An invited commentary on mentoring in infant mental health: A symposium commemorating Robert N. Emde.

This paper is based on a symposium on mentoring in infant mental health that took place at the 18th World Association for Infant Mental Health (WAIMH) conference. The symposium commemorated Robert N. Emde who was one of the founders of the field of Infant Mental Health, and devoted much of his career to mentorship. From an IMH perspective, mentoring experiences are best thought of as relationships, significant for both mentor and mentee, with positive mentoring experiences crucial for the development of IMH clinicians and researchers. The symposium participants, two pairs of mentor-mentee dyads, first gave an opening statement about what mentoring meant for them generally and personally, and then addressed three issues: the goodness of fit between mentor and mentee, "light and shadow" in mentoring relationships, and balancing old wisdom with new trends in mentoring. The paper brings the participants' views and personal experiences regarding these issues in their own words, highlighting key personal and professional issues related to mentorship from the perspectives of both mentor and mentee.

Este artículo se basa en un simposio sobre Consejería en el campo de la Salud Mental Infantil que se llevó a cabo en el Decimoctavo Congreso de la Asociación Mundial para la Salud Mental Infantil (WAIMH). El simposio fue dedicado a Robert N. Emde, uno de los fundadores del campo de Salud Mental Infantil, quien dedicó gran parte de su carrera a la consejería y guía profesional. Desde una perspectiva de IMH, la mejor interpretación de las experiencias de consejería es verlas como una significativa relación tanto para el consejero como para el aconsejado, considerando que las positivas experiencias son cruciales para el desarrollo de los profesionales clínicos e investigadores de IMH. Los participantes en el simposio, dos pares de díadas consejero­aconsejado, dieron primero una presentación de apertura sobre lo que significaba para ellos la consejería general y personalmente, para entonces abordar tres asuntos: la bondad de ajuste entre consejero y aconsejado, "Luz y Sombra" en la relación de consejería, así como el equilibrio en la consejería entre la vieja sabiduría y los nuevos acercamientos. El ensayo presenta los puntos de vista y experiencias personales de los participantes sobre estos asuntos en sus propias palabras, subrayando asuntos personales y profesionales claves relacionados con la consejería desde la perspectiva tanto del consejero como del aconsejado.

Cet article est basé sur un symposium sur le Mentorat en Santé Mentale de la Petite Enfance qui s'est tenu lors de la 18ème conférence de l'Association Mondiale pour la Santé Mentale de la Petite Enfance (World Association Infant Mental Health ­ WAIMH). Ce symposium a commémoré Robert N. Emde qui fut l'un des fondateurs du domaine de la Santé Mentale de la Petite Enfance et a consacré une large partie de sa carrière au mentorat. Du point de vue de la Santé Mentale de la Petite Enfance les expériences de mentorat sont davantage considérées comme des relations, importantes pour à la fois le et le ou la mentoré(e), avec des expériences de mentorat positives et cruciales pour le développement des cliniciens et des chercheurs IMH. Les participants au symposium, deux paires de dyades mentor­mentoré, ont d'abord fait un discours d'ouverture sur ce que le mentorat signifiait pour eux généralement et personnellement, et ont ensuite parlé de trois défis: le bon ajustement entre mentor et mentoré, « la lumière et l'ombre ¼ dans la relation de mentorat et l'équilibre de la vieille sagesse avec les nouvelles tendances dans le mentorat. Cet article récapitule les vues et les expériences personnelles des participants pour ce qui concerne ces défis, avec leurs propres mots, mettant en valeur les défis personnels et professionnels clés liés au mentorat de la perspective d'à la fois le mentor et le mentoré.

Promoting reflective practice in an infant and early childhood training program.

Reflective practices provide a supportive base through which preservice infant and early childhood teachers and allied professionals can achieve knowledge, skills, and professional dispositions to support young children and their families. This paper is a program description that describes the rationale for infusing reflective practices into the learning goals for preservice early childhood training, highlighting the specific reflection skills from the Infant and Early Childhood Mental Health Competency Guidelines. We describe how one university early childhood training program promotes student reflection skills referencing three distinct perspectives: (1) why reflection is essential to developing knowledge and skills; (2) the role group reflection plays in sustaining deep knowledge and skill development for students and faculty; (3) how faculty promote students' awareness of the connection between personal experience and professional dispositions through reflection during practicum experiences. The benefits and challenges of embedding reflective practices in preservice early childhood training are also discussed.

