Factors that influence development of speech pathology skills required for videofluoroscopic swallowing studies.

BACKGROUND: Perceptual, cognitive and previous clinical experience may influence a novice Videofluoroscopic Swallowing Study (VFSS) analyst's trajectory towards competency. Understanding these factors may allow trainees to be better prepared for VFSS training and may allow training to be developed to accommodate differences between trainees. AIMS: This study explored a range of factors previously suggested in the literature as influencing the development of novice analysts' VFSS skills. We hypothesised that knowledge of swallow anatomy and physiology, visual perceptual skills, self-efficacy and interest, and prior clinical exposure would all influence VFSS novice analysts' skill development. METHODS & PROCEDURES: Participants were undergraduate speech pathology students recruited from an Australian university, who had completed the required theoretical units in dysphagia. Data assessing the factors of interest were collected-the participants identified anatomical structures on a still radiographic image, completed a physiology questionnaire, completed subsections of the Developmental Test of Visual Processing-Adults, self-reported the number of dysphagia cases they managed on placement, and self-rated their confidence and interest. Data for 64 participants relating to the factors of interest were compared with their ability to accurately identify swallowing impairments following 15 h of VFSS analytical training, using correlation and regression analysis. OUTCOMES & RESULTS: Success in VFSS analytical training was best predicted by clinical exposure to dysphagia cases and the ability to identify anatomical landmarks on still radiographic images. CONCLUSIONS & IMPLICATIONS: Novice analysts vary in the acquisition of beginner-level VFSS analytical skill. Our findings suggest that speech pathologists who are new to VFSS may benefit from clinical exposure to dysphagia cases, sound foundational knowledge of anatomy relevant to swallowing and the ability to see the anatomical landmarks on still radiographic images. Further research is required to equip VFSS trainers and trainees for training, to understand differences between learners during skill development. WHAT THIS PAPER ADDS: What is already known on the subject The existing literature suggests that no vice Video fluoroscopic Swallowing Study (VFSS) analysts training may be influenced by their personal characteristics and experience. What this study adds This study found that student clinicians, clinical exposure to dysphagia cases and their ability to identify anatomical landmarks relevant to swallowing on still radiographic images prior to training best predicted their ability to identify swallowing impairments after training. What are the clinical implications of this work? Given the expense of training health professionals, further research is required into the factors that successfully prepare clinicians for VFSS training, including clinical exposure, foundational knowledge of anatomy relevant to swallowing and the ability to identify the anatomical landmarks on still radiographic images.

Attributes of excellence in practice educators: the perspectives of Australian occupational therapy students.

AIM: Occupational therapists frequently undertake the role of practice educator contributing to the development of the future workforce, however, little is known about how they effectively perform this role. This study aimed to elucidate students' perspectives on what makes an excellent practice educator. METHOD: Documentation for 124 Practice Excellence Commendations nominations by Queensland occupational therapy students for Queensland Occupational Therapy Fieldwork Collaborative awards between 2008 and 2011 were analysed. These were based on students' experiences on long block placements (five weeks or more) in their later years of undergraduate or masters' entry study. Written nominations addressing five selection criteria were de-identified and responses to each of these compiled. One independent coder and the two lead authors read the transcripts, identified coding categories and reached consensus regarding emerging themes using standard content and thematic analysis techniques. RESULTS: Providing the 'just right' challenge was the overarching theme that symbolised excellence in practice education from students' perspectives. Three themes emerged that enabled practice educators to provide student support needed to balance the challenges of learning on placement; (i) valuing a reciprocal relationship; (ii) facilitating learning opportunities and experiences; and (iii) encouraging autonomy and independence. CONCLUSION: Findings provided insights into student perceptions about how excellent practice educators facilitated their learning while on placement. These insights can be used to inform practice educators who wish to enhance their supervision skills. Future research should focus on how the attributes of practice educators positively influence student learning outcomes.

Developing novice analysts' videofluoroscopic swallowing study skills in speech-language pathology: A randomised control trial comparing blended and online training approaches.

