bluuebunny/crossref_metadata_2025 huggingface dataset:
To Determine the Efficacy of Suprachoroidal Triamcinolone Injection for the Treatment of Refractory Diabetic Macular Edema
Authors: Chandni Ayesha , Bhatti Sharfe Rehman , Khawer Fatima , Ijaz Maryam , Rafique Danish , Choudhry Tanveer Ahmed
Published: January 2023

Goal: To determine the safety and effectiveness of suprachoroidal triamcinolone injections (SCT) in refractory diabetic macular edema cases. Study Design: An Interventional case series. Place and Duration: In the Ophthalmology department of Allama Iqbal Memorial Teaching Hospital, Sialkot for six-months duration from January 2021 to June 2021 Methods: A total of 40 eyes from patients with type-I or II diabetes who were over the age of 18 years and were included. Inclusion criteria for the study included patients with treatment resistant central Diabetic Macular Edema of at least 320 um or above (as determined by Zeiss Cirrus HD-OCT) and a BCVA of equal to or less than 20/40. The central subfield thickness (CST), BCVA, and intraocular pressure (IOP) were all documented. Patients who had received suprachoroidal triamcinolone (SCTA) were monitored for 3-months and the similar clinical parameters were noted, and the findings were noted. Results: The results showed that 22 (55%) of the 40 patients were female and 18 (45%) were male. The 0.9± 0.22 was the mean log MAR BCVA and 612.89± 195.58 um was the mean pre-injection CST. In the first and third months, the mean post-injection CST was 308.59± 56.75um and 304.89± 54.29um, respectively. After injection at 1 and 3-months, the mean log MAR BCVA was 00.51± 0.3 and 0.36 ±0.20, correspondingly. At the first and third months, the results for pre- and post-injection CST were statistically significant (p value <0.00001). Conclusion: The reduction of refractory diabetic macular edema and improvement of macular thickness on OCT can both be accomplished safely and effectively using CST. Keywords: Central subfield thickness, suprachoroidal triamcinolone, diabetic macular edema.
Epidemiology of Different Types of Cancer in District Dera Ghazi Khan, Pakistan
Authors: Bano Saira , Sheraz Muhammad , Kaul Haiba , Tanveer Khuzeema , Zafar Zeenat , Azam Sheikh Muhammad , Arif Shumaila , Hassan Shoaib , Khan Mm
Published: January 2023

Aim: Cancer incidence are rising but its prevalence in District Dera Ghazi is not available on government or private level. Therefore, it is difficult to deal with cancer about its statistics and specific type prevalence. Our study was aimed to find the prevalence of cancer in various tehsils of Dera Ghazi Khan District, along with its trend from 2015 to 2021. Method:This was a cross-sectional study, conducted on cancer prevalence in three tehsils of Dera Ghazi Khan includes; DG Khan, Taunsa and Tribal area. A self-made questionnaire was used to assess the cancer prevalence in the form of;gender discrimination, prominent cancer types, number of death per year, number of cancer cases in various tehsils and number of live cancer patients and individuals survived. Results:Total 817 cancer patients were included in this study, 415 belong to Tribal area tehsil. Total 350 female cancer patients were reported in this study, 173 were affected by breast cancer and mostly of them belong to urban area. Breast, blood, liver, throat and stomach cancers were most prevalent in district. Highest proportion of cancer affected individuals were aged between 25 to 65 years. Cancer death rate was found to be in increasing order from 2015 (68) to 2020 (116). 2021 was recorded with 109 deaths. 157 cancer patients were under treatment and only 18 patients could have recovered from cancer in last 5 years. Conclusion:Cancer was highly prevalent in DG Khan especially in tribal area. Reason for high cancer prevalence might be presence of radioactive elements in environment, illiteracy and unavailability of cancer treatment and early diagnose center in DG Khan District. Keywords: Liver Cancer; Epidemiology; DG Khan; Breast Cancer; Colorectal Cancer
Diagnostic Accuracy of Triphasic CT in the Characterization of Incidental Focal Liver Lesions
Authors: Jabeen Farkhanda , Khail Natasha Khawaja , Mushtaq Riffat , Kalsoom Ume
Published: January 2023