Las prácticas de reflexionar proveen una base de apoyo a través de la cual los maestros y profesionales aliados en el pre-servicio de infantes y la temprana niñez pueden lograr conocimientos, habilidades y disposiciones profesionales para apoyar a los pequeños niños y sus familias. Este ensayo es la descripción de un programa que describe la razón fundamental para incluir las prácticas de reflexionar dentro de los objetivos de aprendizaje para el entrenamiento del pre-servicio en la temprana niñez, subrayando las habilidades de reflexionar específicas que parten de los Preceptos Guías para la Competencia en la Salud Mental de la Infancia y la Temprana Niñez. Describimos cómo el programa de entrenamiento en la temprana niñez en una universidad promueve las habilidades de reflexionar en el estudiante, haciendo referencia a tres perspectivas distintas: 1. Por qué el reflexionar es esencial para desarrollar el conocimiento y las habilidades; 2. El papel que juega el grupo de reflexión para sostener el profundo desarrollo del conocimiento y las habilidades para estudiantes y profesores; 3. Cómo el profesorado promueve la concienciación de los estudiantes sobre la conexión entre la experiencia personal y las disposiciones profesionales a través de la reflexión durante las experiencias de práctica. También se discuten los beneficios y retos de incluir prácticas de reflexión en el entrenamiento del pre-servicio en la temprana niñez.

Les pratiques de réflexion offrent une base de soutien au travers de laquelle les enseignants et professionnels allies de la petite enfance et des services aux nourrissons peuvent développer et acquérir des connaissances, des compétences et des dispositions professionnelles afin de soutenir les jeunes enfants et leurs familles. Cet article est une description qu'un programme qui décrit la rationnelle pour l'infusion de compétences de réflexions dans les objectifs d'apprentissage pour la formation pré-service de la petite enfance, mettant en évidence les compétences de réflexion spécifiques qui se trouvent dans les Grandes Lignes de Compétence en Santé Mentale de la Petite Enfance. Nous décrivons la manière dont le programme de formation pour la petite enfance d'une université promeut des compétences de réflexion des étudiants en faisant référence à trois perspectives distinctes: 1. Pourquoi la réflexion est essentielle au développement des connaissances et des compétences; 2. Le rôle que joue la réflexion de groupe pour le maintien de connaissances profondes et le développement des compétences pour les étudiants et les professeurs; 3. La manière dont les professeurs promeuvent la prise de conscience de la part des étudiants du lien entre l'expérience personnelle et les dispositions professionnelles au travers de la réflexion durant les expériences en stages. Les bénéfices et les défis qu'il y a à intégrer des pratiques de réflexion dans la formation pré-service de la petite enfance sont aussi discutés.

Training home visitors in mentalization-based practice: A qualitative case study of clinical supervision in mothering from the inside out.

Attachment-based interventions are important for improving parent-child outcomes. These interventions must be scaled and made available to under-resourced communities. An important part of scaling these interventions is delineating and reproducing high-quality training, including clinical training which often requires the completion of a supervised case. However, descriptions and guidelines for clinical training are frequently broad or not available in the literature. A detailed description of clinical training could lead to further research to improve the effectiveness and dissemination of evidence-based interventions. Mothering from the Inside Out (MIO) is an attachment-based parenting intervention effective at reducing substance use and depression, improving caregiving, and enhancing child attachment. It is now being brought from research to community settings. This paper outlines the didactic and clinical training components of MIO. We then present a qualitative case study of one community-based counselor participating in the clinical training of MIO and employ qualitative methods to describe the main themes that arose during the training. We aim to illustrate how the trainer assisted the counselor in implementing the core components of MIO, which included (a) refining the language used in MIO sessions, (b) making space to explore mental states, and (c) addressing trauma. We conclude by presenting the implications of these findings.

Las intervenciones con base en la afectividad son importantes para mejorar los resultados de relación progenitor-niño. Estas intervenciones deben ser adaptadas y estar disponibles para comunidades sin recursos suficientes. Una parte importante de la adaptación de estas intervenciones es delinear y reproducir el entrenamiento de alta calidad, incluyendo entrenamiento clínico que a menudo requiere completar un caso supervisado. Sin embargo, las descripciones y los parámetros de guía para entrenamiento clínico son frecuentemente generales o no están disponibles en el material escrito. Una detallada descripción del entrenamiento clínico pudiera llevar a una posterior investigación para mejorar la eficacia y diseminación de intervenciones con base en la afectividad. Cuidados Maternales de Adentro Hacia Afuera (MIO) es una intervención de crianza con base en la afectividad que es eficaz para reducir el uso de sustancias y la depresión, mejorar la prestación de cuidado y fortalecer la afectividad del niño. Ahora se le lleva de la investigación a los escenarios comunitarios. Este artículo subraya los componentes de didáctica y entrenamiento clínico de MIO. Presentamos entonces un caso de estudio cualitativo de un consejero con base en la comunidad que participó en el entrenamiento clínico de MIO y empleamos métodos cualitativos para describir los temas principales que surgieron durante el entrenamiento. Nos propusimos ilustrar cómo el entrenador ayudó al consejero a implementar los componentes centrales de MIO, los cuales incluyen (a) refinar el lenguaje usado en la terapia, (b) abrir un espacio para explorar estados mentales, y (c) ocuparse del trauma. Concluimos con la presentación de las implicaciones que conllevan estos resultados.

