The Transition and Transformation process to become an Improving Access to Psychological Therapies Therapist. A study using Interpretative Phenomenological Analysis

Abstract Background Too many practitioners leave Improving Access to Psychological Therapy (IAPT) services roles and this puts IAPT services at risk. In the context of increasing access to IAPT services, this creates a deficit that can impact patient care. Therefore, ways to improve work satisfaction and role adjustment may help people to transition more effectively. There is a commitment in England to expand the IAPT services so that 1.9 million adults with mental health problems can access treatment every year by 2023/2024. This requires the recruitment of 4500 new therapists by 2021 and an extra 6000 by 2024. However, IAPT services are struggling to recruit and retain its workforce. Therefore, investigating what may improve recruitment and retention is essential. This includes examining the support needed with role transition for IAPT practitioners. This study investigated the lived experience of psychotherapists who transition to working as High-Intensity Therapists in IAPT services. Method The theoretical framework for this inductive qualitative inquiry was Interpretative Phenomenological Analysis. Seven non-IAPT qualified psychotherapists transitioned to IAPT services participated in audio-recorded semi-structured interviews. Interviews were transcribed and a case-by-case idiographic analysis was undertaken. This process was followed by a cross-case analysis. XIV Findings Four super-ordinate themes were identified through the IPA process ‘Transition’ highlighted participants’ experiences in their early phase of moving to the IAPT services. ‘Learning the ropes’ emphasised participants’ endeavour to understand and make sense of IAPT. The super-ordinate theme ‘Adjustment’ described the changes participants made to adapt to the new IAPT role and position themselves in the new system. ‘Transformation’ described the participants’ cognitive and emotional evolution while transitioning to the IAPT system. Conclusion This study provides a detailed, phenomenological account of the lived experience of the transition of seven non- IAPT qualified psychotherapists to IAPT services. Transition to IAPT services for this group of therapists presents unique challenges that employers might consider in attracting and retaining experienced therapists. New insights were developed that can inform not only IAPT services but also other mental health services. The role of the organisation in facilitating the transition to IAPT services was explored specifically for experienced therapists. New avenues for future research were also identified, such as empirical studies into IAPT managers’ challenges in IAPT with its fast expansion and how they could support newcomers to IAPT

Cross-cultural validation and measurement invariance of the Short Grit scale (Grit-S): preliminary results.

Preliminary results of a cross-cultural validation of the Grit -

Genome-wide mRNA and miRNA expression profiling reveal multiple regulatory networks in colorectal cancer

Despite recent advances in cancer management, colorectal cancer (CRC) remains the third most common cancer and a major health-care problem worldwide. MicroRNAs have recently emerged as key regulators of cancer development and progression by targeting multiple cancer-related genes; however, such regulatory networks are not well characterized in CRC. Thus, the aim of this study was to perform global messenger RNA (mRNA) and microRNA expression profiling in the same CRC samples and adjacent normal tissues and to identify potential miRNA-mRNA regulatory networks. Our data revealed 1273 significantly upregulated and 1902 downregulated genes in CRC. Pathway analysis revealed significant enrichment in cell cycle, integrated cancer, Wnt (wingless-type MMTV integration site family member), matrix metalloproteinase, and TGF-β pathways in CRC. Pharmacological inhibition of Wnt (using XAV939 or IWP-2) or TGF-β (using SB-431542) pathways led to dose- and time-dependent inhibition of CRC cell growth. Similarly, our data revealed up- (42) and downregulated (61) microRNAs in the same matched samples. Using target prediction and bioinformatics, ~77% of the upregulated genes were predicted to be targeted by microRNAs found to be downregulated in CRC. We subsequently focused on EZH2 (enhancer of zeste homolog 2 ), which was found to be regulated by hsa-miR-26a-5p and several members of the let-7 (lethal-7) family in CRC. Significant inverse correlation between EZH2 and hsa-miR-26a-5p (R(2)=0.56, P=0.0001) and hsa-let-7b-5p (R(2)=0.19, P=0.02) expression was observed in the same samples, corroborating the belief of EZH2 being a bona fide target for these two miRNAs in CRC. Pharmacological inhibition of EZH2 led to significant reduction in trimethylated histone H3 on lysine 27 (H3K27) methylation, marked reduction in cell proliferation, and migration in vitro. Concordantly, small interfering RNA-mediated knockdown of EZH2 led to similar effects on CRC cell growth in vitro. Therefore, our data have revealed several hundred potential miRNA-mRNA regulatory networks in CRC and suggest targeting relevant networks as potential therapeutic strategy for CRC

