Professional Development, Supervision, and Mentoring

The chapter discusses the complexities involved in the supervision and mentoring process for school social workers. The orientation and training of social workers is often in contrast to that of their school colleagues and administrators, so they may need to educate their supervisors and colleagues about a variety of social work topics. This chapter explains the importance of connecting with professional organizations for continued professional development. It explores ways to bridge the gap between orientation and training and offers tips and tools to help new social workers become leaders in their profession and in their district. The experiences of the chapter authors, an educator and a social worker, are highlighted. © Oxford University Press 2022. All rights reserved.

FINDING SOLUTIONS TO DIGITAL INEQUALITY IN A BLENDED LEARNING ENVIRONMENT

The move to off campus learning and teaching in Higher Education (HE) in the UK due to the Covid-19 pandemic resulted in innovative and exciting opportunities for students to study in a more flexible, bespoke way from home using a Personal Computer (PC) or equivalent device. However, for an Engineering student to benefit from these opportunities they would require regular and prolonged access to a working, up-to-date PC, which they can use to download and access software and applications, join group discussions, access learning materials etc. This access is perhaps less likely for students from lower income backgrounds or areas of higher deprivation, and there is a risk of digital inequality widening the attainment gap. At Aston University (AU), a Virtual Desktop Interface (VDI) was implemented in order to provide students with a way to access high performance PCs remotely using their own device from home in order to use software and applications. To evaluate the VDI as a solution to digital inequality, a questionnaire (QNR) was developed and sent to AU students studying across a range of engineering programmes, and across a range of year groups. Results from the QNR (n=53) showed that almost three quarters (73.6 %) of respondents accessed the VDI during their study, with students being able to rate the usefulness of this for different activities. Of those students that did not access the VDI, the most commonly chosen reason was that they did not need to use it (50.0 %). The VDI system implemented at AU was well used by respondents, and comments were positive overall. Administering an online QNR presented some limitations to this study. Therefore, a paper-based QNR will be used for future research, which will be conducted at the end of this academic year. This will also allow a comparison of results between those in fully online learning environments, and the current blended delivery modes used at AU. © CDIO 2022.All rights reserved.

Achieving equitable access to cancer care and clinical trials in regional Australia: A networked approach to expand capacity and implement COSA teletrials model

Aim: Peoplewith cancer living in regional Victoria are less likely to participate in a clinical trial than metropolitan patients.We established a new geographically based trials network with the gaol of increasing the number of regional cancer patients recruited to clinical trials. Method(s): Initially six regional services and Cancer Trials Australia (CTA) collaborated to form Regional Trials Network Victoria (RTNV). Two more sites, Latrobe Regional Hospital and Mildura Public Hospital were added in 2021. This network represents a population of 1.9 million people and approximately 8000 new cancer diagnoses each year. Access to cancer clinical trials at regional sites was achieved by: Building capacity of regional clinical trial units Improving the efficiency of clinical trial conduct Implementing the COSA teletrial framework Investing in the capability of staff Increasing the number of clinical trials Results: In 2017, the CCV Clinical Trial Management Scheme (CTMS) recorded 1587 Victorians recruited to cancer clinical intervention trials. 428 resided in regional Victoria, but only 81 of these participated at a regional site, with others needing to travel. In 2017, 135 patients were recruited to RTN sites (regional plus Geelong) across 55 trials. By 2021, despite the impacts of the COVID19 pandemic the number of recruiting clinical trials increased by 54% and the number of regional patients recruited to CTMS studies in the network increased to 179. Driven by uptake of teletrials and registry trials total recruitment increased to 620 patients. RTNV leveraged funding to sustain core activity and was awarded $18.5 million from the Medical Research Future Fund to conduct health services research over the next 5 years. Conclusion(s): The RTNV is a successful implementation of a regionally based clinical trials network, improving access and participation of regional patients. Much of the increase was driven by the use of COSA Teletrials methodology.

