scholarly journals Is specialist registrar training in cognitive therapy effective?

1999 ◽  
Vol 23 (10) ◽  
pp. 603-607
Author(s):  
Steve Moorhead ◽  
Jan Scott
Keyword(s):  
Cognitive Therapy ◽  
Effect Size ◽  
Clinical Effectiveness ◽  
Drop Out ◽  
Specialist Registrar ◽  
Drop Out Rate ◽  
Psychometric Data ◽  
Cluster B Personality Disorders ◽  
Registrar Training ◽  
And Training

Aims and methodThis paper describes the characteristics and outcome of the first 20 patients seen by a newly appointed specialist registrar in cognitive therapy. The outcome of the first (cases 1–10) and second (cases 11–20) cohorts were evaluated to assess if training had any impact on clinical effectiveness.ResultsComorbidity was common, but more patients improved following the intervention (effect size=0.64–1.34). The 25% therapy drop-out rate was comparable with previously reported rates. Four out of five patients who dropped out had Cluster B personality disorders. The two cohorts showed similar baseline characteristics, but the second cohort showed improved outcome (effect size of training=0.89–1.04) and had a significantly shorter course of therapy (P=0.02).Clinical ImplicationsSpecialist registrar training in cognitive therapy provides experience in treating a wide variety of mental disorders. The routine collection and analysis of clinical and psychometric data helps identify training effectiveness and training needs. The data demonstrate that training was associated with improved patient outcomes.

scholarly journals Community gynaecology

2005 ◽  
Vol 4 (12) ◽  
pp. 345-346
Author(s):  
Cathy Tupper
Keyword(s):  
Primary Care ◽  
Family Planning ◽  
Clinical Effectiveness ◽  
Standards Of Care ◽  
Family Planning Services ◽  
Specialist Registrar ◽  
Level Training ◽  
Registrar Training ◽  
And Training

Community gynaecology is a new subspeciality within gynaecology and encompasses the disciplines of family planning and sexual health. Basic diploma level training is available for postgraduate trainees in primary care and gynaecology, but in addition there is now specialist registrar training over three years for consultant posts in community gynaecology. In addition, the Faculty of Family Planning (www.ffprhc.org.uk) sets and monitors standards and training in primary and secondary care arenas, maintains uniform standards of care with clinical effectiveness guidelines, and provides ongoing accred-itation. Cathy Tupper describes the evolving role of her subspeciality, which has kept many of the aspects of the former family planning services such as walk-in clinics and self-referrals that made the work so variable and the service so accessible.

scholarly journals Higher specialist training in child and adolescent psychiatry: a survey of academic programmes

2006 ◽  
Vol 30 (1) ◽  
pp. 19-23
Author(s):  
Tim Hawkins ◽  
Alison Lee ◽  
Helen Stephens ◽  
Gisa Matthies ◽  
Alison Bailey
Keyword(s):  
Teaching Methods ◽  
Postal Questionnaire ◽  
Child And Adolescent Psychiatry ◽  
Local Planning ◽  
Specialist Registrar ◽  
Protected Time ◽  
Active Involvement ◽  
Registrar Training ◽  
And Training ◽  
Academic Programme

Aims and MethodAcademic programmes are mandatory in child psychiatry specialist registrar training. A postal questionnaire survey was undertaken to explore the views of specialist registrars and academic programme coordinators identified nationally with regard to their local academic programme.ResultsSixty per cent of specialist registrars (152 out of 253) and 90% of coordinators (17 out of 19) responded. All schemes offered an academic programme with protected time. Teaching methods were diverse, and satisfaction varied within and between schemes, with trainees reporting greater satisfaction associated with active involvement of coordinators.Clinical ImplicationsThe authors provide recommendations for local planning of academic programmes. The authors request the assistance of CAPSAC in standardising the appointment and training of coordinators and facilitating their release from clinical commitments.

Why Are So Many Aboriginal Children Not Achieving At School ?

