Increasing access to psychological therapies – looking beyond the workforce question

While improving access to psychological therapies requires a greater number of trained professionals able to provide evidence-based treatments, it also requires services to respond more flexibly to the needs of people likely to benefit from the treatments they offer. CBT workshops are an example of innovative, evidence-based treatments that – in addition to providing clinical benefits – provide easy access through self-referral and convenient weekend sessions, while reducing costs to the NHS

Can psycho-educational workshops help stem the tide of depression? Several randomised controlled trials suggest that they are an accessible and cost-effective option.

Depression is on the rise: It alone is currently responsible for 6% of the total burden of disease in Europe (Ustun et al. 2004) and is expected to be the second highest cause of disease burden worldwide by 2020 (World Health Organization 2008)

Support for adoption placements: the first six months

Adoption can provide stability and improved outcomes for looked after children, but the support needs of adoptive families range from financial support to managing difficult behaviours and attachment problems. This study looks at the use of services and associated costs over a six-month period through data collected from nineteen adoptive parents six months after a child (average age twenty-three months) had been placed with them for adoption and at the patterns of service needs, usefulness of services and satisfaction with services, supplemented with data from twenty-seven families who were interviewed about their experience of post-adoption support. In line with previous research findings, the core element of support was provided by social workers and over a third of families received financial support from social service departments. Involvement of specialist services such as mental health professionals and educational support was low, probably because of the children’s young age. Satisfaction with the support provided by social workers varied and depended on their relationship with the parents. The mean public sector cost of services was £2,842 (range £980–£6,270) and most costs were borne by children’s social services. These support costs compare favourably with other placement options such as children’s homes or foster-care

Evaluation of three lidar scanning strategies for turbulence measurements

Several errors occur when a traditional Doppler beam swinging (DBS) or velocity–azimuth display (VAD) strategy is used to measure turbulence with a lidar. To mitigate some of these errors, a scanning strategy was recently developed which employs six beam positions to independently estimate the <i>u</i>, <i>v</i>, and <i>w</i> velocity variances and covariances. In order to assess the ability of these different scanning techniques to measure turbulence, a Halo scanning lidar, WindCube v2 pulsed lidar, and ZephIR continuous wave lidar were deployed at field sites in Oklahoma and Colorado with collocated sonic anemometers.</br></br>Results indicate that the six-beam strategy mitigates some of the errors caused by VAD and DBS scans, but the strategy is strongly affected by errors in the variance measured at the different beam positions. The ZephIR and WindCube lidars overestimated horizontal variance values by over 60 % under unstable conditions as a result of variance contamination, where additional variance components contaminate the true value of the variance. A correction method was developed for the WindCube lidar that uses variance calculated from the vertical beam position to reduce variance contamination in the <i>u</i> and <i>v</i> variance components. The correction method reduced WindCube variance estimates by over 20 % at both the Oklahoma and Colorado sites under unstable conditions, when variance contamination is largest. This correction method can be easily applied to other lidars that contain a vertical beam position and is a promising method for accurately estimating turbulence with commercially available lidars

