RESUMO
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.
Assuntos
Serviços de Saúde Mental , Saúde Mental , Criança , Lactente , Humanos , Pessoal de Saúde/psicologia , Reflexão Cognitiva , PensamentoRESUMO
Reflective practice (RP) is a core component of infant mental health (IMH); however, there is limited published empirical research on IMH practitioner experiences of RP. This two-stage, qualitative, multimodal study explored Irish IMH practitioners' experiences of RP spaces. Visual and verbal data from seven individual interviews and a participatory arts-based focus group with seven participants (eight participants in total, all white Irish females) were analyzed using Interpretative Phenomenological Analysis. Five group experiential themes (Just get on with it; What should I be bringing to this space?; Who are my "hands"?; Taking a step back; and You go in heavy and you come out light) were generated by the analysis. These were used to construct a developmental and experiential model of learning in an RP space. The themes portray how a practitioner's RP experience can change over time: influenced by prior experiences and practice development stage, practitioners move from initial uncertainty, anxiety, and perceived pressure in a busy workload to developing the trust and ability to be vulnerable in an RP space. Through relationships (supervisor/facilitator or group members), a shared safe space can be created, which addresses practitioners' needs for containment, allowing for experiential learning through a process of transformational moments.
La práctica con reflexión (RP) es un componente central de la salud mental infantil (IMH), sin embargo, existe una limitada investigación empírica publicada sobre las experiencias de RP de los profesionales de la práctica de IMH. Este estudio multimodal, cualitativo, en dos etapas, exploró las experiencias de los espacios de RP de profesionales irlandeses en la práctica de IMH. Se analizó la información visual y verbal de siete entrevistas individuales y un grupo de enfoque participativo con base artística de siete participantes (ocho participantes en total, todas mujeres blancas irlandesas) usando el Análisis Fenomenológico Interpretativo. El análisis generó cinco temas de la experiencia de grupo (Manos a la obra; ¿Qué debo aportar a este espacio?; ¿Quiénes son mis 'manos'?; Dar un paso atrás; y Se comienza pesado y se termina liviano). Estos temas se usaron para construir un modelo de desarrollo y experimental de aprendizaje dentro de un espacio de RP. Los temas describieron cómo la experiencia de RP de un profesional de la práctica puede cambiar a lo largo del tiempo: influida por experiencias previas y un estado de desarrollo práctico, los profesionales de la práctica pasan de la incertidumbre inicial, la ansiedad y la percibida presión dentro de una ocupada carga de trabajo a desarrollar la confianza y la habilidad de ser vulnerable dentro de un espacio de RP. A través de relaciones (supervisor/facilitador o miembros de grupo), se puede crear un espacio seguro compartido, el cual aborda las necesidades de contención de los profesionales de la práctica, permitiendo el aprendizaje experimental a través de un proceso de momentos transformacionales.
Assuntos
Reflexão Cognitiva , Serviços de Saúde Mental , Adulto , Feminino , Humanos , Lactente , Grupos Focais , Pessoal de Saúde/psicologia , Irlanda , Saúde Mental , Pesquisa QualitativaRESUMO
BACKGROUND: Staff member's views and attitudes can have a significant impact on people with an intellectual disability. This study explores staff attitudes and experiences of people with an intellectual disability's expression of relationships and sexuality across service providers in Ireland. METHODS: Staff (n = 86) from service providers (n = 5) completed the Attitudes to Sexuality Questionnaire-Individuals with an Intellectual Disability (ASQ-ID) and open-ended questions. RESULTS: Multidirectional significant differences were noted on staff attitudes to sexuality based on demographic factors, that is, age, education, as well as non-demographics, for example, attendance at training, and active practising of religion. Qualitatively, three themes emerged: "Unsupported and Frustration"; "Taboo Subject Matter" and "Vulnerability and Access to Education". Staff reported a lack of service supports, dominant conservative cultures and people with an intellectual disability's vulnerability. CONCLUSION: This study highlights the need for improved service practices and enhanced provisions for staff and the people with an intellectual disability that they support.
Assuntos
Deficiência Intelectual , Atitude do Pessoal de Saúde , Humanos , Comportamento Sexual , Sexualidade , Inquéritos e QuestionáriosRESUMO
Compounds and products in the biocide and plant protection sector can only be registered after formal risk assessment to ensure safety for users and the environment. In bird and mammal risk assessment, this is routinely done using generic focal species as models, which are of particular exposure risk. Such a species is the common vole (Microtus arvalis) due to its high food intake relative to the low body weight. For wild species, biological samples, data and hence realistic exposure estimations are particularly difficult to obtain. In recent years, advances have been made in the techniques related to serial microsampling of laboratory mice and rats that allow for a reduction in sampling volumes. Similar progress in wild species sampling is missing. This study presents a proof of concept to dose wild rodents with relevant compounds and to draw serial, low volume blood samples suitable for state-of-the art toxicokinetic analyses. For the first time, the jugular vein of common voles was used to administer compounds (two frequently used fungicidal components). This procedure and the following microsampling of blood (2 × 10 µl six times within 24 hours) from the lateral tail vein did not affect body weight and mortality of voles. Samples were sufficient to detect dissipation patterns of the compounds from blood in toxicokinetic analysis. These results suggest that microsampling can be well translated from laboratory mice to wild rodent species and help to obtain realistic exposure estimates in wild rodents for ecotoxicological studies as well as to promote the 3R concept in studies with wild rodent species.