Transgelin is a TGFβ-inducible gene that regulates osteoblastic and adipogenic differentiation of human skeletal stem cells through actin cytoskeleston organization

Regenerative medicine is a novel approach for treating conditions in which enhanced bone regeneration is required. We identified transgelin (TAGLN), a transforming growth factor beta (TGFβ)-inducible gene, as an upregulated gene during in vitro osteoblastic and adipocytic differentiation of human bone marrow-derived stromal (skeletal) stem cells (hMSC). siRNA-mediated gene silencing of TAGLN impaired lineage differentiation into osteoblasts and adipocytes but enhanced cell proliferation. Additional functional studies revealed that TAGLN deficiency impaired hMSC cell motility and in vitro transwell cell migration. On the other hand, TAGLN overexpression reduced hMSC cell proliferation, but enhanced cell migration, osteoblastic and adipocytic differentiation, and in vivo bone formation. In addition, deficiency or overexpression of TAGLN in hMSC was associated with significant changes in cellular and nuclear morphology and cytoplasmic organelle composition as demonstrated by high content imaging and transmission electron microscopy that revealed pronounced alterations in the distribution of the actin filament and changes in cytoskeletal organization. Molecular signature of TAGLN-deficient hMSC showed that several genes and genetic pathways associated with cell differentiation, including regulation of actin cytoskeleton and focal adhesion pathways, were downregulated. Our data demonstrate that TAGLN has a role in generating committed progenitor cells from undifferentiated hMSC by regulating cytoskeleton organization. Targeting TAGLN is a plausible approach to enrich for committed hMSC cells needed for regenerative medicine application

On the Energy Transfer Performance of Mechanical Nanoresonators Coupled with Electromagnetic Fields

We study the energy transfer performance in electrically and magnetically coupled mechanical nanoresonators. Using the resonant scattering theory, we show that magnetically coupled resonators can achieve the same energy transfer performance as for their electrically coupled counterparts, or even outperform them within the scale of interest. Magnetic and electric coupling are compared in the Nanotube Radio, a realistic example of a nano-scale mechanical resonator. The energy transfer performance is also discussed for a newly proposed bio-nanoresonator composed of a magnetosomes coated with a net of protein fibers.Comment: 9 Pages, 3 Figure

The Palomar Transient Factory: System Overview, Performance and First Results

The Palomar Transient Factory (PTF) is a fully-automated, wide-field survey aimed at a systematic exploration of the optical transient sky. The transient survey is performed using a new 8.1 square degree camera installed on the 48-inch Samuel Oschin telescope at Palomar Observatory; colors and light curves for detected transients are obtained with the automated Palomar 60-inch telescope. PTF uses eighty percent of the 1.2-m and fifty percent of the 1.5-m telescope time. With an exposure of 60-s the survey reaches a depth of approximately 21.3 in g' and 20.6 in R (5 sigma, median seeing). Four major experiments are planned for the five-year project: 1) a 5-day cadence supernova search; 2) a rapid transient search with cadences between 90 seconds and 1 day; 3) a search for eclipsing binaries and transiting planets in Orion; and 4) a 3-pi sr deep H-alpha survey. PTF provides automatic, realtime transient classification and follow up, as well as a database including every source detected in each frame. This paper summarizes the PTF project, including several months of on-sky performance tests of the new survey camera, the observing plans and the data reduction strategy. We conclude by detailing the first 51 PTF optical transient detections, found in commissioning data.Comment: 12 pages, 11 figures, 3 tables, submitted to PAS

The Teaching and Learning Cultural Competence in a Multicultural Environment (CCMEn) Model