Les interventions basées sur l'attachement sont importantes quand il s'agit d'améliorer les résultats parent-enfant. Ces interventions doivent être mises à l'échelle et doivent être disponibles pour toutes les communautés ayant peu de moyens. Un côté important de la mise à l'échelle de ces interventions consiste à délinéer et à reproduire une formation de haute qualité, y compris une formation clinique qui souvent exige la réalisation d'un cas supervisé. Cependant les descriptions et les lignes directrices de la formation clinique sont fréquemment larges ou ne sont pas disponibles dans des publications. Une description détaillée de formation Clinique pourrait conduire à des recherches approfondies sur la manière d'améliorer l'efficacité et la dissémination d'interventions fondées sur des données probantes. Le maternage de l'intérieur (abrégé ici MIO pour reprendre l'anglais Mothering from the Inside Out) est une intervention de parentage basée sur l'attachement qui est efficace pour ce qui concerne la réduction de toxicomanie et de dépression, l'amélioration des soins ainsi que de l'attachement de l'enfant. On le fait en ce moment passer des recherches aux contextes communautaires. Cet article décrit les composantes de formation didactique et clinique du MIO. Nous présentons ensuite une étude de cas qualitative d'un thérapeute communautaire participant à une formation clinique du MOI et employons des méthodes qualitatives pour décrire les thèmes principaux qui sont apparus durant la formation. Nous nous donnons pour but d'illustrer la manière dont le formateur a aidé le thérapeute à mettre en place les composantes essentielles du MIO, y compris (a) l'affinage du langage utilisé en thérapie, (b) la nécessité de faire de la place afin d'explorer les états mentaux, et (c) la nécessité d'aborder le trauma. Nous concluons en présentant les implications de ces résultats.

Clinical use and implementation of the diagnostic classification of mental health and developmental disorders of infancy and early childhood.

The Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC: 0-5) was developed to provide a framework for diagnosis of infants and young children, and a training curriculum supports implementation of the manual in clinical practice. This study surveyed 100 mental health clinicians (93% female and 53% Latinx/Hispanic) who had completed training in the DC: 0-5 classification system and worked with infants/young children and their families primarily in urban, public insurance-funded, community mental health settings in the United States. The survey explored their use of the diagnostic manual in clinical practice as well as supports and barriers to implementation. Survey results indicated a high level of adoption of the manual in clinical practice, although all five axes and the cultural formulation were used less often than the Axis I Clinical Disorders section. Barriers to implementation included systemic issues such as agency and billing requirements necessitating simultaneous use of other diagnostic manuals, lack of supports and expertise within their agency, and difficulty making time to fully utilize the manual. The findings suggest that policy and systems changes may be needed to enable clinicians to fully integrate the DC: 0-5 into their case conceptualizations.

La Clasificación de Diagnosis de Salud Mental y Trastornos del Desarrollo de la Infancia y la Temprana Niñez (DC: 0 - 5) fue desarrollada para proveer un marco de trabajo para la diagnosis de infantes y niños pequeños, y un currículo apoya la implementación del manual en la práctica clínica. Este estudio consultó a 100 profesionales clínicos de la salud mental (93% mujeres y 53% hispanos/latinx) quienes habían completado el entrenamiento en el sistema de clasificación DC: 0 - 5 y trabajado con infantes/niños pequeños y sus familias en escenarios comunitarios de salud mental urbanos y que recibían fondos públicos de seguros en Estados Unidos. La encuesta exploró el uso del manual de diagnóstico en la práctica clínica, así como también los apoyos y barreras a la implementación. Los resultados de la encuesta indicaron un alto nivel de adopción del manual en la práctica clínica, aunque todos los cinco ejes centrales y la formulación cultural se usaron menos a menudo que la sección del Eje Central I de los Trastornos Clínicos. Entre las barreras a la implementación se incluyen asuntos sistemáticos tales como los requisitos de la agencia y la forma de cobro, necesitando así el uso simultáneo de otros manuales de diagnóstico, la falta de apoyos y de conocimientos dentro de sus agencias, así como la dificultad de encontrar el tiempo para utilizar el manual al máximo. Los resultados sugieren que pudieran necesitarse cambios en la política y los sistemas para permitirles a los profesionales clínicos integrar completamente el DC: 0 - 5 dentro de sus conceptualizaciones de casos.

La classification diagnostique de la santé mentale et des troubles du développement de la petite enfance (DC: 0-5) a été développée afin d'offrir une structure pour le diagnostic des bébés et des petits enfants, et un curriculum de formation soutient la mise en place du manuel dans la pratique clinique. Cette étude a sondé 100 cliniciens de santé mentale (93% femmes et 53% Latinx/Hispaniques) ayant fini la formation pour le système de classification DC: 0 - 5 et travaillé avec des bébés/jeunes enfants et leurs familles principalement dans des contextes communautaires de santé mentale, urbains et financés par l'assurance publique aux Etats-Unis d'Amérique. Ce sondage a exploré leur utilisation du manuel diagnostique dans la pratique clinique ainsi que les soutiens et les barrières à la mise en place. Les résultats du sondage indiquent un niveau élevé d'adoption du manuel dans la clinique pratique, bien que tous les cinq axes et la formulation culturelle aient été moins souvent utilisés que la section Axes / Troubles Cliniques. Les barrières à la mise en place ont inclus des problèmes systémiques comme l'agence ou les exigences de facturation nécessitant une utilisation simultanée d'autres manuels diagnostiques, le manque de soutien et d'expertise au sein de leur propre agence, et la difficulté à prendre le temps d'utiliser le manuel à fond. Les résultats suggèrent que des changements de politique et de systèmes pourraient s'avérer nécessaires pour permettre aux cliniciens d'intégrer pleinement la DC: 0 - 5 dans leurs conceptualisations de cas.

