Tensions in Cultural Identity and Sense of Belonging for Internally Displaced Adolescents in Ukraine

This article examines the cultural, educational and mental health consequences of large-scale internal displacement for children and adolescents from the Donbas to other parts of Ukraine. The research findings and methodological innovations of the study are discussed in the context of forced migration and displacement caused by the previous (2014) armed conflict in East Ukraine and Donbas with additional challenges posed by the Covid-19 pandemic. Our data collection was halted by the military action in Ukraine that started in February 2022 that has caused another wave of forced migration. We reflect on the experience gained from conducting research on sensitive topics of displacement using online methods in the environment of restricted access to schools and adolescents. The adolescents who were interviewed described their experiences of displacement, which for some had taken place nearly eight years before. Trauma from conflict and displacement can have mental health, educational and social consequences for displaced adolescents. These displaced young people and their families face, as internally displaced populations, a double-edged sword in their relationship with their new contexts. They often have numerous challenges in their settling in a new location and public sphere given the existing ethnic, cultural and language diversity of Ukraine and yet have the advantage of being able to adopt and adapt to their new socio-cultural contexts relatively quickly and minimise their pre-migration identities, if they so wish.

Evaluating Availability of Glucose Data During In-person versus Telemedicine Visits in an Endocrinology Specialty Clinic

Introduction: Blood glucose (BG) data are essential for diabetes management. Before Coronavirus Disease 2019 (COVID-19) pandemic, BG data would be obtained as patient fingerstick BG logs, or insulin pump and/or continuous glucose monitor (CGM) data downloaded from patients' devices during in-person visits. Transition to telemedicine during the pandemic altered clinic workflow and challenged access to BG data. This study compares availability and sources of BG data in telemedicine versus in-person endocrinology visits. Research Question or Hypothesis: Hypotheses: 1) BG data availability was higher for in-person versus telemedicine visits. 2) More fingerstick BG logs were available for in-person visits. 3) Availability of pump and/or CGM data was higher during in-person versus in-person visits. Study Design: This was an observational retrospective study conducted via chart review. Methods: We randomly screened adult diabetes management clinic visits at Banner 'University Medicine Endocrinology Clinic from 6/1/2019 to 12/13/2019 (in-person, Group A) and 6/1/2020 to 12/31/2020 (telemedicine, Group B). Incomplete visits were excluded. Chi-square test was used for between group comparison. Results: Out of the 766 screened visits, 200 were included in Group A and 199 in Group B. Overall, availability of BG data (from all noted sources) was higher for Group A (79%) than Group B (46.2%), P<0.001. More fingerstick BG logs were available for Group A (78.5%) than Group B (21.5%), P<0.001. Availability of insulin pump and/or CGM data was not statistically significant between the two groups (54.1% vs 45.9%, P=0.210). Conclusion: The higher overall BG data availability for in-person visits was driven by that of fingerstick BG logs. Pump and CGM data availability did not differ between groups suggesting that those data were successfully shared with the clinic for telemedicine visits. Enhancing ability to share fingerstick BG data for telemedicine visits should be considered. Future studies are needed to assess availability of clinically relevant data.

Comparison of patient satisfaction and outcomes of day case mastectomy versus inpatient model, using a validated questionnaire

Introduction: Many women undergoing simple mastectomy have an overnight hospital stay. Offering a day case procedure for simple mastectomy has the potential to improve outcomes in terms of patient safety, feasibility, and reduction in associated costs. We aimed to study the proportion of day case mastectomies over a 2-year period and assessed relative readmission and complication rates alongside patient reported outcome measures (PROMs). Following this, we wanted to analyse whether a day case procedure should be routinely offered. Method: A retrospective audit was conducted on all patients undergoing a simple mastectomy. Data were collected from patient and pathology records. PROMs were obtained via telephone conversation using the validated BREAST-Q survey. Patient demographics, reason for mastectomy and readmission for complications were all assessed. Results: Out of the 202 patients analysed, over 75%had an overnight stay. The most common complications for both groups of patients were readmission due to infection and haematoma evacuation, with similar rates across the two (p=0.26, p=0.69). Data from PROMs also suggested that patients had similar outcome and satisfaction levels (p=0.27). Conclusions: The result from this study shows that it is safe as well as acceptable to patients to offer simple mastectomies as a day case procedure. This has become more important since COVID-19 reduced inpatient theatre capacity, and it is anticipated that these outcomes will allow a routine day case mastectomy pathway to be established even when normal operations recommence as encouraged by the association of day case surgery.

SCHOOL MENTAL HEALTH: A BAROMETER FOR OUR TIMES

Objectives: This presentation will discuss a range of interventions that have been conducted in schools, from specific services for refugee children to global services for all children. The range of interventions span from the promotion of mental well-being to interventions aimed at either the prevention of mental illness or the treatment of established difficulties. The limitations of the evidence base and the challenges that the field needs to address will be examined with a focus on some of the ethical dilemmas that working in schools can raise. Methods: A school mental health and well-being survey of over 20,000 school-aged children (the OxWell School Survey) will also be presented to highlight new areas to be considered in light of the COVID-19 pandemic and ensuing disruption to school-aged children. Results: Current rates and student perceptions of needs will be presented. Conclusions: The limitations of the evidence base and the challenges that the field needs to address will be examined with a focus on some of the ethical dilemmas of working in schools. EBP, SAC, TREAT