Design and implementation of the child and adolescent psychoanalytic psychotherapy training programme by the International Psychotherapy Institute for Jiandanxinli

The author describes how her interest in China and Chinese families led her to direct an online two-year programme for training Chinese therapists in child and adolescent psychoanalytic psychotherapy. She sets her work in its social and professional context. She outlines the design and discusses modification in teaching technique to suit this educational setting, in which time must be allowed for translation from English to Chinese, and from conscious to unconscious. She illustrates a clinical case consultation group to show the group mind at work, and concludes with oral and written evaluation from participants.

Little Streamer: learning the unconscious symbolism of computer jargon

A Chinese student of psychoanalytic child therapy, Hu Fangjia (HF), presented to a small clinical case consultation group an obsessional thirteen-year-old boy who spoke of nothing but equipment for streaming video games. A Western small group consultant, Jill Savege Scharff (JSS), encouraged the bored group to consider the unconscious symbolism in the boy’s obsessive communication in order to sustain interest in understanding his experience of loss and neglect as the eldest living boy in his family.

Pelatihan Pembuatan E-Modul Menggunakan eXe-Learning di Lingkungan Lahan Basah

Masih banyak guru yang belum memahami tentang pembuatan e-modul. Selain itu juga belum banyak yang mengetahui mengenai aplikasi yang dapat digunakan dalam pembuatan e-modul. Hal ini melatarbelakangi dilakukan pelatihan pembuatan e-modul menggunakan eXe-learning di lingkungan lahan basah. Kegiatan pelatihan ini bertujuan untuk meningkatkan pemahaman para guru dalam membuat e-modul menggunakan eXe-learning di lingkungan lahan basah. Selain itu juga untuk mengetahui respon guru dalam mengikuti pelatihan. Peserta pelatihan ini ialah 23 orang guru kelompok Musyawarah Guru Mata Pelajaran (MGMP) Kimia di Kabupaten Hulu Sungai Utara (HSU). Kegiatan pelatihan dilaksanakan melalui metode ceramah, diskusi dan praktik secara langsung dalam membuat e-modul dengan menggunakan eXe-learning. Berdasarkan hasil pelatihan diperoleh bahwa terjadi peningkatan pemahaman guru tentang pembuatan e-modul menggunakan eXe-learnig dan respon guru terhadap kegiatan pelatihan minimal memiiki kategori baik. Pelatihan ini dapat meningkatkan pemahaman guru tentang pembuatan e-modul menggunakan eXe-learning. Produk e-modul yang dihasilkan dapat digunakan dalam membantu proses pembelajaran. There are still many teachers who do not understand about making e-modules. In addition, not many people know about applications that can be used in making e-modules. So that training on making e-modules using eXe-learning is carried out in a wetland environment. This training activity aims to improve teachers' understanding of making e-modules using eXe-learning in a wetland environment. In addition, to find out the teacher's response in participating in the training. The training participants were 23 teachers of the Chemistry Subject Teacher Consultation Group (MGMP) in Hulu Sungai Utara (HSU) District. Training activities are carried out through lectures, discussions and direct practice in e-modules using eXe-learning. Based on the training results, it was found that there was an increase in teachers' understanding of making e-modules using eXe-learning, and the teacher's response to training activities had at least a good category. This training can improve teachers' understanding of making e-modules using eXe-learning. The resulting e-module product can be used to assist the learning process.