Coaching home visitors: A thematic review with an emphasis on research and practice needs.

There is wide recognition in early childhood fields that coaching is important to a professional's development and growth in general, but little is known about coaching home visiting professionals in particular. An early childhood home visiting professional works with families to encourage positive parent-child interactions, family goal setting, and family well-being and health. Determining the essential components of coaching home visitors will help advance this field. Because coaching in the home visiting field is emergent, this article draws on literature from the early childhood field with an emphasis on applications for home visiting. We gleaned six themes that may represent common features of coaching. This article presents a compilation of common themes identified in literature reviews on coaching professionals across the early childhood field that warrant further development and evaluation by home visiting practitioners and researchers regardless of the home visiting model. The discussion concludes with recommendations to stimulate research and practice on coaching home visitors.

Se reconoce ampliamente en los campos de la temprana niñez que el entrenamiento es importante para el desarrollo y crecimiento en general de todo profesional, pero poco se conoce acerca del entrenamiento de profesionales que hacen visitas a casa, en particular. Un profesional del campo de visitas a casa en la temprana niñez trabaja con familias para motivar las positivas interacciones entre progenitores y niños, el proceso de establecer metas familiares, así como el bienestar y salud de la familia. Determinar los componentes esenciales del entrenamiento a visitantes a casa ayudará en el progreso de este campo profesional. Dado que el entrenamiento en el campo de visitas a casa es algo que está surgiendo, este artículo toma aspectos de la literatura en el campo de la temprana niñez con énfasis en lo que es aplicable a las visitas a casa. Recogimos seis temas que pudieran representar características comunes del entrenamiento. Este artículo presenta una compilación de temas comunes identificados en las revisiones de la literatura sobre el entrenamiento de profesionales en todo el campo de la temprana niñez que garantizan el fomento del desarrollo y la evaluación por parte de quienes practican e investigan sobre el campo de las visitas a casa, independientemente del modelo de visitas a casa. La discusión concluye con recomendaciones para estimular la investigación y la práctica acerca del entrenamiento a quienes hacen las visitas a casa.

On reconnaît dans les domaines de la petite enfance que le coaching est très important pour le développement d'un professionnel et sa progression en général, mais on sait peu de choses sur les professionnels qui font du coaching en visite à domicile. Un professionnel visiteur à domicile de l'enfance travaille avec des familles afin d'encourager des interactions parent-enfant positives, la fixation d'objectifs pour la famille, et le bien-être et la santé de la famille. Déterminer les composantes essentielles des visiteurs à domiciles qui coachent nous aidera à faire avancer le domaine. Parce que le coaching dans le domaine de la visite à domicile est émergent cet article s'appuie sur des recherches ayant trait au domaine de la petite enfance mettant l'accent sur les applications pour la visite à domicile. Nous avons glané six thèmes qui pourraient représenter les traits principaux du coaching. Cet article présente une compilation de thèmes communs identifiés dans des analyses documentaires sur les professionnels du coaching au travers du domaine de la petite enfance qui méritent des développements ultérieurs et une évaluation par les professionnels de la visite à domicile et les chercheurs, quel que soit le modèle de visite à domicile. La discussion se termine avec des recommandations afin de stimuler les recherches et la pratique sur les visiteurs à domicile qui font du coaching.

Sparking collaboration and instilling core competencies through training a statewide workforce in Infant Mental Health: Report from the field.

Fostering collaboration and instilling core competencies across the diverse Infant Mental Health systems and understanding their training needs are crucial endeavors to support the delivery of evidence-based care and treatment continuity for infants and their families. This paper details the Connecticut Association for Infant Mental Health's use of a comprehensive infant mental health training series as a vehicle to achieve these aims. The training series, and the steps taken to execute and evaluate it are described to provide a framework for future collaborative training initiatives. Evaluation efforts were designed to address knowledge sought and gained and included pre and posttraining tests, participant reports of their training goals and needs, and interviews with trainers regarding the series' strengths and limitations. Findings suggest significant improvements in participants' knowledge of training content across trainings. Participants indicated a desire for trainings on working with the whole family and their plan to integrate skills from the training into their work. Recommendations from trainers and evaluators are provided to spark future trainings and collaborative efforts.

