How do we leverage data through replication and warehousing to meet blood collection and transfusion service needs.

BACKGROUND: With the widespread adoption of Blood Establishment Computer Systems and other Blood Collection and Transfusion Service (BCTS) clinical information systems (CIS), electronic blood donor, product, and patient data are now routinely required for clinical, regulatory, operational, and quality needs. That data are often not readily accessible for such secondary use within CIS databases, particularly for applications with significant data availability requirements such as machine learning and artificial intelligence. Data replication provides one avenue by which CIS data can be made more readily available. STUDY DESIGN AND METHODS: Members of the AABB's Information Systems Committee along with institutional information technology colleagues provided a multi-institutional viewpoint on data replication through the lens of BCTS specific use cases. Case studies of informatics offerings leveraging such technologies were also elicited. RESULTS: Six distinct use cases describe the potential role of data replication including the creation of data warehouses for frontline laboratory staff. Specific BCTS examples for each use case are presented to highlight the value of data replication, including visualization of critical inventory (O red blood cells, HLA-compatible platelets) and utilization analytics for patient blood management. Two case studies describe the approach to implement such technologies to (1) optimize staffing via laboratory workload reporting and (2) improve access to blood via antigen-negative blood product location services. DISCUSSION: Data replication and warehousing can empower BCTS analytic offerings not otherwise natively available through one's CIS to improve patient care and laboratory operations.

Responding to COVID-19 in social work field education in Australia, New Zealand and the United States.

This descriptive article reports immediate responses to COVID-19 by social work field education faculty in four universities in Australia, New Zealand and the United States. Moving swiftly to online innovations, tele-supervision, teaching remote practice methods, and establishing alternative placements allowed students to meet required competencies while supporting students during the immediate crisis. Collaboration between field education faculty teams, professional bodies and agencies and clear communication with students and supervisors enabled all stakeholders to be open to flexible placement options. To conclude, COVID-19 brought opportunities to reflect on responses and explore new possibilities for field education in a post-COVID-19 world.

The Impact of Critical Life Points and Events for Survivors of Institutional Child Sexual Abuse: Understanding Trauma and the Role of Compensation in Recovery.

Although the impact of child sexual abuse (CSA) is well documented in the international literature, little is known about the critical points of recovery across the life course for survivors of institutional CSA. The aim of this study was to identify critical points, or events across the life course that may increase, or decrease, a survivor's vulnerability to the complex traumatization of institutional CSA (ICSA). The sample consisted of two hundred and forty-eight witness statements extracted from the 56 publicly available case studies presented to the Australian Royal Commission into Institutional Responses to Child Sexual Abuse during 2013-2016 (Commonwealth of Australia, 2017). A content analysis and thematic coding of the statements identified seven main themes in the witness statements (Gender, Organization, Triggers, Trauma, Mental Health, Intervention and Compensation), that appeared to be critical events across the life course. The themes were transformed into variables for further analysis using SPSS. Significant Likelihood Ratios were found between associations with the organization where the abuse occurred and between triggers and breastfeeding/sensory, breast feeding/childcare, emotional and physical distress, and mental health (p < 0.01). Significant associations were also found between receiving compensation for the CSA and triggers, trauma, breast feeding-sensory and childcare (p < 0.05) and gender and breast feeding (p < 0.05). Overall, the findings showed that triggers can be random across the life course occurring mainly through indirect association, or in situations that evoke memories of the CSA, and that receiving compensation can assist survivors in their recovery journey. The findings also indicate the need for health care professionals to be aware of the critical points in a CSA survivor's recovery and how triggers may impact on their mental welling throughout the life course.

Update on Canterbury Charity Hospital Trust activities 2013 to end of 2020: adapting to changing unmet secondary elective healthcare need.