PURPOSE: This research investigates the relative effectiveness of independent online and blended learning approaches for novice analysts' development of videofluoroscopic swallowing study (VFSS) analytical skills. The secondary aims were to explore the impact of training on decision-making and to describe learners' perspectives of training outcomes. METHOD: Undergraduate speech-language pathology students (n = 74) who had completed the dysphagia academic curriculum in an undergraduate speech-language pathology program were recruited for a randomised control trial. The ability to identify swallowing impairments in adults was compared pre- and post-training across three conditions: independent online (n = 23), peer-supported (n = 23), and expert-facilitated training (n = 28). The training comprised online VFSS training and practice with a commercially available digital video disc (DVD). RESULT: The three training approaches were equal in improving novice analysts' identification of impairments on VFSS. Participants' analysis improved pre- to post-training (p = <.001), with no statistical difference amongst training conditions (p = .280). However, the expert facilitation condition resulted in better decision-making skill for novice analysts, as well as higher levels of confidence and greater engagement in the learning. CONCLUSION: Well-designed independent online methods are appropriate to prepare novice analysts for VFSS analytical training. Expert facilitation and peer-supported environments may have benefits for more advanced skill development and engagement, and should be investigated in future studies.

A Narrative Review of Compassion Focused Therapy on Positive Mental Health Outcomes.

BACKGROUND: Compassion-focused therapy (CFT) has been attracting attention in mental health practice and research. CFT is effective in reducing a variety of negative mental health symptoms. Positive mental health (PMH) focuses on an individual's functioning, quality of life, and well-being, aiming to achieve fulfilment. A need for PMH has been increasingly recognised such as national policies incorporating recovery-oriented approaches. However, how effective CFT is for PMH outcomes remains to be investigated. This narrative review aimed to identify the literature that reports evidence on CFT used against PMH outcomes. METHODS: Our research questions (RQs) were as follows: RQ1. What PMH outcomes are targeted in CFT intervention research? RQ2. Is CFT effective for PMH?" Medline, Embase, and PsycINFO were searched on the Ovid platform. All studies that mentioned "compassion focused therapy" and "compassion-focused therapy" were searched. RESULTS: Sixteen RCTs were included published since 2012. Nine studies were from Europe, four from Asia, two from Northern America, and one from Australia and New Zealand. CFT was used for diverse PMH outcomes, and the effects were overall positive. Self-compassion and compassion were the most frequently evaluated outcomes. CONCLUSIONS: The mechanism of action for CFT on PMH needs to be evaluated. CFT can be used as part of personal recovery in mental health. More evidence from non-WEIRD countries including LMICs is needed.

Communicative capital: a key resource for human-machine shared agency and collaborative capacity.

In this work, we present a perspective on the role machine intelligence can play in supporting human abilities. In particular, we consider research in rehabilitation technologies such as prosthetic devices, as this domain requires tight coupling between human and machine. Taking an agent-based view of such devices, we propose that human-machine collaborations have a capacity to perform tasks which is a result of the combined agency of the human and the machine. We introduce communicative capital as a resource developed by a human and a machine working together in ongoing interactions. Development of this resource enables the partnership to eventually perform tasks at a capacity greater than either individual could achieve alone. We then examine the benefits and challenges of increasing the agency of prostheses by surveying literature which demonstrates that building communicative resources enables more complex, task-directed interactions. The viewpoint developed in this article extends current thinking on how best to support the functional use of increasingly complex prostheses, and establishes insight toward creating more fruitful interactions between humans and supportive, assistive, and augmentative technologies.

Comparing the Mental Health of Healthcare Students: Mental Health Shame and Self-compassion in Counselling, Occupational Therapy, Nursing and Social Work Students.

Poor mental health of healthcare students is a cause for concern in many universities. Though previous research has identified mental health shame and self-compassion as critical in this student group, how these variables differ across different healthcare disciplines remains to be evaluated. Healthcare students (n = 344; counselling, occupational therapy, social work and nursing) completed measures regarding these variables. MANOVA and regression analyses were performed. (1) Counselling and nursing students were more depressed than occupational therapy students; (2) nursing students were more anxious than occupational therapy and social work students; (3) occupational therapy students had more positive attitudes towards mental health than the others; and (4) nursing students worried about their own reputation associated with their family more than counselling students. Self-compassion was the strongest predictor of mental health in all groups; however, the effect sizes varied: largest in nursing and smallest in social work students. Findings will help inform effective interventions for students in each healthcare discipline.

