratio of 1s in data values, has not been thoroughly studied. In this paper, we observe that most small files do not contain uniform 1s and 0s among these common file types (i.e., image, audio, text, executable file), leading to programming WL cells in different states unevenly. Some cell states dominate over the WL, while others are not. Based on this observation, we propose a flexible reliability enhancement scheme based on the OSP scheme. This scheme programs the cells into different states with varied , i.e., these cells in one state, whose number is the largest in one WL, are programmed with a fine-grained (namely slow write). In contrast, the minority are programmed with a coarse-grained (namely fast write). So the reliability is improved due to averaging the major enhanced cells with the minor degraded cells without program latency overhead. A series of experiments have been conducted, and the results indicate that the proposed scheme achieves 34% read performance improvement and 16% lifetime elongation on average.

A-7 Improving Brain-Behavior Health in Pediatric Survivors of ECMO

Objective Extracorporeal Membrane Oxygenation (ECMO) is a lifesaving measure associated with developmental delays and disabilities among survivors. While guidelines recommend follow-up care for ECMO survivors, children miss care due to the lack of standardized follow-up programs and formalized medical homes. We identified deficiencies in follow-up and developed a novel, structured program at a tertiary care children’s hospital called Standardizing Therapies after ECMO program (STEp) for ECMO survivors. Methods An IRB approved program, STEp was implemented in 2017. If consented, a STEp physician formally evaluated the patient’s post ECMO needs, ordered necessary consults, provided parental education and a letter to pediatrician describing patient’s likely long term medical needs and entered patient in a structured post-discharge follow-up program. We conducted a retrospective chart review to collect data prior to and after implementation of the program in 2017. Results There were 33 survivors in the pre-STEp period (2011–16) and 46 survivors in the STEp period (2017–2020). Consent was provided for STEp in 40 patients (87%). The referral rate improved in all necessary specialties (audiology, PT/OT, Neurology). Neuropsychology evaluation referrals improved from 42% to 58% and the timely evaluation improved from 50% to 100%. 35% of the patients evaluated by neuropsychology in the STEp period were diagnosed with a neurodevelopmental/neurocognitive disorder and thus received appropriate therapies. Conclusions Implementation of a standardized follow-up program for ECMO is feasible and can be implemented successfully. STEp demonstrates that with a structured post-ECMO follow-up program, ECMO survivors can receive appropriate neuropsychological evaluations consistently, thereby identifying potential problems and treatment options.

METHODOLOGICAL ASPECTS OF TEACHING THE BASICS OF PROGRAMMING IN THE PASCALABC.NET (DRAWMAN)

The article describes the methodological rationale for using the virtual robot Drawman in the PascalABC.NET environment for teaching the basics of programming. There is a didactic material on the basics of working with the virtual robot Drawman, which can be used in informatics lessons or in additional classes. Detailed instructions can be both an assistant to the teacher for working in the lesson, and a guide for students working at an individual pace, and schoolchildren in self-study of the basics of programming. However, under teacher guidance, this training will be more effective. The article examines tasks from various topics — linear programs, loop operators, nested loops, procedures and procedures with a parameter — with a detailed description of how to solve these problems, which will allow students to solve other tasks from these topics on their own. For the first linear program, step-by-step instructions are given on how to implement the task and write the first program in the PascalABC.NET environment for the virtual robot Drawman, as well as to automatically check the completed task. Depending on the interests and level of preparation of the students, the material may be useful for students in the sixth or seventh grades.

An ICT Strategy Based upon E-Teaching and E-Learning in Response to the COVID-19 Crisis in Africa

