Helping Hands

Introduction: We work in a large, tertiary Teaching Hospital Critical Care unit. As such we have a sizeable and diverse workforce from multiple professional backgrounds. We noted both anecdotally, and from the formal process of Exit Interviews that the changes imposed by the Covid-19 pandemic were impacting on team relationships. Physical barriers enforced by social distancing, as well as the burden of increased patient numbers and changes to job roles had driven apart nursing and medical teams. Critical care appeals to many staff because of the MDT and the chance to work with highly qualified, ambitious colleagues with varying skill sets. Nurturing this positive working relationship between different teams requires a commitment from all to share the burden of increased pressures wherever possible. Objective(s): The aims for this project are to identify specific areas within the working relationship between the medical team and the nursing team that can be improved. More than this, we want to open wider conversation about how teams can work more collaboratively for the benefit of the working environment, staff mental health and ultimately the patient. Method(s): We created an e-survey with input from the critical care matrons and psychologists before distributing amongst nursing staff. Questions focused on communication, practical support and the general working relationship. Each section contained MCQ's and white space questions to allow us to collect both quantitative and qualitative data. Following collection of responses we identified common themes that could be addressed and created an eye-catching poster with specific suggestions for the medical team. Result(s): Communication: Common themes were more presence on the unit with more regular walk-rounds and that STAT medications are often prescribed but not communicated to the nurse at the bedside and are therefore delayed. Practical support: Common suggestions were helping with repositioning patients and relieving breaks. Others included, pulling blood gases, printing off blood request forms and working in pairs for lines so that the nurse doesn't have to be engaged. Working relationship: suggestions mainly focused around introducing ourselves and level of training as well as social integration of the two teams. A few said that improving the communication and assisting with tasks would feed into improving the relationship. A few also said that the survey itself was a good start. Discussion(s): The survey generated many useful suggestions as well as demonstrating an open and receptive attitude. Responses were used to create a poster that gives clear and practical advice to the medical team. This method is easily reproducible and we believe that we have already seen positive changes that have been widely well received. We plan also to send a follow up survey once changes have become ingrained into the culture of the workforce. Acknowledgements Matthew Powell Jane Atkins Nathan Shearman Helen Horton.

Resiliency among Older Adults Receiving (Roar) Lung Cancer Treatment: A Feasibility Study

PURPOSE/HYPOTHESIS: Poor physical performance and negative mood are two risk factors for functional decline among older adults with lung cancer. Yet, targeted interventions to maintain independence prevent functional decline are not well studied. Our primary objective was to assess the feasibility of a novel virtual health physical therapy (PT) plus progressive muscle relaxation (PMR) intervention with longitudinal microbiome biospecimen collection delivered to older adults with advanced lung cancer. Secondary objectives were to characterize functional status and clinical factors pre and post-study intervention. NUMBER OF SUBJECTS: We accrued adults aged >=60 years with advanced non-small cell or extensive-stage small cell lung cancer receiving treatment at The Ohio State University James Comprehensive Cancer Center (OSU-JCCC) in the Thoracic Oncology department (N=22). There were no exclusion criteria pertaining to Eastern Cooperative Oncology Group (ECOG) performance status, laboratory values, prior cancer diagnoses, presence of comorbidities, or brain metastases. MATERIALS AND METHODS: Participants were asked about functional status, symptoms, mood through the PHQ-9, GAD-7, POMS, and acceptability questions about the program. PT evaluation and assessment included SPPB and 2- or 6-minute walk test outcomes. The study sought to collect gut microbiome samples for every in-person visit and activity monitoring data (Actigraph) on a subset. Feasibility was defined as successfully collecting specimens, wearing an Actigraph activity monitor, and adhering to the intervention. PT and psychologists evaluated participants in-person at the first and final visit. The rest of the 12-week intervention was conducted via virtual health. Physical therapy intervention consisted of endurance, strength, and flexibility exercises. RESULT(S): In total, 22 patients consented and 18 started the intervention (81.8%). Seven microbiome samples were collected from four participants. Six patients collected activity monitoring data. Among the 18 participants, 11 participants (61.1%) completed 70% or more of all the intervention visits. The SPPB data show a moderate effect size (Cohen's d=0.24) from pre- to post-data. On average patients improved by 1.8 total points on the SPPB. Patients demonstrated improvement on timed walk tests throughout intervention from an average of 108 feet pre-intervention to an average of 138.4 feet post intervention. CONCLUSION(S): Despite the challenges of the COVID-19 pandemic, longitudinal biospecimen and correlative data collection were feasible in the context of PT and PMR intervention among older adults with advanced lung cancer. Virtual physical therapy interventions can be safely delivered to improve physical performance as demonstrated by a moderate effect size for the SPPB in this patient population. CLINICAL RELEVANCE: Based on the feasibility study results, delivering a virtual PT intervention to older patients with lung cancer can improve SPPB score leading to decreased frailty and improve quality of life among patients.

