Evaluating a transdiagnostic acceptance and commitment therapy psychoeducation intervention

© British Association for Behavioural and Cognitive Psychotherapies 2017. Psychoeducation courses have gained some empirical support as effective early intervention strategies. Many of these courses reflect traditional cognitive behaviour therapy (CBT) thinking but psychoeducation courses based on other approaches are beginning to emerge. One such course, 'ACTivate Your Life', is based on acceptance and commitment therapy (ACT). The aim of this preliminary investigation is to evaluate a four-session (eight-hour) ACT psychoeducation intervention delivered within the Abertawe Bro Morgannwg University (ABMU) Health Board. Participants were invited to complete four outcome measures (assessing depression, anxiety, self-esteem and life satisfaction) and two process measures (assessing mindfulness self-efficacy and psychological flexibility) at pre- and post-intervention. Statistical analysis indicated that participants' scores across each of the measured domains showed highly significant changes. These results suggest that a brief psychoeducation ACT course may be useful in helping people in need of early psychological intervention, and that further research is now needed to provide a definitive evaluation of its effectiveness

Improved GNSS-R bi-static altimetry and independent DEMs of Greenland and Antarctica from TechDemoSat-1

Improved Digital Elevation Models (DEMs) of the Antarctic and Greenland Ice Sheets are presented, derived from Global Navigation Satellite Systems-Reflectometry (GNSS-R). This builds on a previous study (Cartwright et al., 2018) using GNSS-R to derive an Antarctic DEM but uses improved processing and an additional 13 months of measurements, totalling 46 months of data from the UK TechDemoSat-1 satellite. A median bias of under 10 m and root-mean-square (RMS) errors of under 53 m for the Antarctic and 166 m for Greenland are obtained, as compared to existing DEMs. The results represent, compared to the earlier study, a halving of the median bias to 9 m, an improvement in coverage of 18 %, and a four times higher spatial resolution (now gridded at 25 km). In addition, these are the first published satellite altimetry measurements of the region surrounding the South Pole. Comparisons south of 88° S yield RMS errors of less than 33 m when compared to NASA’s Operation IceBridge measurements. Differences between DEMs are explored and the future potential for ice sheet monitoring by this technique is noted

Improved GNSS-R bi-static altimetry and independent digital elevation models of Greenland and Antarctica from TechDemoSat-1

Improved digital elevation models (DEMs) of the Antarctic and Greenland ice sheets are presented, which have been derived from Global Navigation Satellite Systems-Reflectometry (GNSS-R). This builds on a previous study (Cartwright et al., 2018) using GNSS-R to derive an Antarctic DEM but uses improved processing and an additional 13 months of measurements, totalling 46 months of data from the UK TechDemoSat-1 satellite. A median bias of under 10 m and root-mean-square errors (RMSEs) of under 53 m for the Antarctic and 166 m for Greenland are obtained, as compared to existing DEMs. The results represent, compared to the earlier study, a halving of the median bias to 9 m, an improvement in coverage of 18 %, and a 4 times higher spatial resolution (now gridded at 25 km). In addition, these are the first published satellite altimetry measurements of the region surrounding the South Pole. Comparisons south of 88∘ S yield RMSEs of less than 33 m when compared to NASA's Operation IceBridge measurements. Differences between DEMs are explored, the limitations of the technique are noted, and the future potential of GNSS-R for glacial ice studies is discussed

Forensic service users' experiences of adversity and psychological interventions in secure care