1991 ◽  
Vol 19 (2) ◽  
pp. 42-53 ◽  
Author(s):  
Jeff Guider
Keyword(s):  
Cultural Values ◽  
Aboriginal People ◽  
Task Force ◽  
Drop Out ◽  
Aboriginal Education ◽  
Beliefs And Practices ◽  
Drop Out Rate ◽  
Employment Education ◽  
Aboriginal Children ◽  
And Training

In 1988 the Aboriginal Education Policy Task Force called for broad equity between Aboriginal people and other Australians in access, participation, and outcomes at all stages of education. Aboriginals are not achieving a comparative level of success at school compared to non-Aboriginals. Symptomatic of problems in our schools are, the over representation of Aboriginals in lower classes, the high drop-out rate of Aboriginal children and their low participation rates in the senior years of high school. Some 17% of Aboriginal youth continue their schooling to year 12 compared to 49% of all students (Department of Employment, Education and Training, 1988, p.7). The failure of Aboriginal children to achieve at school has been widely interpreted as an individual failure on the part of Aboriginal children. Poor attainment has been attributed to lower I.Q. and ability, inadequate home environments, and poor parenting and not to the inadequacies of the education provided, to prejudices Aboriginal children face or to the active resistance by Aboriginal people to the cultural destruction implicit in many educational programs (McConnochie, 1982, p.20). An examination of the determinants of school success shows that Aboriginal children’s cultural values, beliefs and practices and Australian schools are often in conflict. To improve the outcomes for Aboriginal children schools are required to assess whether or not they are catering for the inherent needs and talents of individual Aboriginal children.

Entwicklung und Evaluation einer internetbasierten begleiteten Selbsthilfe-Intervention zur Bewältigung von Albträumen

2015 ◽  
Vol 63 (2) ◽  
pp. 117-124 ◽  
Author(s):  
Max Böckermann ◽  
Annika Gieselmann ◽  
Marjolijn Sorbi ◽  
Reinhard Pietrowsky
Keyword(s):  
Drop Out ◽  
Drop Out Rate

Hintergrund: Dieser Artikel beschreibt die Entwicklung eines internetbasierten begleiteten Selbsthilfetrainings (Albtraumcoach) zur Bewältigung von Albträumen, das innerhalb zweier Pilotstudien auf seine Durchführbarkeit und Anwendbarkeit getestet wurde. Methoden: Innerhalb eines neunstufigen Modells wird die Entwicklung der Intervention beschrieben. Dabei wird neben der wissenschaftlichen Evidenz, die die Basis für die Intervention bildet, auf technische, ethische, datenschutzrechtliche und weitere spezifische Maßnahmen innerhalb der Interventionsentwicklung eingegangen. In zwei Pilotstudien evaluierten zudem 10 Personen mit schlechten Träumen in der Vergangenheit die Durchführbarkeit (Studie 1) und 12 Personen mit wiederkehrenden Albträumen die Anwendbarkeit sowie den Nutzen der Intervention (Studie 2). Abhängige Variablen waren die Qualität der einzelnen Sitzungen, die Zufriedenheit mit der Intervention sowie Albtraumfrequenz, Albtraumbelastung, Schlafqualität und Depressivität. Ergebnisse und Diskussion: Die Durchführbarkeit und Anwendbarkeit des Trainings wurden positiv beurteilt. Während die Drop-out-Rate verhältnismäßig hoch war, ergaben sich erste, zurückhaltend zu beurteilende, Hinweise für einen Nutzen der Intervention.

Ohrakupunktur in der Therapie alkohol- und substanzbezogener Störungen – eine Übersicht

2004 ◽  
Vol 50 (3) ◽  
pp. 196-203 ◽  
Author(s):  
Stephanie Kunz ◽  
Michael Schulz ◽  
Gabriele Syrbe ◽  
Martin Driessen
Keyword(s):  
Drop Out ◽  
Randomisierte Kontrollierte Studien ◽  
Drop Out Rate ◽  
Kontrollierte Studien ◽  
Methodische Qualität

<B>Fragestellung:</B> Lässt die wissenschaftliche Datenlage positive Behandlungseffekte durch Ohrakupunktur in der Entzugsbehandlung von Alkohol- und Opiatabhängigen erwarten? </P><P> <B>Methodik:</B> Die im Rahmen der Recherche gefundenen Studien bezogen sich auf den Entzug von Alkohol (sechs) und von Kokain und Opiaten (acht). Die Studien wurden auf ihre methodische Qualität hin überprüft. </P><P> <B>Ergebnisse:</B> Es konnten 14 randomisierte kontrollierte Studien (RCT) zu Ohrakupunktur in der Behandlung von Alkohol- und Opiatabhängigkeit identifiziert werden. Dabei weisen die meisten Studien methodische Mängel auf. Ein Vergleich der Studien ist aufgrund unterschiedlicher Paradigmen kaum möglich, die Drop Out Rate liegt häufig über 20%. </P><P> <B>Schlussfolgerung:</B> Insgesamt reicht die verfügbare wissenschaftliche Datenlage nicht aus, um eine positive Wirkung der Akupunktur bei substanzbezogenen Störungen als gesichert anzunehmen.