Objectives: To determine the diagnostic accuracy of triphasic CT in the diagnosis of focal liver lesions as benign or malignant by using histopathology as the gold standard. Methods: This descriptive cross-sectional study was carried out at the diagnostic radiology department of the Pakistan Institute of Medical Sciences (P.I.M.S.) in Islamabad.110 individuals with localized liver lesions between the ages of 15 and 65 years and both genders were included. All of the study subjects were then undergoing triphasic CT scan of the liver. The CT findings were recorded as benign or malignant and correlated with histopathology findings. Data collection was done by using the self-structured proforma. Results: Patient’s mean age was 43.92 ± 12.87 years. Out of all, males were 68 (61.82%) and females were 42 (38.18%), with a female-to-male ratio of 1:1.6. Malignant lesions were 73 (66.36%) and 37 (33.54%) patients had benign lesions as per Triphasic CT diagnosis. Furthermore, in these 73 malignant cases, 67 cases were observed with malignant lesions and 6 cases had benign lesions on histopathology, while among the 37 CT cases of benign lesions, 8 cases had malignant lesions as per the histopathological diagnosis. Although triphasic CT showed 89.33% sensitivity and 82.86% specificity in the diagnosis of focal liver lesions by using histopathology as the gold standard. Conclusion: Triphasic CT was observed to be a non-invasive, accurate, and highly sensitive imaging technique in the diagnosis of focal liver lesions, whether (benign or malignant). Therefore, it can be used frequently to lower the number of pure diagnostic biopsies. Keywords: Malignant hepatic lesions, non-invasive, imaging modality, sensitivity
Lipid Profile Abnormalities among Patients with Diabetes Mellitus Type II, Presented at Tertiary Care Hospital
Authors: Memon Nadeem , Rani Shabnam , . Rajkumar , Singh Dolat , Memon Majida , Sadiq Muneer
Published: January 2023

Objective: To determine the lipid profile abnormalities among diabetes patients presented at tertiary care Hospital. Methods: This cross-sectionals study was done at medicine out patient’s department (OPD) at Muhammad Medical College Mirpur-Khas, from September 2020 to September 2021. Patients of type II diabetes mellitus, presented at medicine OPD, aged more than 40 years, diabetes duration more than three years and both genders were included. A five ml blood sample was obtained in fasting from each case and sent to the Hospital laboratory to assess the HbA1c and lipid profile. All the data was collected via a structured study proforma, and the analysis was done using SPSS version 20. RESULTS: In this study, 67 known diabetic patients were studied to observe the frequency of lipid profile abnormalities. Patient’s mean age was 51.64+10.32 years, mean BMI was 25.20+3.23 kg/m2 and mean Hba1c was 7.84+2.94%. Males were in majority 61.2% and females were 38.8%. Out of all 56.7% patients had lipid profile abnormalities. There was a positive correlation between hba1c and triglyceride level and a significant positive correlation between hba1c and total cholesterol level (r = 0.431, p = 0.001). Frequency of lipid profile abnormalities was statistically insignificant according to gender and duration of disease (p=>0.05). Conclusion: Lipid profile abnormalities were observed to be highly frequent among patients with type II diabetes mellitus. The early identification and treatment of dyslipidemia in individuals with DM seems to be a significant aspect of lowering the risk of DM-related morbidity and mortality. Keywords: Diabetes type II, lipid profile, Hba1c
Propofol's Effectiveness in Preventing Nausea and Vomiting Following ENT Procedures Performed Under General Anesthesia
Authors: Sifatullah Ambareen , Babar Abdullah , Haq Imran Ul , Khan Javed , Arif Navishta Sahar , Waheed Abdul
Published: January 2023

Objective: Evaluation of Propofol's effectiveness in preventing post-surgery nausea and vomiting after ENT operations performed under general anesthesia Study design: Observational study Sampling method: lottery system Study Place: Peshawar Methods: 70 patients between age 18-65, having elective ENT surgery under conventional general anesthesia were included in this observational. After the surgical procedure, the patients were given either 10 mg/kg of dexamethasone, or 0.5 mg/kg of propofol intravenously. For 24 hours after surgery, the patients were monitored for any instances of nausea and vomiting. Results: No significant variation in Mean ± S.D of age, gender, BMI, ASA categorization and type of surgery was observed in both dexamethasone and propofol group. A significant variation in surgery duration (p=0.031) and anesthesia time (0.001) was observed in both the groups. PONV was more common in the propofol group (70%) than in the dexamethasone group (40%), particularly in the first six hours after surgery. Practical implication: this study will help to determine the whether propofol is a better choice for preventing post-operative nausea and vomiting. Conclusion: Propofol was less efficient than dexamethasone in preventing PONV, necessitating less rescue antiemetic use. Keywords: ENT, Propofol, nausea, vomiting, post-surgery complication, dexamethasone, effectiveness
Prevalence of Dermatological Problems in Beta-Thalasemic Patients at Al-Khidmat Hospital, Peshawar
Authors: Awan Shahzad Rashid , Fahim Muhammad , Shaheen Saba , Qamar Naveed , Khattak Jamshida Iqbal , Khan Abdul Qayum
Published: January 2023

