139 research outputs found
The Association Between Supervisory Alliance, Counterproductive Events During Psychotherapy Supervision, and Trainee Self-Efficacy
The supervisory alliance between psychology trainee and clinical supervisor plays an important role in the growth and development of the psychologist in training. There are numerous factors that relate to the supervisory alliance. Previous research has indicated that both positive and negative supervision experiences occur during supervision and they act to influence the supervisory working alliance. A counterproductive event is an example of a negative supervision event in which the trainee perceives that an experience in supervision either harmed or hindered his or her growth and development as a therapist. Because counterproductive events regularly happen during a supervision experience, it is important to investigate how the strength of the supervisory alliance relates to counterproductive events. In addition it is important to investigate how the counterproductive event and state of the working alliance relate to the self-efficacy of the trainee. The current study investigated whether counterproductive events that occurred in clinical supervision related to the supervisory working alliance as perceived by the trainee. Additionally the study explored whether there was a relationship between the supervisory working alliance, the presence of counterproductive events, and the trainee\u27s level of self-efficacy. This study utilized a quantitative research design and also included a larger sample than the qualitative research designs used in previous researc
The Association Between Supervisory Alliance, Counterproductive Events During Psychotherapy Supervision, and Trainee Self-Efficacy
The supervisory alliance between psychology trainee and clinical supervisor plays an important role in the growth and development of the psychologist in training. There are numerous factors that relate to the supervisory alliance. Previous research has indicated that both positive and negative supervision experiences occur during supervision and they act to influence the supervisory working alliance. A counterproductive event is an example of a negative supervision event in which the trainee perceives that an experience in supervision either harmed or hindered his or her growth and development as a therapist. Because counterproductive events regularly happen during a supervision experience, it is important to investigate how the strength of the supervisory alliance relates to counterproductive events. In addition it is important to investigate how the counterproductive event and state of the working alliance relate to the self-efficacy of the trainee. The current study investigated whether counterproductive events that occurred in clinical supervision related to the supervisory working alliance as perceived by the trainee. Additionally the study explored whether there was a relationship between the supervisory working alliance, the presence of counterproductive events, and the trainee\u27s level of self-efficacy. This study utilized a quantitative research design and also included a larger sample than the qualitative research designs used in previous researc
POSTER: The Beat Stops Here: A Nurse-Driven Protocol to Manage Telemetry Orders
At a large midwestem healthcare organization, cardiac telemetry monitoring orders are not aligned with clinical guidelines developed by the American Heart Association (AHA). A nurse-driven protocol, based on AHA guidelines, to manage cardiac telemetry orders may reduce telemetry usage. Donabedian\u27 s quality improvement framework of strnch1re-process-outcomes was utilized as the theorical framework for this project, with the purpose to reduce telemetry days within 30 days on a selected acute care unit utilizing AHA guidelines. Project objectives included developing an assessment tool based on AHA guidelines, educating pe1iinent stakeholders on the nurse assessment tool, and implementation of the tool on the chosen acute care unit for 30 days. Pre- and post-implementation data that included the date telemetry was started and stopped were obtained from the organization\u27s Central Monitoring Unit (CMU). Upon commencement of the implementation, submitted assessment tools were reviewed for completion accuracy and paired with post-implementation data provided by the CMU resulting in 14 patients with complete data for analysis. Data analysis indicates a potential 30.5% decrease in telemetry monitored days and a potential savings of over $2 million annually to the identified healthcare organization
REPORT: The Beat Stops Here: A Nurse-Driven Protocol to Manage Telemetry Orders
At a large midwestem healthcare organization, cardiac telemetry monitoring orders are not aligned with clinical guidelines developed by the American Heart Association (AHA). A nurse-driven protocol, based on AHA guidelines, to manage cardiac telemetry orders may reduce telemetry usage. Donabedian\u27 s quality improvement framework of strnch1re-process-outcomes was utilized as the theoretical framework for this project, with the purpose to reduce telemetry days within 30 days on a selected acute care unit utilizing AHA guidelines. Project objectives included developing an assessment tool based on AHA guidelines, educating pe1iinent stakeholders on the nurse assessment tool, and implementation of the tool on the chosen acute care unit for 30 days. Pre- and post-implementation data that included the date telemetry was started and stopped were obtained from the organization\u27s Central Monitoring Unit (CMU). Upon commencement of the implementation, submitted assessment tools were reviewed for completion accuracy and paired with post-implementation data provided by the CMU resulting in 14 patients with complete data for analysis. Data analysis indicates a potential 30.5% decrease in telemetry monitored days and a potential savings of over $2 million annually to the identified healthcare organization
Cosmological and communal wellbeing in the JSRP’s research on justice provision
In this blog, Tom Kirk and Holly Porter explore the JSRP’s work on how local understandings of justice are often embedded in notions of cosmological and communal wellbeing. Furthermore, they argue that practitioners that do not ground their interventions in these understandings risk creating a gap between their own normative assertions about what justice ought to achieve, and how justice is understood and practised by ordinary people
The Origin of Sequential Chromospheric Brightenings
Sequential chromospheric brightenings (SCBs) are often observed in the
immediate vicinity of erupting flares and are associated with coronal mass
ejections. Since their initial discovery in 2005, there have been several
subsequent investigations of SCBs. These studies have used differing detection
and analysis techniques, making it difficult to compare results between
studies. This work employs the automated detection algorithm of Kirk et al.
