Reflective supervision and reflective practice in infant mental health: A scoping review of a diverse body of literature.

Reflective practice is a core component of Infant Mental Health (IMH) training and work in the form of reflective supervision/consultation (RS/C). RS/C supports and facilitates relationship-based practice, and is considered to help prevent burnout and promote work satisfaction. In response to an identified gap in empirical research on RS/C, this scoping review aimed to give an overview of the broad range of study designs and outcomes by systematically charting empirical studies on RS/C in IMH-based work with children and families. Searches of Academic Search Complete, CINAHL, MEDLINE, APA PsychArticles, APA PsycInfo, and Web of Science were supplemented with a Google Scholar search and citation searching. Following title/abstract screening (n = 233) and full-text review (n = 168), 35 reports met criteria for inclusion. Key findings were organized into four categories: Essential components and processes of RS/C; Experiences and outcomes of RS/C; Emerging issues in RS/C literature; and Measuring, researching, and reporting on RS/C. Results describe the components and experience of engaging in quality RS/C, and show that practitioners generally experience RS/C as supportive and beneficial. The existing literature has some methodological limitations and further empirical research is needed on outcomes of RS/C. Practice implications and potential future research directions are discussed.

La práctica con reflexión es un componente central del entrenamiento y trabajo en el campo de Salud Mental Infantil (IMH), en forma de una supervisión/consulta con reflexión (RS/C). RS/C apoya y facilita la práctica que tiene como base la relación y se considera que ayuda a prevenir el agotamiento y a promover la satisfacción en el trabajo. Como respuesta a un identificado vacío en la investigación empírica sobre RS/C, esta revisión de los antecedentes se propuso presentar una visión general de la amplia gama de diseños y resultados de estudios por medio de un trazado sistemático de estudios empíricos sobre RS/C en el trabajo basado en IMH con niños y familias. La búsqueda en Academic Search Complete (Completa Búsqueda Académica), en CINAHL, MEDLINE, APA, PsychArticles, APA PsycInfo y Web of Science (Red de la Ciencia) se suplementó con una búsqueda en Google Scholar y una búsqueda de citas anotadas. Después de seguir la detección de título/resumen (n = 233) y una revisión del texto completo (n = 168), 35 reportes reunieron los criterios para ser incluidos. Los resultados claves se organizaron en 4 categorías: Componentes y procesos esenciales de RS/C; Experiencias y resultados de RS/C; Asuntos incipientes en la literatura sobre RS/C; y Medir, investigar y reportar sobre RS/C. Los resultados describen los componentes y experiencias de participar en RS/C de calidad, y muestran que los profesionales de la práctica generalmente experimentan RS/C como un proceso de apoyo y beneficioso. La literatura existente tiene algunas limitaciones metodológicas y se necesita una mayor investigación empírica sobre los resultados de RS/C. Se discuten las implicaciones en la práctica y las potenciales directrices para la futura investigación.

Lonely SARTs: loneliness and sustained attention in the Irish longitudinal study of aging.

Based on biologically plausible mechanisms and previous research, it is possible to hypothesize a reciprocal association between sustained attention and loneliness. We investigated this association using a cross-lagged modeling approach. Using data from 6,239 participants aged over 50 in TILDA, a nationally representative study of aging, we used structural equation models to investigate potential cross-lagged associations between sustained attention and loneliness, measured at baseline and again after four years. Sustained attention at baseline had a small association with loneliness four years later, but loneliness at baseline was not associated with sustained attention at follow-up. Auto-regressive associations were strong for both loneliness over time and sustained attention over time. Sustained attention may account for a small proportion of the variance in loneliness over time among older adults, and may constitute a risk factor in the development of loneliness. Implications for the identification of at-risk individuals and the prevention of loneliness are discussed.

Systemic inflammatory markers and sources of social support among older adults in the Memory Research Unit cohort.

Potential associations between systemic inflammation and social support received by a sample of 120 older adults were examined here. Inflammatory markers, cognitive function, social support and psychosocial wellbeing were evaluated. A structural equation modelling approach was used to analyse the data. The model was a good fit χ1082=256.13 , p < 0.001; comparative fit index = 0.973; Tucker-Lewis Index = 0.962; root mean square error of approximation = 0.021; standardised root mean-square residual = 0.074). Chemokine levels were associated with increased age ( ß = 0.276), receipt of less social support from friends ( ß = -0.256) and body mass index ( ß = -0.256). Results are discussed in relation to social signal transduction theory.

Associations and effects of omega-3 polyunsaturated fatty acids on cognitive function and mood in healthy adults: a protocol for a systematic review of observational and interventional studies.