Comparison of Academic Motivation between Business and Healthcare Students in Online Learning: A Concurrent Nested Mixed-Method Study.

While the demand for online education and the diversity of online students have been increasing worldwide, how online students motivate themselves to continuously engage in learning remains to be appraised. Research in the face-to-face contexts reports that academic motivation is central to student success and wellbeing, and the type of motivation can differ by subject. In particular, the motivation of business students and healthcare students can differ considerably. This study aimed to understand the motivation of online students, and compare them between business and healthcare students using a concurrent nested mixed-method design with correlation and thematic analyses. A survey regarding motivation, learning enjoyment, and study willingness was responded to by 120 online students (61 business and 59 healthcare). Business students were associated with extrinsic motivation, whereas healthcare students were associated with intrinsic motivation. While students in both groups enjoyed the pursuit of knowledge, healthcare students valued the process and accomplishment, whereas business students regarded education as steppingstones in their careers. Findings can help educators develop effective motivational support for these student groups.

Effects of Online Mental Health Classes on Mental Health and Stigma: a Controlled Before-After Study with 1-Month Follow-Up.

Though the importance of mental health education has been emphasised, how learning about mental health helps the learners' mental health remains to be evaluated. Accordingly, this study aimed to appraise the mental health effects of online mental health classes in a controlled before-after study with a 1-month follow-up. The Depression, Anxiety and Stress Scale-21 and Depression Stigma Scale were completed by 16 students in a mental health class and 12 in a non-mental health class. While there was no significant difference in depression, anxiety and stress, between groups (type of class) and within groups (assessment points), the levels of stigma were significantly lower in mental health students than non-mental health students at post-semester (p = .004). Findings illustrate temporal effectiveness of mental health classes on stigma; however, continuous education is needed to maintain the effects. Educators in mental health are recommended to design a long-term plan to support learners' mental health.

Mental Health of Czech University Psychology Students: Negative Mental Health Attitudes, Mental Health Shame and Self-Compassion.

High rates of mental health problems are a growing concern in Czech higher education, negatively impacting students' performance and wellbeing. Despite the serious nature of poor mental health, students often do not seek help because of negative attitudes and shame over mental health problems. Recent mental health research reports self-compassion is strongly associated with better mental health and reduced shame. However, relationships between those constructs remain to be evaluated among Czech students. This study aims to appraise the relationships between mental health problems, negative mental health attitudes, mental health shame, and self-compassion in this population. An opportunity sample of 119 psychology students from a Czech university completed questionnaires regarding these constructs. Correlation, regression, and path analyses were conducted. Mental health problems were positively associated with negative mental health attitudes and shame, and negatively associated with self-compassion. Self-compassion negatively predicted mental health problems, while negative attitudes and shame did not. Last, self-compassion fully mediated the negative attitudes-mental health problems relationship, and partially mediated the shame-mental health problems relationship. Findings suggest self-compassion is essential for mental health in Czech students and associated with negative mental health attitudes and mental health shame. Czech universities can benefit from incorporating self-compassion training into their curricula to protect students' mental health.

Mental Health Shame, Caregiver Identity, and Self-Compassion in UK Education Students.

Although students in education have high rates of mental health problems, many of them do not ask for help, which can exacerbate their symptoms. One reason for their low help-seeking is shame associated with mental health problems. As education students aspire to provide care for children, they may feel ashamed to care for themselves, as the role identity theory suggests. Self-compassion is reported to reduce shame and mental health problems. This study explored the relationships between mental health problems, mental health shame, self-compassion, and caregiver identity among UK education students. One hundred and nine postgraduate students completed four self-report scales regarding those constructs. Correlation and regression analyses were performed. Mental health problems were positively associated with shame and identity, and negatively associated with self-compassion. Self-compassion was the only significant predictor of mental health problems. Findings will help educators and education students to develop effective approaches for their mental health problems.

Policing in a Pandemic: a Commentary on Officer Well-being During COVID-19.