(Solar Phys. 283, 97, 2013) to extract the physical characteristics of SCBs in
11 flares of varying size and intensity. We demonstrate that the magnetic
substructure within the SCB appears to have a significantly smaller area than
the corresponding H-alpha emission. We conclude that SCBs originate in the
lower corona around 0.1 R_sun above the photosphere, propagate away from the
flare center at speeds of 35 - 85 km/s, and have peak photosphere magnetic
intensities of 148 +/- 2.9 G. In light of these measurements, we infer SCBs to
be distinctive chromospheric signatures of erupting coronal mass ejections.Comment: 25 pages, 9 figures, 5 table
Combination interventions for Hepatitis C and Cirrhosis reduction among people who inject drugs: An agent-based, networked population simulation experiment
Hepatitis C virus (HCV) infection is endemic in people who inject drugs
(PWID), with prevalence estimates above 60 percent for PWID in the United
States. Previous modeling studies suggest that direct acting antiviral (DAA)
treatment can lower overall prevalence in this population, but treatment is
often delayed until the onset of advanced liver disease (fibrosis stage 3 or
later) due to cost. Lower cost interventions featuring syringe access (SA) and
medically assisted treatment (MAT) for addiction are known to be less costly,
but have shown mixed results in lowering HCV rates below current levels. Little
is known about the potential synergistic effects of combining DAA and MAT
treatment, and large-scale tests of combined interventions are rare. While
simulation experiments can reveal likely long-term effects, most prior
simulations have been performed on closed populations of model agents--a
scenario quite different from the open, mobile populations known to most health
agencies. This paper uses data from the Centers for Disease Control's National
HIV Behavioral Surveillance project, IDU round 3, collected in New York City in
2012 by the New York City Department of Health and Mental Hygiene to
parameterize simulations of open populations. Our results show that, in an open
population, SA/MAT by itself has only small effects on HCV prevalence, while
DAA treatment by itself can significantly lower both HCV and HCV-related
advanced liver disease prevalence. More importantly, the simulation experiments
suggest that cost effective synergistic combinations of the two strategies can
dramatically reduce HCV incidence. We conclude that adopting SA/MAT
implementations alongside DAA interventions can play a critical role in
reducing the long-term consequences of ongoing infection
Predictive ethoinformatics reveals the complex migratory behaviour of a pelagic seabird, the Manx Shearwater
Understanding the behaviour of animals in the wild is fundamental to conservation efforts. Advances in bio-logging technologies have offered insights into the behaviour of animals during foraging, migration and social interaction. However, broader application of these systems has been limited by device mass, cost and longevity. Here, we use information from multiple logger types to predict individual behaviour in a highly pelagic, migratory seabird, the Manx Shearwater (Puffinus puffinus). Using behavioural states resolved from GPS tracking of foraging during the breeding season, we demonstrate that individual behaviours can be accurately predicted during multi-year migrations from low cost, lightweight, salt-water immersion devices. This reveals a complex pattern of migratory stopovers: some involving high proportions of foraging, and others of rest behaviour. We use this technique to examine three consecutive years of global migrations, revealing the prominence of foraging behaviour during migration and the importance of highly productive waters during migratory stopover
Interpopulation differences and temporal synchrony in rates of adult survival between two seabird colonies that differ in population size and distance to foraging grounds
Understanding the processes that drive interpopulation differences in demography and population dynamics is central to metapopulation ecology. In colonial species, populations are limited by local resource availability. However, individuals from larger colonies will travel greater distances to overcome density-dependent competition. Consequently, these individuals may also experience greater carry-over effects and interpopulation differences in demography. To test this prediction, we use mark-recapture data collected over four decades from two breeding colonies of a seabird, the Manx shearwater (Puffinus puffinus), that exhibit strong spatial overlap throughout the annual cycle but differ in population size and maximum foraging distances. We quantify interpopulation differences and synchrony in rates of survival and assess whether local mean wind speeds act to strengthen or disrupt synchrony. In addition, we examine whether the imputed interpopulation differences in survival can generate population-level consequences. The colony where individuals travel further during the breeding season had slightly lower and more variable rates of survival, indicative of individuals experiencing greater carry-over effects. Fluctuations in survival were highly synchronous between the colonies, but neither synchronous, nor asynchronous, variation could be strongly attributed to fluctuations in local mean wind speeds. Finally, we demonstrate that the imputed interpopulation differences in rates of survival could lead to considerable differences in population growth. We hypothesise that the observed interpopulation differences in rates of adult survival reflect carry-over effects associated with foraging distances during the breeding season. More broadly, our results highlight that breeding season processes can be important for understanding interpopulation differences in the demographic rates and population dynamics of long-lived species, such as seabirds
Demographic profiles and environmental drivers of variation relate to individual breeding state in a long-lived trans-oceanic migratory seabird, the Manx shearwater.
Understanding the points in a species breeding cycle when they are most vulnerable to environmental fluctuations is key to understanding interannual demography and guiding effective conservation and management. Seabirds represent one of the most threatened groups of birds in the world, and climate change and severe weather is a prominent and increasing threat to this group. We used a multi-state capture-recapture model to examine how the demographic rates of a long-lived trans-oceanic migrant seabird, the Manx shearwater Puffinus puffinus, are influenced by environmental conditions experienced at different stages of the annual breeding cycle and whether these relationships vary with an individual's breeding state in the previous year (i.e., successful breeder, failed breeder and non-breeder). Our results imply that populations of Manx shearwaters are comprised of individuals with different demographic profiles, whereby more successful reproduction is associated with higher rates of survival and breeding propensity. However, we found that all birds experienced the same negative relationship between rates of survival and wind force during the breeding season, indicating a cost of reproduction (or central place constraint for non-breeders) during years with severe weather conditions. We also found that environmental effects differentially influence the breeding propensity of individuals in different breeding states. This suggests individual spatio-temporal variation in habitat use during the annual cycle, such that climate change could alter the frequency that individuals with different demographic profiles breed thereby driving a complex and less predictable population response. More broadly, our study highlights the importance of considering individual-level factors when examining population demography and predicting how species may respond to climate change
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