The COVID-19 pandemic is a crisis that has gripped the world, causing governments and development agencies to search for critical measures to protect their people. The situation not only represents a significant health risk but has resulted in school closures that have disrupted agricultural education. This impedes the attainment of Africa’s larger food security and rural transformation agendas. Six months before the advent of the pandemic, the International Institute of Tropical Agriculture initiated a pilot project, Start Them Early Program (STEP) whose goal is to reinforce pathways to careers in agriculture within secondary schools in DR Congo, Kenya, and Nigeria. The project has now been forced to rethink its approach while embracing information and communication technologies due to the school closures. This paper describes the process involved in that operational pivot, particularly concerning the shift from electronic teaching by instructors towards distance electronic learning by students. Key issues addressed are the consolidation of digital applications, development of a mobile-based toolbox for use by young farmers, and constraints to device ownership. The means of addressing these concerns through working with instructors and their larger school systems are explained. Action points and resources that are recommended include the distribution of upgraded instructor workstations, a listing of relevant software applications, and the design of a mobile-based all-in-one toolkit for agriculture students and young farmers. The latter two developments have wider application in the reform of agricultural extension amongst the tech-savvy youth taking up agribusiness.

4R Care Delivery Program results: Impact of implementation metrics on patient self-management and 4R usefulness.

225 Background: We previously proposed a 4R care delivery model that facilitates teamwork and patient self-management (pSM) in cancer care (NCI ASCO Teams Project, Trosman JOP 2016). 4R (Right Info / Care / Patient / Time) enables patient and care team to manage complex care with an innovative 4R Care Sequence. We tested 4R at 10 US sites in a stepwise mode 2016-2019. Methods: Step 1 included 1 academic and 2 nonacademic sites; step 2 included 3 academic and 4 nonacademic sites. Patients with stage 0-III breast cancer received 4R Sequences (4R Cohort). We surveyed 4R and historical control cohorts of patients treated at the same sites pre-4R. We assessed the impact of implementation metrics on usefulness of 4R to the 4R cohort and on improvement of pSM in 4R cohort vs historical control cohort. Results: Survey response rates: 63%, 422/670 (4R cohort); 47%, 466/992 (control cohort). Three of the five implementation metrics significantly impacted patient usefulness of 4R (Table). Patients at step 2 sites; sites with a systematic care process; and sites with small practices reported significantly higher 4R usefulness than patients in the comparison subgroup within respective metrics. 4R usefulness was not affected by practice setting or availability of patient navigators. pSM was significantly improved between control and 4R cohorts along all implementation metrics (p < .001), but the magnitude of incremental improvement between comparison subgroups varied across metrics (Table), with the largest increment associated with the program step metric. Conclusions: 4R is useful to patients across settings, with or without patient navigators. Stepwise design is effective in increasing 4R impact overtime. Future 4R Program will investigate an expanded array of implementation metrics and their influence on 4R outcomes. [Table: see text]

4R Care Delivery Program results: Impact of implementation metrics on patient self-management and 4R usefulness.

e14039 Background: We previously proposed a 4R care delivery model that facilitates teamwork and patient self-management (pSM) in cancer care (NCI ASCO Teams Project, Trosman JOP 2016). 4R (Right Info / Care / Patient / Time) enables patient and care team to manage complex care with an innovative 4R Care Sequence. We tested 4R at 10 US sites in a stepwise mode 2016-2019. Methods: Step 1 included 1 academic and 2 nonacademic sites; step 2 included 3 academic and 4 nonacademic sites. Patients with stage 0-III breast cancer received 4R Sequences (4R Cohort). We surveyed 4R and historical control cohorts of patients treated at the same sites pre-4R. We assessed the impact of implementation metrics on usefulness of 4R to the 4R cohort and on improvement of pSM in 4R cohort vs historical control cohort. Results: Survey response rates: 63%, 422/670 (4R cohort); 47%, 466/992 (control cohort). Three of the five implementation metrics significantly impacted patient usefulness of 4R (Table). Patients at step 2 sites; sites with a systematic care process; and sites with small practices reported significantly higher 4R usefulness than patients in the comparison subgroup within respective metrics. 4R usefulness was not affected by practice setting or availability of patient navigators. pSM was significantly improved between control and 4R cohorts along all implementation metrics (p < .001), but the magnitude of incremental improvement between comparison subgroups varied across metrics (Table), with the largest increment associated with the program step metric. Conclusions: 4R is useful to patients across settings, with or without patient navigators. Stepwise design is effective in increasing 4R impact overtime. Future 4R Program will investigate an expanded array of implementation metrics and their influence on 4R outcomes. [Table: see text]

