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This cross-sectional study investigated staff’s attitudes towards the use of mobile telepresence robots in long-term care (LTC) homes in western Canada. We drew on a Health Technology Assessment Core Model 3.0 to design a survey examining attitudes towards nine domains of mobile telepresence robots. Staff, including nurses, care staff, and managers, from two LTC homes were invited to participate. Statistical analysis of survey data from 181 participants revealed that overall, participants showed positive attitudes towards features and characteristics, self-efficacy on technology use, organizational aspects, clinical effectiveness, and residents and social aspects; neutral attitudes towards residents’ ability to use technology, and costs; and negative attitudes towards safety and privacy. Participants who disclosed their demographic backgrounds tended to exhibit more positive attitudes than participants who did not. Content analysis of textual data identified specific concerns and benefits of using the robots. We discuss options for implementing mobile telepresence robots in LTC.
To evaluate if fusion computed tomography–diffusion-weighted magnetic resonance imaging may have a role in the pre-operative assessment of congenital middle-ear cholesteatoma.
Methods
A retrospective chart review of surgically treated congenital middle-ear cholesteatoma patients over a 2-year timespan was conducted. Pre-operative staging was performed on computed tomography and fusion computed tomography–diffusion-weighted magnetic resonance imaging based on extension of the disease according to the ChOLE classification system and the Potsic classification system. Intra-operative staging was compared to imaging findings to evaluate accuracy of the two imaging modalities in predicting congenital middle-ear cholesteatoma extent.
Results
Computed tomography was able to correctly predict congenital middle-ear cholesteatoma extent in three out of six cases according to the ChOLE classification system, all of which were staged as Ch1a and Ch1b on pre-operative computed tomography. Cases in which computed tomography was not able correctly to determine congenital middle-ear cholesteatoma extent were staged as Ch3 on pre-operative computed tomography. Fusion scans correctly determined congenital middle-ear cholesteatoma extent in all cases according to the ChOLE classification.
Conclusions
Fusion computed tomography–diffusion-weighted magnetic resonance imaging may be helpful in cases of congenital middle-ear cholesteatoma where pre-operative computed tomography shows mastoid and antrum opacification, in which computed tomography alone may overestimate cholesteatoma extension beyond the level of the lateral semi-circular canal.
In this paper, we consider subgeometric (specifically, polynomial) ergodicity of univariate nonlinear autoregressions with autoregressive conditional heteroskedasticity (ARCH). The notion of subgeometric ergodicity was introduced in the Markov chain literature in the 1980s, and it means that the transition probability measures converge to the stationary measure at a rate slower than geometric; this rate is also closely related to the convergence rate of $\beta $-mixing coefficients. While the existing literature on subgeometrically ergodic autoregressions assumes a homoskedastic error term, this paper provides an extension to the case of conditionally heteroskedastic ARCH-type errors, considerably widening the scope of potential applications. Specifically, we consider suitably defined higher-order nonlinear autoregressions with possibly nonlinear ARCH errors and show that they are, under appropriate conditions, subgeometrically ergodic at a polynomial rate. An empirical example using energy sector volatility index data illustrates the use of subgeometrically ergodic AR–ARCH models.
How we adapt treatment algorithms to complex, clinically untested, difficult-to-engage patient groups without losing evidence base in everyday practice is a clinical challenge. Here we describe process and reasoning for fast, pragmatic, context-relevant and service-based adaptations of a group intervention for unaccompanied minor asylum seekers (UASC) arriving in Europe. We employed a distillation-matching model and deployment-focused process in a mixed-method, top-down (theory-driven) and bottom-up (participant-informed) approach. Prevalence of mental disorders amongst UASC is extremely high. They also represent a marginalised and hard-to-engage group with limited evidence for effective treatments.
Method:
Content and process adaptations followed four steps: (1) descriptive local group characterisation and theoretical formulation of problems; (2) initial adaptation of evidenced treatment, based on problem-to-component grid; (3) iterative adaptation using triangulated feedback; and (4) small-scale pilot evaluation.