Comparison of Telemedicine Versus In-Person Postoperative Appointments Following Drug-Induced Sleep Endoscopy

Introduction: Telemedicine has been a useful tool in the virtual management of patients with sleep disorders during the COVID-19 pandemic. Given the detrimental effects of chronic, untreated obstructive sleep apnea (OSA) on patient health, it is important that patients receive timely care. This study investigates whether the use of telemedicine is associated with delays in care or different rates of patient follow-up after drug-induced sleep endoscopy (DISE). Method(s): We performed a retrospective review of 166 patients who underwent DISE during 4-month periods of March-June 2019 and March-June 2021. The efficiency of telemedicine vs inpatient appointments following DISE was assessed using the time from DISE to the patient's first postop visit and the time from that postop visit to surgical intervention, referral to another specialty, or clinic follow-up. Additional variables of interest included patient demographics, characteristics of their OSA (sleep study results, Epworth score, positive airway pressure use), and the type of further care received (clinic follow-up, referral to another specialty, or surgery). Result(s): There was a significant increase in the rate of initial post-DISE telemedicine visits during the COVID-19 pandemic, with 39.7% of visits being telemedicine (P<.001) compared with 13.0% of visits pre-pandemic. The use of telemedicine was not associated with significant delays in obtaining initial post-DISE appointments, further surgical interventions, specialist referrals, or clinic follow-ups. There were no significant differences in follow-up rates between inperson or telemedicine appointments. In addition, there were no significant differences in telemedicine usage among patients of various demographics or with different severities of OSA compared with in-person appointments. Conclusion(s): Telemedicine appointments are an efficient alternative to in-person appointments following DISE for the management of OSA. In this setting, telemedicine was not associated with any significant delays in patient care or decreased follow-up rates, even among various patient demographics.

Staff and patient experience of the implementation and delivery of a virtual health care home monitoring service for COVID-19 in Melbourne, Australia.

BACKGROUND: Provision of virtual health care (VHC) home monitoring for patients who are experiencing mild to moderate COVID-19 illness is emerging as a central strategy for reducing pressure on acute health systems. Understanding the enablers and challenges in implementation and delivery of these programs is important for future implementation and re-design. The aim of this study was to explore the perspectives of staff involved with the implementation and delivery, and the experience of patients managed by, a VHC monitoring service in Melbourne, Australia during the COVID-19 pandemic. METHODS: A descriptive qualitative approach informed by naturalist inquiry was used. Staff interviews were analysed using the Consolidated Framework for Implementation Research (CFIR). Patient experience was captured using a survey and descriptive statistics were used to describe categorical responses while content analysis was used to analyse free text responses as they related to the CFIR. Finally, data from the interviews and patient experience were triangulated to see if patient experience validated data from staff interviews. RESULTS: All 15 staff were interviewed, and 271 patients were surveyed (42%). A total of four final overarching themes emerged: service implementation enablers, service delivery benefits for patients, fragmentation of care, and workforce strengths. 19 subthemes aligned with 18 CFIR constructs from staff and patient data. CONCLUSION: Rapid implementation was enabled through shared resources, dividing implementation tasks between senior personnel, engaging furloughed healthcare staff in design and delivery, and having a flexible approach that allowed for ongoing improvements. Benefits for patients included early identification of COVID-19 deterioration, as well as provision of accurate and trustworthy information to isolate safely at home. The main challenges were the multiple agencies involved in patient monitoring, which may be addressed in the future by attributing responsibility for monitoring to a single agency.

Whiteness, Religious Diversity and Relational Belonging: Opportunities and Challenges for African Migrants in Australia

African communities in Australia reflect the rich cultural and religious diversity of the African continent. Despite their persistence and agency, many members from these communities continue to experience a 'fractured belonging' due to persistent issues of racism and exclusion;issues that have been exacerbated during the COVID-19 pandemic. Religious community groups and organizations have long played important roles in assisting new migrants with settlement and belonging in Australia, including African migrants. This article presents preliminary findings from an Australian Research Council project on religious diversity and social cohesion, drawing on census data and interviews with African-Australian community and religious leaders in Melbourne and Hobart, from Mauritian, Ghanaian, Ethiopian, Somalian and South Sudanese communities. It explores the roles that religion and spirituality play in both addressing and perpetuating issues of racism, trauma and displacement. It also examines the development of 'relational belonging' and diverse, complex and dynamic identities among African migrants in contemporary Australia. It argues the case for retelling the history of African migration to Australia, to subvert the myth of a white Christian nation that excludes non-white Australians. It centres African migrants' lived experience narratives and theories of belonging developed by African scholars to counter narrow and negative stereotypes perpetuated by political and media discourses.

