The primary school as a therapeutic community

Purpose – The purpose of this paper is to consider the changes underway in the delivery of services to children and young people in schools, not least that OFTSED will soon be routinely carrying out an assessment of mental health provision in schools. This paper considers the policy context to these changes and the recent initiatives that are informing the evolution of initial teacher training. Alongside the changes in Child and Adolescent Mental Health Services there are an increasing number of schools developing counselling and psychotherapy services. How can the School counsellor look to develop a who school as therapeutic community. Design/methodology/approach – A case narrative is presented of a seven-year-old child who was referred to the school counselling service. The narrative draws attention to the array of dynamic interactions, from peers to teachers to parents which the school counselling manager encountered. Findings – It is argued that it is necessary for the school counsellor to have a framework for understanding how all parts of the school work together and it is proposed that we might usefully consider the primary school as a therapeutic community. Originality/value – There are a raft of policy changes and practices in recent years that have altered the landscape of early intervention and the mental health agenda in primary schools. This paper captures this debates and consider how therapeutic community ideology is positioned as an opportunity to think more expansively about mental health in primary school

Total Packages of Work: Women Living in Atlantic Canada Compared to the Rest of Canada

Atlantic Canadian women report significantly longer total hours of work (paid plus unpaid) than their sisters living elsewhere in Canada. We examine a variety of potential explanations, including demographic, economic, social/cultural and policy factors, highlighting the need for additional research on this issue.Les femmes du Canada atlantique rapportent des heures de travail considérablement plus longues (rémunérées et non rémunérées) que leurs soeurs qui résident ailleurs au Canada. Nous étudions une variété d'explications possibles y compris les facteurs démographiques, économiques, sociaux/culturels et de politiques, qui mettent en évidence le besoin de recherche additionnelle sur cette question

Investigating the Integration of Student Learning Resources in Preparation for the NCLEX-RN: Phase One of a Canadian Two-Phase Multi-Site Study

Evidence-informed education practices are critical in determining effective student preparatory learning resources for the NCLEX-RN examination. Standardized testing in nursing education programs has been demonstrated to increase students NCLEX-RN success. A widely researched assessment tool for predicting NCLEX-RN examination outcomes is the HESITM RN Exit Exams. The HESI Exit Exam (E2) was determined to be between 93.36% and 99.16% accurate in predicting NCLEX-RN success (N = 49,115) with samples derived from various nursing programs throughout the United States. Purpose: This two-phase, multi-site ex-post facto study was to investigate NCLEX-RN Student Preparatory Learning Resources within the Canadian context. Phase One, which is reported here, was to determine if there was a relationship between student HESITM RN Exit and Computer Adaptive Testing (CAT) Exam scores, student grade point average (GPA), and the time lag between graduation and writing the National Licensure exam, and student outcome on the NCLEX-RN exam. Procedure: New nursing graduates were emailed study information and asked to provide their consent for the use of their student data (GPA, HESITM Exit and CAT Exam scores) for research purposes and to request that they self-report (via a password protected secure email address created for this study) their NCLEX-RN Licensure exam date and result (pass/fail) of their first exam writing. Results: Among a convenience sample of 117 new nursing alumni (graduates of 2015) from three universities in Nova Scotia, we found statistically significant mean differences in HESITM RN Exit Exam Version 1, Version 2, and CAT scores among those students that were successful on the NCLEX-RN exam versus those students that were not successful on their first writing of the NCLEX-RN exam. There was an inverse statistically significant relationship between time lag and NCLEX-RN outcome indicating that the longer the time period from graduation to writing, the less likely that the student will be successful. We found no relationship between student GPA and NCLEX-RN outcome. Discussion: Phase One results of this study suggest that there are differences in HESITM RN Exit exam and CAT scores among those students who were successful on the first write of NCLEX-RN exam versus those students who were not successful.. Although HESITM exams are just one type of the many available nursing resources to assist students to prepare for writing the National Licensure examination, our findings are significant and warrant Canadian nurse educators’ attention. Résumé Les pratiques de formation fondées sur des résultats probants sont essentielles pour déterminer l’efficacité des ressources d’apprentissage préparatoires à l’examen NCLEX-RN offertes aux étudiantes. Il a été démontré que l’utilisation d’examens standardisés dans les programmes de formation en sciences infirmières augmente le taux de réussite des étudiants à l’examen NCLEX-RN. Un outil d’évaluation qui a été largement étudié et qui permet de prédire les résultats d’examen au NCLEX-RN est l’examen final HESIMD RN. Il a été déterminé que l’examen final HESI (E2) prédisait avec une précision se situant entre 93,36 % et 99,16 % le taux de réussite à l’examen NCLEX-RN (N = 49 115) dans des échantillons provenant de différents programmes de sciences infirmières aux États-Unis. Objectif : Cette étude multi-sites, en deux phases, réalisée a posteriori visait à examiner les ressources d’apprentissage préparatoires au NCLEX-RN offertes aux étudiantes dans le contexte canadien. La première phase, dont il est question dans cet article, était conçue pour déterminer s’il existait une relation entre les résultats d’examens finaux au HESIMD RN, les résultats au test adaptatif informatisé (TAI), la moyenne générale (MG) des étudiants, l’intervalle de temps entre l’obtention du diplôme et le passage de l’examen national d’autorisation à exercer, et les résultats à l’examen NCLEX-RN. Procédure : Les nouvelles diplômées en sciences infirmières recevaient un courriel fournissant des informations sur l’étude et sollicitant leur consentement pour l’utilisation de données de leur dossier d’étudiante (leur MG, leur résultat à l’examen final HESIMD et leur résultat au TAI) à des fins de recherche. Ce message leur demandait également de déclarer (par l’entremise d’une adresse courriel sécurisée protégée par mot de passe et créée pour l’étude) la date et le résultat (réussite/échec) de leur premier examen d’autorisation à exercer NCLEX-RN. Résultats : Dans l’échantillon de convenance de 117 nouvelles diplômées en sciences infirmières (diplômées de 2015) de trois universités en Nouvelle-Écosse, nous avons découvert des différences de moyennes statistiquement significatives entre les étudiantes qui ont réussi à l’examen NCLEX-RN et celles qui ne l’ont pas réussi à la première tentative, pour leurs résultats à l’examen final HESIMD RN, version 1 et version 2, et les résultats du TAI. . Une relation inverse statistiquement significative fut remarquée entre l’intervalle de temps avant de passer l’examen NCLEX-RN et le résultat à ’cet examen, ce qui indique que plus la période est longue entre l’obtention du diplôme et le passage de l’examen, moins il est probable que l’étudiante réussisse l’examen. Nous n’avons trouvé aucune relation entre la MG de l’étudiante et le résultat au NCLEX-RN. Discussion : Les résultats de la première phase de cette étude indiquent qu’il existe des différences quant aux résultats à l’examen final HESIMD RN et au TAI entre les étudiantes qui ont réussi l’examen NCLEX-RN la première fois et celles qui l’ont échoué. Bien que les examens HESIMD ne soient qu’un type de ressources parmi de nombreuses autres ressources disponibles en sciences infirmières pour aider les étudiantes à se préparer à l’examen national d’autorisation à exercer, nos résultats sont significatifs et méritent l’attention des infirmières formatrices canadiennes