The present thesis recognises that capturing service users’ experiences can add insightful information to research and clinical practice. This thesis acknowledges that this collaborative approach can be often underrepresented and particularly in forensic psychiatric settings, where care and treatment are often determined by legal requirements, received on an involuntary basis and where coercive measures may be used. This thesis offers two papers which explored forensic service users’ perspectives. The first paper considered how forensic service users may be expected to engage in psychological treatments as part of their care and treatment plans, and consequently, individuals may comply without feeling personally motivated or invested. Most of the evidence for psychological interventions in forensic psychiatric care is based on quantitative data, which provides tentative and limited evidence to support its effectiveness. The first paper reviewed forensic service users’ perspectives on such interventions, and aimed to inform clinicians and services providing such treatments. Paper one followed a meta-ethnography approach to synthesise the findings from 11 qualitative papers. This synthesis described six super-ordinate themes that reflect which aspects of psychological interventions service users found both valuable and not so valuable. The synthesis demonstrated that many individuals comply with these treatments as they believe this is expected of them, perhaps because it is the only way to move towards discharge, or because they have no other choice. Whilst a collaborative approach was recognised as valuable, this can be a challenge to establish in forensic practice and a good therapeutic relationship is pivotal. The results indicated that interventions should be tailored to each individuals’ abilities and that many prefer a gradual approach to ease them into the therapeutic process. Service users reported positive changes from engaging in psychological interventions, including increased emotional regulatory skills, 6 interpersonal skills and personal growth, which enabled them to think more positively about the future. It is recommended that these findings should be used in conjunction with the quantitative evidence available and further research is still needed in this area. The second paper also considered service users’ perspectives, but from a trauma-informed approach. It recognised that forensic service users have often had experiences of adversity and trauma throughout their lives, and research increasingly shows a strong relationship between these experiences, mental health difficulties and offending behaviours. Services are encouraged to adopt a collaborative stance, however, the literature in this area lacks forensic service users’ perspectives. Paper two aimed to address this through interviewing forensic service users about their past adverse experiences and how they make sense of these, particularly in relation to their detention in secure care. This paper captured the voices of eight service users, six of whom are male, detained in medium and low secure wards. Four super-ordinate themes are discussed from an interpretative phenomenological analysis (IPA) and relate to: service users’ experiences of living amongst adversity; managing these adversities throughout their lives; relating their pasts to their detention in secure care; and how the past still impacts them in the present. Individuals described previously feeling isolated and let down by others, and therefore, they used destructive ways to internalise and externalise their distress. There were differences between how individuals related these past experiences to their detention, with some individuals being more aware of this relationship than others. It seemed that individuals’ insight to this relationship was part of a process, which was facilitated by staff input. Service users also tended to use avoidant strategies to cope with their pasts and this was evident in some of the interviews. This paper related these findings to attachment theory from a developmental trauma perspective and proposed the adoption of trauma-informed care in forensic services. 7 Some aspects of paper one and paper two can be related. For instance, they both acknowledged that service users have interpersonal difficulties and that services can adapt their approaches to minimise the impact of these and to enhance trusting and collaborative relationships. Although limitations of each paper are acknowledged, they both provided clinical implications for forensic psychiatric services. Paper one provided implications for clinicians offering psychological interventions and also for the wider systems, as the importance of collaboration, positive relationships and transparent communication can be considered necessary throughout the services. Paper two also provided implications for service delivery and supports the notion of trauma informed care. It highlighted that staff should be aware of the impact and consequences of adverse experiences, for both the service users and for themselves when supporting service users. It also referred to the psychological interventions discussed in paper one, which acknowledge the impact of past adverse experiences. Future research is recommended for both papers. Both papers have been written in line with the standards of the Journal of Forensic Psychiatry and Psychology but as per doctorate guidelines, a word limit of 8000 is used for each (Appendix A)

Dietary patterns of competitive swimmers with moderate-to-severe cerebral palsy : A 3-year longitudinal evaluation