A psychologist among the school desks

The Covid-19 health emergency has helped in Italy to accelerate reflection on the importance of psychologists at school. it is essential to try to understand their role, tasks and areas of intervention, in order to promote their professional characterization as a figure who works within the educational contexts. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

What is the role of psychologists during the COVID-19 Pandemic? The necessity of taking actions reflecting public voices

This paper discusses what psychologists should do to help the general public in response to the new coronavirus infectious disease (COVID-19) in Japan. Four things psychologists could do are listed in the Japanese Psychological Association article entitled "Against Violence in the Home." However, the style of the article seems insufficient for psychologists to perceive the article as general behavioral guidelines for helping people suffering from psycho logical stress. Psychologists should be encouraged to publicly disseminate relevant information because the current domestic policies may cause confusion for the public as they provide insufficient behavioral principles and re- search-based perspectives. This paper proposes three different levels of roles for taking actions as psychologists: as a professional individual, as a member of an academic society, and as a public figure disseminating relevant in formation. To be impactful in carrying out these roles, setting up a "place" where individual practices and opinions can be quickly aggregated is required. Moreover, it is important for psychologists to listen to public voices and be prepared to focus their professional Eves on tackling social issues. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

School psychologist: School as an interweaving of relationship

The Coronavirus with the measures adopted by the government, have brought school psychology and the role of the psychologist in the school to the fore. The school psychologist must promote well-being in school. In pursuing this goal, attention to school relations is central. The school psychologist works for the promotion of well-being, but he must also be able to intercept and give an initial response to the discomfort. He is a figure rooted in the school with specific personal and professional skills. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Formation of a virtual cystic fibrosis support group: Connecting with Other Parents' Experiences

Background: Before the COVID-19 pandemic, families at a large pediatric cystic fibrosis (CF) center expressed interest in participating in support groups through informal oral feedback during CF clinic visits. Many barriers existed related to CF guidelines restricting in-person contact, traveling to the hospital to attend, feasibility of attending groups regularly, and lack of technology. The COVID-19 pandemic drastically improved the availability of telecommunication, which expanded options for support. This project involved development and implementation of a formal virtual support group for caregivers of children recently diagnosed with CF. Method(s): The psychosocial team (2 licensed clinical social workers, 2 psychologists,1psychology trainee)developedacurriculumwiththemesand discussion topics for each session that included processing and sharing diagnosis story, mobilizing support, treatment fears and frustrations, and celebrating milestones and successes. Eligible group members were caregivers of babies diagnosed with CF who were in their first year of life. All eligible caregivers were emailed to assess interest and collect feedback that was used to inform implementation of the group. A total of 12 families were eligible for the first round of Connecting with Other Parents' Experiences (COPE) group sessions and 14 families for the second round. The first cohort met biweekly in for six 90-minute sessions. After the initial group, adjustments were made based on feedback and participation. The second cohort met weekly for four 1-hour sessions. All participants were scheduled onthelicensedclinicalsocialworkers orpsychologyscheduleandjoinedeach session via the institution's HIPPA-secure virtual platform(Vidyo). Result(s): The first COPE group sessions were held from July to September 2020. Sixty-seven percent of eligible families expressed interest in participating (n = 8). Fifty percent of families who expressed interest in the group attended at least one session (n = 4). Each group session ranged from one to four families. The second COPE group sessions were held in October 2021. Sixty-four percent of eligible families expressed interest in participating (n = 9). Forty-four percent of families who expressed interest in the group attended at least one session (n = 4). Anecdotal evidence from the parent support groups has been overwhelmingly positive. Parents reported appreciating the social support and have begun to connect with each other outside of the group for ongoing support. Conclusion(s): COVID-19 and the increase in telemedicine expanded our ability to provide support to caregivers in away that had not been feasible previously. Caregivers were engaged and reported experiencing less isolation and normalization of emotions and challenges related to having a baby with CF. Several barriers to offering support groups exist, such as determining times that work for most families and interest in regular participationCopyright © 2022, European Cystic Fibrosis Society. All rights reserved

