Impact of Optimized Breastfeeding on the Costs of Necrotizing Enterocolitis in Extremely Low Birthweight Infants

To estimate risk of NEC for ELBW infants as a function of preterm formula and maternal milk (MM) intake and calculate the impact of suboptimal feeding on NEC incidence and costs

Improvements in psychologists’ metacommunication self‐efficacy, willingness, and skill following online training and a supervision exercise

2019 Wiley Periodicals, Inc. Objective(s): Psychologists\u27 experiences of an online training tool in metacommunication as well as an in-supervisory metacommunication exercise were examined. Method: A total of 101 participants completed a training tool in metacommunication and changes in self-efficacy (SE) to use metacommunication with clients, the proportion of metacommunication used in vignette-responses, and their willingness to use metacommunication in supervision were assessed pre- and posttraining and at 6-week follow-up. A total of 48 participants elected to undertake the in-supervision exercise. Results: Participants reported significantly higher willingness and self-efficacy after completing the online training. They also showed a higher proportion of metacommunicative statements in their posttraining vignette responses compared with pretraining. The increase in willingness was retained at 6-week follow-up. There was an increase in self-efficacy from pre- to postonline-training, and this increased at follow-up. Conclusions: This opens the door to better developing metacommunication skills in supervisees through both online training and the metacommunication supervisory exercise. Areas for continued research are outlined

Challenges of nurse delivery of psychological interventions for long-term conditions in primary care: a qualitative exploration of the case of chronic fatigue syndrome/myalgic encephalitis

Background The evidence-base for a range of psychosocial and behavioural interventions in managing patients with long term conditions (LTCs) is now well-established. With increasing numbers of such patients with such conditions being managed in primary care, and a shortage of specialists in psychology and behavioural management to deliver interventions, such therapeutic interventions are increasingly being delivered by general nurses with limited training in psychological interventions. It is unknown what issues this raises for the nurses or their patients. The purpose of the study was to examine the challenges faced by non-specialist nurses when delivering psychological interventions for a long term condition (Chronic Fatigue Syndrome /Myalgic Encephalomyelitis; CFS/ME) within a primary care setting. Methods A qualitative study nested within a randomised controlled trial [ISRCTN 74156610] explored the experiences and acceptability of two different psychological interventions (pragmatic rehabilitation and supportive listening) from the perspectives of nurses, their supervisors and patients. Exploring data from each perspective provides triangulation, and therefore increased trustworthiness, of the analysis. Semi-structured in-depth interviews were conducted with 46 patients, three nurse therapists and three supervisors and an iterative approach was used to develop conceptual categories from the dataset. Results Analyses reveal four sets of challenges that were common to both interventions: i) Being a novice therapist; ii) engaging patients in the therapeutic model; iii) dealing with emotions and iv) complexity of primary care. Each challenge had the potential to cause tension between therapist and patient. A number of strategies were developed by participants to manage the tensions. Conclusion Tensions exist for nurses when attempting to deliver psychological therapy for patients with CFS/ME in a primary care trial which would need to be addressed before implementing within routine clinical practice. Similar tensions may be found for other long term conditions. These have implications for developing therapeutic alliance and highlight the need for regular supervision

Therapeutic collaboration and the assimilation of problematic experiences in emotion-focused therapy for depression: Comparison of two cases

Objective: The Assimilation model argues that therapists should work responsively within the client's therapeutic zone of proximal development (TZPD). This study analyzed the association between the collaborative processes assessed by the Therapeutic Collaboration Coding System (TCCS) and advances in assimilation, as assessed by the Assimilation of Problematic Experiences Scale (APES). Method: Sessions 1, 4, 8, 12, and 16 of two contrasting cases, Julia and Afonso (pseudonyms), drawn from a clinical trial of 16-sessions emotion-focused therapy (EFT) for depression, were coded according to the APES and the TCCS. Julia met criteria for reliable and clinically significant improvement, whereas Afonso did not. Results: As expected, Julia advanced farther along the APES than did Afonso. Both therapists worked mainly within their client's TZPD. However, Julia's therapist used a balance of supporting and challenging interventions, whereas Afonso's therapist used mainly supporting interventions. Setbacks were common in both cases. Conclusions: This study supports the theoretical expectation that EFT therapists work mainly within their client's TZPD. Therapeutic exchanges involving challenging interventions may foster client change if they occur in an overall climate of safety.- This study was partially conducted at Psychology Research Centre (UID/PSI/01662/2013), University of Minho, and supported by the Portuguese Foundation for Science and Technology and the Portuguese Ministry of Science, Technology and Higher Education through national funds and co-financed by FEDER through COMPETE2020 under the PT2020 Partnership Agreement (POCI-01-0145-FEDER-007653). This article was supported by the Portuguese Foundation for Science and Technology (FCT) [grant number PTDC/PSI-PCL/103432/2008] (Decentering and change in psychotherapy, 2010-2013).info:eu-repo/semantics/publishedVersio