Fomentar la colaboración e inculcar las competencias centrales entre los diversos sistemas de Salud Mental Infantil, así como comprender las necesidades de entrenamiento son iniciativas cruciales para apoyar la continuidad del ofrecimiento del cuidado y el tratamiento con base en la evidencia para infantes y sus familias. Este ensayo detalla el uso de una serie de entrenamientos de salud mental infantil comprensiva de la Asociación de Connecticut para la Salud Mental Infantil como un vehículo para lograr las metas mencionadas. La serie de entrenamientos y los pasos que se toman para ejecutarlo y evaluarlo se describen para aportar un marco de trabajo para futuras iniciativas colaborativas de entrenamiento. Los esfuerzos de evaluación se diseñaron para tomar en cuenta el conocimiento que se busca y se recibe e incluyeron exámenes previos y posteriores al entrenamiento, el reporte de los participantes sobre sus metas y necesidades en el entrenamiento, así como entrevistas con entrenadores acerca de los puntos fuertes y limitaciones de la serie. Los resultados sugieren mejoras significativas en cuanto al conocimiento de los participantes acerca del contenido del entrenamiento a lo largo de las sesiones de entrenamiento. Los participantes manifestaron su deseo de ser entrenados en trabajar con la familia entera y su plan de integrar habilidades aprendidas en el entrenamiento en su trabajo. Se incluyen las recomendaciones de los entrenadores y evaluadores con el fin de motivar futuros entrenamientos y esfuerzos colaborativos.

Le fait de cultiver des collaborations et le fait d'instiller des compétences fondamentales au travers des divers systèmes de Santé Mentale du Nourrisson, tout comme le fait de comprendre leurs besoins en formation sont des tentatives cruciales de soutenir la prestation de soins factuels et la continuité de traitement pour les nourrissons et leurs familles. Cet article détaille l'utilisation qu'a faite l'Association de Santé Mentale du Nourrisson de l'état du Connecticut aux Etats-Unis d'une série de formation complète en santé mentale du nourrisson en tant que véhicule afin d'achever ces buts. La série de formation et les mesures prises pour la mettre en place et l'évaluer sont ici décrites afin d'offrir une structure d'initiatives collaboratives de formation. Les efforts d'évaluation ont été conçus afin d'aborder les connaissances désirées et acquises et ont inclus des tests pré- et post-formation, des rapports des participants sur leurs buts et leurs besoins de formation, et des entretiens avec les formateurs concernant les points forts et les limitations de la série. Les résultats suggèrent des améliorations importantes dans les connaissances sur le contenu de la formation de la part des participants au travers des formation. Les participants ont indiqué le désir de formation sur le travail avec toute la famille et les intentions qu'ils avaient d'intégrer les compétences acquises durant la formation dans leur travail. Des recommandations pour les formateurs et les évaluateurs sont présentées afin de faire naître dans le future d'autres formations et efforts collaboratifs.

Simulated training program in abdominal paracentesis for undergraduate medical students.

BACKGROUND AND AIMS: Abdominal paracentesis is an area that every general physician should know about, and the current learning model is unsafe for patients. Simulation allows students to develop their skills prior to clinical confrontation with minimal risks. The aims of this study were to design and evaluate a paracentesis simulation workshop for undergraduate students. METHODS: A workshop was implemented using a specially designed and validated simulation model for abdominal paracentesis. The simulated technique considered the recognition of materials, operator equipment, asepsis, anesthesia, puncture and obtaining liquid, collecting samples for analysis, withdrawal of the material and occlusion. A 24-point direct observation checklist was administered to assess the student. We assessed two students at the beginning of the workshop and all the students at the end. A perception survey was applied to attendees at the end of the workshop. RESULTS: 247 students were included and a workshop that involved 8 students per session was held. Students significantly improved their skills comparing pre- and post-evaluation results [13.36±4.46 (55.7%) vs. 22.3±1.83 (92.9%) respectively (n=69) p<0.001]. The students' perception questionnaire (n=38) showed that the training sessions were highly valued, averaging 4.8±0.38 on a Likert scale of 1-5. CONCLUSIONS: Simulated training in abdominal paracentesis is a very good teaching method. This teaching methodology should be highly recommended as an educational strategy in medicine because it could accelerate the acquisition of clinical skills in a safe learning environment.

[Effectiveness of training programs on alcohol consumption in the Primary Care setting: Systematic review]. / Efectividad de programas formativos orientados al consumo de alcohol en atención primaria: revisión sistemática.

OBJECTIVE: To evaluate the effectiveness of training activities directed at Primary Health Care personnel on the management of patients with alcohol consumption problems. DESIGN: A systematic review of randomised controlled trials. DATA SOURCES: Trip Database, Cochrane Central Register of Controlled Trials (CENTRAL), Medline, EMBASE, CINAHL, Web of Science, Scopus, Alcohol and Alcohol Problems Science Database - ETOH and FAMILY RESOURCES DATABASE. The search was performed in June 2017. STUDY SELECTION: The final sample was n=3 studies. Randomised controlled trials, indexed until 30 May 2017, with the objective of assessing the effectiveness of training programs directed at Primary Care providers in the management of patients with alcohol abuse disorder were included. DATA EXTRACTION: The main variables were expressed in terms of effectiveness of the training program: level of global implementation, screening of alcohol consumption, intervention in patients with a consumption risk, and level of support required. RESULTS: Three Randomised controlled trials, published from 1999 to 2004, were included. Both screening and short intervention techniques showed an increase of its application in the three studies after the development of the three training programs. Statistical significance in terms of effectiveness was achieved in 2 of the 3 selected trials: both in detection of risk consumers, and in short intervention. CONCLUSION: The development of training programs in the management of patients with alcohol abuse disorder is an effective strategy for Primary Care providers, allowing the implementation of population screening, as well as the application of intervention techniques.