Competencies and intervention areas of the school psychologist. Invitation to a discussion

Due also to the effects of Coronavirus, there was an increase of psychological requests and interventions within Italian schools, and the government adopted specific measures. However, the entity of the presence of the school psychologist and the types of competencies and interventions vary substantially between schools. There is therefore a need of clarification on what Italian school psychologists have done and may do. The present paper, based on an analysis of the international and national situations, opens a discussion on the competences and role of psychologists in the Italian schools. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

How to Develop a Virtual Tour in Medical Physics

Purpose: For several years, virtual and blended-learning courses in Medical Physics are offered at the German Cancer Research Center (DKFZ) for national and international postgraduates, working in clinical or research institutes at the same time. While hosting such courses, we were able to gain a deeper understanding of multimedia learning for working professionals and their specific needs. Based on this long-lasting experience, we could transfer all courses into a full virtual mode since the start of the Covid-19 pandemic. However, visits to Heidelberg and our clinical institutes were and still are not possible. Therefore, participants are lacking this important experience. Material(s) and Method(s): To fulfil this gap, we decided to develop a first virtual tour about our division Medical Physics in Radiation Oncology, based on previous work of the Austrian authors (e.g. developing virtual labs for students). The idea is to evaluate the workload, technical challenges and possibilities that are available to us for future tours. As theoretical context we understand "multimedia learning" as "learning from words and pictures" (Mayer 2008, p. 761). Thus, it follows two channels: auditory/verbal and visual/pictorial. Both channels are limited and can only process a limited number of simultaneous processes (elaborated as Cognitive Load Theory by Sweller 2005). Main criteria derived from this framework are the basis for developing the tour layout (Mayer & Moreno 2003). To develop the tour we decided to use existing tools like our Moodle platform which includes the H5P plugin and allows us to design virtual tours based on 360-degree pictures. In addition to existing audio-video equipment, we purchased a simple 360-degree camera. Result(s): We are going to present the virtual tour and its layout and design, consisting of 360-degree pictures, text and videos offering an overview about our division at DKFZ. Conclusion(s): The tour is considered as template for tours to be developed in the future. More work about the application of didactical criteria and about the user's perspective is needed to integrate virtual tours in didactical settings. References: 1. Mayer, R. E., & Moreno, R. (2003). Nine ways to reduce cognitive load in multimedia learning. Educational Psychologist, 38(1), 43-52. 2. Mayer, R. E. (2008). Applying the Science of Learning: Evidence Based Principles for the Design of Multimedia Instruction. The American Psychologist, 63, 760-769. 3. Sweller, J. (2005). Implications of cognitive load theory for multimedia learning. In R. E. Mayer (Ed.), The Cambridge Handbook of Multimedia Learning (19-30). Cambridge [u.a.].Copyright © 2023 Southern Society for Clinical Investigation.

Mental health training needs of physicians in Bangladesh: Views from stakeholders