AIM: To update activities of the Canterbury Charity Hospital (CCH) and its Trust over the eight-year period 2013 to end of 2020, following previous reports in 2010 and 2013. METHOD: CCH continued to provide free secondary elective healthcare services to some patients in the Canterbury Distinct Health Board (CDHB) region who were unable to access healthcare they needed through public hospitals and were unable to pay for private care. CCH's services were supplied by a large volunteer workforce, supported by a skeleton staff, and were financed solely by charitable giving. Changes occurred periodically in the quantity and nature of regional unmet healthcare need, largely due to changes in services provided by the CDHB. In order to accommodate these changes, major structural and infrastructural developments were necessitated at CCH. RESULTS: Many healthcare services at CCH remained the same as before this period but new changes occurred there as a result of: (i) establishment of a flexible sigmoidoscopy day clinic for the management of fresh rectal bleeding in those under 50 years of age; (ii) requirement for a sudden increase in counselling services immediately after the terror attacks at Christchurch mosques; (iii) expansion of the Dental and Oral Surgery Service; and (iv) interruption of CCH service provision by the COVID-19 pandemic. CONCLUSIONS: CCH continued to fill some of the regional unmet elective healthcare need. This is, however, a national problem as attested by the presence of a charity hospital in Auckland and another being planned for Invercargill. Hopefully present and future governments will appreciate that free universal access to secondary elective healthcare is not only a humane imperative, but also a sound economic investment.

Supporting conscious competency: Validation of the Generic Supervision Assessment Tool (GSAT).

OBJECTIVES: Clinical supervision is essential for ensuring effective service delivery. International imperatives to demonstrate professional competence has increased attention on the role of supervision in enhancing client outcomes. Although supervisor competency tools are recognised as important components in effective supervision, there remains a shortage of tools that are evidenced-based, applicable across workforces and freely accessible. DESIGN: An expert multidisciplinary group developed the Generic Supervision Assessment Tool (GSAT) to assess supervisor competencies across a range of professions. Initially the GSAT consisted of 32 items responded to by either a supervisor (GSAT-SR) or supervisee (GSAT-SE). The current study, using surveys, employed a cross-sectional design to test the reliability and construct validity of the GSAT. METHODS: The study consisted of two phases and included 12 professional groups across Australasia. In 2018, exploratory factor analysis (EFA) was undertaken with survey data from 479 supervisors and 447 supervisees. In 2019 survey data from 182 supervisors and 186 supervisees were used to conduct confirmatory factor analysis (CFA). The results were used to refine and validate the GSAT. RESULTS: The final GSAT-SR has four factors with 26 competency items. The final GSAT-SE has two factors with 21 competency items. The EFA and CFA confirmed that the GSAT-SR and the GSAT-SE are psychometrically valid tools that supervisors and supervisees can utilise to assess competencies. CONCLUSION: As a non-discipline specific supervision tool, the GSAT is a validated, freely available tool for benchmarking the competencies of clinical supervisors across professions, potentially optimising supervisory evaluation processes and strengthening supervision effectiveness. PRACTITIONER POINTS: Supervisor competency tools are recognised as important components of safe and effective supervision provision yet there is a dearth of valid, reliable and effective measures. The Generic Supervision Assessment Tool (GSAT-SR and GSAT-SE) are unique psychometrically valid, and reliable measures of supervisor competence. The GSAT-SR and the GSAT-SE can enhance translation of evidence-based supervision competency skills into regular practice. Validated with a broad cross section of professionals in diverse practice settings the GSAT provides a comprehensive conceptualization of supervisor competence.

Demoralization in the wake of the COVID-19 pandemic: Whereto the future for young Australians?

COVID-19 is changing lives. Less attention has been paid to the future of young people by governments since the onset of the pandemic. We suggest that young people are vulnerable to demoralization, a state of hopelessness and helplessness, during and post-COVID-19. This reflection drawn from journaling and ongoing reflexive conversation from December 2019 to April 2020 offers a critical perspective on the circumstances of young Australians that encompasses consideration of the structural factors that impact on health, life chances, equality and social justice as well as the personal aspects of reflection.

Perceptions of influenza and pneumococcal vaccine uptake by older persons in Australia.

