208 research outputs found
Measuring competence in systemic practice: development of the āsystemic family practice ā systemic competency scaleā (SPS)
Ensuring that practitioners are competent in the therapies they deliver is important for training, therapeutic outcomes and ethical practice. The development of the Systemic Practice Scale (SPS) is reported - a measure to assess the competence of novice systemic practitioners trialed by Children and Young Personās Improving Access to Psychological Therapies (CYP-IAPT) training courses.
Initial reliability assessment of the SPS with twenty-eight supervisors of systemic practice evaluating studentsā competence using an online recording of a family therapy session is detailed. The SPS was found to be a reliable measure of systemic competence across training settings. Rating variability was noted, with training and benchmarking to improve rating consistency recommended.
Further research using the SPS to further establish the reliability and validity of the scale is required
Gibt es einen āPrimat der praktischen Vernunftā in der Logik?
Tekst wystÄ
pienia w czasie III MiÄdzynarodowego Kongresu Filozoficznego, ktĆ³ry odbyÅ siÄ w Heidelbergu w 1908 roku. Opublikowany pierwotnie w: E. Lask: Gibt es einen āPrimat der praktischen Vernunftā in der Logik? In: Bericht Ć¼ber den III. internationalen KongreĆ fĆ¼r Philosophie zu Heidelberg. 1. bis 5. September 1908. Hrsg. von Th. El enhans. Heidelberg 1909, s. 671ā679, a nastÄpnie w: E. Lask: Gesammelte Schriften. Hrsg. von E. Herrigel. Bd. 1. TĆ¼bingen 1923, s. 347ā356. Przedrukowany rĆ³wnież w: Erkenntnistheorie und Logik im Neukantianismus. Texte von Cohen, Natorp, Cassirer, Windelband, Rickert, Lask, Bauch. Hrsg. von W. Flach und H. H olzhey. Hildesheim 1980, s. 543ā552.Przez naukÄ o prymacie rozumu praktycznego rozumiemy każdy poglÄ
d, ktĆ³ry pojÄciu Åwiadomej obowiÄ
zku woli przyznaje centralne miejsce rĆ³wnież w filozofii teoretycznej, poglÄ
d uznajÄ
cy dominujÄ
cÄ
rolÄ praktycznego momentu wartoÅciowania w nauce o sÄ
dzie. Dzisiejszy referat ma stanowiÄ tylko niewielkÄ
uwagÄ polemicznÄ
w stosunku do tej teorii, poczynionÄ
jedynie w celu uwolnienia ogromnego podstawowego poglÄ
du filozoficznego, zawdziÄczajÄ
cego swe istnienie temu problemowi, od przeszkadzajÄ
cych drobiazgĆ³w etycznych, okrywajÄ
cych obecnie jego odwiecznÄ
treÅÄ.
Nauka o pierwszeÅstwie tego, co etyczne, przed tym, co teoretyczne, wyniknÄÅa z tego zasadniczego filozoficznego poznania, ktĆ³re uważam za uwalniajÄ
cy, wyjaÅniajÄ
cy czyn w obszarze filozofii teoretycznej, mianowicie z poglÄ
du (Einsicht), że logika i teoria poznania skÅadajÄ
siÄ na krytykÄ rozumu, naukÄ o wartoÅci, dociekanie nad sensem i znaczeniem [...]
Adherence to medication in adults with Cystic Fibrosis: An investigation using objective adherence data and the Theoretical Domains Framework
Objectives
Adherence to nebulizer treatment in adults with Cystic Fibrosis (CF) is poor, and interventions are needed. This research aimed to identify the factors affecting nebulizer adherence using the Theoretical Domains Framework (TDF) and to compare these for participants with different levels of adherence.
Design
Dataāprompted interviews using the TDF.
Methods
Eighteen semiāstructured interviews were conducted with adults with CF during which objectively measured adherence data were discussed. Framework analysis was used to code the data into TDF domains, and inductive qualitative content analysis was used to code different beliefs and experiences. Aspects of the TDF that differed between participants with different adherence levels were explored.
Results
Factors influencing adherence to treatment included all 14 domains of the TDF, 10 of which appeared to vary by adherence level: Skills; Memory and decisionāmaking; and Behavioural regulation; Environmental context and resources; Social influences; Beliefs about consequences; Beliefs about capability; Reinforcement; Social role and identify; Intentions; Optimism; and Emotions.