A view of the global conservation job market and how to succeed in it.

The high demand for conservation work is creating a need for conservation-focused training of scientists. Although many people with postsecondary degrees in biology are finding careers outside academia, many programs and mentors continue to prepare students to follow-in-the-footsteps of their professors. Unfortunately, information regarding how to prepare for today's conservation-based job market is limited in detail and scope. This problem is complicated by the differing needs of conservation organizations in both economically developed and developing regions worldwide. To help scientists identify the tools needed for conservation positions worldwide, we reviewed the current global conservation job market and identified skills required for success in careers in academia, government, nonprofit, and for-profit organizations. We also interviewed conservation professionals across all conservation sectors. Positions in nonprofit organizations were the most abundant, whereas academic jobs were only 10% of the current job market. The most common skills required across sectors were a strong disciplinary background, followed by analytical and technical skills. Academic positions differed the most from other types of positions in that they emphasized teaching as a top skill. Nonacademic jobs emphasized the need for excellent written and oral communication, as well as project-management experience. Furthermore, we found distinct differences across job locations. Positions in developing countries emphasized language and interpersonal skills, whereas positions in countries with advanced economies focused on publication history and technical skills. Our results were corroborated by the conservation professionals we interviewed. Based on our results, we compiled a nondefinitive list of conservation-based training programs that are likely to provide training for the current job market. Using the results of this study, scientists may be better able to tailor their training to maximize success in the conservation job market. Similarly, institutions can apply this information to create educational programs that produce graduates primed for long-term success.

Impact of the endoscopist's experience on the negative predictive value of capsule endoscopy. / Influencia de la experiencia acumulada del explorador en el valor predictivo negativo de la cápsula endoscópica.

INTRODUCTION: The impact of the accumulated experience of the capsule endoscopy (CE) reader on the accuracy of this test is discussed. AIM: To determine whether the negative predictive value of CE findings changes along the learning curve. METHODS: We reviewed the first 900 CE read by 3 gastroenterologists experienced in endoscopy over 8 years. These 900 CE were divided into 3 groups (300 CE each): group 1 consisted of the sum of the first 100 CE read by each of the 3 endoscopists; group 2, the sum of the second 100 and groups 3, the sum of the third 100. Patients with normal CE were monitored for at least 28 months to estimate the negative predictive value. RESULTS: A total of 54 (18%) CE in group 1, 58 (19.3%) in group 2 and 47 (15.6%) in group 3 were normal, although only 34 patients in group 1, 38 in group 2 and 36 in group 3 with normal CE completed follow up and were eventually studied. The negative predictive value was 88.2% in group 1, 89.5% in group 2 and 97% in group 3 (P>.05). CONCLUSION: The negative predictive value tended to increase, but remained high and did not change significantly after the first 100 when readers are experienced in conventional endoscopy and have preliminary specific training.

IMPACT OF A SUPPORT GROUP FOR THE CAREGIVERS AT AN ORPHANAGE IN TURKEY.

This study examined the effectiveness of a 20-session training and supervision support group for caregivers working at an orphanage in Istanbul. The support group's goals were to promote sensitive and responsive caregiving in an institutional setting, to decrease the stress level of the caregivers, and to increase the quality of the relationship between caregivers and children. Thirty-six children (15-37 months) and 24 caregivers participated in this study. Comparison of the pre- and posttest measures of the caregiver intervention and control groups indicated that the intervention yielded successful outcomes. Caregivers in the intervention group displayed significant decreases in the amount of psychological symptoms that they reported and in their emotional burnout levels. Their sense of self-efficacy also improved. In addition, at the end of the 5-month training program, positive developments were observed regarding children's development and problem behaviors. Having regular visitors also was found to be a significant predictor for better developmental outcomes for the children under institutional care.

DOES TRAINING IN THE CIRCLE OF SECURITY FRAMEWORK INCREASE RELATIONAL UNDERSTANDING IN INFANT/CHILD AND FAMILY WORKERS?

This article evaluated whether attendance at Circle of Security training workshops resulted in attendees showing greater empathy and attachment-related knowledge and understanding, and fewer judgmental responses to viewing a stressful parent-child interaction. Participants were 202 practitioners who attended and completed a 2-day (n = 70), 4-day (n = 105), or 10-day (n = 27) COS training workshop in Australia or New Zealand in 2015. In a pre/post design, participant reactions to a video clip of a challenging parent-child interaction were coded for empathic, judgmental, or attachment-focused language. Attachment understanding was coded in response to questions about the greatest challenge that the dyad faced. In all training conditions, participants provided significantly more attachment-focused descriptors and showed significantly greater attachment understanding after training, but significantly fewer empathic descriptors. While participants at the longer workshops provided significantly fewer judgmental/critical descriptors, there was no change for those attending the 2-day workshop. Irrespective of workshop duration or professional background, participants took a more relational perspective on the vignette after the training workshops. More detailed research is required to establish the extent to which this increased knowledge and understanding is retained and integrated into infant mental health practice with parents and young children.