Effectiveness of Classification Measures in Predicting Achievement in the Israel Defence Forces - Fitness Instruction Trainers Courses as a Case Study

2012 ◽  
Vol 21 (5-6) ◽  
pp. 145-172
Author(s):  
Yair Galily ◽  
Orly Kayam ◽  
Michael Bar-Eli
Keyword(s):  
Training System ◽  
Drop Out ◽  
Validity And Reliability ◽  
Screening Process ◽  
Training Course ◽  
Drop Out Rate ◽  
Army Service ◽  
Israeli Army ◽  
Israel Defense Forces

Abstract Human resources are the most crucial element in the selection of suitable fitness instruction trainers (FIT) and the results of the screening process impact greatly on the entire physical training system in the Israeli army, both in the short-term and the long-term (potential officers, young officers and developing and veteran officers). The aim of the current study is to examine the effectiveness, validity and reliability of the screening process for acceptance to the female fitness instructors training course in the Israel Defense Forces (IDF). The screening process aims to identify those that are most suitable from a large pool of candidates, in order to ensure the highest possible level of candidates and the lowest possible drop-out rate from the training course and subsequent army service. The paper examines the reliability of the classification exam currently administered in the course and its validity in predicting those candidates who will succeed in the course and in their assignments afterwards. The sample is based on a data analysis of nine screening dates over three years (three each year). The evaluation of validity is based on the relationship between the course entrance exam grades (administered a year before enlistment), exam grades at the beginning of the course and additional data relating to success in the field.

scholarly journals Potential Virus Involvement in Alzheimer’s Disease: Results from a Phase IIa Trial Evaluating Apovir, an Antiviral Drug Combination

2021 ◽  
pp. 1-19
Author(s):  
Nina Lindblom ◽  
Lars Lindquist ◽  
Jacob Westman ◽  
Mikael Åström ◽  
Roger Bullock ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cerebrospinal Fluid ◽  
Drug Combination ◽  
Antiviral Treatment ◽  
Antiviral Drug ◽  
Disease Process ◽  
Drop Out ◽  
Large Drop ◽  
Drop Out Rate

Background: Accumulating data suggest infectious agents are involved in Alzheimer’s disease (AD). The two primary aims of this trial were to assess safety and efficacy of an antiviral drug combination on AD progression. Objective: The trial evaluated whether Apovir, a combination of two antiviral agents, pleconaril (active on enteroviruses) and ribavirin (active on several viruses), could slow AD progression. Methods: Sixty-nine patients 60–85 years were treated with Apovir or placebo for 9 months and followed until 12 months after end of treatment. Cognitive tests, safety, biomarkers, drug plasma, and cerebrospinal fluid concentrations were assessed. Results: The tolerability of Apovir was compromised as demonstrated by the large drop-out rate and increased frequency and severity of adverse events. The primary endpoint, demonstrating a difference in change from baseline to 9 months between groups in ADAS-cog total score, was not met (p = 0.1809). However, there were observations indicating potential effects on both ADAS-cog and CDR-SB but these effects need to be verified. Also, there was a decrease in cerebrospinal fluid amyloid-β in Apovir at 9 months (p = 0.0330) but no change in placebo. Conclusion: This was the first randomized, placebo controlled clinical trial exploring antiviral treatment on AD progression. The trial is considered inconclusive due to the large drop-out rate. New trials are needed to verify if the indications of effect observed can be confirmed and which component(s) in Apovir contributed to such effects. Pleconaril alone may be studied to improve the tolerability and to verify if enterovirus is involved in the disease process.

scholarly journals A novel preference-informed complementary trial (PICT) design for clinical trial research influenced by strong patient preferences

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Samina Ali ◽  
◽  
Gareth Hopkin ◽  
Naveen Poonai ◽  
Lawrence Richer ◽  
...  
Keyword(s):  
External Validity ◽  
Treatment Options ◽  
Internal Validity ◽  
Clinical Effectiveness ◽  
Drop Out ◽  
Innovative Design ◽  
Clinical Trial Research ◽  
Research Questions ◽  
Internal And External Validity ◽  
Treatment Population