Liver transplant recipients’ experiences and perspectives of a telehealth-delivered lifestyle programme A qualitative study

Introduction Dietary modification and exercise are encouraged to address cardiometabolic risk factors after solid organ transplantation. However, the lived experience of attempting positive lifestyle changes for liver transplant recipients is not known. The aim of this study was to explore the experiences of liver transplant recipients and their perspectives of a 12-week telehealth lifestyle programme and assess the feasibility of this innovative health service. Methods Focus groups and one-on-one interviews were conducted with participants who had completed a 12-week, group-based, telehealth-delivered diet and exercise programme and thematic qualitative analysis was used to code and theme the data. Results In total, 19 liver transplant recipients participated in the study (25-68 years, median time since transplant 4.4 years, 63% male). Overarching themes included: (a) 'broad telehealth advantages' which highlighted that telehealth reduced the perceived burdens of face-to-face care; (b) 'impact of employment' which identified employment as a competing priority and appeared to effect involvement with the programme; (c) 'adapting Mediterranean eating pattern to meet individual needs' which identified the adaptability of the Mediterranean diet supported by sessions with the dietitian; (d) 'increasing exercise confidence' which recognised that a tailored approach facilitated confidence and acceptability of the exercise component of the programme. Discussion A telehealth lifestyle programme delivered by dietitians and exercise physiologists is an acceptable alternative to face-to-face care that can meet the needs of liver transplant recipients. There is a need to further innovate and broaden the scope of routine service delivery beyond face-to-face consultations

The essentials of counselling and psychotherapy in primary schools

The book is targeted at all practitioners in the helping and enabling professions working with children and young people, and is essential reading for anyone undertaking training where elements of psychotherapy and counselling are requisite to practice. As well as a guide for trainees in the helping professions, the book also speaks to advancing practitioners insofar as essential elements of the therapeutic relationship, such as containment, trust and transference, are re-cast in light of the modern challenges of working with children, especially young children. There are an increasing number of courses in the UK (and abroad) which focus on developing practitioners who are delivering early interventions for mental health issues and so The Essentials of Counselling and Psychotherapy in Primary Schools offers a strong underpinning with a particular focus that offers a marker for the development of the special interest section of the UKCP. Psychotherapy with children and young people has traditionally rooted practitioners in psychoanalytic theory. The Essentials of Counselling and Psychotherapy in Primary Schools pays heed to this lineage with a fresh perspectives on what are the ingredients in practice which will tackle the impediment to flourishing in children