BACKGROUND: Influenza and pneumococcal vaccinations reduce adverse health outcomes in older adults. The Australian National Immunisation Program (NIP) provides free seasonal influenza and pneumococcal vaccinations for adults ≥65 y. Guidelines recommend all adults ≥65 y receive one dose of 23-valent pneumococcal polysaccharide vaccine (23vPPV) regardless of their risk of invasive pneumococcal disease. However, the reported rate of vaccination against pneumococcal disease is much lower than seasonal influenza. Identifying and understanding the perspective of older people on vaccination is important to informing effective promotional strategies for this age group. METHODS: Using a purposive and snowball recruitment strategy, 36 participants aged between 65 and 84 years of age were recruited in south-east Queensland and northern New South Wales. Face-to-face qualitative interviews conducted between July 2017 and January 2018 were recorded, transcribed and thematically analysed. RESULTS: In this sample, the uptake of the influenza vaccine (n = 28, 78%) was greater than for the pneumococcal vaccine (n = 14, 39%). Five key themes identified were health practitioner influence; anti-vaccination influence; social responsibility; work-based vaccination; and perceptions of age. The influences on uptake were complex and multi-faceted. CONCLUSIONS: Findings provide new insights, in particular, the role of social responsibility, the long-term impact of workplace vaccinations, and how older people do not necessarily consider themselves old.

A study of whether individual and dyadic relations between spirituality and resilience contribute to psychological adjustment among individuals with spinal cord injuries and their family members.

OBJECTIVE: To test a model of spiritual well-being and resilience among individuals with spinal cord injuries and their family members. DESIGN: Prospective cross-sectional observational data were analyzed by structural equation modelling. SETTING: Inpatient and community services at one rehabilitation hospital. SUBJECTS: Individual with spinal cord injury (n = 50) and family member (n = 50) dyads. INTERVENTIONS: Standard rehabilitation, both inpatient and community. MAIN MEASURE(S): Functional assessment of chronic illness therapy - spiritual well-being scale - expanded, Connor-Davidson resilience scale, positive and negative affect scale, depression anxiety and stress scale-21, satisfaction with life scale. RESULTS: Median time post-injury was 8.95 months (IQR (interquartile range) = 14.15). Individuals with spinal cord injury and family members reported high scores for both spiritual well-being (66.06 ± 14.89; 68.42 ± 13.75) and resilience (76.68 ± 13.88; 76.64 ± 11.75), respectively. Analysis found the model had acceptable fit (e.g. chi-square goodness of fit statistic = 38.789; P = .263). For individuals with spinal cord injury, spiritual well-being was positively associated with resilience which, in turn, was associated with increasing positive affect and satisfaction with life. Among family members, spiritual well-being was positively associated with resilience. Resilience was then associated with lowered levels of depression and mediated the impact of depression on satisfaction with life. Limited evidence was found for mutual dyadic links, with the only significant pathway finding that resilience in the individual with spinal cord injury was associated with increased satisfaction with life among family members. CONCLUSION: Increased spirituality and resilience make a significant contribution (both independently and in combination) to positive psychological outcomes for both individuals with spinal cord injury and their family members.

Incorporating Demoralization into Social Work Practice.

This article explores the relevance of demoralization to social work research and practice. Demoralization connects to the very core of being human. It is present in social work client groups and is an important but neglected concept in social work. Demoralization occurs when life becomes so overwhelming that daily functioning is affected and people lose all hope, agency, and the capacity to overcome their circumstances. Although a demoralized state is not recognized as a mental illness in the Diagnostic and Statistical Manual of Mental Disorders, it is often confused with psychiatric disorders and its presence can lead to clinical conditions and suicide. This article discusses demoralization and its place in social work practice, identification, and measurement, and appropriate psychosocial interventions are also explored. The article concludes that demoralization has particular relevance to contemporary social work and should be considered in social work practice and research.

Moving forward on the journey: Spirituality and family resilience after spinal cord injury.

PURPOSE/OBJECTIVE: The aim of this exploratory study was to consider how spirituality (encompassing meaning, hope and purpose), may facilitate family resilience after spinal cord injury (SCI) over time. Research Method/Design: A qualitative, longitudinal study design was adopted. Semistructured interviews were conducted with 10 family dyads (consisting of the individual with SCI and a nominated family member) on 2 occasions, 6 months apart. A thematic analysis was conducted. RESULTS: Participants reported drawing upon a range of different sources of spirituality, including religious faith, the natural world, inner strength, and meaningful connectedness with others. These sources of spirituality were often tested in some way after the SCI. Meaning-making responses to these tests were linked with 3 key outcomes: gratitude, hope, and deeper connectedness with others, assisting families to move forward in their journey after SCI. Over time sources of spirituality did not change significantly; however, the intensity of spiritual experience lessened for some families. CONCLUSIONS: This study indicated that spirituality after SCI plays an important role for both the injured individual and their family members. Families draw upon a range of sources of spirituality, and these sources of spirituality may assist the family to move forward together after SCI. Further investigation of how health professionals can better address spirituality during spinal rehabilitation is warranted. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

The role of spirituality in spinal cord injury (SCI) rehabilitation: exploring health professional perspectives.

