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Can an interactive e-learning training package improve the understanding of Personality Disorder within mental health professionals?

Purpose -Personality disorder is reported to elicit strong emotional responses and negative attitudes in mental health staff (Bodner et al., 2015). The purpose of this paper is to provide an overview of the design and development of a co-produced e-learning training package for personality disorder awareness and an evaluation of its effectiveness. This study was carried out to explore if e-learning is an effective mode of training delivery for raising personality disorder awareness. Design/methodology/approach - The e-learning was uniquely developed by subject matter experts working in co-production with people with lived experience. Self-reported measures were completed at three separate intervals to evaluate the effectiveness of the training: at pre-, post- and three-month follow up. Quantitative data were collected via these questionnaires. Findings - The results from this evaluation show that e-learning is an effective mode of delivery for raising the awareness of personality disorder among mental health professionals, achieving similar outcomes to those reported following face-to-ace training. Research limitations/implications - Attrition at follow-up phase was high which was consistent with other similar studies. The evaluation was led by the lead contributors and in the geographical area of its development. The study was relatively small and the participants were self-selected, therefore findings should be treated with caution. Practical implications - E-learning can provide flexible training to compliment and act as an alternative to face-to-face personality disorder training. E-learning may provide an alternative refresher course to knowledge and understanding framework or other face-to-face methods. Co-produced training can be mirrored within an e-learning programme, careful planning to ensure the service user voice is heard and that their lived experience is embraced is required. Originality/value - This is the first evaluation of a co-produced e-learning only personality disorder awareness training

Can a carer (peer) led psychoeducation programme improve mental health carers well-being, reduce burden and enrich empowerment: a service evaluation study

Purpose: Carers of people with mental health problems present with high levels of burden, poor mental wellbeing and feelings of disempowerment by mental health services. The aim of this study was to establish whether providing a psychoeducation skills programme for carers would lead to an improvement of mental wellbeing, reduce the levels of burden that carers sometimes feel in caring for someone with mental illness, and also to increase empowerment. This paper provides a service evaluation study of an innovative carer led psychoeducational intervention that was undertaken. Design/ Methodology/ Approach: This programme was initiated and led by a carer who had themselves experienced a lack of service provision to support carers and families in understanding and caring for a relative with severe and enduring mental health diagnoses. A model of co-production was adopted with the carer who led this initiative working closely with an occupational therapist and consultant psychologist in its development and delivery. Data was collected to measure the impact of the training at 5 different time points. The measures employed to measure outcomes were the Warwick- Edinburgh Mental Well-Being Scale (WEMWEBS), the Burden Assessment Scale (BAS) and Family Empowerment Scale (FES). Findings: Results indicated improved well-being, reduced burden and increased family empowerment in carers who completed this peer led carer initiative psychoeducational programme. Research Limitations/ Implications: This service evaluation study was conducted in a single site and in the site in which it was developed. The carer consultant who led this evaluation and development of the intervention was also the peer worker who delivered the interventions. Hence, we are unable to ascertain if the results reported are unique to the individual peer worker. The transferability of this programme and generalisability of the result should therefore be treated with caution and further replication of this model and research is required. This would be beneficial to be conducted in an alternative site from where it was developed, delivered by different facilitators and include a control group. Practical Implications: The evidence from this study indicates that carers are able and willing to attend a group psychoeducational programme. The high number of referrals to the programme in a relatively short timeframe, indicates that there is significant demand for such a service. Implementation of the programme is relatively straight forward. The key challenges for practical implementation are to have the of Mental Health Training, Education and Practiceright carer to lead and deliver the programme, and the right support system in place for them (financial and supervision). Co-production also is not without challenges, the peer worker and occupational staff need to ensure mutually valued and respected working relationship develop. Originality Value: This is the first evaluation of the impact of a carer led psychoeducation intervention for carers of people with mental health difficulties in secondary mental health services

Evaluating the impact of a nationally recognised training programme that aims to raise the awareness and challenge attitudes of personality disorder in multi-agency partners