High-intensity interval training is safe, feasible and efficacious in nonalcoholic steatohepatitis : a randomized controlled trial

Background: High-Intensity Interval Training (HIIT) involves bursts of high-intensity exercise interspersed with lower-intensity exercise recovery. HIIT may benefit cardiometabolic health in people with nonalcoholic steatohepatitis (NASH). Aims: We aimed to examine the safety, feasibility, and efficacy of 12-weeks of supervised HIIT compared with a sham-exercise control (CON) for improving aerobic fitness and peripheral insulin sensitivity in biopsy-proven NASH. Methods: Participants based in the community [(n = 14, 56 ± 10 years, BMI 39.2 ± 6.7 kg/m2, 64% male), NAFLD Activity Score 5 (range 3–7)] were randomized to 12-weeks of supervised HIIT (n = 8, 4 × 4 min at 85–95% maximal heart rate, interspersed with 3 min active recovery; 3 days/week) or CON (n = 6, stretching; 3 days/week). Safety (adverse events) and feasibility determined a

The Effect of Diet and Exercise Interventions on Body Composition in Liver Cirrhosis: A Systematic Review

Alterations in body composition, in particular sarcopenia and sarcopenic obesity, are complications of liver cirrhosis associated with adverse outcomes. This systematic review aimed to evaluate the effect of diet and/or exercise interventions on body composition (muscle or fat) in adults with cirrhosis. Five databases were searched from inception to November 2021. Controlled trials of diet and/or exercise reporting at least one body composition measure were included. Single-arm interventions were included if guideline-recommended measures were used (computed tomography/magnetic resonance imaging, dual-energy X-ray absorptiometry, bioelectrical impedance analysis, or ultrasound). A total of 22 controlled trials and 5 single-arm interventions were included. Study quality varied (moderate to high risk of bias), mainly due to lack of blinding. Generally, sample sizes were small (n = 6–120). Only one study targeted weight loss in an overweight population. When guideline-recommended measures of body composition were used, the largest improvements occurred with combined diet and exercise interventions. These mostly employed high protein diets with aerobic and or resistance exercises for at least 8 weeks. Benefits were also observed with supplementary branched-chain amino acids. While body composition in cirrhosis may improve with diet and exercise prescription, suitably powered RCTs of combined interventions, targeting overweight/obese populations, and using guideline-recommended body composition measures are needed to clarify if sarcopenia/sarcopenic obesity is modifiable in patients with cirrhosis

Utilizing Technology for Diet and Exercise Change in Complex Chronic Conditions Across Diverse Environments (U-DECIDE): Protocol for a Randomized Controlled Trial

BACKGROUND: The metabolic syndrome is common across many complex chronic disease groups. Advances in health technology have provided opportunities to support lifestyle interventions. OBJECTIVE: The purpose of this study is to test the feasibility of a health technology-assisted lifestyle intervention in a patient-led model of care. METHODS: The study is a single-center, 26-week, randomized controlled trial. The setting is specialist kidney and liver disease clinics at a large Australian tertiary hospital. The participants will be adults with a complex chronic condition who are referred for dietetic assessment and display at least one feature of the metabolic syndrome. All participants will receive an individualized assessment and advice on diet quality from a dietitian, a wearable activity monitor, and standard care. Participants randomized to the intervention group will receive access to a suite of health technologies from which to choose, including common base components (text messages) and optional components (online and mobile app–based nutrition information, an online home exercise program, and group-based videoconferencing). Exposure to the optional aspects of the intervention will be patient-led, with participants choosing their preferred level of engagement. The primary outcome will be the feasibility of delivering the program, determined by safety, recruitment rate, retention, exposure uptake, and telehealth adherence. Secondary outcomes will be clinical effectiveness, patient-led goal attainment, treatment fidelity, exposure demand, and participant perceptions. Primary outcome data will be assessed descriptively and secondary outcomes will be assessed using an analysis of covariance. This study will provide evidence on the feasibility of the intervention in a tertiary setting for patients with complex chronic disease exhibiting features of the metabolic syndrome. RESULTS: The study was funded in 2019. Enrollment has commenced and is expected to be completed by June 2022. Data collection and follow up are expected to be completed by December 2022. Results from the analyses based on primary outcomes are expected to be submitted for publication by June 2023. CONCLUSIONS: The study will test the implementation of a health technology–assisted lifestyle intervention in a tertiary outpatient setting for a diverse group of patients with complex chronic conditions. It is novel in that it embeds patient choice into intervention exposure and will inform health service decision-makers in regards to the feasibility of scale and spread of technology-assisted access to care for a broader reach of specialist services. TRIAL REGISTRATION: Australian New Zealand Clinical Trial Registry ACTRN12620001282976; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378337 INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/3755