Teachers' readiness in the teaching of Mathematics and Science in English / Richard Anak Banter

When the Malaysian Education Ministry announced a change in the medium of instruction from the national language, Bahasa Malaysia to English for Mathematics and science subjects for Primary one, form one, and lower sixth forms, beginning the year 2003, teachers and students nationwide have to grapple with the switch of language. As the implementation news was announced at a very short notice, many teachers were caught by surprise as some were not prepared to deliver the subjects using English. This is probably due to lack of proficiencies, confidence and inadequate command of English. These problems, if not taken seriously would undermine the process of teaching and learning and subsequently students would be the victim as they are the ones that sit for the assessment and examination. Therefore,this study using questionnaires is undertaken to investigate the Teachers' Readiness in the Teaching of Mathematics and Science in English. Sixty-nine respondents from four selected secondary schools in Kuching, Sarawak participated in this study. The major finding shows that a large number of the respondents felt that they were ready to teach Mathematics and Science in English. The finding also indicated that the respondents were proficient and confident in teaching both the subjects in English as indicated by 75% or 53 of the respondents. Although, courses and training were given 25% or 16 of the respondent encountered problems in understanding some of the terminologies and pronunciation in English. A positive finding from the study revealed that majority of the respondents was well prepared before each lesson as indicated by 80% or 57 of the respondents. Finally, respondents were of the opinion that they were ready to teach both the subjects in English as indicated. In addition, it can be implied that some Mathematics and science teachers should be given motivational training to upgrade their proficiency in English Language. Based on the findings which only involved sixty-nine Mathematics and Science teachers, thus it is recommended that a larger study could be carried out with lager sample from the whole state of Sarawak that could provide a more valid and reliable information.Secondly, this study only concentrates on teachers' readiness, thus, it is appropriate to conduct a study that involves students' readiness too for both the primary and secondary schools. Finally, as this study only covered some aspects of technical training ICT for courseware for the respondents, it is recommended that a special study be conducted on teacher's training on handling of computer course wares in future to further enhance the process of teaching and learning Mathematics and Science in English

The implementation of mentalization-based treatment for adolescents: a case study from an organizational, team and therapist perspective

Background: Reports on problems encountered in the implementation of complex interventions are scarce in psychotherapy literature. This is remarkable given the inherent difficulties of such enterprises and the associated safety risks for patients involved.Case description: A case study of the problematic implementation process of Mentalization- Based Treatment for Adolescents (MBT-A), a new therapy for 14 to 18 year old youngsters with severe personality disorders, is presented. The implementation process is described and analyzed at an organizational, team and therapist level.Discussion and evaluation: Our analysis shows that problems at all three levels contributed and interacted to make the implementation cumbersome and hazardous.Conclusion: The implementation of complex psychotherapeutic programs for difficult patients could benefit from a structured attention to processes at multiple levels. We therefore propose a new comprehensive heuristic model of treatment integrity. This new model includes organisational, team and therapist adherence to the treatment model as necessary components of treatment integrity in the implementation of complex interventions. The application of this new model of treatment integrity potentially increases the chance of successful implementations and reduces safety risks for first patients enrolling in a new program

Strengthening the Status of Psychotherapy for Personality Disorders: An Integrated Perspective on Effects and Costs

Objective: Despite scientific evidence of effectiveness, psychotherapy for personality disorders is not yet fully deployed, nor is its reimbursement self-evident. Both clinicians and health care policy-makers increasingly rely on evidence-based medicine and health economics when determining a treatment of choice and reimbursement. This article aims to contribute to that understanding by applying these criteria on psychotherapy as a treatment for patients with personality disorder. Method: We have evaluated the available empirical evidence on effectiveness and cost-effectiveness, and integrated this with necessity of treatment as a moderating factor. Results: The effectiveness of psychotherapy for personality disorders is well documented with favourable randomized trial results, 2 metaanalyses, and a Cochrane review. However, the evidence does not yet fully live up to modern standards of evidence-based medicine and is mostly limited to borderline and avoidant personality disorders. Data on cost-effectiveness suggest that psychotherapy for personality disorders may lead to cost-savings. However, state-of-the-art cost-effectiveness data are still scarce. An encouraging factor is that the available studies indicate that patients with personality disorder experience a high burden of disease, stressing the necessity of treatment. Conclusions: When applying an integrated vision on outcome, psychotherapy can be considered not only an effective treatment for patients with personality disorder but also most likely a cost-effective and necessary intervention. However, more state-of-the-art research is required before clinicians and health care policy-makers can fully appreciate the benefits of psychotherapy for personality disorders. Considerable progress is possible if researchers focus their efforts on evidence-based medicine and cost-effectiveness research. Clinical Implications · From an effectiveness point of view, psychotherapy is the treatment of choice for personality disorders. · The limited evidence about cost-effectiveness and necessity suggests that psychotherapy for personality disorders is a cost-effective treatment for patients with a high burden of disease. · To understand and influence health policy-making in mental health care successfully, clinicians need to adopt an integrated perspective on effectiveness, cost-effectiveness, and necessity. Limitations · Some so-called effectiveness studies are in fact efficacy trials and most effectiveness research is limited to borderline and avoidant personality disorders. · The evidence on cost-effectiveness is limited to borderline personality disorder and involves cost-minimization studies rather than state-of-the-art economic evaluations. · The evidence on burden of disease is still scarce