INTRODUCTION: The association between long-chain omega-3 polyunsaturated fatty acids (PUFAs), brain health, cognitive function and mood has been the subject of intensive research. Marine-derived omega-3 PUFAs, such as docosahexaenoic acid and eicosapentaenoic acid, are highly concentrated in neuronal membranes and affect brain function. Many studies have found that consumption of omega-3 PUFAs is associated with lower risk of cognitive or mood dysfunction. However, other studies have demonstrated no beneficial effects. There appears to be inconsistent findings from both epidemiological and randomised controlled trial (RCT) studies. The aim of this review is to compile the previous literature and establish the efficacy of omega-3 PUFAs in enhancing cognitive performance and mood in healthy adults. METHODS AND ANALYSIS: Prospective cohort studies, RCTs, controlled clinical trials, controlled before and after studies, interrupted time series with a minimum of 3 months duration will be eligible for inclusion. Studies on healthy adults over the age of 18, where the intervention/exposure of interest is omega-3 PUFAs will be included. The outcomes of interest are cognition and mood. Studies will be eligible for inclusion if they measure changes in cognitive function or mood, or the risk of developing cognitive or mood disorders using validated tools and assessments. Relevant search terms and keywords will be used to generate a systematic search in Cochrane Library, MEDLINE, EMBASE, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Web of Science, Scopus and the grey literature. Two independent reviewers will screen studies for eligibility. Risk of bias in cohort and non-randomised studies will be assessed using the ROBINS-I tool. The Cochrane Collaboration's tool for assessing risk of bias in randomised trials will be used for RCTs. If there are sufficient data, a meta-analysis will be conducted. ETHICS AND DISSEMINATION: This systematic review does not involve primary data collection and therefore formal ethical approval is not required. Results will be disseminated through peer reviewed publications, conference presentations and the popular press. PROSPERO REGISTRATION NUMBER: CRD42018080800.

Needs of informal caregivers across the caregiving course in amyotrophic lateral sclerosis: a qualitative analysis.

OBJECTIVES: Amyotrophic lateral sclerosis (ALS), also known as motor neuron disease (MND), is a debilitating terminal condition. Informal caregivers are key figures in ALS care provision. The physical, psychological and emotional impact of providing care in the home requires appropriate assistance and support. The objective of this analysis is to explore the needs of informal ALS caregivers across the caregiving course. DESIGN: In an open-ended question as part of a semistructured interview, caregivers were asked what would help them in their role. Interviews took place on three occasions at 4-month to 6-month intervals. Demographic, burden and quality of life data were collected, in addition to the open-ended responses. We carried out descriptive statistical analysis and thematic analysis of qualitative data. SETTING AND PARTICIPANTS: Home interviews at baseline (n=81) and on two further occasions (n=56, n=41) with informal caregivers of people with ALS attending the National ALS/MND Clinic at Beaumont Hospital, Dublin, Ireland. RESULTS: The majority of caregivers were family members. Hours of care provided and caregiver burden increased across the interview series. Thematic analysis identified what would help them in their role, and needs related to external support and services, psychological-emotional factors, patient-related behaviours, a cure and 'nothing'. Themes were interconnected and their prevalence varied across the interview time points. CONCLUSION: This study has shown the consistency and adaptation in what caregivers identified as helpful in their role, across 12-18 months of a caregiving journey. Support needs are clearly defined, and change with time and the course of caregiving. Caregivers need support from family, friends and healthcare professionals in managing their tasks and the emotional demands of caregiving. Identifying the specific needs of informal caregivers should enable health professionals to provide tailored supportive interventions.

Caregivers of patients with amyotrophic lateral sclerosis: investigating quality of life, caregiver burden, service engagement, and patient survival.

Few studies in amyotrophic lateral sclerosis (ALS) have profiled disease-specific features of the condition in conjunction with assessment of caregivers' burden, distress, quality of life, and investigated patient survival. Eighty-four ALS patients and their primary caregivers were enrolled. Patients completed ALS-specific measures of physical and cognitive function, while caregivers completed measures of anxiety, depression, caregiver burden, and quality of life. Patient-caregiver dyads were interviewed about their health-service utilisation. Survival data were obtained through the Irish register for ALS. Participants were dichotomised into low/high groups according to the severity of self-reported caregiver burden, based on statistically derived cut-off scores. High-burdened caregivers (n = 43) did not significantly differ from low-burdened caregivers (n = 41) with respect to disease-specific characteristics, i.e., ALSFRS-R, bulbar- or spinal-onset ALS, disease duration, or survival data. However, significant differences were reported on subjective measures of anxiety (p < 0.000), depression (p < 0.001), distress (p < 0.000), and quality of life (p < 0.000). These data demonstrate the limited impact of ALS patient-related variables, i.e., ALSFRS-R and onset, on caregiver burden in ALS, and identify the importance of the psychological composition of caregivers. This study suggests that the subjective experience of individual caregivers is an important factor influencing the severity of experienced caregiver burden.