Impact of COVID-19 on emergency department attendance in an Australia hospital: a parallel convergent mixed methods study.

OBJECTIVES: The COVID-19 pandemic has changed the way people are accessing healthcare. The aim of this study was to examine the impact of COVID-19 on emergency department (ED) attendance for frequent attenders and to explore potential reasons for changes in attendance. DESIGN: This convergent parallel mixed methods study comprised two parts. SETTING: An interrupted time-series analysis evaluated changes in ED presentation rates; interviews investigated reasons for changes for frequent ED users in a culturally and linguistically diverse setting. PARTICIPANTS: A total of 4868 patients were included in the time series. A subgroup of 200 patients were interviewed, mean age 66 years (range 23-99). RESULTS: Interrupted time-series analysis from 4868 eligible participants showed an instantaneous decrease in weekly ED presentations by 36% (p<0.001), with reduction between 45% and 67% across emergency triage categories. 32% did not know they could leave home to seek care with differences seen in English versus non-English speakers (p<0.001). 35% reported postponing medical care. There was a high fear about the health system becoming overloaded (mean 4.2 (±2) on 6-point scale). Four key themes emerged influencing health-seeking behaviour: fear and/or avoidance of hospital care; use of telehealth for remote assessment; no fear or avoidance of hospital care; not leaving the house for any reason. CONCLUSIONS: This study demonstrated reduced ED use by a vulnerable population of previously frequent attenders. COVID-19 has resulted in some fear and avoidance of hospitals, but has also offered new opportunity for alternative care through telehealth.

Were pregnant patients more likely to consider home birth after the pandemic compared to before?

Objective: The SARS-CoV-2 pandemic affected every aspect of the pregnancy process from antepartum, labor and delivery, and postpartum. To maintain the safety of pregnant patients and healthcare providers, changes were made in the hospitals, especially at University Hospital in Newark, New Jersey, an epicenter of the pandemic in March 2020. This pilot study aimed to elucidate concerns of pregnant women regarding attending antepartum visits and delivering in the hospital during the pandemic. regarding antepartum visits and delivering in the hospital during the pandemic. Study Design: Telephone surveys were conducted with patients 18 years or older who were pregnant during or after the statewide lockdown beginning on March 21st, 2020. Eligible patients were identified from the University Hospital Department of Obstetrics, Gynecology and Women’s Health database. From October 2020 through January 2021, 124 participants were contacted and 55 were successfully surveyed. Surveys assessed concerns regarding in-person appointments/delivery, potential changes in birth plan, and attitude towards home birth. Demographic information (age, race, and ethnicity) was collected. For this pilot study simple descriptive statistics were employed. Results: Our survey response rate was 55 out of 124 (44.4%). The median age was 28(IQR 24-35) and of the 55 respondents, 48(87.3%) self-identified as African American. Of the 55 respondents, 16(29.1%) reported having concerns about delivering in the hospital while 7(12.7%) reported concerns about attending prenatal visits during the pandemic. Only 8 women (14.5%) reported considering home birth prior to the shutdown. Although 29.1% reported concerns about delivering in the hospital, only 5 women (9.1%) reported that they were considering a change to their birth plan. No women reported considering changing from a hospital to home birth. Conclusion: In this pilot study, where 87% of the respondents were African American, almost 30% reported having concerns about delivering in the hospital during the pandemic but none of the respondents reported considering changing their birth plan from in-hospital to home birth. Further studies are needed to validate these findings. [Formula presented]

Feasibility of a virtual hybrid resistance and balance training program for older patients with cancer and its preliminary effects on lower body strength and balance