SPARX-R computerized therapy among adolescents in youth offenders' program: Step-wise cohort study

© 2019 The Authors Background: Youth offenders have high rates of unmet mental health needs, including elevated rates of subclinical or clinical depression. Computerized cognitive behavioral therapy (cCBT) has been shown to be effective for depression, and cognitive behavioral therapy (CBT) is among the most effective psychological treatments for offence related behaviours. We planned to evaluate the impact of SPARX-R 1.0 (the first iteration of a revised version of SPARX cCBT) for adolescents in a community day program (Mentoring Youth New Directions or MYND) for male recidivist youth aged between 14 and 17 years. Recruitment and retention in the trial were lower than anticipated. In this brief report we present main findings and discuss implications. Methods: We developed a stepwise cohort design to investigate the acceptability and effectiveness of SPARX-R in a complex, real-world setting. Participants were allocated to the MYND program only (treatment as usual), or MYND with the addition of SPARX-R. All adolescents referred to MYND within a specified period were assigned to one of four social workers, as per usual practice. Each social worker was randomized to begin SPARX-R with consenting new clients from one of four time points. Assessments were completed within the first two weeks of commencing the MYND program and then at 10 and 20 weeks after commencement. We solicited brief feedback on SPARX-R from young people and staff who used it. Results: Of 64 eligible youth who began MYND during the trial period, 51 consented but 25 stopped attending MYND despite court orders or because their court orders were changed. Nineteen participants were randomized to SPARX-R but only two completed two or more levels of the 7-level program, so it was not possible to evaluate the impact as planned. The four participants who provided feedback were indifferent or negative about SPARX-R. Staff advised that technical difficulties (such as loading or saving problems) were off putting and that SPARX-R was slow and not appealing to their clients. Conclusions: Computerized CBT was not successfully implemented in this group, highlighting challenges in retention in this non-residential justice program. The findings also indicate that computerized therapies of proven acceptability and effectiveness in one setting may be unappealing in another. Implementation and equity efforts need to consider and test the specialist needs of diverse groups.

SPARX-R computerized therapy among adolescents in youth offenders' program: Step-wise cohort study

© 2019 The Authors Background: Youth offenders have high rates of unmet mental health needs, including elevated rates of subclinical or clinical depression. Computerized cognitive behavioral therapy (cCBT) has been shown to be effective for depression, and cognitive behavioral therapy (CBT) is among the most effective psychological treatments for offence related behaviours. We planned to evaluate the impact of SPARX-R 1.0 (the first iteration of a revised version of SPARX cCBT) for adolescents in a community day program (Mentoring Youth New Directions or MYND) for male recidivist youth aged between 14 and 17 years. Recruitment and retention in the trial were lower than anticipated. In this brief report we present main findings and discuss implications. Methods: We developed a stepwise cohort design to investigate the acceptability and effectiveness of SPARX-R in a complex, real-world setting. Participants were allocated to the MYND program only (treatment as usual), or MYND with the addition of SPARX-R. All adolescents referred to MYND within a specified period were assigned to one of four social workers, as per usual practice. Each social worker was randomized to begin SPARX-R with consenting new clients from one of four time points. Assessments were completed within the first two weeks of commencing the MYND program and then at 10 and 20 weeks after commencement. We solicited brief feedback on SPARX-R from young people and staff who used it. Results: Of 64 eligible youth who began MYND during the trial period, 51 consented but 25 stopped attending MYND despite court orders or because their court orders were changed. Nineteen participants were randomized to SPARX-R but only two completed two or more levels of the 7-level program, so it was not possible to evaluate the impact as planned. The four participants who provided feedback were indifferent or negative about SPARX-R. Staff advised that technical difficulties (such as loading or saving problems) were off putting and that SPARX-R was slow and not appealing to their clients. Conclusions: Computerized CBT was not successfully implemented in this group, highlighting challenges in retention in this non-residential justice program. The findings also indicate that computerized therapies of proven acceptability and effectiveness in one setting may be unappealing in another. Implementation and equity efforts need to consider and test the specialist needs of diverse groups.