Purpose – An innovative training initiative to raise the awareness of personality disorder and enable more effective working with people with personality disorder who come into contact with the wider multi-agency system has been developed. For the purpose of the training initiative the nationally recognised Knowledge and Understanding Framework (KUF, awareness-level programme) has been employed. An overview of the comprehensive multi-agency training initiative will be outlined with reporting and discussion of the outcome data provided within this paper. The paper aims to discuss these issues. Design/methodology/approach – This paper outlines the development and outcomes of a service evaluation study. The utilised outcome measures were carried out at pre-, post- and three-month follow-up measures. The Personality Disorder-Knowledge Attitude and Skills Questionnaire was utilised on the recommendation of the central team. Additionally a Visual Analogue Scalewas developed for the purpose of this studywas also employed. Findings – Data findings are positive particularly when comparing pre- and post-results and the pre- and follow-up results. There appears to be an apparent peak in results post-training which could be attributed to the fact that knowledge and understanding is recent and fresh in the delegates mind, however positive results are still reported at follow-up there does appear to be decline in results and durability of the effect when three-month follow-up is compared against the post-training results. Research limitations/implications – Follow-up was at three months, which is a relatively short-time span post-training it would be of great interest to see in the future if the decline in the three areas continues. If this was followed up and if this pattern continued this could provide us with evidence to support the development of refresher courses. In the future, due to the multi-agency design of this service evaluation, comparisons of the different sectors, agencies and occupations involved, could also be explored further to establish what multi-agency areas the training has had the most effect and impact. Practical implications – High levels of demand from multi-agencies to receive training in personality disorder is reported. Our findings and experience provide evidence that multi-agencies partners from a variety of professional backgrounds can effectively work in partnership with people with lived experience to effectively deliver the KUF training. Social implications – This innovative roll-out of KUF training provides evidence that with a little investment, a comprehensive multi-agency roll-out of KUF is achievable and can provide statistically significant positive results displaying the effectiveness and change brought about via the KUF training. Originality/value – The originality of this sustainable and low-cost approach to educating the wider system is reported in this paper. This has lead to the strategy receiving national recognition winning a nursing times award in 2011 and a model of innovative practice nationally

Watson Brake, A Middle Archaic Mound Complex in Northeast Louisiana

Middle Archaic earthen mound complexes in the lower Mississippi valley are remote antecedents of the famous but much younger Poverty Point earthworks. Watson Brake is the largest and most complex of these early mound sites. Wry extensive coring and stratigraphic studies, aided by 25 radiocarbon dates and six huninescence dates, show that minor earthworks were begun here at ca. 3500 B.C. in association with an oval arrangement of burned rock middens at the edge of a stream terrace. The full extent of the first earthworks is not yet known. Substantial moundraising began ca. 3350 B.C. and continued in stages until some time after 3000 B.C. when the site was abandoned. All 11 mounds and their connecting ridges were occupied between building bursts. Soils,formed on some of these temporary surfaces, while lithics. fire-cracked rock. and,fired clay/loam objects became scattered throughout the mound fills. Faunal and floral remains from a basal midden indicate all-season occupation, supported by broad-spectrum foraging centered on nuts, fish, and deer All the overlying fills are so acidic that organics have not survived. The area enclosed by the mounds was kept clean of debris, suggesting its use as ritual space. The reasons why such elaborate activities first occurred here remain elusive. However some building bursts covary with very well-documented increases in El Nino/Southern Oscillation events. During such rapid increases in ENSO frequencies, rainfall becomes extremely erratic and unpredictable. It may be that early moundraising was a communal response to new stresses of droughts and flooding that created a suddenly more unpredictable food base

Mainstreaming domestic and gender-based violence into sociology and the criminology of violence

Sociological and criminological views of domestic and gender-based violencegenerally either dismiss it as not worthy of consideration, or focus on specificgroups of offenders and victims (male youth gangs, partner violence victims). Inthis paper, we take a holistic approach to violence, extending the definition fromthat commonly in use to encompass domestic violence and sexual violence. Weoperationalize that definition by using data from the latest sweep of the CrimeSurvey for England and Wales. By so doing, we identify that violence is currentlyunder-measured and ubiquitous; that it is gendered, and that other forms of violence (family violence, acquaintance violence against women) are equally ofconcern. We argue that violence studies are an important form of activity forsociologists

The global impact of the DRACMA guidelines cow’s milk allergy clinical practice

Background: The 2010 Diagnosis and Rationale for Action against Cow’s Milk Allergy (DRACMA) guidelines are the only Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines for cow’s milk allergy (CMA). They indicate oral food challenge (OFC) as the reference test for diagnosis, and suggest the choice of specific alternative formula in different clinical conditions. Their recommendations are flexible, both in diagnosis and in treatment. Objectives & methods: Using the Scopus citation records, we evaluated the influence of the DRACMA guidelines on milk allergy literature. We also reviewed their impact on successive food allergy and CMA guidelines at national and international level. We describe some economic consequences of their application. Results: DRACMA are the most cited CMA guidelines, and the second cited guidelines on food allergy. Many subsequent guidelines took stock of DRACMA’s metanalyses adapting recommendations to the local context. Some of these chose not to consider OFC as an absolute requirement for the diagnosis of CMA. Studies on their implementation show that in this case, the treatment costs may increase and there is a risk of overdiagnosis. Interestingly, we observed a reduction in the cost of alternative formulas following the publication of the DRACMA guidelines. Conclusions: DRACMA reconciled international differences in the diagnosis and management of CMA. They promoted a cultural debate, improved clinician’s knowledge of CMA, improved the quality of diagnosis and care, reduced inappropriate practices, fostered the efficient use of resources, empowered patients, and influenced some public policies. The accruing evidence on diagnosis and treatment of CMA necessitates their update in the near futur