Bangladesh is a lower-middle-income country with a high burden of mental health conditions and inadequate health systems. Prior research in similar settings has found that training physicians in mental health literacy can contribute to reducing the mental health treatment gap and strengthening the mental health care pathway. This study explores the need for mental health training for physicians by gathering stakeholders' perspectives and proposes recommendations for designing a mental training program in the context of Bangladesh. Key informant interviews were conducted among psychiatrists (n = 9), and mental health entrepreneurs (n = 7);one focus group discussion was conducted with psychologists (n = 8);and one-on-one interviews were held with physician (n = 17). Due to the COVID-19 restrictions, all interviews were conducted online, recorded and transcribed. Transcriptions were analyzed thematically, utilizing both an inductive and deductive approach. The data analysis from forty-one stakeholders generated three major themes and eight subthemes. Stakeholders perceived that the inadequate mental health system and low mental health awareness among physicians significantly contribute to the mental health treatment gaps. Stakeholders emphasized the need to include mental health training for physicians to increase skills related to identification and management of mental health conditions. Stakeholders suggested some basic components for the training content, feasible modalities to deliver the training, and implementation challenges. Recommendations included utilizing online training, ensuring interesting and practical content, and incorporating certification systems. At a systems level, stakeholders recommended including a mental health curriculum in undergraduate medical education, capacity building of other healthcare workers and increasing awareness at the policy level. There is clear agreement among stakeholders that implementing mental health training for physicians will promote universal health coverage and reduce the mental health treatment gap in Bangladesh. These findings can support creation of policies to strengthen the care pathway in countries with limited resources.Copyright © 2022 The Authors

Perceived effects of the COVID-19 pandemic on clinical psychology internships in Sweden.

BACKGROUND: The COVID-19 pandemic has had an unprecedented impact on societies and health care services worldwide, including the clinical training of psychology interns. Some of the pandemic-related restrictions were in breach of the internship requirements, increasing the risk of failed internships and a shortage of new health care professionals. This situation needed to be assessed. METHODS: Web-based surveys were administered to clinical psychology interns in Sweden 2020 (n = 267) and 2021 (n = 340), as well as to supervisors in 2020 (n = 240). The supervisors also provided information about their interns (n = 297). RESULTS: Risk factors for a prolonged internship, such as pandemic-related absence from work (12.4% in 2020 and 7.9% in 2021), unqualified work (0% in 2020, 3% in 2021), and change in internship content were low. However, remote interactions using digital services increased. Face-to-face patient contacts decreased significantly from 2020 to 2021 (Χ2 = 5.17, p = .023), while remote work and remote supervision increased significantly (Χ2 = 53.86, p < .001 and Χ2 = 8.88, p = .003, respectively). Still, the content in patient contacts and supervision was maintained. Most interns reported no difficulties with remote supervision or supervision in personal protective equipment. However, of the interns who reported difficulties, role-play and skills training in remote supervision were perceived as significantly harder (Χ2 = 28.67, p < .001) than in supervision using personal protective equipment. CONCLUSIONS: The present study indicates that clinical training of psychology interns in Sweden could proceed despite a societal crisis. Results suggest that the psychology internship was flexible in the sense that it could be realized in combined face-to-face and remote formats without losing much of its value. However, the results also suggest that some skills may be harder to train in remote supervision.

Psychologists' attitudes and COVID-19

Video based online psychotherapy has traditionally been an under-utilized tool by psychologists. Lack of experience, comfort with technology, and lack training, amongst other variables have historically been attributed as major barriers to adoption of online therapy. Only recently have psychologists' attitudes about online therapy been explored. Recent literature suggests psychologists' attitudes could significantly account for psychologists' intent to utilize online therapy in the future. The COVID-19 pandemic provided an unprecedented opportunity for psychologists to experience providing video based online therapy. This study examined psychologists' attitudes about video based psychotherapy, their comfort providing telepsychological services, challenges they experienced in transitioning to online services and what resources they used to aid their transition during the COVID-19 pandemic. Psychologists' intent to use online therapy for the future and platforms used to deliver therapy during the pandemic were also investigated. This study surveyed 230 psychologists and psychology trainees, collecting demographic data including practice setting, professional status, age, and ethnicity. Using the Unified Theory of Acceptance and Use of Technology (UTAUT) model, attitudes about online therapy are discussed. Data analysis was conducted on quantitative measures and qualitative responses were categorized and coded. Results indicate most psychologists reported positive attitudes about online therapy and endorsed using online therapy in the future. Previous experience in online therapy had a statistically significant impact on psychologists' attitudes and their comfort level with the technology. This study's findings present a massive shift in participant comfort level with online therapy. Results show 90% of participants intend to use online therapy in the future. The implications of this study highlight the need to standardize training and incorporate training into psychology doctoral programs. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Psychological Responses to Coronavirus Disease 2019 amongst Healthcare Workers in South Africa during the Pandemic