Assuntos
Arvicolinae/sangue , Coleta de Amostras Sanguíneas/métodos , Dioxóis/toxicidade , Ecotoxicologia/métodos , Exposição Ambiental/efeitos adversos , Monitoramento Ambiental/métodos , Fungicidas Industriais/toxicidade , Pirimidinas/toxicidade , Pirróis/toxicidade , Administração Intravenosa , Animais , Dioxóis/administração & dosagem , Dioxóis/sangue , Dioxóis/farmacocinética , Feminino , Fungicidas Industriais/administração & dosagem , Fungicidas Industriais/sangue , Fungicidas Industriais/farmacocinética , Masculino , Pirimidinas/administração & dosagem , Pirimidinas/sangue , Pirimidinas/farmacocinética , Pirróis/administração & dosagem , Pirróis/sangue , Pirróis/farmacocinética , Reprodutibilidade dos Testes , Medição de Risco , ToxicocinéticaRESUMO
We performed a retrospective (n = 121) and prospective (n = 305) verification of the Cepheid Xpert Flu assay to determine its performance characteristics. The overall sensitivity and specificity were 93% and 100%, respectively. Nasopharyngeal specimen sensitivities were 100% for seasonal influenza A/H1 virus and influenza A/H3 virus, 90% for influenza A/2009/H1N1 virus, and 95% for influenza B virus.
Assuntos
Vírus da Influenza A/isolamento & purificação , Vírus da Influenza B/isolamento & purificação , Influenza Humana/diagnóstico , Influenza Humana/virologia , Técnicas de Diagnóstico Molecular/métodos , Virologia/métodos , Humanos , Vírus da Influenza A/classificação , Vírus da Influenza B/classificação , Nasofaringe/virologia , Estudos Prospectivos , Estudos Retrospectivos , Sensibilidade e EspecificidadeRESUMO
BACKGROUND: Cancer cachexia is a syndrome of progressive weight loss. Non-small cell lung cancer patients experience a high incidence of cachexia of 61%. Research into methods to combat cancer cachexia in various tumour sites has recently progressed to the combination of agents.The combination of the anti-cachectic agent Eicosapentaenoic acid (EPA) and the cyclo-oxygenase-2 (COX-2) inhibitor celecoxib has been tested in a small study with some benefit. The use of progressive resistance training (PRT) followed by the oral ingestion of essential amino acids (EAA), have shown to be anabolic on skeletal muscle and acceptable in older adults and other cancer groups.The aim of this feasibility study is to evaluate whether a multi-targeted approach encompassing a resistance training and nutritional supplementation element is acceptable for lung cancer patients experiencing cancer cachexia. METHODS/DESIGN: Auckland's Cancer Cachexia evaluating Resistance Training (ACCeRT) is an open label, prospective, randomised controlled feasibility study with two parallel arms. All patients will be treated with EPA and the COX-2 inhibitor celecoxib on an outpatient basis at the study site. In the experimental group patients will participate in PRT twice a week, followed by the ingestion of essential amino acids high in leucine. A total of 21 patients are planned to be enrolled. Patients will be randomised using 1:2 ratio with 7 patients enrolled into the control arm, and 14 patients into the treatment arm. The primary endpoint is the acceptability of the above multi-targeted approach, determined by an acceptability questionnaire. DISCUSSION: To our knowledge ACCeRT offers for the first time the opportunity to investigate the effect of stimulating the anabolic skeletal muscle pathway with the use of PRT along with EAA alongside the combination of EPA and celecoxib in this population. TRIAL REGISTRATION: Netherlands Trial Register (NTR): ACTRN12611000870954.
Assuntos
Caquexia/terapia , Carcinoma Pulmonar de Células não Pequenas/complicações , Inibidores de Ciclo-Oxigenase 2/uso terapêutico , Ácido Eicosapentaenoico/uso terapêutico , Leucina/uso terapêutico , Neoplasias Pulmonares/complicações , Pirazóis/uso terapêutico , Treinamento Resistido , Sulfonamidas/uso terapêutico , Adulto , Aminoácidos Essenciais/uso terapêutico , Carcinoma Pulmonar de Células não Pequenas/terapia , Celecoxib , Terapia Combinada/métodos , Suplementos Nutricionais , Estudos de Viabilidade , Feminino , Humanos , Neoplasias Pulmonares/terapia , Masculino , Pessoa de Meia-Idade , Nova Zelândia , Satisfação do Paciente , Estudos ProspectivosRESUMO
Penicillin-binding protein (PBP) 2a latex agglutination was compared with conventional susceptibility testing and mecA real-time PCR for the detection of oxacillin resistance in Staphylococcus aureus. Inoculum volume and induction with oxacillin were PBP 2a testing variables. For coagulase-negative Staphylococcus, an increased inoculum volume of 10 microl greatly reduced the number of isolates requiring induction.