Background: Beta-thalassemia is the world's most prevalent single-gene disease with a reduction in the synthesis of hemoglobin b-chain. A lot of skins problems occur in thalassemia patients but, no study have been conducted in Pakistan to determine their prevalence. Objective: To determine the prevalence of dermatological problems in beta-thalasemic patients Methodology: This was cross sectional study carried out at the department of dermatology Al-Khidmat hospital Peshawar for a period of one year from August 2020 to August 2021. All the beta-thalassemia patients were examined for dermatological problems by a single expert dermatologist. All of the data was entered and analyzed by using the SPSS version 20 software. Results: Amongst 150 beta-thalasemic patients, 122 (81.33%) patients were observed with dermatological problems. The most frequent dermatological problem observed in our study was pruritus in 54 (36%) patients followed by xerosis in 34 (22.67%), urticaria in 30(20%), Pigmentary disorders in 33(22%) patient, freckles in 24(16%), tinea infections in 15(10%), pitriasis alba in 13 (8.67%) patients, scars in 13 (8.67%), hypersensitivity to deferoxamine pump in 12 (8%), herpes simplex in 12 (8%), Verruca vulgaris in 10 (6.67%), acne in 8 (5.33%) patients, miliaria in 8 (5.33%) while contact dermatitis was observed in 6(4%) of the patients. Conclusion: Our study concludes that dermatological problems are highly prevalent in beta-thalassemia patients with pruritus as the most common problem followed by xerosis. Keywords: Prevalence; Dermatological problems; Beta-thalasemia; Pruritus; Xerosis.
Prevalence and Antimicrobial Susceptibility Pattern of Enterobacteriaceae Isolated from Hospitals Wastewater
Authors: Rizwan Muhammad , Ullah Habib , Ayoub Anjala , Rehman Haris Abdul , Umar Muhammad , Qurban Aqsa , Aslam Muhammad , . Usama , Kausar Maria , Syed Aamna
Published: January 2023

Background: Hospital wastewater (HWW) is bearing in mind the main root to proliferate multidrug-resistant among the Enterobacteriaceae family. Enterobacteriaceae is suited to be a considerable risk for antibiotic-resistant through CTX-M production which is observed as an important factor leading to multiple drug-resistant. Study Design: A total of 100 samples of HWW and community wastewater were collected aseptically. Samples were sub-cultured through basic, selective, and UTI Chrome agar. Place of the study: This research was conducted in the Postgraduate Research Laboratory of the Department of Microbiology, Government College University Faisalabad. Duration of the study: The duration of the study was started from September 2018 to May 2019. Methodology: Bacteria were identified based on cultural characteristics and different biochemical tests. Antimicrobial susceptibility testing was performed as per CLSI 2016 guidelines. The molecular characterization of the CTX-M was done bt PCR to present its association with multidrug-resistant. Results: Among the total 165 isolates, the predominant bacteria were E.coli (48.1%) followed by K. pneumonia (25.3%), Shigella species (8.0%), and P.aeruginosa (12.7%) from hospital wastewater while E.coli (30.3%) followed by K. pneumonia (32.6%), Shigella species (20.9%) and P.aeruginosa (11.6%) were isolated from community wastewater. The AST of CTX-M producers and Non-CTX-M producers was also compared to find the relation of CTX-M to multidrug-resistant. Tigecycline was observed as a predominant resistant (≥96%) antibiotic followed by meropenem (≥40%) against all isolated CTX-M producers. Conclusion: The conclusion represented the existence of MDR Enterobacteriaceae in untreated hospital wastewater. All efforts revealed realize the requisite that hospital wastewater should be treated with standard treatment plants before exposing it to community wastewater. Keywords: Hospital wastewater; Antibiotic Resistance genes; CTX-M producers; Urinary Tract Infection (UTI),Enterobacteriaceae
KEEFEKTIFAN MODEL WORD SQUARE (KOTAK KATA) TERHADAP KEMAMPUAN MEMBACA PEMAHAMAN SISWA KELAS VII SMP PATRA MANDIRI 1 PLAJU
Authors: Armi Antasari  , Rio Septora
Published: January 2023