STUDY DESIGN: Descriptive, qualitative study. OBJECTIVES: To explore the perspectives of health professionals (HPs) regarding the role of spirituality in spinal cord injury (SCI) rehabilitation. SETTING: Single centre rehabilitation hospital, NSW, Australia. METHODS: Two focus groups (n = 12) were conducted with HPs (e.g., nursing, allied health, medical) working in SCI inpatient rehabilitation. A semi-structured interview was employed, consisting of questions about spirituality and its role in SCI rehabilitation. The groups were audio recorded and transcribed. An inductive thematic analysis was conducted. RESULTS: Six themes were identified from the focus group data: (i) the meaning of spirituality; (ii) spirituality as a help; (iii) spirituality as a hindrance; (iv) how spirituality is indirectly addressed in practice; (v) perceived barriers to incorporating spirituality into practice; (vi) how spirituality can be better integrated into practice. HPs recognised that spirituality played an important role in the adjustment of many individuals and their families after SCI. However, spirituality was not proactively addressed during SCI rehabilitation, and most often arose during informal interactions with clients. Spirituality, and specifically religious belief, was perceived to sometimes raise difficulties for clients and staff. The use of physical space and a review of rehabilitation processes were suggested by HPs as two ways spirituality could be better incorporated into practice. CONCLUSIONS: The findings of this study reveal that spiritual needs of clients and their family members during SCI rehabilitation are important and could be better addressed. A range of initiatives are proposed, including staff training and the use of standardised spiritual assessment tools.

Red cell genotyping precision medicine: a conference summary.

This review summarizes the salient points of the symposium 'Red Cell Genotyping 2015: Precision Medicine' held on 10 September 2015 in the Masur Auditorium of the National Institutes of Health. The specific aims of this 6th annual symposium were to: (1) discuss how advances in molecular immunohematology are changing patient care; (2) exemplify patient care strategies by case reports (clinical vignettes); (3) review the basic molecular studies and their current implications in clinical practice; (4) identify red cell genotyping strategies to prevent alloimmunization; and (5) compare and contrast future options of red cell genotyping in precision transfusion medicine. This symposium summary captured the state of the art of red cell genotyping and its contribution to the practice of precision medicine.

Moral distress as experienced by hospital social workers in South Korea and Australia.

This exploratory, qualitative research explored the ethical problems faced by hospital social workers in South Korea and Australia, and what and who influenced their decision making using a focus group design. Although dilemmas of boundaries, confidentiality, self-determination, and other complex scenarios found in practice were identified, moral distress, a consequence of the unresolvable conflicts, dominated participants' narratives. This was particularly the case for the Korean social workers in this sample. A thematic analysis of the data yielded three main themes: 'Under pressure-"It's very uncomfortable"'; 'Failing our patients'; and 'Coping and codes'.

An open trial of equine-assisted therapy for children exposed to problematic parental substance use.

Children exposed to problematic parental substance use (PPSU) often face a number of deleterious developmental outcomes, yet these children are less likely to become known to child protection and welfare services. Although there is a growing evidence base for equine-assisted therapy (EAT) as an effective treatment modality for atypically developing children and adolescents, scant research has explored the benefit of EAT for children exposed to PPSU. The current study is the first to explore the benefit of EAT for children exposed to PPSU in Victoria, Australia. Five 12-week EAT programmes were delivered from 2012 to 2015 with a total of 41 children (mean age of 10.26 years) taking part. Children's parents (n = 41) and schoolteachers (n = 31) completed the Strengths and Difficulties Questionnaire pre- and post-intervention. Parents reported that children's total difficult behaviour and emotional problems decreased following the 12-week EAT programme. In addition, parents and teachers observed a significant decrease in children's hyperactivity. The findings obtained highlight the benefit of EAT for children exposed to PPSU and thus, extends the existing evidence base for this treatment modality.

Does spirituality facilitate adjustment and resilience among individuals and families after SCI?