Background: It is important to understand HCWs' (healthcare workers) psychological responses to the Coronavirus disease 2019 (COVID-19) pandemic as theare exposed to the virus on a daily basis. This study helps identify some of the challenges they face. Aim: The overall aim of the study was to investigate psychological responses to COVID-19, including vaccinations and stressors, amongst healthcarHCWs in South Africa during the pandemic. Setting: HCWs who worked in private and state hospitals and private practice in Tshwane, South Africa. Methods: A quantitative approach using a cross-sectional survey design was used. Several standardised and validated questionnaires were used in the surveincluding the Coronavirus-19 Fear Scale, the COVID-19-related stigma scale and the COVID-19 stress scale. A purposive sample (N=103) waanalysed using descriptive statistics and chi-square. Results: There were 103 completed questionnaires. Many (76% and 54%) either knew someone close who contracted COVID or died from COVID-19respectively. Most (58%) were in favour of being vaccinated. A significant proportion (42%;p= 0.009) of the HCWs felt uncomfortable whethinking about COVID. Physical reactions such as sweating, or a pounding heart were reported by 17% of the HCWs. A majority of the HCWdisagreed with any form of stigmatization of COVID-19. Most of the HCWs expressed a need for mental health support during the COVID-1pandemic. About three-quarters of the respondents expressed a need to talk to someone about their worries about COVID-19. Conclusion: Most of the respondents either knew someone who either contracted COVID-19 or died because of it. Many experienced anxiety symptoms whethinking about COVID-19. Many HCWs reported anxiety and stress symptoms such as insomnia, palpitations, sweating and difficultconcentrating. An overwhelming majority of the HCWs stated that people should not be discriminated against or stigmatized in any way because oCOVID-19. The majority of the HCWs expressed a need for psychological support during the COVID-19 pandemic. About 20% of the HCWwere against being vaccinated. This is worrisome as they are at high risk. The HCWs clearly expressed a need for more attention and supportowards their mental health during the COVID-19 pandemic. © 2023 Nel et al.

Short Time: Postnatal Hospital Care during Covid-19 Pandemic. The Results of a Psychological Wellbeing Screening in the Immediate Postpartum

Introduction: During the Covid-19 pandemic, isolation, fear of contagion, changes in care circumstances, and suspended or restricted visitor access impacted the psychological wellbeing of puerperae. As shown in literature [1,2], Covid-19 pandemic increased depressive and post-traumatic stress related symptoms in mothers in the postnatal period. Moreover, it could determine serious psychological challenges for pregnant and postpartum women, with potential "short" and "long" term consequences for the health of mothers and their children [2]. Healthcare providers should guarantee easy access to mental health services, as a primary strategy to support the health of both mothers and children [2]. After the worldwide spread of Covid-19 the organization of every hospital ward changed, including the obstetric and neonatal units. Compared to the pre-pandemic period, a reduction of the average length of stay in hospital for the new mothers was instituted [3]. This was the result of a reduction of the hospital beds, mostly because of the need to allocate mothers tested positive for Covid-19 in a separate area and to lower the risk of Covid-19 transmission in hospitals. The Obstetric Psychological Service of the Spedali Civili hospital in Brescia started a screening program for the wellbeing of the perinatal period in 2018, with a gradual development and improvement of the organization of this activity [4]. Screening was suspended during the first wave of Covid-19 pandemic from 6th of March to 4th of May 2020. Nevertheless, it was necessary to cope with the Covid-19 pandemic changing demands and methods in order to continue with the screening of women admitted in obstetrics ward. Method(s): A screening of psychological perinatal wellbeing was performed in puerperae admitted to the Second Department of Obstetrics at Spedali Civili hospital in Brescia. Screening consisted in a psychological consult, during which the psychologist illustrated the Obstetric Psychological Service to the woman and identified her psychological need, without using tests. This was eventually followed by an assessment consultation, specialist care and referral to the out-of-hospital psychological services, if required by the woman or considered necessary by the psychologist. It was made a comparison between data collected from October 2019 to January 2020 and from May 2020 to December 2021. Result(s): Compared to the pre-pandemic period, average length of stay in the Second Division of Obstetrics was reduced. In particular, starting from March 2020, the expected discharge of the puerpera was about 24 hours after vaginal birth and 48 hours after cesarean delivery, if no complications occurred for both mother and newborn. Previously, discharge was expected after about 48 hours and 72 hours, respectively. Discharge that occurs 24 hours after vaginal birth is named "Early discharge" and requires the activation of the out-of-hospital services, with home visits by an obstetrician. From October 2019 to January 2020, 470 admitted women were screened, of which 23 (4,9%) demanded a further psychological consultation[4]. Between May 2020 and December 2021, 5145 screening were performed. Among them 550 (10.7%) demanded a further psychological consultation. From those data we can affirm that there was an increase in psychological consultations (from 4.9% to 10.7%), after exhibiting a psychological need during the postnatal screening. Conclusion(s): Covid-19 pandemic changed the care conditions of the woman during the pregnancy and the immediate post-partum. The reduction of the average length of hospital stay of the women in the postpartum did not stop the Psychological Service prevention program. The Obstetric Psychological Service of the Spedali Civili hospital in Brescia implemented his activity increasing the pace of work, to be able to screen as many admitted women as possible. It was noticed that, after the Covid-19 first outbreak, the demand for psychological consultation after the screening consult was more than doubled in comparison to the pre-pandemic perio . This emphasized the benefit of an early interception of the psychological need of the women in the immediate post-partum period, especially during the Covid-19 pandemic.