Penelitian ini bertujuan untuk mengetahui efektif atau tidaknya model Word Square (Kotak Kata) terhadap kemampuan membaca pemahaman siswa kelas VII SMP Patra Mandiri 1 Plaju. Mode Word Square Menurut Laurence Urdang dikutip Jamaluddin Kidung yaitu sejumlah kata yang disusun satu di bawah yang lain dalam bentuk bujur sangkar dan dibaca secara mendatar dan menurun. Metode penelitian yang digunakan adalah metode eksperimen semu. Teknik analisis data yang digunakan adalah dengan perhitungan uji-t dengan menggunakan SPSS 19. Taraf signifikansi 95% (α = 0,025). Hasil penelitian telah menunjukkan bahwa terdapat perbedaan hasil tes antara kelas kontrol dengan kelas eksperimen. Nilai rata-rata tes awal (pretest) memebaca pemahaman kelas eksperimen 59,04 dan kelas kontrol 59,27. Nilai rata-rata tes akhir (postest) membaca pemahaman kelas eksperimen 74,52 dan kelas kontrol 68,41. Hal ini menunjukkan bahwa ada peningkatan kemampuan membaca pemahaman siswa kelas VII SMP Patra Mandiri 1 Plaju pada kelas eksperimen sebesar 15,48 poin. Hasil analisis data dengan uji-t membuktikan bahwa harga “t” perhitungan lebih besar dari harga “t” kritik pada taraf signifikansi 95% yaitu diperoleh t-hitung sebesar (2,205), sedangkan t-tabel sebesar (2,005). Dengan demikian, Ha yang berbunyi “Ada perbedaan kemampuan menulis puisi antara siswa yang diajar menggunakan model Word Square dengan siswa yang diajar menggunakan model konvensional (µ1 ≠ µ2)”  diterima. Dengan diterimanya Ha, maka dapat disimpulkan bahwa penerapan model Word Square dalam pembelajaran membaca pemahaman efektif.
Historical myopia and behaviourism in clinical psychology
Authors: Skelly Allan
Published: January 2023

This paper reflects on recent discussions of Positivism and Behaviourism in clinical psychology practice, considering their expression in specialist intellectual disability services. I describe relatively recent evidence of the ideological positivism inherent in behavioural practice and a simplistic understanding of behaviourism by its practitioners, which lacks subtlety or historical reflection on its own misuse.

‘We undertake to predict and control the behaviour of the individual organism.’

(Skinner, 1953, p.35).
A differential pathway into secure care: Compulsory care orders as a marker of elevated adverse childhood experiences (ACEs) in adolescents with a developmental disorder
Authors: Webb Elanor , Lamplough Hannah , Morris Deborah
Published: January 2023

This paper reports on the pathways into secure care for adolescents detained to an inpatient developmental disorder service. Findings highlighted differences in the demographic and clinical profiles and pre-admission histories of those who had been removed from the family home.
‘No one’s gonna tell your story better than you are’: The use of a narrative therapy approach informed by the Tree of Life with children and young people subject to sexual exploitation
Authors: Farooq Romana , Addy Chelsea , Smyth Gavin , Appiah Afua , Kennedy Patrick J.
Published: January 2023

Child sexual exploitation ‘is a form ofchild sexual abuse where an individual or group… manipulate… a child or young person under the age of18 into sexual activity … in exchange for something the victim needs or wants’ (Department for Education, 2017, p.5).

High numbers of cases of child sexual exploitation persists as a growing concern regionally and nationally in England and continues to provide systemic challenges when aiming to effectively reduce risk and harm in at-risk children and young people.

At present, ‘best practice fit’ routine interventions are used with children and young people subject to or at risk of sexual exploitation and although these can be effective at reducing harm in the short-term, few interventions have been developed which begin to promote long-term and sustainable positive change in the lives of children and young people (Countryma,n-Roswurm & DiLollo, 2017).

Here we outline the use of narrative therapy techniques with children and young people subject to sexual exploitation, in particular the Tree of Life Approa,ch (Ncube, 2006). The provision of a case example on the feasibility and acceptability of this narrative technique is discussed.