Verbreitung und Auswirkungen von mobiler Arbeit und Homeoffice: Kurzexpertise

Mit dem Wandel der Arbeitswelt gehen auch neue Formen flexiblen Arbeitens einher. In diesem Zusammenhang sind vermehrt Fragen der Nutzung, Gestaltung und Wirkung von Homeoffice und ortsmobilem Arbeiten in den Fokus gerückt. Dies gilt umso mehr, als Unternehmen und Beschäftigte während der COVID-19-Pandemie in großem Stil die Arbeit von zu Hause als Möglichkeit genutzt haben, um betriebliche Abläufe trotz Mobilitätsbeschränkungen und Abstandsregelungen aufrecht zu erhalten. Auch der Koalitionsvertrag der Bundesregierung greift das Thema auf und spricht sich für eine Erleichterung, Förderung und rechtliche Rahmung mobiler Arbeit aus. Gegenstand dieser Kurzexpertise ist es, das verfügbare Wissen über die Nutzung, die Effekte und die rechtliche Gestaltung zu mobiler Arbeit und Homeoffice zusammenzustellen, zu bewerten und an einigen Stellen gezielt zu erweitern. Hierzu wird die verfügbare Literatur systematisch ausgewertet. Dies wird mit repräsentativen Umfragen vor und während der COVID-19-Pandemie, einer international vergleichenden Untersuchung sowie betriebliche Fallstudien vertieft. Um die positiven Aspekte von Homeoffice und mobilem Arbeiten realisieren zu können, stellen sich, wie die Studie belegt, einerseits erhöhte Anforderungen an die betriebliche Organisation von Arbeit und Zusammenarbeit, andererseits an die Fähigkeiten zur Selbstorganisation bei den Beschäftigten. Die Praxis zeigt, dass in vielen Fällen passende Arrangements gefunden werden. Gleichwohl wird ein individueller Rechtsanspruch auf Prüfung der Machbarkeit ortsflexiblen Arbeitens im Einzelfall von einer Mehrheit der Beschäftigten befürwortet. Insgesamt ist davon auszugehen, dass die Arbeit im Homeoffice auch nach der Pandemie, wie es sich bereits abzeichnet, als ein normaler Baustein im Arbeitsleben für breitere Beschäftigtengruppen angesehen werden wird.The transformation of the world of work is accompanied by new forms of flexible work. In this context, questions of the use, design and effect of work from home and mobile working have recently come increasingly into focus. This is all the more true as companies and employees during the COVID-19 pandemic used working from home on a large scale as an opportunity to maintain operational processes despite mobility restrictions and physical distancing. The coalition agreement of the Federal Government also takes up the topic and advocates the facilitation, promotion and legal framing of mobile work. The object of this report is to compile and evaluate the available knowledge about the use, effects and legal design of mobile work and home office, and to expand it in some areas in a targeted manner. For this purpose, the available literature is systematically evaluated. This is deepened with representative surveys before and during the COVID-19 pandemic, an international comparative study as well as operational case studies. To be able to realize the positive aspects of remote and mobile work, the study shows that on the one hand increased demands are placed on the operational organization of work and cooperation, and on the other hand on the employees’ abilities for self-organization. Practical experiences show that in many cases suitable arrangements can be found. Nevertheless, an individual legal entitlement, which implies an examination of the feasibility of location-flexible working in individual cases, is supported by a majority of employees. It can therefore be assumed that also after the pandemic, as is already becoming apparent, work from home will continue to be regarded as a normal component of working life for broader groups of employees

A web-based intervention for carers of individuals with anorexia nervosa (We Can): trial protocol of a randomised controlled trial investigating the effectiveness of different levels of support

Background Anorexia nervosa (AN) is a life-threatening mental disorder that is associated with substantial caregiver burden. Carers of individuals with AN report high levels of distress and self-blame, and insufficient knowledge to help their loved ones. However, carers can have a very important role to play in aiding recovery from AN, and are often highly motivated to assist in the treatment process. This manuscript presents the protocol for a randomised controlled trial (RCT) of We Can, a web-based intervention for carers for people with AN. The study aims to investigate the effectiveness of We Can delivered with different intensities of support. Methods The study takes the form of a multi-site, two-country, three group RCT, comparing We Can (a) with clinician messaging support (We Can-Ind), (b) with moderated carer chatroom support (We Can-Chat) and (c) with online forum only (We Can-Forum). Participants will be 303 carers of individuals with AN as well as, where possible, the individuals with AN themselves. Recruitment will be via specialist eating disorder services and carer support services in the UK and Germany. Randomisation of carers to one of the three intervention conditions in a 1:1:1 ratio will be stratified by whether or not the individual with AN has (a) agreed to participate in the study and (b) is a current inpatient. The We Can intervention will be provided to carers online over a period of 12 weeks. Participants will complete self-report questionnaires at pre-intervention (T1), mid-intervention (mediators only; 4-weeks post-randomisation), post-intervention (T2; 3-months post randomisation), and 6 months (T3) and 12 months (T4) after randomisation. The primary outcome variables are carer symptoms of depression and anxiety. Secondary outcome variables will be measured in both carers and individuals with AN. Secondary carer outcome variables will include alcohol and drug use and quality of life, caregiving behaviour, and the acceptability and use of We Can and associated supports. Secondary outcomes measured in individuals with AN will include eating disorder symptoms, and symptoms of depression and anxiety. The study will also evaluate the cost-effectiveness of the three We Can conditions, and test for mediators and moderators of the effects of We Can. The trial is registered at the International Standard Randomisation Controlled Trial Number (ISRCTN) database, registration number: ISRCTN11399850. Discussion The study will provide insight into the effectiveness of We Can and its optimal method/s of delivery