The role of police officers during the coronavirus (COVID-19) pandemic is challenging, faced with the difficult task of keeping communities safe and preventing the spread of COVID-19 while putting their physical and mental health at risk. Emerging evidence points to the stress experiences of officers during the COVID-19 pandemic. With cases now surpassing 174 million and close to four million deaths worldwide, as well as stringent lockdown measures, police officers are faced with unprecedented challenges resulting from the pandemic. This commentary suggests police departments strengthen resources by putting in place appropriate emergency planning for future public health incidents, in addition to preparing for temporary or permanent loss of human resources. It is important to implement robust training plans post-pandemic to allow officers to offer better care for communities when faced with future public health emergencies. Finally, police officers should be provided with the resources and support to cope with the stresses associated with COVID-19.

Training for videofluoroscopic swallowing analysis: A systematic review.

PURPOSE: To synthesise the available evidence relating to best practice in training videofluoroscopy and barium swallow analysts. METHOD: The review was conducted according to the PRISMA statement and registered in PROSPERO (CRD42017053744). Data were extracted from nine databases. Studies were included if they described training approaches for clinicians or students of any profession learning to interpret videofluoroscopic (VFSS) or barium swallow studies and were written in English. The methods were heterogeneous and a metanalysis was not possible; a narrative review is presented. RESULT: Sixteen studies were eligible, including those designed to evaluate the influence of training as well as those that described training as part of validating an assessment tool or method. The quality of the studies was assessed with the Hawker scale and assigned an NHMRC rating. While the evidence was low quality (NHMRC level IV), training consistently improved the accuracy and reliability of clinicians and students conducting VFSS. No studies reported the outcome of training for barium swallow analysis. There was significant variability in the dose, method, and setting of training. CONCLUSION: To elucidate best practice in VFSS analysis to ensure training is cost effective and results in accurate diagnosticians requires further research.

Qualitative Investigation into Therapists' Experiences of Online Therapy: Implications for Working Clients.

Online therapy has increasingly been utilised during the COVID-19 pandemic by many, including working populations. However, few qualitative studies have explored how online therapy is experienced in practice and discussed its implications for those working clients. Semi-structured interviews attended by nine integrative psychotherapists practising in California, the United States, were conducted. Thematic analysis of the transcripts identified three themes: (i) 'Positive experiences of online therapy', (ii) 'Challenges experienced by therapists and clients in online therapy', and (iii) 'Preparation and training for online therapy'. Online therapy was assessed as being helpful, particularly in terms of mitigating against previous geographical and temporal barriers to uptake. However, due to technological disruptions and potential blurring of professional boundaries, online therapy may detract from the emotional salience of therapy, negatively impacting the therapeutic relationship and containment. Considering these positive experiences, participants expected that the demand for online therapy would continue to increase. Particularly in the occupational context, online therapy can offer interventions without fostering shame regarding mental health. The findings provide preliminary qualitative evidence that online therapy can be a useful adjunct to traditional forms of face-to-face therapy. However, therapists require more explicit training in implementing online therapy. Results are discussed in particular regarding the utility of this therapy for working clients.

Burnout in Professional Psychotherapists: Relationships with Self-Compassion, Work-Life Balance, and Telepressure.

Though negative impacts of COVID-19 on occupational mental health have been reported, the mental health of psychotherapists has not been evaluated in depth. As this occupational group treats ever-increasing mental health problems, it is essential to appraise key factors for their mental health. Accordingly, this study aimed to explore burnout of professional psychotherapists. A total of 110 participants completed self-report measures regarding burnout, self-compassion, work-life balance and telepressure. Correlation, regression and moderation analyses were conducted. Both of the burnout components-emotional exhaustion and depersonalisation-were positively associated with weekly working hours and telepressure, and negatively associated with age, self-compassion and work-life balance. Weekly working hours and work-life balance were significant predictors of emotional exhaustion and depersonalisation. Lastly, self-compassion partially mediated the relationship between work-life balance and emotional exhaustion but did not mediate the relationship between work-life balance and depersonalisation. The findings suggest that maintaining high work-life balance is particularly important for the mental health of psychotherapists, protecting them from burnout. Moreover, self-compassion needs to be cultivated to mitigate emotional exhaustion. Mental health care for this occupational group needs to be implemented to achieve sustainable mental health care for workers and the public.

Self-Compassion in Irish Social Work Students: Relationships between Resilience, Engagement and Motivation.