PURPOSE: The purpose of this scoping review was to investigate the role of spirituality in facilitating adjustment and resilience after spinal cord injury (SCI) for the individual with SCI and their family members. METHOD-DATA SOURCES: Peer reviewed journals were identified using PsychInfo, MEDLINE, CINAHL, Embase and Sociological Abstracts search engines. STUDY SELECTION: After duplicates were removed, 434 abstracts were screened applying inclusion and exclusion criteria. DATA EXTRACTION: The selected 28 studies were reviewed in detail and grouped according to methodological approach. RESULTS: Of the 28 studies relating to spirituality and related meaning-making constructs, 26 addressed the adjustment of the individual with SCI alone. Only two included family members as participants. Quantitative studies demonstrated that spirituality was positively associated with life satisfaction, quality of life, mental health and resilience. The utilisation of meaning-making and hope as coping strategies in the process of adjustment were highlighted within the qualitative studies. Clinical implications included recommendations that spirituality and meaning-making be incorporated in assessment and interventions during rehabilitation. The use of narratives and peer support was also suggested. CONCLUSIONS: Spirituality is an important factor in adjustment after SCI. Further research into the relationship between spirituality, family adjustment and resilience is needed. IMPLICATIONS FOR REHABILITATION: Higher levels of spirituality were associated with improved quality of life, life satisfaction, mental health, and resilience for individuals affected by spinal cord injury. Health professionals can enhance the role that spirituality plays in spinal rehabilitation by incorporating the spiritual beliefs of individuals and their family members into assessment and intervention. By drawing upon meaning-making tools, such as narrative therapy, incorporating peer support, and assisting clients who report a decline in spirituality, health professionals can provide additional support to individuals and their family members as they adjust to changes after spinal cord injury.

Is the degree of demoralization found among refugee and migrant populations a social-political problem or a psychological one?

Background and Objectives: Many international studies point to the negative impact of migration on refugee mental health while others consider the social and political aspects of resettlement are more important. This paper presents the findings from studies examining the degree of demoralization and the impact of other factors on resettlement among three cohorts of resettled refugees and migrant people residing in Australia, Canada and New Zealand. The aims were to determine: participant levels of demoralization; ascertain if the goals contained in the New Zealand Immigration Settlement Strategy are achievable and whether the lack of such goals impacted on participant levels of demoralization. Methods: Study questionnaires, standardized inventories, focus groups, individual semistructured interviews, and a demoralisation scale were completed by three different cohorts of refugee and migrant people attending mental health and resettlement services in Australia, Canada and New Zealand. The data was analyzed using statistical and thematic analysis. Results: While a degree of demoralization was evident across all cohorts significant differences (p < 0.01) were found between mental health participant scores in comparison to non-clinical cohorts. Factors such as an ability to speak English (p < 0.01) and unemployment (p < 0.001) also significantly impacted on the demoralization mean scores. Conclusions: The findings support the view that social and cultural issues play a role in understanding the degree of psychological distress among culturally diverse clients. Thus, in order to reduce the risk, additional factors associated with migration that may impact on resettlement need to be taken into account (AU)

A mental health brief intervention in primary care: does it work?

An onsite adjunctive service appears to improve the care of patients with mental health disorders.

Applying radio-frequency identification (RFID) technology in transfusion medicine.

ISO/IEC 18000-3 mode 1 standard 13.56 MHz RFID tags have been accepted by the International Society for Blood Transfusion (ISBT) and the United States Food and Drug Administration (FDA) as data carriers to integrate with and augment ISBT 128 barcode data carried on blood products. The use of 13.56 MHz RFID carrying ISBT 128 data structures allows the global deployment and use of RFID, supporting both international transfer of blood and international disaster relief. The deployment in process at the BloodCenter of Wisconsin and testing at the University of Iowa Health Center is the first FDA-permitted implementation of RFID throughout in all phases of blood banking, donation through transfusion. RFID technology and equipment selection will be discussed along with FDA-required RF safety testing; integration with the blood enterprise computing system and required RFID tag performance. Tag design and survivability is an issue due to blood bag centrifugation and irradiation. Deployment issues will be discussed. Use of RFID results in significant return on investment over the use of barcodes in the blood center operations through labor savings and error reduction.