Background: Falls are a major issue among older patients with cancer and can lead to interruption in cancer treatment. Ample evidence shows resistance and balance training can prevent falls in older adults;however, there is a paucity of evidence regarding exercise on fall prevention in the older cancer population, who often have unique risk factors for falls. Given the new reality of the COVID-19 pandemic, minimizing group gatherings and its associated risks is imperative for older patients, who are a vulnerable population. This study sought to investigate the feasibility of an 8-week, virtual exercise program and its preliminary effects on lower body strength and balance in community-dwelling cancer patients. Methods: Study participants were recruited for this pretest-posttest intervention study using consecutive sampling over a one-year period from the Cross Cancer Institute in Edmonton, Alberta. The intervention entailed leg muscle strengthening and balance training exercises that progressed in difficulty as outlined by the Otago program, and involved a virtual component (facilitated live by a certified exercise physiologist via Zoom meeting platform once a week) and independent at-home training component (twice a week). Lower body strength and balance were assessed using the 5-times chair-stand and the 4- stage balance test, respectively, and were analyzed using the Wilcoxon Signed Rank test. Results: Twenty-seven older patients (mean age 70.1, range 65-76) participated. The most common cancer sites were breast (48%) and prostate (41%). One participant withdrew due to personal reasons unrelated to the program. The remaining 26 participants completed the intervention. Attendance rate for the virtual component was 97.6% and independent component 84.7%. Participants perceived the program as rewarding and enjoyable (100%), felt this program prepared them to exercise on their own (92%), were confident to continue exercising on their own (81%), and would recommend the program to other patients (100%). At baseline, 33% (n = 9) ≥1 fall over the past 6 months. A statistically significant improvement in lower body strength was detected post-intervention (p =.001), whereas no difference was detected in balance (p =.059). Conclusions: This virtual, hybrid resistance and balance training program was feasible, overwhelmingly accepted by our older participants, and appeared effective in improving lower body strength. Findings from this study may have potential to inform design of a larger, randomized multi-site study.

Descriptive Analysis of a Telephone Based Community Monitoring Service for COVID-19.

The coronavirus disease (COVID-19) pandemic has required health services to rapidly respond to the needs of people diagnosed with the virus. Over 80% of people diagnosed with COVID-19 experience a mild illness and there is a need for community management to support these people in their home. In this paper we present, a telephone based COVID-19 community monitoring service developed in an Australian public health network, and we describe the rapid implementation of the service and the demographic and clinical characteristics of those enrolled. A retrospective mixed methods evaluation of the COVID-19 community monitoring service using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. Eight hundred and fifty COVID-19 positive patients were enrolled, 54% female, 45% male, mean age 34 years SD 17. Four hundred and nine (48%) patients were born outside Australia. Among the 850 patients, 305 (36%) were classified as having a high risk of serious illness from COVID-19. The most prevalent risk factors were cardiovascular disease (37%), lung disease (30%) and age over 60 years (26%). The most common reported ongoing symptoms were fatigue (55%), breathing issues (26%) and mental health issues such as low mood (19%). There were no deaths in patients that participated in the service. The process of risk stratification undertaken with telephone triage was effective in determining risk of prolonged illness from COVID-19. Telephone monitoring by trained health professionals has a strong potential in the effective management of patients with a mild COVID-19 illness.

Building drainage system design for tall buildings: Current limitations and public health implications

National design guides provide essential guidance for the design of building drainage sys-tems, which primarily ensure the basic objectives of preventing odor ingress and cross-transmission of disease through water-trap seal retention. Current building drainage system design guides only extend to buildings of 30 floors, while modern tall buildings frequently extend to over 100 floors, exceeding the predictive capability of current design guides in terms of operating system condi-tions. However, the same design guides are being used for tall buildings as would be used for low-rise buildings. A complicating factor is the historic roots of current design guides and standards (including the interpretation of the governing fluid mechanics principles and margins of safety), causing many design differences to exist for the same conditions internationally, such as minimum trap seal retention requirements, stack-to-vent cross-vent spacing, and even stack diameter. The design guides also differ in the size and scale of the systems they cover, and most make no allowance for the specific building drainage system requirements of tall buildings. This paper assesses the limitations of applying current building drainage system design guides when applied to the case of tall buildings. Primarily, the assessments used in this research are based on codes from Europe, the USA and Australia/New Zealand as representative of the most common approaches and from which many other codes and standards are derived. The numerical simulation model, AIRNET, was used as the analysis tool. Our findings confirm that current design guides, which have been out of date for a number of decades, are now in urgent need of updating as code-compliant systems have been shown to be susceptible to water-trap seal depletion, a risk to cross-transmission of disease, which is a major public health concern, particularly in view of the current COVID-19 pandemic. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.