Background: Within the European higher education context, students and lecturers are encouraged to engage in teaching and learning activities abroad. This frequently involves using a second language and being exposed to students and lecturers from culturally different backgrounds. Objective: To design a model for teaching and learning cultural competence in a multicultural environment (CCMEn). Design: Theory development from empirical experience, research, and scholarly works. Method: This model was developed based on our experience of teaching and learning cultural competence in a multicultural environment in a nursing education context; it rests on three pillars, namely, Coyle's Content and Language Integrated Learning educational approach, the concept of social and emotional learning, as defined by the Collaborative for Academic, Social and Emotional Learning, and the existing literature surrounding teaching and learning cultural competence in higher education. Results: The CCMEn model is intended to guide the process of teaching and learning cultural competence in a multicultural environment through the use of a second language and has been adapted from existing educational approaches and theory. Conclusion: Teaching and learning in multilingual and multicultural contexts in Europe is becoming more common. Students who learn alongside students and teachers from different cultural backgrounds need to be supported from an academic, linguistic and socioemotional perspective. We believe that the CCMEn model can serve as a guide to enhancing student learning in this context

Nursing students’ experience of learning cultural competence

Introduction European societies are rapidly becoming multicultural. Cultural diversity presents new challenges and opportunities to communities that receive immigrants and migrants, and highlights the need for culturally safe healthcare. Universities share a responsibility to build a fair and equitable society by integrating cultural content in the nursing curricula. This paper aims to analyze European student nurses´ experience of learning cultural competence and of working with patients from diverse cultural backgrounds. Materials and methods A phenomenological approach was selected through a qualitative research method. 7 semi-structured focus groups with 5–7 students took place at the participants’ respective universities in Spain, Belgium, Turkey and Portugal. Results 5 themes and 16 subthemes emerged from thematic analysis. Theme 1, concept of culture/ cultural diversity, describes the participants’ concept of culture; ethnocentricity emerged as a frequent element in the students’ discourse. Theme 2, personal awareness, integrates the students’ self-perception of cultural competence and their learning needs. Theme 3, impact of culture, delves on the participants’ perceived impact of cultural on both nursing care and patient outcomes. Theme 4, learning cultural competence, integrates the participants’ learning experiences as part of their nursing curricula, as part of other academic learning opportunities and as part of extra-academic activities. Theme 5, learning cultural competence during practice placements, addresses some important issues including witnessing unequal care, racism, prejudice and conflict, communication and language barriers, tools and resources and positive attitudes and behaviors witnesses or displayed during clinical practice. Conclusion The participants’ perceived level of cultural competence was variable. All the participants agreed that transcultural nursing content should be integrated in the nursing curricula, and suggested different strategies to improve their knowledge, skills and attitudes. It is important to listen to the students and take their opinion into account when designing cultural teaching and learning activities. © 2021 Antón-Solanas et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

Nursing lecturers’ perception and experience of teaching cultural competence: a european qualitative study

Cultural competence is an essential component in providing effective and culturally responsive healthcare services, reducing health inequalities, challenging racism in health care and improving patient safety, satisfaction and health outcomes. It is thus reasonable that undergraduate nursing students can develop cultural competency through education and training. The aim of this paper was to investigate nursing lecturers’ perception and experience of teaching cultural competence in four undergraduate nursing programs. A phenomenological approach was selected to illicit nursing lecturers’ perception of culture and experience of teaching cultural competence. Semi-struc-tured personal interviews were held with a sample of 24 lecturers from four European universities. The anonymized transcripts were analyzed qualitatively following Braun and Clark’s phases for thematic analysis. Six themes and fifteen subthemes emerged from thematic analysis of the tran-scripts. Cultural competence was not explicitly integrated in the nursing curricula. Instead, the lecturers used mainly examples and case studies to illustrate the theory. The integration of cultural content in the modules was unplanned and not based on a specific model. Nursing programs should be examined to establish how cultural content is integrated in the curricula; clear guidelines and standards for a systematic integration of cultural content in the nursing curriculum should be de-veloped