How can we define social care and what are the levels of true integration in integrated care? A narrative review

Purpose: Integrated health and social care initiatives are increasing and health and social care systems are aiming to improve health and social outcomes in disadvantaged groups. There is a global dialogue surrounding improving services by shifting to an integrated health and social care approach. There is consensus of what is "health care”;however, the "social care” definition remains less explored. The authors describe the state of "social care” within the current integrated care literature and identify the depth of integration in current health and social care initiatives. Design/methodology/approach: A narrative literature review, searching Medline, PsychINFO, CINAHL, PubMed, Scopus and Cochrane databases and grey literature (from 2016 to 2021), employing a search strategy, was conducted. Findings: In total. 276 studies were eligible for full-text review, and 33 studies were included and categorised in types: "social care as community outreach dialogues”, "social care as addressing an ageing population”, "social care as targeting multimorbidity and corresponding social risks factors” and "social care as initiatives addressing the fragmentation of services”. Most initiatives were implemented in the United Kingdom. In total, 21 studies reported expanding integrated governance and partnerships;27 studies reported having health and social care staff with clear integrated governance;17 had dedicated funding and 11 used data-sharing and the integration of systems' records. Originality/value: The authors' demonstrate that social care approaches are expanding beyond the elderly, and these models have been used to respond to multimorbidity [including coronavirus disease 2019 (COVID-19)], targeting priority groups and individuals with complex presentations. © 2023, Gabriela Uribe, Ferdinand Mukumbang, Corey Moore, Tabitha Jones, Susan Woolfenden, Katarina Ostojic, Paul Haber, John Eastwood, James Gillespie and Carmen Huckel Schneider.

High-Intensity, Occupation-Specific Physical Therapy for a Firefighter's Return to Work Following Critical Covid-19

BACKGROUND AND PURPOSE: Firefighting is a demanding and hazardous profession requiring optimal physical and cognitive health. Occupational risk factors associated with firefighting (contact with the public, pulmonary damage from repeated exposure to fire) may place firefighters at an increased risk of contracting SARSCoV-2 as well as for suffering complications resulting from fulminant COVID-191, which can result in impaired physical2 and cognitive3 performance. Current recommendations for rehabilitation following COVID-19 may be insufficient to address the unique physical and cognitive demands required to perform fire suppression tasks.4 The purpose of this case report is to describe the efficacy of a high-intensity, occupation-specific physical therapy (HIOS-PT)5 program to improve aerobic capacity, muscular strength, and cognitive performance sufficient to return a firefighter to full duty within 6 months following hospital discharge for critical COVID-19. CASE DESCRIPTION: A 36-year-old firefighter completed 30 sessions of HIOS-PT with hopes of returning to his strenuous occupation as a firefighter following a 70-day complicated hospitalization for critical COVID-19 pneumonia and acute respiratory distress syndrome requiring invasive mechanical ventilation. Initial evaluation revealed impaired aerobic capacity of less than the first percentile for age and sex on cardiopulmonary exercise testing6, impaired muscular strength on isokinetic testing, and impaired cognitive performance as assessed by an app-based information processing task (reaction time and accuracy). The HIOS-PT program was symptom-limited simulated real work activities based on previous literature describing the effect of similar programming with first responders in cardiac rehabilitation5, while improving strength, cognition, and aerobic capacity sufficient to meet fitness standards required to return to work. Additionally, the patient performed 3 simulated candidate physical ability tests each increasing in intensity which consisted of 9 fire suppression activities required by his department7. Followup assessments were performed after completion of 30 HIOS-PT sessions. OUTCOME(S): Aerobic capacity increased 54% from a VO2=25.4 mL/kg/min (7.3 METs) to VO2=39.2 mL/kg/min (11.2 METs). Muscular strength increased from 59% to >96% body weight. Cognitive performance on an information processing test increased 175% from a score of 556 to 1530. Upon discharge from the HIOS-PT program, the patient returned to full duty as a firefighter. DISCUSSION: HIOS-PT was well tolerated and effective in rehabilitating a firefighter to return to work following a prolonged hospitalization for critical COVID-19. Rehabilitation guidelines for occupational athletes, such as firefighters, following critical COVID-19 is limited and may be insufficient to adequately prepare these individuals for return to strenuous work duties. This case supports the exploration into using HIOS-PT for individuals required to perform heavy work following critical COVID-19.

Implementation of a Mathematics Formative Assessment Online Tool Before and During Remote Learning

ASSISTments is a free online learning tool for improving students’ mathematics achievement by providing immediate feedback and hints to students, detailed information on how students performed to teachers, and instructional suggestions for teachers to use. Researchers at the Friday Institute for Educational Innovation conducted an intrinsic, longitudinal multiple-case study of 7th-grade mathematics teachers’ implementation of ASSISTments and its impact on their instruction before and during the COVID-19 pandemic. The study examined teachers’ use of ASSISTments in three instructional contexts: in- person only, remote only, and both in-person and remote. Our findings indicate that teachers in all contexts changed their instructional practices for homework review and for determining whether their students had understood lessons. Teachers used the ASSISTments auto-generated reports to focus their homework reviews, based on their students’ performance, and to provide instructional interventions and/or re-teaching. They also used the instructional suggestions provided by the ASSISTments platform to plan lessons to re-teach concepts or to review prior instruction with their students. © 2022, Springer Nature Switzerland AG.