338 research outputs found
Negotiating in the Shadows of Organizations: Gender, Negotiation, and Change
Published in cooperation with the American Bar Association Section of Dispute Resolutio
Do they practice what we teach? Follow-up evaluation of a Schema Therapy training programme
This study evaluated a three-day Schema Therapy training programme for trainee clinical psychologists. The training used an experiential model of learning, which was intended to encourage the transfer of knowledge and techniques from the learning environment into clinical practice. Using a mixed-methods approach, the training programme was evaluated in
terms of: (1) self-reported changes in knowledge, confidence and willingness to use Schema Therapy-informed techniques; (2) whether the training was integrated into clinical practice; and (3) the perceived barriers/facilitators to achieving practice integration. Participants – 17 of the 19 trainee clinical psychologists enrolled on the Schema Therapy
training programme – completed assessments immediately pre- and post-training. Participants were subsequently followed-up for reassessment three months after the training. Group- and individual-level analyses
showed that most participants reported training-related gains in knowledge and confidence; these were largely sustained at follow-up, and were associated with post-training practice integration of Schema Therapy concepts and techniques. Analysis of qualitative data identified factors moderating use of training in practice. Findings of the study have
implications for future delivery and evaluation of training in cognitive-behavioural therapies
Do they practice what we teach? Follow-up evaluation of a Schema Therapy training programme
This study evaluated a three-day Schema Therapy training programme for trainee clinical psychologists. The training used an experiential model of learning, which was intended to encourage the transfer of knowledge and techniques from the learning environment into clinical practice. Using a mixed-methods approach, the training programme was evaluated in
terms of: (1) self-reported changes in knowledge, confidence and willingness to use Schema Therapy-informed techniques; (2) whether the training was integrated into clinical practice; and (3) the perceived barriers/facilitators to achieving practice integration. Participants – 17 of the 19 trainee clinical psychologists enrolled on the Schema Therapy
training programme – completed assessments immediately pre- and post-training. Participants were subsequently followed-up for reassessment three months after the training. Group- and individual-level analyses
showed that most participants reported training-related gains in knowledge and confidence; these were largely sustained at follow-up, and were associated with post-training practice integration of Schema Therapy concepts and techniques. Analysis of qualitative data identified factors moderating use of training in practice. Findings of the study have
implications for future delivery and evaluation of training in cognitive-behavioural therapies
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An Outside-Inside Evolution in Gender and Professional Work
We study the process by which a professional service firm reshaped its activities and beliefs over nearly two decades as it adapted to shifts in the social discourse regarding gender and work. Analyzing archival data from the firm over eighteen years and representations of gender and work from the business press over the corresponding two decades, we find that the firm internalized the broader social discourse through iterated cycles of analysis and action, punctuated by evolving beliefs about gender and work. Outside experts and shifting social understandings played pivotal roles in changing beliefs and activities inside the firm. We conclude with an internalization model depicting organizational adaptation to evolving social institutions
Strengthening patient-centred communication in rural Ugandan health centres: A theory-driven evaluation within a cluster randomized trial.
This article describes a theory-driven evaluation of one component of an intervention to improve the quality of health care at Ugandan public health centres. Patient-centred services have been advocated widely, but such approaches have received little attention in Africa. A cluster randomized trial is evaluating population-level outcomes of an intervention with multiple components, including 'patient-centred services.' A process evaluation was designed within this trial to articulate and evaluate the implementation and programme theories of the intervention. This article evaluates one hypothesized mechanism of change within the programme theory: the impact of the Patient Centred Services component on health-worker communication. The theory-driven approach extended to evaluation of the outcome measures. The study found that the proximal outcome of patient-centred communication was rated 10 percent higher (p < 0.008) by care seekers consulting with the health workers who were at the intervention health centres compared with those at control health centres. This finding will strengthen interpretation of more distal trial outcomes
Prevalence and characteristics of progressive fibrosing interstitial lung disease in a prospective registry
Rationale
Progressive fibrosing interstitial lung disease (PF-ILD) is characterized by progressive
physiologic, symptomatic, and/or radiographic worsening. The real-world prevalence and
characteristics of PF-ILD remain uncertain.
Methods
Patients were enrolled from the Canadian Registry for Pulmonary Fibrosis between 2015-2020.
PF-ILD was defined as a relative forced vital capacity (FVC) decline ≥10%, death, lung
transplantation, or any 2 of: relative FVC decline ≥5 and <10%, worsening respiratory
symptoms, or worsening fibrosis on computed tomography of the chest, all within 24 months of
diagnosis. Time-to-event analysis compared progression between key diagnostic subgroups.
Characteristics associated with progression were determined by multivariable regression.
Results
Of 2,746 patients with fibrotic ILD (mean age 65±12 years, 51% female), 1,376 (50%) met PFILD criteria in the first 24 months of follow-up. PF-ILD occurred in 427 (59%) patients with
idiopathic pulmonary fibrosis (IPF), 125 (58%) with fibrotic hypersensitivity pneumonitis (HP),
281 (51%) with unclassifiable ILD (U-ILD), and 402 (45%) with connective tissue diseaseassociated ILD (CTD-ILD). Compared to IPF, time to progression was similar in patients with
HP (hazard ratio [HR] 0.96, 95% confidence interval, CI 0.79-1.17), but was delayed in patients
with U-ILD (HR 0.82, 95% CI 0.71-0.96) and CTD-ILD (HR 0.65, 95% CI 0.56-0.74).
Background treatment varied across diagnostic subtypes with 66% of IPF patients receiving
antifibrotic therapy, while immunomodulatory therapy was utilized in 49%, 61%, and 37% of
patients with CHP, CTD-ILD, and U-ILD respectively. Increasing age, male sex,
gastroesophageal reflux disease, and lower baseline pulmonary function were independently
associated with progression.
Interpretation
Progression is common in patients with fibrotic ILD, and is similarly prevalent in HP and IPF.
Routinely collected variables help identify patients at risk for progression and may guide
therapeutic strategie
Distinct expressions of contrast gain control in parallel synaptic pathways converging on a retinal ganglion cell
Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/65990/1/jphysiol.2008.156224.pd
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