De effectiviteit van re-integratietraining versus boostersessies na kortdurende klinische psychotherapie: een gerandomiseerd klinisch onderzoek

Abstract BACKGROUND: Standardised evaluation studies performed in the Netherlands in a large number of inpatient and day-treatment hospitals providing psychotherapy have shown significant symptomatic improvements in patients between the date of entry to the studies and follow-up after one year. However, the work situation of ex-patients hardly changed and a large number of patients were still receiving psychotherapy. AIM: To examine the effectiveness of a specifically designed course of re-integration training. METHOD: A group of 128 patients were assigned randomly either to a re-integration training course aimed at improved functioning at work and improved relationships, or to booster sessions. Outcome measures were symptom level, work status, absence from work, and further psychotherapy. results After two years the number of patients in paid employment remained the same (76%) in the re-integration training course and increased from 67 to 87% in the booster sessions. Attendance was significantly higher in the booster sessions than in the re-integration training. There were no differences in the other outcome measures. CONCLUSION: We conclude that re-integration training was no more effective than the booster sessions. Our hypothesis is that continuity of care (therapists plus programme) explains the favourable result of the booster sessions

Day hospital versus intensive outpatient mentalization-based treatment:3-year follow-up of patients treated for borderline personality disorder in a multicentre randomized clinical trial

Abstract Background Two types of mentalization-based treatment (MBT), day hospital MBT (MBT-DH) and intensive outpatient MBT (MBT-IOP), have been shown to be effective in treating patients with borderline personality disorder (BPD). This study evaluated trajectories of change in a multi-site trial of MBT-DH and MBT-IOP at 36 months after the start of treatment. Methods All 114 patients (MBT-DH n = 70, MBT-IOP n = 44) from the original multicentre trial were assessed at 24, 30 and 36 months after the start of treatment. The primary outcome was symptom severity measured with the Brief Symptom Inventory. Secondary outcome measures included borderline symptomatology, personality and interpersonal functioning, quality of life and self-harm. Data were analysed using multilevel modelling and the intention-to-treat principle. Results Patients in both MBT-DH and MBT-IOP maintained the substantial improvements made during the intensive treatment phase and showed further gains during follow-up. Across both conditions, 83% of patients improved in terms of symptom severity, and 97% improved on borderline symptomatology. No significant differences were found between MBT-DH and MBT-IOP at 36 months after the start of treatment. However, trajectories of change were different. Whereas patients in MBT-DH showed greater improvement during the intensive treatment phase, patients in MBT-IOP showed greater continuing improvement during follow-up. Conclusions Patients in both conditions showed similar large improvements over the course of 36 months, despite large differences in treatment intensity. MBT-DH and MBT-IOP were associated with different trajectories of change. Cost-effectiveness considerations and predictors of differential treatment outcome may further inform optimal treatment selection

Measuring the Core Components of Maladaptive Personality: Severity Indices of Personality Problems (SIPP-118)

This report describes a series of studies among 2231 subjects on the development of the Severity Indices for Personality Problems (SIPP), a self-report questionnaire measuring the core components of (mal)adaptive personality functioning. Results show that the 16 facets have good psychometric properties and test-retest reliability, are generic across various types of personality disorders, and have good discriminative validity between various populations. The facets fit well into a common factor model with five higher-order domains (i.e., self-control, identity integration, responsibility, relational capacities, and social concordance) that are eminently interpretable, and replicable across various populations. Domain scorThis report is the first document to describe the development of the SIPP-118: Severity Indices of Personality Problems, 118 items. It provides details about the items selection, validations and reliability studies and norm values. The report is meant as a detailed description of our investigation and is made directly after the data collection in order to allow for fast communication between researchers. Although the report will probably remain the most detailed description of our research effort, it must not be seen as the final interpretation of the results. The report now serves as an easy accessible collection of research data, on which basis we hope to write peer-reviewed articles. This original report will remain available on request, for those researchers who would like to have a detailed description of the research and the data. Note that parts of the report still reveal the early thoughts and interpretations, which are characteristic for a first report written just after finishing the data collection. Up-to-date information, norm scores, and translations of the SIPP-118 in Dutch, English, Norwegian, Argentinean, and Italian language, are freely available at www.vispd.nl