Pims-Ts: The Psychological Needs of Families Admitted to Intensive Care

Background Paediatric Inflammatory Multisystem Syndrome (PIMS-TS) is a rare inflammatory condition affecting children and young people (CYP) weeks after infection with the COVID-19 virus. The aim of this study was to understand the potential psychological needs of these families. Methods PIMS-TS patients and their parents admitted to the hospital between April 2020 and May 2021 were reviewed by a psychologist 6-8 weeks post discharge as part of their clinical care. Young people over the age of 7 were asked to complete 2 measures for psychological distress and PTSD symptoms (CRIES-13 and PIED) and their parent/carer completed a measure of PTSD symptoms (IES-R). Ethical approval was not required for this study. Results 118 CYP and parents/carers who were admitted to GOSH were screened 6-8 weeks post discharge. 85 of the 118 CYP were aged 8 or over. 76.8% (n=91) of parents/carers completed the IES-R 78% (n=66) of CYPs completed the PIED and CRIES. 15% (n=10) of CYPs scores on the PIED suggested they were at risk of anxiety and depression. 24% (n=16) of CYPs reported clinically significant difficulties for PTSD on the CRIES-13 placing them in high probability of for a diagnosis of PTSD. 35% of parents/carers met the threshold for clinical concern on IES-R with 23% (n=21) scoring in the range for a likely diagnosis of PTSD. Discussion The findings of both the self-report screening questionnaires, indicate that significant number for CYP and their parent/carers are at risk of developing symptoms of psychological distress and trauma in 6-8 week period post discharge after PIMS-TS admission. Conclusion The result of this study clearly show identification of high levels of trauma and emotional distress for the CYP and their parents and carers and a potential need for ongoing psychological support to be provided as part of ongoing care.

Evaluation of a Creative Photography Workshop for Children and Young People Following a Diagnosis of Pims-Ts

Background Paediatric Multisystem Inflammatory Syndrome Temporally Associated with SARS-CoV-2 (PIMS-Ts) is a rare inflammatory condition affecting children and young people (CYP). Many CYP report behavioural/mood changes concentration difficulties and increased isolation which for some occurred following an admission to intensive care. This workshop aimed to reduce CYPs' experiences of isolation using a strength-based Narrative Therapy group approach. Methods The workshop was co-facilitated by a photography artist psychologists and ID clinical team in local gallery to create a safe therapeutic space. The workshop involved activities to allow CYP to explore their identity through the use of photography and to enable them to share their stories of their PIMS-TS experiences with their peers. The participants completed pre and post outcome evaluation measures and a free text feedback form. Two weeks following the workshop parents/carers and CYP were contacted to participate in a semi structured interview to evaluate the impact of the workshop on CYP relationship to their health condition and hospital experience. Results The workshop was attended by 9 CYP (aged 8-11 years). Participants indicated that the workshop had led to increased comfort and confidence in talking about their health condition and that they had appreciated the opportunity to meet other CYP. Discussion Feedback suggests that an arts-based workshop was an effective peer support-based psychological intervention. Conclusion These findings suggest that there are psychological benefits to narrative therapy-based arts group for CYP post discharge to share and reflect on their health and hospital experiences with those who have lived through similar experiences. Given that treatment protocols are still being refined for PIMS-TS the findings of this project suggest that CYP and families may benefit from follow-up interventions to better understand and identify their psychological needs post diagnosis.