Abstract Background Patients and their families often have preferences for medical care that relate to wider considerations beyond the clinical effectiveness of the proposed interventions. Traditionally, these preferences have not been adequately considered in research. Research questions where patients and families have strong preferences may not be appropriate for traditional randomized controlled trials (RCTs) due to threats to internal and external validity, as there may be high levels of drop-out and non-adherence or recruitment of a sample that is not representative of the treatment population. Several preference-informed designs have been developed to address problems with traditional RCTs, but these designs have their own limitations and may not be suitable for many research questions where strong preferences and opinions are present. Methods In this paper, we propose a novel and innovative preference-informed complementary trial (PICT) design which addresses key weaknesses with both traditional RCTs and available preference-informed designs. In the PICT design, complementary trials would be operated within a single study, and patients and/or families would be given the opportunity to choose between a trial with all treatment options available and a trial with treatment options that exclude the option which is subject to strong preferences. This approach would allow those with strong preferences to take part in research and would improve external validity through recruiting more representative populations and internal validity. Here we discuss the strengths and limitations of the PICT design and considerations for analysis and present a motivating example for the design based on the use of opioids for pain management for children with musculoskeletal injuries. Conclusions PICTs provide a novel and innovative design for clinical trials with more than two arms, which can address problems with existing preference-informed trial designs and enhance the ability of researchers to reflect shared decision-making in research as well as improving the validity of trials of topics with strong preferences.

scholarly journals Service Use, Drop-Out Rate and Clinical Outcomes: A Comparison Between High and Low Intensity Treatments in an IAPT Service

2014 ◽  
Vol 42 (6) ◽  
pp. 747-759 ◽  
Author(s):  
Stella W. Y. Chan ◽  
Malcolm Adams
Keyword(s):  
Clinical Outcomes ◽  
High Intensity ◽  
Recovery Rate ◽  
Service Use ◽  
Evaluation Study ◽  
Drop Out ◽  
Stepped Care ◽  
Depression And Anxiety ◽  
Low Intensity ◽  
Drop Out Rate

Background: The IAPT services provide high and low intensity psychological treatments for adults suffering from depression and anxiety disorders using a stepped care model. The latest national evaluation study reported an average recovery rate of 42%. However, this figure varied widely between services, with better outcomes associated with higher “step-up” rates between low and high intensity treatments. Aims: This study aimed to compare the two intensity groups in an IAPT service in Suffolk. Method: This study adopted a between groups design. A sample of 100 service users was randomly selected from the data collected from an IAPT service in Suffolk between May 2008 and February 2011. The treatment outcomes, drop-out rate, and other characteristics were compared between those who received high and low intensity treatments. Results: The high intensity group received, on average, more sessions and contact time. They received more CBT sessions and less guided self-help. There were no group differences in terms of the drop-out and appointment cancellation rates. Analyses on clinical outcomes suggested no group difference but demonstrated an overall recovery rate of 52.6% and significant reduction in both depression and anxiety symptoms. Conclusions: Despite methodological limitations, this study concludes that the service as a whole achieved above-average clinical outcomes. Further research building upon the current study in unpacking the relative strengths and weaknesses for the high and low intensity treatments would be beneficial for service delivery.

Attendance at a psychiatric day centre

1994 ◽  
Vol 11 (4) ◽  
pp. 180-182
Author(s):  
Gerry Lynch ◽  
Margaret McKee ◽  
Daniel M Brennan
Keyword(s):  
Service Quality ◽  
Psychotic Disorders ◽  
Drop Out ◽  
Satisfaction Survey ◽  
First Year ◽  
Service Utilisation ◽  
Diagnostic Data ◽  
Drop Out Rate ◽  
At Home

AbstractObjective: To examine the service utilisation of a newly opened psychiatric day centre. We wished to determine if different diagnostic groups had different perspectives of the day centre, and to see if the drop-out rate differed among clients with neurotic or psychotic disorders.Method: Demographic and diagnostic data was gathered for all clients referred in the first year of operation of the day centre. Those who defaulted from attendance were visited at home and asked to detail reasons for non-attendance. Those who continued to attend 16 months after the centre opened completed a satisfaction survey.Results: The drop-out rate was high for both clients with neurotic and psychotic disorders. Clients who continued to attend were very positive about the day centre. Both client groups saw the benefits of attendance in social rather than therapeutic terms.Conclusions: Consumer opinion may have a valuable part to play in overall measure,measurement of service quality, particularly if it includes the opinion of those who no longer use that service.

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