Economic evaluation of day hospital versus intensive outpatient mentalization-based treatment alongside a randomized controlled trial with 36-month follow-up

Mentalization-based treatment (MBT) has demonstrated robust effectiveness in the treatment of borderline personality disorder (BPD) in both day hospital (MBT-DH) and intensive outpatient MBT (MBT-IOP) programs. Given the large differences in intensity and associated treatment costs, there is a need for studies comparing their cost-effectiveness. A health economic evaluation of MBT-DH versus MBT-IOP was performed alongside a multicenter randomized controlled trial with a 36-month follow-up. In three mental health-care institutions in the Netherlands, 114 patients were randomly allocated to MBT-DH (n = 70) or MBT-IOP (n = 44) and assessed every 6 months. Societal costs were compared with quality-adjusted life years (QALYs) gained and the number of months in remission over 36 months. The QALY gains over 36 months were 1.96 (SD = 0.58) for MBT-DH and 1.83 (SD = 0.56) for MBT-IOP; the respective number of months in remission were 16.0 (SD = 11.5) and 11.1 (SD = 10.7). Societal costs were €106,038 for MBT-DH and €91,368 for MBT-IOP. The incremental cost for one additional QALY with MBT-DH compared with MBT-IOP was €107,000. The incremental cost for 1 month in remission was almost €3000. Assuming a willingness-to-pay threshold of €50,000 for a QALY, there was a 33% likelihood that MBT-DH is more cost-effective than MBT-IOP in terms of costs per QALY. Although MBT-DH leads to slightly more QALYs and remission months, it is probably not cost-effective when compared with MBT-IOP for BPD patients, as the small additional health benefits in MBT-DH did not outweigh the substantially higher societal costs

Indicatoren voor de zorgtoewijzing bij persoonlijkheidsstoornissen: resultaten van een concept map analyse

Using the concept map method, this study revealed patient characteristics that are important for treatment selection decisions in patients with personality disorders. Concept mapping is a specific type of structured conceptualization process and describes the underlying structure of specific phenomena. The method uses qualitative and quantitative methods. In this study, we integrated a literature investigation with the opinions of 29 experts in the field of treatment allocation and/or personality disorders. Our goal was to reduce and describe the number of patient characteristics that are important for treatment allocation in personality disorders. The concept map procedure resulted in eight patient characteristics: (1) severity of symptoms, (2) severity of personality pathology, (3) ego-adaptive capacity, (4) motivation and capacity for a therapeutic alliance, (5) patient’s social system, (6) social demographic variables, (7) traumata, (8) treatment history and physical examination. This report describes in detail the concept mapping procedure and the outcomes are discussed

Day hospital versus intensive outpatient mentalization-based treatment: 3-year follow-up of patients treated for borderline personality disorder in a multicentre randomized clinical trial

BackgroundTwo types of mentalization-based treatment (MBT), day hospital MBT (MBT-DH) and intensive outpatient MBT (MBT-IOP), have been shown to be effective in treating patients with borderline personality disorder (BPD). This study evaluated trajectories of change in a multi-site trial of MBT-DH and MBT-IOP at 36 months after the start of treatment.MethodsAll 114 patients (MBT-DH n = 70, MBT-IOP n = 44) from the original multicentre trial were assessed at 24, 30 and 36 months after the start of treatment. The primary outcome was symptom severity measured with the Brief Symptom Inventory. Secondary outcome measures included borderline symptomatology, personality and interpersonal functioning, quality of life and self-harm. Data were analysed using multilevel modelling and the intention-to-treat principle.ResultsPatients in both MBT-DH and MBT-IOP maintained the substantial improvements made during the intensive treatment phase and showed further gains during follow-up. Across both conditions, 83% of patients improved in terms of symptom severity, and 97% improved on borderline symptomatology. No significant differences were found between MBT-DH and MBT-IOP at 36 months after the start of treatment. However, trajectories of change were different. Whereas patients in MBT-DH showed greater improvement during the intensive treatment phase, patients in MBT-IOP showed greater continuing improvement during follow-up.ConclusionsPatients in both conditions showed sim