Learning From Each Other in the Management of Natural Disaster and COVID-19 Pandemic: A Case Study in Taiwan

In response to the COVID-19 pandemic, Taiwan has been one of the best performers in the world with extremely low infections and deaths. This success can be attributed to the long experiences dealing with natural disasters and communicable diseases. However, with different disastrous characteristics, the disaster management systems for communicable diseases and natural disasters are very different in terms of laws, plans, frameworks, and emergency operations. Taking the response to COVID-19 pandemic as a study subject, we found that disaster management for communicable diseases can be improved through a comparison with natural disasters, and vice versa. First, having wider and longer impacts than natural disasters, the plans and framework for communicable diseases in Taiwan focus more on national and regional scales. Local governments would need more capacity support including budgets and training to conduct investigations and quarantine during the COVID-19 pandemic. Second, for quick response, the emergency operation for communicable diseases was designed to be more flexible than that for natural disasters by giving the commander more authority to adjust to the circumstances. The commanding system requires a more objective consultation group to prevent arbitrary decisions against the COVID-19 pandemic. Finally, risk governance is important for communicable diseases as well as for natural disasters. Additional efforts should be made to enhance vulnerability assessment, disaster reduction, and risk communication for shaping responses and policies in an efficient and coordinating way.

PP298 Scottish Health Technologies Group (SHTG) Adaptations: Utilizing Other Agencies’ HTAs In Scotland

IntroductionHealth Technology Assessment (HTA) is an important but time-consuming process to inform decision-making. Following requests from stakeholders in Scotland to provide advice on technologies that had recently undergone HTA in other jurisdictions, SHTG recognized a gap in their ‘product menu’. Colleagues within the SHTG team devised a mechanism through which an original HTA could be adapted for Scotland, taking into account local contextual factors.MethodsSHTG Adaptations comprise the following: i) assessment of the original HTA using the EUnetHTA HTA Adaptation Toolkit and checklist; ii) draft Adaptation using the outcome of the assessment and contextual information for Scotland; iii) consultation group of relevant Scottish clinicians is provided with the original HTA and draft SHTG Adaptation; iv) modified Delphi approach (max. three rounds of questioning) is used to ascertain the relevance of the original HTA to Scotland; v) the Adaptation is submitted to SHTG Council for endorsement.ResultsSHTG Adaptations have a timeline of 2–3 months, three have been published since this product was launched. The process has run smoothly with excellent clinical engagement from across NHS Scotland. Key learning focusses on the role of the SHTG Council (i.e. appraisal committee) in this process and in handling of expert opinion of evidence which has already been appraised by another agency.ConclusionsThe SHTG Adaptation is a new product which offers a timely assessment and utilization of an HTA from another agency.

OP338 Involving Patients In Research: Early Consultation Of Women To Improve Study Design And Investigate Trial Acceptability

IntroductionGaining the perspective of patients is invaluable in the design, management and reporting of research. As part of the process of facilitating clinical research into the effectiveness of a digital colposcope in a cervical cancer pathway, patients were involved from the outset.MethodsUsing funding made available by a Public Involvement Fund, a patient consultation group was established. The group's initial discussions informed the design of a feasibility study and funding application, which was submitted to the UK National Institute of Health Research (NIHR). A Patient and Public Involvement (PPI) representative was recruited and along with the consultation group, contributed to the ethical approvals for the study. The Patient Information Sheet and Consent Form were reviewed by the patients, to ensure readability, understandability and accessibility. The patient questionnaires and interview topics that are part of the feasibility study were also developed in conjunction with the PPI group, to make sure that women's concerns are being addressed in the research design and protocols.ResultsThe PPI consultation group's contributions helped strengthen the funding application and funding for a feasibility study was granted as part of the NIHR's Research for Patient Benefit funding scheme. Part of the grant will be used for training and reimbursement for time spent for the PPI representative. Data collection for the study is due to commence in the summer of 2021. The PPI group will be consulted at the beginning and end of the data collection period and will contribute to the data analysis and dissemination of the research output, including a Plain English Summary.ConclusionsInvolving patients greatly amplified the quality of the funding and ethical applications and will continue to benefit the ongoing research. Resources were widely available within the researcher's University and also through UK-wide schemes. Such resources are crucial and should be encouraged as part of all clinical research.