Aim: To evaluate the longitudinal dietary patterns of three adolescents with moderate-to-severe cerebral palsy (CP) participating in a performance-focused swimming training intervention. Method: Participants were three previously inactive adolescents with CP (15–16 years, GMFCS IV) who had recently (<6 months) enrolled in a swimming training program. Diet quality from diet histories was calculated at 10-time points over 3.25 years using the Dietary Guidelines Index for Children and Adolescents (DGI-CA) and the Healthy Eating Index for Australian Adults (HEIFA-2013). A food group analysis was compared to the Australian Guide to Healthy Eating recommendations. Trends were considered in the context of dietary advice given and the training load. Results: Longitudinal diet quality scores were consistent and ranged from 40 to 76 (DGI-CA) and 33 to 79 (HEIFA-2013). Food group intake remained stable; participants rarely met the recommendations for fruit, vegetables, dairy, grain, and meat but frequently achieved discretionary serves. Conclusions: Participants with moderate-to-severe CP who were enrolled in a performance-focused swimming training intervention and were monitored frequently maintained diet quality throughout a period where it conventionally declined. Scores were higher than the general population and were maintained irrespective of the training load. Participants frequently met food group recommendations for discretionary foods and were comparable to the general population for other food groups

Deteriorating Access to Women\u27s Health Services in Texas: Potential Effects of the Women\u27s Health Program Affiliate Rule

Based on an earlier study and an in-depth analysis of five market areas, the authors find that Texas\u27 plan to bar Planned Parenthood clinics from participating in the state Women\u27s Health Program (WHP) would leave tens of thousands of women without a source of care, because Planned Parenthood clinics are the dominant WHP providers in those areas and other local family planning clinics lack the capacity to absorb a large number of additional patients

Sea ice detection using GNSS‐R data from TechDemoSat‐1

A new method for the detection of sea ice using GNSS‐R (Global Navigation Satellite Systems Reflectometry) is presented and applied to 33 months of data from the U.K. TechDemoSat‐1 mission. This method of sea ice detection shows the potential for a future GNSS‐R polar mission, attaining an agreement of over 98% and 96% in the Antarctic and Arctic, respectively, when compared to the European Space Agency's Climate Change Initiative sea ice concentration product. The algorithm uses a combination of two parameters derived from the delay‐Doppler Maps to quantify the spread of power in delay and Doppler. Application of thresholds then allows sea ice to be distinguished from open water. Differences between the TechDemoSat‐1 sea ice detection and comparison data sets are explored. The results provide information on the seasonal and multiyear changes in sea ice distribution of the Arctic and Antarctic. Future potential and applications of this technique are discussed

Polar maps of c-band backscatter parameters from the advanced scatterometer

Maps of backscatter anisotropy parameters from the European Organisation for the Exploitation of Meteorological Satellites (EUMETSAT) Advanced Scatterometer (ASCAT), a C-band fan-beam scatterometer, contain unique and valuable data characterising the surface and subsurface of various cryospheric elements, including sea ice and ice sheets. The computational expense and considerable complexity required to produce parameter maps from the raw backscatter data inhibits the wider adoption of ASCAT data. Here, backscatter anisotropy parameter maps gridded at a resolution of 12.5 km per pixel are made available to the community in order to facilitate the exploitation of these parameters for cryospheric applications. These maps have been calculated from the EUMETSAT Level 1B Sigma0 product acquired from ASCAT on board MetOp-A, MetOp-B and MetOp-C. The dataset is unique in that it prioritises anisotropy characterisation over temporal resolution and combines ASCAT data from multiple platforms. The parameterisation chosen assumes a linear falloff of backscatter with incidence angle and a fourth-order Fourier series parameterisation of azimuth angle anisotropy. The product (Fraser and Cartwright, 2022) is available at https://doi.org/10.26179/91c9-4783 presented on three timescales depending on orbital platform availability: 5 d (2007 to 2020 – MetOp-A only – suitable for users requiring a long time series), 2 d (2013 to 2020 – MetOp-A and MetOp-B) and 1 d resolution (2019–2020 – MetOp -A, MetOp-B and MetOp-C – suitable for users needing both high temporal resolution and detailed anisotropy characterisation). Datasets will be updated annually