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Supplemental material, sj-pdf-1-ult-10.1177_1742271X20935911 for UK consensus guidelines for the delivery of unexpected news in obstetric ultrasound: The ASCKS framework by Judith Johnson, Jane Arezina, Liz Tomlin, Siobhan Alt, Jon Arnold, Sarah Bailey, Hannah Beety, Ruth Bender-Atik, Louise Bryant, Jen Coates, Sam Collinge, Jo Fishburn, Jane Fisher, Jan Fowler, Tracey Glanville, Julian Hallett, Ailith Harley-Roberts, Gill Harrison, Karen Horwood, Catriona Hynes, Lindsay Kimm, Alison McGuinness, Lucy Potter, Liane Powell, Janelle Ramsay, Pieta Shakes, Roxanne Sicklen, Alexander Sims, Tomasina Stacey, Anushka Sumra, Samantha Thomas, Karen Todd, Jacquie Torrington, Rebecca Trueman, Lorraine Walsh, Katherine Watkins, Gill Yaz and Natasha K Hardicre in Ultrasound

Supplemental material, sj-pdf-1-ult-10.1177_1742271X20935911 for UK consensus guidelines for the delivery of unexpected news in obstetric ultrasound: The ASCKS framework by Judith Johnson, Jane Arezina, Liz Tomlin, Siobhan Alt, Jon Arnold, Sarah Bailey, Hannah Beety, Ruth Bender-Atik, Louise Bryant, Jen Coates, Sam Collinge, Jo Fishburn, Jane Fisher, Jan Fowler, Tracey Glanville, Julian Hallett, Ailith Harley-Roberts, Gill Harrison, Karen Horwood, Catriona Hynes, Lindsay Kimm, Alison McGuinness, Lucy Potter, Liane Powell, Janelle Ramsay, Pieta Shakes, Roxanne Sicklen, Alexander Sims, Tomasina Stacey, Anushka Sumra, Samantha Thomas, Karen Todd, Jacquie Torrington, Rebecca Trueman, Lorraine Walsh, Katherine Watkins, Gill Yaz and Natasha K Hardicre in Ultrasound

Background/Objectives:Since HPV (human papillomavirus) vaccination was introduced in the U.S. in 2006, adolescent immunization against HPV cancers has lagged expected rates. Educating physicians and other primary care providers to make a strong recommendation for HPV vaccine at every opportunity can lead to increased HPV vaccine uptake. However, it is a challenge to engage providers in continuing medical education (CME) to learn HPV vaccine recommendation techniques. Barriers to providers accessing CME include lack of provider time, lack of interest in subject matter, beliefs that providers are already utilizing this approach, cost, and access. This paper will examine a webinar CME program that teaches HPV vaccination communication strategies, delivered by physicians to physicians and their staff in 3 states, with an evaluation of opportunities and challenges of webinar delivery and the reach of the CME program.Methods:In 2018, our research team recruited and trained five board certified and licensed pediatricians as physician educators to deliver a live webinar continuing medical education (CME) course to clinics in Arizona, New York and Wisconsin. We recruited primary care clinics with the help of the physician educators to participate in a one-hour CME course, Making Effective HPV Vaccine Recommendations using the Announcement Approach. This CME course was presented by the physician educators via live, interactive webinar format during a 21-week period. At the completion of the study period, a co-investigator trained in qualitative methods used phone interviews with the physician educators and research associates to evaluate their experiences. Analysis of clinic participation data were undertaken to determine the reach of this CME training.2Results:The interviewees felt underprepared to recruit clinics to the study, and they agreed that initial contact with clinics would have been enhanced if a contact person had been identified ahead of their first call. Interviewees agreed that summer recruitment was challenging because recruited clinics stated scheduling issues due to provider vacations. The use of influential affiliations, such as the CDC, NCI, or the AAP, was perceived to be valuable in attracting clinics to the CME offering. Physician educators enjoyed using the live webinar software platform (Zoom) for distance education, citing ease of use and no travel as reasons for its appeal; however, technical glitches such as participants lacking webcams or the presentation lacking sound made for frustrations for both the CME presenters and the clinics receiving the instruction.Of the initial pool of 233 clinics in AZ, NY, and WI identified as possible participants in this intervention, 200 clinics were successfully contacted, and 32 of them (16%) participated in the CME webinar. We had an average of 3.3 prescribers per clinic participate in the webinar CME, for the 3 states included in this study. With 16% of clinics successfully completing the webinar, the reach of our program was considered lower than expected.Conclusions:Announcement training about HPV vaccination, using a physician-to-physician live webinar, is a convenient method to deliver training to healthcare providers that can result in improved HPV vaccine coverage for adolescents. Physicians and public health professionals have an important influence over the recommendation of HPV vaccination, and with stronger communication skills, HPV vaccination uptake for adolescents can improve. However, our interventionists experienced challenges in recruiting physicians and their staff to participate in this free CME effort, and our reach was limited to only 16% of clinics contacted.Further implementation research is needed to discern how best to engage the provider and support staff in interventions that will result in strong recommendations.

A Thesis Submitted to the Faculty of Graduate Studies and Research In Partial Fulfillment of the Requirements for the Degree of Master of Arts in Justice Studies, University of Regina. vi, 149 p. Youth living with Fetal Alcohol Spectrum Disorder (FASD) have a 60% risk of being charged and/or convicted of a criminal offence. However, existing research has shown that with effective targeted interventions, youth can disengage from involvement with the criminal justice system. This thesis examines the effectiveness of current programming initiatives for FASD youth incarcerated in Manitoba, where the disorder is a pressing social and economic problem. Semi-structured interviews were conducted with youth correctional service staff at the two closed-custody youth facilities in the province in order to investigate the efficacy of existing programs for this client group. Through these interviews, participants provided insight into the efficacy of services for incarcerated FASD youth in Manitoba. Overall, it was reported that positive strides have taken place over the past number of years within youth corrections in the province. However, while progress has certainly been made, participants also identified numerous barriers that currently exist and hinder the effectiveness of the services and supports provided to incarcerated FASD youth. Gaps such as lacks in diagnostic capacity, resources, adequate programming, communication, and staff training suggest that there is still a lot of work to be done in order to make services for this client group as effective as possible. It is expected that knowledge gathered through this research will provide new insight to policy makers and program providers in order to improve services for this client group. Ideally, Manitoba Justice will be able to use this valuable policy-related knowledge in order to influence positive change for incarcerated FASD youth. Student yes