Association between Cardiologist Consultation and Mortality of Stable Patients with Elevated Cardiac Troponin at Admission

Elevated cardiac troponin (cTn) showed associations with mortality even in stable patients, but management has not been established. We aimed to investigate whether consultation to cardiologists could reduce mortality of stable patients with cTn elevation at admission. We identified 1329 patients with elevated cTn level at hospitalization from outpatient clinic to any department other than cardiology or cardiac surgery between April 2010 and December 2018. The patients were divided into two groups according to cardiologist consultation at admission. For primary outcome, mortality during one year was compared in the crude and propensity-score-matched populations. In 1329 patients, 397 (29.9%) were consulted to cardiologists and 932 (70.1%) were not. Mortality during the first year was significantly lower in patients consulted to cardiologists compared with those who were not (9.8% vs. 14.2%; hazard ratio (HR), 0.50; 95% confidence interval (CI), 0.35–0.72; p < 0.001). After propensity-score matching, 324 patients were in the cardiologist consultation group and 560 patients were in the no cardiologist consultation group. One-year mortality was consistently lower in the cardiologist consultation group (10.5% vs. 14.6%; HR, 0.58; 95% CI, 0.39–0.86; p = 0.01). Cardiologist consultation may be associated with lower mortality in stable patients with cTn elevation at admission. Further studies are needed to identify effective management strategies for stable patients with elevated cTn.

The Impact of the COVID-19 Lockdown on Weight Loss and Body Composition in Subjects with Overweight and Obesity Participating in a Nationwide Weight-Loss Program: Impact of a Remote Consultation Follow-Up—The CO-RNPC Study

The aim of this study was to assess the impact of the nationwide total lockdown (LD) in France on weight loss and body composition modifications in subjects participating in a weight loss program and to evaluate the impact of remote consultations on participants’ adherence to the weight loss program. The CO-RNPC study was a prospective multicentre cohort study including participants undergoing a two to six months program. The rate of weight loss in kg/week was computed before (15 days), during (99 days) and after LD (15 days). In the 1550 completing participants, body weight decreased from 87.1 kg [IQR 77.0; 100.2] to 82.3 kg [72.1; 94.3] resulting in a difference of −4.79 kg [−4.48; −5.10] (p < 0.01), with a corresponding reduction in waist circumference by 4 cm ([0; 9], p < 0.01). The median weight loss was 4.4 kg [0.5; 9.4] in those who used remote consultations, and 1.4 kg [0.8; 5.7] in the no remote consultation group (p < 0.01). In this large prospective cohort, we observed that the rate of weight loss was reduced during LD. This reduction was counterbalanced in participants involved in a remote consultation follow-up with a dose-effect response based on the number of remote consultations.

Developing a model of best practice for teams managing crisis in people with dementia: A consensus approach

Background: Teams delivering crisis resolution services for people with dementia and their carers provide short-term interventions to prevent admission to acute care settings. There is great variation in these services across the UK. This article reports on a consensus process undertaken to devise a Best Practice Model and evaluation Tool for use with teams managing crisis in dementia. Methods: The Best Practice Model and Tool were developed over a three stage process: (i) Evidence gathering and generation of candidate standards (systematic review and scoping survey, interviews and focus groups); (ii) Prioritisation and selection of standards (consultation groups, a consensus conference and modified Delphi process); (iii) Refining and operationalising standards (consultation group and field-testing). Results: 165 candidate standards arose from the evidence gathering stage; were refined and reduced to 90 through a consultation group exercise; and then reduced to 50 during the consensus conference and weighted using a modified Delphi process. Standards were then operationalised through a clinical consultation group and field-tested with 11 crisis teams and 5 non-crisis teams. Scores ranged from 48-92/100. The median score for the crisis teams was 74.5 (range 67-92), and the median score for non-crisis teams was 60 (range 48-72).Conclusions: With further psychometric testing, this Best Practice Model and Tool will be ideal for the planning, improvement and national benchmarking of teams managing dementia crises in the future.