Developing and Implementing Supervisor Training for Clinical Psychologists in the United Kingdom

Engagement in supervision is a professional requirement for clinical psychologists in the UK (Division of Clinical Psychology 2014). There is, however, little guidance regarding how psychologists should be taught the skills required to be a supervisor, or how these skills should be evaluated. This article starts by reviewing the development of national guidance for the training of clinical psychologists as supervisors. Nationally agreed learning objectives for supervisor training are presented. The article then describes how this guidance was operationalised within a region of the UK, and how this has been developed over a number of years. The training and its evaluation processes are outlined and mapped against the learning objectives, with suggestions for future developments

A könnyen érthető kommunikáció (KÉK) használatának megalapozottsága értelmi sérült személyeknél - rendszerszintű szakirodalmi áttekintés

Az elmúlt 20 évben egyre fontosabbá vált az információk hozzáférhetővé alakítása az értelmi sérült személyek számára. A könnyen érthető kiadványok mára már széles körben elérhetőek, fejlesztésüket pedig számos megjelent irányelv segíti. Arról viszont még mindig keveset tudunk, hogy mennyire hatékony a könnyen érthető kommunikáció, és mik azok a specifikus összetevők, melyek hatékonynyá tehetik. Munkánk során elektronikus adatbázisok (Medline, Embase, BNI, CINAHL, HMIC, PsycINFO, ERIC, PubMed és Cochrane Library) szisztematikus szakirodalmi áttekintését végeztük el 2013 novembere és 2014 januárja között. Tizenegy olyan publikációt találtunk, melyek a könnyen érthető kommunikáció alkalmazásának hatékonyságát vizsgálták; az eredmények közvetlen összehasonlítását azonban a kutatási módszerek közötti jelentős eltérések miatt – nem tudtuk elvégezni. Az írott, könnyen érthető szöveget kiegészítő illusztrációk megértést segítő használatáról eltérő megállapítások születtek. A tanulmányokban meghatározó tényezőként szerepelt az olvasó előzetes ismerete az egyes szimbólumok jelentéséről, különösen az elvontabb, tanulást igénylő szimbólumrendszerek esetében. A fényképek és az illusztrációk többségében hasznosnak bizonyultak, a szerzők ugyanakkor megállapították, hogy bizonyos esetekben megtévesztők is lehetnek. Ilyenkor egyértelmű magyarázatok szükségesek a megfelelő üzenet közvetítése érdekében. A szöveg formátuma és nehézségi szintje fontos szerepet játszott a szöveg tartalmának átfogó megértésében. Bizonyos nyelvi tényezők szintén a hozzáférhetőséget segítették. A tanulmányok módszertani korlátait figyelembe vettük, és ezek alapján javaslatokat készítettünk további kutatásokhoz. A könnyen olvasható és könnyen érthető információ ellenőrzésére és terjesztésére is kellő figyelmet kell fordítani, csakúgy, mint a könnyen olvasható és könnyen érthető termékek készítésére

Assessment and improvement of thermoelectric pyranometer measurements

This work evaluates the variability of thermoelectric pyranometer calibration values seen when using different calibration methods and practices. The pyranometer calibration ISO 9847:1992 standard leaves many procedural details to the user’s discretion. The variability resulting from different interpretations influences PV system performance monitoring and energy yield modelling. Improved methods and more robust standardisation are therefore needed to reduce uncertainty in field-deployed thermoelectric pyranometers and consequently reduce risk in PV system energy yield assessment. This paper investigates the variability induced by relaxed calibration procedures defined in the standard Furthermore, it proposes indoor procedures for the characterisation of pyranometer response to incidence angle and temperature which have not yet been defined in the standards. Uncertainty of calibration factors including under high angles of incidence and a few cloudy data series from outdoor methods were found to be up to 2.08%, compared with 1.4% stated by the manufacturer. Uncertainty increases up to 4.73% when reference and test sensors are of different types. Results of indoor calibration procedures agreed to within 1.21% even when calibrating multiple sensors at the same time. The instability of the irradiance source contributed more to the overall uncertainty than the selection of the procedure. The angular response of the devices tested was close to the prescribed limits [1]

Developing a community based psychosocial intervention with older people and third sector workers for anxiety and depression: a qualitative study

Background: One-in-five people in the UK experience anxiety and/or depression in later life. However, anxiety and depression remain poorly detected in older people, particularly in those with chronic physical ill health. In the UK, a stepped care approach, to manage common mental health problems, is advocated which includes service provision from non-statutory organisations (including third/voluntary sector). However, evidence to support such provision, including the most effective interventions, is limited. The qualitative study reported here constitutes the first phase of a feasibility study which aims to assess whether third sector workers can deliver a psychosocial intervention to older people with anxiety and/or depression. The aim of this qualitative study is to explore the views of older people and third sector workers about anxiety and depression among older people in order to refine an intervention to be delivered by third sector workers. Methods: Semi-structured interviews with participants recruited through purposive sampling from third sector groups in North Staffordshire. Interviews were digitally recorded with consent, transcribed and analysed using principles of constant comparison. Results: Nineteen older people and 9 third sector workers were interviewed. Key themes included: multiple forms of loss, mental health as a personal burden to bear, having courage and providing/receiving encouragement, self- worth and the value of group activities, and tensions in existing service provision, including barriers and gaps. Conclusions: The experience of loss was seen as central to feelings of anxiety and depression among community- dwelling older people. This study contributes to the evidence pointing to the scale and severity of mental health needs for some older people which can arise from multiple forms of loss, and which present a significant challenge to health, social care and third sector services. The findings informed development of a psychosocial intervention and training for third sector workers to deliver the intervention

