Using Client and Supervision Feedback to Improve Supervision in Health Care

This paper seeks to establish a conceptual model of client and supervisee feedback that can be used to improve supervision processes and outcomes in health and social care settings. Supervision is a beneficial practice development endeavor that practitioners find rewarding for various reasons. However, the impact of supervision on client outcomes in health and social care settings is scant and not all supervision is helpful; indeed, harmful and inadequate supervision is also prevalent. Using supervisory measures of the alliance between supervisor and supervisee may be one method to help improve processes and outcomes. In addition, providing client feedback to practitioners in health and social care settings has been established as an evidence-based method to improve psychosocial outcomes. Using this feedback data during supervision may help the supervisory process to focus on practitioner development objectively, and limit the extent of negative client experiences in systems of care. A conceptual model describing bidirectional feedback based on objective assessment is articulated; client to practitioner/practitioner to supervisor. A lack of primary data poses limitations to this review. Thus, future research may like to establish whether integrating these processes together as a conceptual model provides added value

Beyond The Competency Model of Therapist Trainings - Developing Expertise Through Deliberate Practice

The purpose of the present paper is to describe how Deliberate Practice (DP) can be used to assist individual therapists develop expertise and improve their ability to effect change in their clients\u27 psychotherapy outcomes. The author provides a targeted review of this literature and articulates a method of training therapists based on this relatively new and exciting concept. The initial training of psychotherapists represents an important milestone in an often lifelong career and one that is marked with a continuous professional development trajectory. While it is particularly important to achieve competency in many foundational skills and techniques during training, this method of training and continuous development of therapists does relatively little to engage individual practitioners based on their individual needs, which are said to be vast. Individual therapist effects account for a large proportion of the variance of client outcomes. However, historically, the individual therapist has been given little consideration. DP seeks to move beyond the standardized competency framework and provide a highly individualized training regime to therapists based on their individual deficits identified through data mining and linked to factors of therapy practice that have demonstrated to impact client outcomes; and as such, they can be leveraged by therapists. The findings of this review are used to inform seven recommendations for practitioners, training institutes, and regulatory bodies to consider for the initial and continuous development of therapists

Integrated model of the vertebrate augmin complex

Accurate segregation of chromosomes is required to maintain genome integrity during cell division. This feat is accomplished by the microtubule-based spindle. To build a spindle rapidly and with high fidelity, cells take advantage of branching microtubule nucleation, which rapidly amplifies microtubules during cell division. Branching microtubule nucleation relies on the hetero-octameric augmin complex, but lack of structure information about augmin has hindered understanding how it promotes branching. In this work, we combine cryo-electron microscopy, protein structural prediction, and visualization of fused bulky tags via negative stain electron microscopy to identify the location and orientation of each subunit within the augmin structure. Evolutionary analysis shows that augmin\u27s structure is highly conserved across eukaryotes, and that augmin contains a previously unidentified microtubule binding site. Thus, our findings provide insight into the mechanism of branching microtubule nucleation

On staying grounded and avoiding Quixotic dead ends

The 15 articles in this special issue on The Representation of Concepts illustrate the rich variety of theoretical positions and supporting research that characterize the area. Although much agreement exists among contributors, much disagreement exists as well, especially about the roles of grounding and abstraction in conceptual processing. I first review theoretical approaches raised in these articles that I believe are Quixotic dead ends, namely, approaches that are principled and inspired but likely to fail. In the process, I review various theories of amodal symbols, their distortions of grounded theories, and fallacies in the evidence used to support them. Incorporating further contributions across articles, I then sketch a theoretical approach that I believe is likely to be successful, which includes grounding, abstraction, flexibility, explaining classic conceptual phenomena, and making contact with real-world situations. This account further proposes that (1) a key element of grounding is neural reuse, (2) abstraction takes the forms of multimodal compression, distilled abstraction, and distributed linguistic representation (but not amodal symbols), and (3) flexible context-dependent representations are a hallmark of conceptual processing

Longitudinal double-spin asymmetries in semi-inclusive deep-inelastic scattering of electrons and positrons by protons and deuterons

A comprehensive collection of results on longitudinal double-spin asymmetries is presented for charged pions and kaons produced in semi-inclusive deep-inelastic scattering of electrons and positrons on the proton and deuteron, based on the full HERMES data set. The dependence of the asymmetries on hadron transverse momentum and azimuthal angle extends the sensitivity to the flavor structure of the nucleon beyond the distribution functions accessible in the collinear framework. No strong dependence on those variables is observed. In addition, the hadron charge-difference asymmetry is presented, which under certain model assumptions provides access to the helicity distributions of valence quarks

Bose-Einstein correlations in hadron-pairs from lepto-production on nuclei ranging from hydrogen to xenon

Bose-Einstein correlations of like-sign charged hadrons produced in deep-inelastic electron and positron scattering are studied in the HERMES experiment using nuclear targets of $^1$H, $^2$H, $^3$He, $^4$He, N, Ne, Kr, and Xe. A Gaussian approach is used to parametrize a two-particle correlation function determined from events with at least two charged hadrons of the same sign charge. This correlation function is compared to two different empirical distributions that do not include the Bose-Einstein correlations. One distribution is derived from unlike-sign hadron pairs, and the second is derived from mixing like-sign pairs from different events. The extraction procedure used simulations incorporating the experimental setup in order to correct the results for spectrometer acceptance effects, and was tested using the distribution of unlike-sign hadron pairs. Clear signals of Bose-Einstein correlations for all target nuclei without a significant variation with the nuclear target mass are found. Also, no evidence for a dependence on the invariant mass W of the photon-nucleon system is found when the results are compared to those of previous experiments

Gene expression signatures associated with the in vitro resistance to two tyrosine kinase inhibitors, nilotinib and imatinib

The use of selective inhibitors targeting Bcr-Abl kinase is now established as a standard protocol in the treatment of chronic myelogenous leukemia; however, the acquisition of drug resistance is a major obstacle limiting the treatment efficacy. To elucidate the molecular mechanism of drug resistance, we established K562 cell line models resistant to nilotinib and imatinib. Microarray-based transcriptome profiling of resistant cells revealed that nilotinib- and imatinib-resistant cells showed the upregulation of kinase-encoding genes (AURKC, FYN, SYK, BTK and YES1). Among them, the upregulation of AURKC and FYN was observed both in nilotinib- and imatinib-resistant cells irrespective of exposure doses, while SYK, BTK and YES1 showed dose-dependent upregulation of expression. Upregulation of EGF and JAG1 oncogenes as well as genes encoding ATP-dependent drug efflux pump proteins such as ABCB1 was also observed in the resistant cells, which may confer alternative survival benefits. Functional gene set analysis revealed that molecular categories of ‘ATPase activity', ‘cell adhesion' or ‘tyrosine kinase activity' were commonly activated in the resistant clones. Taken together, the transcriptome analysis of tyrosine kinase inhibitors (TKI)-resistant clones provides the insights into the mechanism of drug resistance, which can facilitate the development of an effective screening method as well as therapeutic intervention to deal with TKI resistance

Tract-specific white matter structural disruption in patients with bipolar disorder

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