Improving cardiovascular health behaviors through a comprehensive lifestyle intervention program during the pandemic in India

Background: We have witnessed a dramatic dip in adherence to cardiovascular health behaviors during the COVID-19 pandemic. Data from across the globe has shown that risk factors for cardiovascular disease (CVD) such as decreased physical activity, poor diet, and increased depression, loneliness, and stress have peaked during the pandemic. Having been badly affected by the pandemic and having had prolonged periods of countrywide lockdown, the at-risk and established CVD population has faced a major challenge in adhering to a healthy lifestyle in India. Purpose(s): This study aimed to analyze the change in cardiovascular health behaviors brought about by a comprehensive lifestyle intervention program (CLIP) during the pandemic in India. Method(s): All at-risk and CVD patients who had participated in the CLIP from mid 2020 to mid 2022 and had completed the internally validated health behavior assessment questionnaire, pre and post-program, were included in this retrospective study. A multidisciplinary team consisting of Physician, Physiotherapist, Dietician, and Counseling Psychologist provided the sessions online and/or in-person for the home-based and hybrid programs respectively. When a combination of online and in-person sessions were provided for a subject, it was called a hybrid program. The core components of the CLIP were exercise training, education on relevant health topics, nutritional guidance and psychosocial counseling. Result(s): Age of the subjects (n=50) at enrolment was 54+/-13 years and 40 (80%) were male. The time between pre-program and post-program assessments was 110 (IQR 47) days. Number of at-risk and CVD patients attending home-based and hybrid programs are shown in the Figure. There were 4 couples in the study cohort;21 (50%) of the remaining 42 subjects had at least 1 other family member attend the majority of sessions. There was a significant improvement in all the cardiovascular health behaviors, namely adequate daily intake of fruits, vegetables and whole grains, choice of heart-healthy foods between meals, sufficient weekly exercise and a reduction in self-reported chronic stress, upon completion of the CLIP (Table). Conclusion(s): A comprehensive lifestyle intervention program that incorporates a multipronged approach to behavior modification is effective in improving cardiovascular health behaviors in individuals at-risk as well as with established cardiovascular disease in India. The ripple effect of behavior modification in the accompanying family members needs to be studied systematically.

Continuing professional development in school psychology: Participation and needs

Continuing professional development (CPD) is both a requirement for licensure and an ongoing professional expectation in the field of school psychology. Examination of the types of CPD that have been completed, those that are still needed, and the modalities that should be used has been a neglected area of study in this profession. To answer these questions and assess how the COVID-19 pandemic had influenced the answers, if at all, a survey was distributed electronically to NASP regular members. A small, representative sample of the population (n = 27) completed the survey. Results indicated that in the past, the most frequent CPD topics included social emotional intervention, behavioral intervention, and social emotional assessment. Subsequent to the COVID-19 pandemic, the last two were replaced with remote service provision and diversity in learning in the aftermath. Going forward, school psychologists reported wanting to continue studying social emotional interventions, new ethical and legal guidance, and crisis intervention and prevention. Participants are most likely to engage in these trainings via live webinars or distance learning, school district trainings, state school psychology conferences, and self-study. The needs and interests of school psychologists should be taken into account when planning professional development activities at the district, state, and national level. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Implementation of pulmonary rehabilitation in postCOVID19 in Latin America: 18 months later