Self-compassion recognises a meaning of life's suffering, aligning with existential positive psychology. Although this construct is known to protect our mental health, how to augment self-compassion remains to be evaluated. Social work students suffer from high rates of mental health problems; however, research into self-compassion in this population remains to be developed. This study aimed to evaluate (i) relationships between self-compassion and more traditional positive constructs-resilience, engagement and motivation, and (ii) differences of these constructs between the levels of studies to inform how self-compassion can be enhanced in social work students. A total of 129 Irish social work students completed self-report scales regarding self-compassion, resilience, engagement and motivation. Correlation, regression and one-way MANOVA were conducted. Self-compassion was associated with gender, age, resilience, engagement and intrinsic motivation. Resilience and intrinsic motivation were significant predictors of self-compassion. There was no significant difference in the levels of these constructs between the levels of studies. Findings suggest that social work educators across different levels can strengthen students' resilience and intrinsic motivation to cultivate the students' self-compassion. Moreover, the close relationships between self-compassion, resilience and intrinsic motivation indicate that orienting students to the meaning of the studies helps their mental health.

Development of a Risk Behavior Diagnosis Scale for E-cigarette Use.

Objectives: Adolescent use of electronic cigarettes has risen dramatically, prompting concerns about the health effects. There is need for brief measures to assess adolescents' perceived threat and efficacy related to e-cigarette use and cessation. A 12-item Likert-type scale was modeled after the Risk Behavior Diagnosis Scale and designed to assess threat (ie, severity and susceptibility of threat) and efficacy (ie, self-efficacy and response efficacy) as they relate to e-cigarette use. Methods: The scale was administered online to a developmental sample of 674 adolescents to examine internal consistency and factor structure. Participants (52.1% female, M age = 14.6) were representative of the surrounding community (60% non-Hispanic white; 27% non-Hispanic black; 8% Hispanic). Results: Factor analysis and Velicer's minimum average partial test revealed 2 factors (as expected), which explained 68% of the variance. Analyses revealed strong internal consistency, with Cronbach's alpha of .93 overall and alphas of .92 and .87 for threat and efficacy subscales, respectively. The measure also exhibited good convergent and discriminant validity with other constructs. Conclusions: The measure demonstrates strong preliminary reliability and validity for a developmental sample of adolescents.

Ann's perfect pitch. Interview by Elizabeth Lynch.

When local teams would not offer her client a place, mental health nurse Ann Edwards set up her own. Now 90 players are reaping the benefits.

Computerized neuropsychological profiles of South African versus US athletes: a basis for commentary on cross-cultural norming issues in the sports concussion arena.

Computerized programs are widely used as part of the overall medical management of concussion in order to monitor recovery and facilitate safe return-to-play decisions. Typically, neurocognitive profiles of concussed athletes are compared with baseline and/or normative data in the absence of baseline scores. However, the cultural equivalence of performance on neuropsychological tests cannot be assumed and has not been sufficiently researched. The purpose of this study was to investigate the neuropsychological test profiles of the ImPACT (Immediate Postconcussion Assessment and Cognitive Testing) on age-matched South African (SA) rugby and US football players. Participants included 11 257 English-speaking, predominantly white male athletes from multiple SA and US schools and sports organizations in 3 age groups: 11 to 13 years (SA, n = 301; US, n = 775); 14 to 16 years (SA, n = 997; US, n = 4081); and 17 to 21 years (SA, n = 319; US, n = 4784). ImPACT neurocognitive composite scores (verbal and visual memory, visual motor speed, reaction time, impulse control) and the ImPACT total symptom score, derived from the initial baseline testing, were used for comparison purposes between the targeted groups. Independent t-test comparisons revealed overall equivalence between the SA and US athletes on the neurocognitive measures, but they also revealed consistently higher symptom scores for SA athletes in association with clinically relevant effect sizes. It was concluded that US neurocognitive normative data on the ImPACT test are appropriate for use on South African athletes whose first language is English, whereas culture-specific sensitivity for symptom reporting on this same population should be taken into consideration for management purposes. It is argued that neurocognitive equivalence is less likely to apply in educationally disadvantaged populations. The use of registered psychologists is deemed necessary to provide contextualized interpretations of computerized test scores, thereby protecting against misdiagnosis that may occur within the concussion management arena via actuarial approaches that fail to take sociocultural complexities into account.