ARE HEALTH VISITORS' OBSERVATIONS OF EARLY PARENT-INFANT INTERACTIONS RELIABLE? A CROSS-SECTIONAL DESIGN.

Health visitors need competences to promote healthy early parent-infant relationships. The aims of this study were to explore whether there are differences between groups of health visitors with and without additional parenting program education in terms of their knowledge of infant-parent interaction and their observation and assessment skills of such interactions. The cross-sectional study included 36 health visitors' certified Marte Meo therapists and 85 health visitors without additional parenting program education. Health visitors' observation skills were measured assessing five video-recorded mother-infant interactions. A questionnaire was used to measure their intention, self-efficacy, and knowledge. More certified Marte Meo therapists than health visitors without additional parenting program education reported a significantly higher mean level of knowledge of the early relationship, 6.42 (95% CI; 6.18-6.66) versus 5.05 (95% CI; 4.86-6.10), p = .04; and more certified Marte Meo therapists than health visitors without additional parenting program education reported a higher mean level of knowledge of infant self-regulation, 2.44 (95% CI; 2.18-2.71) versus 1.83 (95% CI; 1.62-2.03), p < .001. In the latter group, 54% (95% CI; 0.43-0.64) reported a significantly higher need for further education versus 22% (95% CI; 0.11-0.39), p = .001. Compared to health visitors without any parenting program education, health visitors certified as Marte Meo therapists reported a significantly higher frequency of correct assessment of mothers' sensitivity in two of five video-recordings, with 77.78% (95% CI; 0.61-0.87) compared to 45.88% (95% CI; 0.35-0.57) in Video 3, p = .001, and 69.44% (95% CI; 0.52-0.82) compared to 49.41% (95% CI; 0.39-0.60) in Video 4, p = .04, respectively. The results of the present study support the use of video-based education of health visitors to increase their knowledge of and skills in assessing parent-infant interactions. Randomized controlled trials are needed to determine whether the improved level of health visitors' knowledge and observation skills may be assigned to participation in the Marte Meo education program.

The role of automated feedback in training and retaining biological recorders for citizen science.

The rapid rise of citizen science, with lay people forming often extensive biodiversity sensor networks, is seen as a solution to the mismatch between data demand and supply while simultaneously engaging citizens with environmental topics. However, citizen science recording schemes require careful consideration of how to motivate, train, and retain volunteers. We evaluated a novel computing science framework that allowed for the automated generation of feedback to citizen scientists using natural language generation (NLG) technology. We worked with a photo-based citizen science program in which users also volunteer species identification aided by an online key. Feedback is provided after photo (and identification) submission and is aimed to improve volunteer species identification skills and to enhance volunteer experience and retention. To assess the utility of NLG feedback, we conducted two experiments with novices to assess short-term (single session) and longer-term (5 sessions in 2 months) learning, respectively. Participants identified a specimen in a series of photos. One group received only the correct answer after each identification, and the other group received the correct answer and NLG feedback explaining reasons for misidentification and highlighting key features that facilitate correct identification. We then developed an identification training tool with NLG feedback as part of the citizen science program BeeWatch and analyzed learning by users. Finally, we implemented NLG feedback in the live program and evaluated this by randomly allocating all BeeWatch users to treatment groups that received different types of feedback upon identification submission. After 6 months separate surveys were sent out to assess whether views on the citizen science program and its feedback differed among the groups. Identification accuracy and retention of novices were higher for those who received automated feedback than for those who received only confirmation of the correct identification without explanation. The value of NLG feedback in the live program, captured through questionnaires and evaluation of the online photo-based training tool, likewise showed that the automated generation of informative feedback fostered learning and volunteer engagement and thus paves the way for productive and long-lived citizen science projects.

A COMMUNITY MENTAL HEALTH PROFESSIONAL DEVELOPMENT MODEL FOR THE EXPANSION OF REFLECTIVE PRACTICE AND SUPERVISION: EVALUATION OF A PILOT TRAINING SERIES FOR INFANT MENTAL HEALTH PROFESSIONALS.

The Michigan Association for Infant Mental Health identified a need for reflective supervision training for infant mental health (IMH) specialists providing home-based services to highly vulnerable infants and their families. Findings indicate that this pilot of an IMH community mental health professional development model was successful, as measured by the participants' increased capacity to apply reflective practice and supervisory knowledge and skills. Furthermore, IMH clinicians demonstrated an increase in the frequency of their use of reflective practice skills, and their supervisors demonstrated an increase in their sense of self-efficacy regarding reflective supervisory tasks. Finally, the evaluation included a successful pilot of new measures designed to measure reflective practice, contributing to the growing body of research in the area of reflective supervision.