The impact of immediate breast reconstruction on the time to delivery of adjuvant therapy: the iBRA-2 study

Background: Immediate breast reconstruction (IBR) is routinely offered to improve quality-of-life for women requiring mastectomy, but there are concerns that more complex surgery may delay adjuvant oncological treatments and compromise long-term outcomes. High-quality evidence is lacking. The iBRA-2 study aimed to investigate the impact of IBR on time to adjuvant therapy. Methods: Consecutive women undergoing mastectomy ± IBR for breast cancer July–December, 2016 were included. Patient demographics, operative, oncological and complication data were collected. Time from last definitive cancer surgery to first adjuvant treatment for patients undergoing mastectomy ± IBR were compared and risk factors associated with delays explored. Results: A total of 2540 patients were recruited from 76 centres; 1008 (39.7%) underwent IBR (implant-only [n = 675, 26.6%]; pedicled flaps [n = 105,4.1%] and free-flaps [n = 228, 8.9%]). Complications requiring re-admission or re-operation were significantly more common in patients undergoing IBR than those receiving mastectomy. Adjuvant chemotherapy or radiotherapy was required by 1235 (48.6%) patients. No clinically significant differences were seen in time to adjuvant therapy between patient groups but major complications irrespective of surgery received were significantly associated with treatment delays. Conclusions: IBR does not result in clinically significant delays to adjuvant therapy, but post-operative complications are associated with treatment delays. Strategies to minimise complications, including careful patient selection, are required to improve outcomes for patients

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Restraint and Seclusion in Services for People with Mental Health Problems and Learning Disabilities: A Literature Review

This paper reviews the literature pertaining to the practice and experience of restraint and seclusion in inpatient psychiatric settings. These are physical practices typically used by nursing staff in order to manage violence within such services. The available quantitative literature demonstrates the variability in the prevalence of the practices and attitudes towards them. Qualitative research has focussed on then experience of the practices and the different but largely negative impacts they have. Many of these qualitative studies produce interesting and valuable findings; however the literature does not account for the role that language may play in constructing the experience and meaning of the practices for those involved. This and other limitations in the research are described and direction for further research indicated

A Grounded Theory Investigation of Consultees’ Perception and Experience of Psychological Consultation

Consultation is identified as a core skill that clinical psychologists are expected to deliver; however there is little research that has identified how the recipients of the consultation understand or experience this consultation. The aim of this research was to explore, using grounded theory methodology, how mental health and social care staff experienced psychological consultation provided by a clinical psychologist. The research findings indicate that consultation is generally felt to be a positive and helpful vehicle in improving work practice. Consultation tended to be seen as a collaborative process between consultant and consultee with psychologists being viewed as experts in the area of mental health. More specifically, consultees tended to initially request and expect cognitive ideas but ultimately gained most benefit from more emotional processes, such as being listened to and affirmation of their own knowledge. Implications for further research were discussed

Psychosocial interventions in a medium secure unit for people with learning disabilities: A service development

Psychosocial Interventions (PSI), a whole systems approach, is an integral part of the agenda for modernising mental health services. It is advocated as an effective approach for services in promoting the recovery of people with schizophrenia and other psychoses. The literature relevant to the approach is reviewed. However there is a dearth of literature with regard to PSI in mental health services for people with learning disabilities. This absence is particularly marked in secure settings where there is no established evidence based model of care. This paper describes the implementation of PSI in such a setting, including the central tenets of individual and group therapy, family intervention and formulation based care planning. This is supported by group supervision, staff training and the explicit support of the centre’s clinical management team. The implementation is still in progress. The evaluation strategy is also described

'Getting into trouble': A qualitative analysis of the onset of offending in the accounts of men with learning disabilities

Quantitative and epidemiological studies have identified common factors in the histories of people who offend. People with learning disabilities are over-represented among certain groups of offenders. However, there is an absence of literature that examines this phenomenon from the perspective of the individual by exploring the experience and understanding in their own narrative. This study provides an account of the lived experiences of men with learning disabilities who have offended, seeking to examine the ways in which these men made sense of their own behaviour and history. Six participants were interviewed using a semi-structured schedule. All participants were men with learning disabilities who were detained in conditions of medium or low security. The research was conducted using interpretative phenomenological analysis (IPA). Three superordinate themes emerged: social factors, protection, and inherent factors. Participants accounted for their experience and understanding in terms of both internal states and external contexts, and the analysis reflected this. It is essential that the development of offending is understood through both nomothetic and idiographic research paradigms. Findings such as these are useful when considering prevention and intervention. IPA was a constructive tool with which to explore these issues with men with learning disabilities