Results:
Based on evidence and participant feedback, adaptations included minimising verbal demands, facilitating in-session inductive learning, fostering social connectedness via games, enhancing problem-solving skills, accounting for multi-traumatisation, uncertainty and deportation. Quantitative evaluation suggested improved feasibility, with increased attendance, low drop-out and symptom improvement on depression and trauma scores.
Conclusions:
By describing the principles under-pinning development of a group intervention for severely traumatised UASC, we contribute to the literature supporting dynamic adaptations of psychological interventions, without losing reference to evidence base. Complex and difficult-to-reach clinical groups are often those in most need of care, yet least researched and most affected by inequality of care. Pragmatic adaptations of proven programs are often necessary to increase feasibility.
Maternal perinatal depression (PND) and partnership problems have been identified to influence the development of later child adjustment difficulties. However, PND and partnership problems are closely linked which makes it difficult to draw conclusions about the exact transmission pathways. The aim of the present study was to investigate to what extent PND symptoms and partnership problems influence each other longitudinally and to examine the influence of their trajectories on child adjustment difficulties at the age of three. Analyses were based on publicly available data from the German family panel “pairfam”. N = 354 mothers were surveyed on depressive symptoms and partnership problems annually from pregnancy (T0) until child age three (T4). Child adjustment difficulties were assessed at age three. Results of latent change score modeling showed that partnership problems predicted change in PND symptoms at T0 and T3 while PND symptoms did not predict change in partnership problems. Child adjustment difficulties at age three were predicted by PND symptoms, but not by partnership problems. Partnership problems predicted externalizing, but not internalizing symptoms. Results underline the effects of family factors for the development of child adjustment difficulties and emphasize the importance of early interventions from pregnancy onwards
This article analyzes the print culture of the Black and multiethnic community known as L8 in the northern British city of Liverpool. Through a critique of printed materials, including newsletters, magazines, and pamphlets all written, produced and read within the locale, the author assesses the construction of a community that was at once imagined and lived. This print infrastructure facilitated a collective sense of L8 as a marker of identity and belonging in a city and a nation that otherwise often harbored racialized hostility to the residents’ economic and political interests. Such a commitment to the locale, the author asserts, became a key factor in organizing the collective action taken by the residents in the 1981 Toxteth protests. Before and after that event, the neighborhood's print culture served to justify to residents the reasons for taking violent action against the state. Equally, this source material highlights the fissures and divergences between neighbors in their deliberations over the definitions—and limitations—of such a community and its relation to the nation. The author thus offers new ways to think about Black British protest in close relation to the specific political and social dynamics of neighborhoods across Britain.
The rising prevalence of mental illness among youth has underscored the critical need for proficient therapists trained in effective methods for treating prevalent mental disorders. As mental health services grapple with resource constraints, the demand for shorter training programs has increased. This study aimed to investigate whether therapist competence improves continuously over a two-year cognitive behavioural therapy (CBT) training course, whether specific CBT skills show greater improvement than generic skills, and whether self-perceived competence varies based on therapist characteristics. Data were gathered from seven different CBT training courses spanning the years 2013–2021 involving a total of 151 Norwegian therapists. Therapist self-assessed their CBT competence using the Cognitive Therapy and Adherence Scale (CTACS). The collected data were analysed using mixed effects models using the R program. The findings revealed a significant increase in self-reported competence throughout the two-year training period. Notably, skills related to case formulation and CBT techniques displayed the most substantial improvements, indicating a high level of competence attained by the conclusion of training. No significant interactions were identified between time and therapist characteristics. The outcomes of this study support the efficacy of in-depth training through an extended CBT course spanning multiple semesters. The observed progress in CBT skills suggests that investments in therapist training can yield high levels of competence. Furthermore, this investment appears warranted regardless of therapists’ individual characteristics.
Key learning aims
(1) To gain insight into the differential development of generic and CBT specific competence during CBT training.
(2) To reflect on the significance of therapist characteristics in the training process.
(3) To reflect on the possible importance of reaching a high level of CBT competence during CBT training.