Introduction: The impact caused by the Coronavirus disease (COVID-19) has considerably altered the provision of outpatient rehabilitation services, especially pulmonary rehabilitation (PR). Objective(s): To describe the situation of PR services in Latin America 18 months after the beginning of the COVID-19 pandemic. Method(s): Cross-sectional study in which a survey was sent to professionals from PR centers in Latin America. An online questionnaire was applied from May to September 2021. The following data were included: demographic data of the programs, evaluation strategies, program structure, RP intervention in post-COVID-19 patients, and perception of therapeutic strategies for the care of post-COVID patients. COVID-19. The questionnaire was distributed in Spanish and Portuguese languages. This study was approved by the ethics committee. Result(s): Responses were received from 196 centers from 14 countries;Most of the surveys were answered by physiotherapists/kinesiologists in 65.7%. In the evaluation of exercise tolerance, the 6-minute walk test is the most used. Less than 50% of the institutions evaluate the quality of life, symptoms, and lung function. In the prescription of exercise intensity, there is reduced use of CPET and it is prescribed mainly with subjective scales of symptoms (Borg Scale) (78.1%), and response to exercise with vital signs (71.4%). The programs have, practically, for the most part, physical therapists (90.8%), as well as pulmonologists (60%), psychologists (35%), among other professionals. Conclusion(s): The application of these programs in Latin America is heterogeneous, both in the evaluations and the interventions carried out.

Multiple voices and lockdown

Between January 2019 and December 2022, a student (named L.A.) doing a BTS (a senior technologist's certificate) in Management was treated using a trimodal system of care by the BAPU of the Claude Bernard Center. How was this original system organized, and how did changes related to the lockdown of March-May 2020 allow for progress in the proposed treatment? The consulting psychologist, Ms. Beaudre, received the initial request: L.A. had multiple difficulties (learning, language, social, psychic, somatic, etc.). Rapid guidance was recommended in an individual space dedicated to educational psychology, while continuing with consultations. In the educational psychology space, L.A. met with Mr. Sanchez and first explained to him her concerns about her difficulties with the French language, her rejection of her mother tongue and her accent. Her learning difficulties made her fear she would fail the BTS. L.A. had low self-esteem. At the start of the lockdown of March-May 2020, the educational psychological support was done at a distance (by telephone), and this did not help to reduce L.A.'s anxiety. Shortly before the start of the lockdown, L.A. had met with Ms. Dziwulski, psychologist-psychotherapist, as part of a therapeutic relaxation session. The question of the physical isolation was an overwhelming concern. The isolation imposed by COVID-19 posed a serious problem for the continued use of this trimodal system of care: how to continue working with L.A.? Within the parameters of this trimodal care, an attempt was made to adapt the follow-up for L.A. around the question of the verbal contact via telephone and the physical presence (distant or real), in a way which would allow this young woman to question/examine the orders given by her inner voice that she called her "policeman". The temporary suspension of in person contact, as well as work on her self-image and imagination, the exclusivity of her inner voice and then the application of the telephone voice/real physical presence at the BAPU leading to the questioning of the role of the body in her difficulties, allowed L.A to exist differently. The establishment of and the modifications made to this system of care ultimately functioned as a mediation, which provided L.A. the possibility of acquiring another voice, another space in which to think.Copyright © 2023

Quality of life of a group of Ecuadorian health professionals in covid-19

Introduction: Covid-19 was the cause of a pandemic that claimed thousands of human lives. The pandemic has caused health professionals mental health problems that influence emotional, psychological and social well-being, which affects the way they think, feel and act in daily life. Objective(s): To de-termine the quality of life of health personnel during the Co-vid-19 pandemic in public institutions in the city of Cuenca. Material(s) and Method(s): Descriptive, cross-sectional and observational study. The study sample was 338 health professionals belonging to the Ministry of Public Health of the Canton Cuenca, province of Azuay-Ecuador, doctors, nurses, dentists, psychologists, assistants and biochemists who work at differ-ent levels of care were included. Two WHOQOL surveys and the Lazarus and Folkman scale of coping modes were used, for the tabulation of the data the RStudio statistical program was used. Result(s): In the psychological domain, no significant destructuring was found in the personnel studied. In the field of health, it should be noted that the personnel studied reported the inability to carry out the activities they need and the diffi-culty in moving from one place to another. Conclusion(s): When investigating the relationship of health personnel with the envi-ronment, no statistically significant alteration was found, but it was evidenced that social support is a protective factor for the mental health of personnel.Copyright © 2022, Venezuelan Society of Pharmacology and Clinical and Therapeutic Pharmacology. All rights reserved.