Effectiveness of motor imagery or mental practice in functional recovery after stroke: a systematic review.

INTRODUCTION: In recent decades, many stroke rehabilitation methods have been developed. Mental practice (MP) is a dynamic state in which the subject evokes an imaginary representation of a motor action or skill in order to learn or perfect that action. Although functional imaging has shown that MP produces similar cortical activation patterns to those of movement, the clinical effectiveness of such methods in rehabilitation and functional recovery has yet to be demonstrated. DEVELOPMENT: Systematic search of all clinical studies published in the main scientific databases between December 2011 and October 2012 concerning mental practice in stroke rehabilitation. We selected 23 clinical trials testing different MP protocols in patients with hemiparesis. CONCLUSIONS: MP is effective when used in conjunction with conventional physical therapy for functional rehabilitation of both upper and lower limbs, as well as for the recovery of daily activities and skills. Owing to the heterogeneity of the studies with regard to the intervention protocol, specific imagery technique, time spent practicing, patient characteristics, etc., more studies are needed in order to determine the optimal treatment protocol and patient profile.

Design and application of model for training ultrasound-guided vascular cannulation in pediatric patients.

UNLABELLED: Central vascular cannulation is not a risk-free procedure, especially in pediatric patients. Newborn and infants are small and low-weighted, their vascular structures have high mobility because of tissue laxity and their vessels are superficial and with small diameter. These characteristics, together with the natural anatomical variability and poor collaboration of small children, make this technique more difficult to apply. Therefore, ultrasound imaging is increasingly being used to locate vessels and guide vascular access in this population. OBJECTIVE: (a) To present a model that simulates the vascular system for training ultrasound-guided vascular access in pediatrics patients; (b) to ultrasound-guided vascular cannulation in the model. RESULTS: The model consisted of two components: (a) muscular component: avian muscle, (b) vascular component: elastic tube-like structure filled with fluid. 864 ecoguided punctures was realized in the model at different vessel depth and gauge measures were simulated, for two medical operators with different degree of experience. The average depth and diameter of vessel cannulated were 1.16 (0.42)cm and 0.43 (0.1)cm, respectively. The average number of attempts was of 1.22 (0.62). The percentage of visualization of the needle was 74%. The most frequent maneuver used for the correct location, was the modification of the angle of the needle and the relocation of the guidewire in 24% of the cases. The average time for the correct cannulations was 41 (35.8)s. The more frequent complications were the vascular perforation (11.9%) and the correct vascular puncture without possibility of introducing the guidewire (1.2%). The rate of success was 96%. CONCLUSIONS: The model simulates the anatomy (vascular and muscular structures) of a pediatric patient. It is cheap models, easily reproducible and a useful tool for training in ultrasound-guided puncture and cannulation.

Influence of volunteer and project characteristics on data quality of biological surveys.

Volunteer involvement in biological surveys is becoming common in conservation and ecology, prompting questions on the quality of data collected in such surveys. In a systematic review of the peer-reviewed literature on the quality of data collected by volunteers, we examined the characteristics of volunteers (e.g., age, prior knowledge) and projects (e.g., systematic vs. opportunistic monitoring schemes) that affect data quality with regards to standardization of sampling, accuracy and precision of data collection, spatial and temporal representation of data, and sample size. Most studies (70%, n = 71) focused on the act of data collection. The majority of assessments of volunteer characteristics (58%, n = 93) examined the effect of prior knowledge and experience on quality of the data collected, often by comparing volunteers with experts or professionals, who were usually assumed to collect higher quality data. However, when both groups' data were compared with the same accuracy standard, professional data were more accurate in only 4 of 7 cases. The few studies that measured precision of volunteer and professional data did not conclusively show that professional data were less variable than volunteer data. To improve data quality, studies recommended changes to survey protocols, volunteer training, statistical analyses, and project structure (e.g., volunteer recruitment and retention).

BUILDING A WORKFORCE COMPETENCY-BASED TRAINING PROGRAM IN INFANT/EARLY CHILDHOOD MENTAL HEALTH.

This article describes findings from a project conducted in Western Australia (Mental Health Commission WA, 2015) that investigated the education and training needs of the Infant/Early Childhood Mental Health (I/ECMH) workforce. We examined international training programs and models of delivery in infant mental health, including a review of the current training available in Australia. Data collected from over 60 interviews were analyzed, and a staged delivery model for I/ECMH training and supervision that aligned with the Michigan Association for Infant Mental Health (2014) Competency Guidelines was recommended. These findings led to the purchase of the Michigan Association for Infant Mental Health (2014) for use in Western Australia. In a very short time, use of the Michigan Competency Framework by the Australian Association for Infant Mental Health West Australian Branch Incorporated has begun to change the training and education opportunities for upskilling the infant and early childhood workforce in Western Australia. It has resulted in a map to guide and develop training in the I/ECMH field for individual practitioners and professionals as well as for workplaces that will ultimately benefit Western Australian infants, young children, and their families during the perinatal period and in the early years.