Conclusions
This study is the first to use objectively measured adherence data in a dataāprompted interview using the TDF framework to systematically assess the full range of factors potentially influencing adherence. The results highlighted that interventions need to consider issues of capability, opportunity, and motivation. Interventions that challenge dysfunctional beliefs about adherence and which support the development of routines or habits and problemāsolving may be particularly useful for adults with CF
When is forgetting not forgetting? A discursive analysis of differences in forgetting talk between adults with cystic fibrosis with different levels of adherence to nebulizer treatments
Forgetting is often cited as a reason why people struggle to adhere to treatments for chronic conditions. Interventions have tried to improve forgetting behavior using reminders. We used a discursive psychological approach to explore differences in how high and low adherers constructed forgetting their nebulizer treatments for cystic fibrosis. Interviews were conducted with 18 adults from a cystic fibrosis center in the United Kingdom. High adherers constructed forgetting treatments as occasional lapses in automaticity and temporary lapses in memory that they found easy to repair. Low adherers utilized forgetting to normalize more consistent nonadherence to treatments. However, it is important to contextualize forgetting as a discursive resource that helped these participants to negotiate moral discourses around adherence to treatment that reminder interventions cannot address; we therefore recommend a more behavioral, patient-focused, theory-driven approach to intervention development
Mechanisms of action of a web-based intervention with health professional support to increase nebulizer adherence in adults with cystic fibrosis: a qualitative interview study
Background: Adherence to nebulizer treatments in adults with cystic fibrosis (CF) is often low. A new complex intervention to help adults with CF increase their adherence to nebulizer treatments was tested in a pilot randomized controlled trial (RCT) in 2 UK CF centers. Patients used a nebulizer with electronic monitoring capabilities that transferred data automatically to a digital platform (CFHealthHub) to monitor adherence over time and to a tailored website to display graphs of adherence data and educational and problem-solving information about adherence. A trained interventionist helped patients identify ways to increase their adherence.
Objective: This study aims to explore the mechanisms of action underpinning the intervention.
Methods: A qualitative interview study was conducted concurrently with a pilot RCT. In total, 25 semistructured interviews were conducted with 3 interventionists at 2 time points, 14 patients in the intervention arm of the trial, and 5 members of the multidisciplinary teams offering wider care to patients. A framework approach was used for the analysis.
Results: The intervention was informed by a theoretical framework of behavior change. There was evidence of the expected behavior change mechanisms of action. There was also evidence of additional mechanisms of action associated with effective telehealth interventions for self-management support: relationships, visibility, and fit. Patients described how building a relationship with the interventionist through face-to-face visits with someone who cared about them and their progress helped them to consider ways of increasing adherence to medication. Rather than seeing the visibility of adherence data to clinicians as problematic, patients found this motivating, particularly if they received praise about progress made. The intervention was tailored to individuals, but there were challenges in how the intervention fitted into some patientsā busy lives when delivered through a desktop computer.
Conclusions: The mechanisms of action associated with effective telehealth interventions for self-management operated within this new intervention. The intervention was modified to strengthen mechanisms of action based on these findings, for example, delivery through an app accessed via mobile phones and then tested in an RCT in 19 UK CF centers
Clinical Ethics Consultation: Examining how American and Japanese experts analyze an Alzheimer's case
Thinking about Eating Food Activates Visual Cortex with Reduced Bilateral Cerebellar Activation in Females with Anorexia Nervosa: An fMRI Study
Background: Women with anorexia nervosa (AN) have aberrant cognitions about food and altered activity in prefrontal cortical and somatosensory regions to food images. However, differential effects on the brain when thinking about eating food between healthy women and those with AN is unknown. Methods: Functional magnetic resonance imaging (fMRI) examined neural activation when 42 women thought about eating the food shown in images: 18 with AN (11 RAN, 7 BPAN) and 24 age-matched controls (HC). Results: Group contrasts between HC and AN revealed reduced activation in AN in the bilateral cerebellar vermis, and increased activation in the right visual cortex. Preliminary comparisons between AN subtypes and healthy controls suggest differences in cortical and limbic regions. Conclusions: These preliminary data suggest that thinking about eating food shown in images increases visual and prefrontal cortical neural responses in females with AN, which may underlie cognitive biases towards food stimuli and ruminations about controlling food intake. Future studies are needed to explicitly test how thinking about eating activates restraint cognitions, specifically in those with restricting vs. binge-purging AN subtypes
How many replicate tests are needed to test cookstove performance and emissions? ā Three is not always adequate
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