Keywords:Child sexual exploitation; narrative therapy; Tree of Life.
Staff involvement in Health and Social Care Teams: Exploration using a 4-dimensional model
Authors: Rauch Robert , Jordan Julie-Ann
Published: January 2023

Involvement has been identified as an important characteristic in enabling staff to develop, express, and act upon their ideas about improvement. We have employed an adapted 4-dimensional model to explore involvement across a large group of staff in psychological services.
Getting online quickly in the first Covid-19 lockdown: ‘Stress Control at Home’
Authors: White Kirsty , White Jim
Published: January 2023

In order to provide help to NHS, HSE and HSCNI services at the start of the Covid-19 lockdown, we offered online Stress Control classes, free-of-charge. These ran over three weeks in April. Due to its success, we repeated the classes in May.
Multidisciplinary care: Facilitating recovery from stroke
Authors: Obele Antonia , Myles Liam
Published: January 2023

Stroke affects one out of every six people and represents one of the main causes of severe, long-term disability across the globe. This article outlines the role of multidisciplinary teams in promoting recovery in individuals who have had a stroke.
A guided self-help intervention supporting mental health professionals’ decisions regarding sharing of lived experience
Authors: Scior Katrina , Evans Julie , Hildebrand Anna , Mills Harriet , Raeder Sophie , Smith Vivienne , Corrigan Patrick W. , Clements Henry
Published: January 2023

Mental health professionals with lived experience often experience heightened stigma and fear that their competency may be questioned. We present a new intervention (HOP-MHP) designed to support them in decisions about sharing their lived experience and preliminary results regarding the intervention’s acceptability and feasibility.
Reinventing the WHEEL: Developing a psychosocial screening tool in a paediatric psychology service
Authors: Evans Davy , Barker-Ellis Clare , Christopher J’nae , Perkins Matt
Published: January 2023

This article describes the development of the WHEEL: a tool to facilitate screening for psychological strengths and difficulties in children and young people living with a physical health condition accessing a paediatric psychology service.
Luta pela vida– The struggle for life
Authors: Indoe Derek
Published: January 2023

This paper is an introduction to the psychological perspective of the Indigenous people of Brazil, the violations of their human rights and what they perceive as ‘genocide’. From a world perspective the murdering of the best curators of the Amazon forest is perversely adding to the environmental crisis and climate change. Some prefer gold, and beef to the natural wonder of the Amazons. Pursuing monetary gains not only devalues but destroys both forest and humans, causing it to produce CO2instead of absorbing it, and a threat to the globe rather than mitigating disaster. The article touches on what psychology can offer to and learn from the Indigenous people and the need for more research.
The HCPC should support climate change activists, not question their fitness to practise
Authors: Cox Philip
Published: January 2023

Scientist-practitioner psychologists arrested at Extinction Rebellion events for non-violent civil disobedience, face prosecution for misconduct by the HCPC. Psychologists can self-organise to change the Fitness to Practise process and support the HCPC to become a leader regarding the climate emergency.
From practicing sustainably to becoming an activist psychiatrist
Authors: Shukla Kirsten
Published: January 2023

This account of the author’s development as a climate activist psychiatrist includes reflection on how psychiatry is contributing to the crisis and how both prescribing less and moving away from the medical model can be helpful responses to the crisis. It calls for psychiatrists to critically review their practise and mobilise for collective action on the climate and ecological crisis.
DCP Climate Change Champion – Changing our behaviour
Authors: Robertson Alison
Published: January 2023

Fàs a ghrunnd – airreir an uachdaraìn. (The yield of the ground will depend on the landlord).

Tha ‘n seillein fo dhion, thig gaillionn is sìan. (When the bees hide away, the summer is over).

(Nicolson, A. Ed. 2018)

Life and commuting to work on the Outer Hebrides has prompted greater reflection on sustainable travel and renewables. DCP Climate Change Champion reflects on what makes behaviour change more likely and what more should be done.
Bringing climate change into clinical psychology teaching
Authors: Walker Alice , Hewitt-Johns Lealah
Published: January 2023

In this article we bring together four stories about integrating teaching on climate change into Clinical Psychology Doctorate courses. We hope it provides tangible examples that may inspire others to ensure all trainees have opportunities to consider this critical topic during training.
Helping people and planet: Clinical psychology in a time of climate change
Authors: Rehling Joe
Published: January 2023

Drawing on recent qualitative research, this paper argues that increasing access to small-group, nature-based, ecologically-protective activities (i.e. green prescribing) constitutes the most direct and effective way for clinical psychology to help planet and people in a time of climate change.
Transposing stories of birthing something new; psychologists as activists in the pregnant pause before COP26
Authors: Johnson Rebecca
Published: January 2023

This article describesExtinction Rebellion (XR) Psychologists’project in which the metaphor of pregnancy and birth is used to articulate emotions associated with efforts to birth and subsequently sustain a new era of post-growth values for planetary health and habitability.
Service user and staff perspectives of the implementation of a trauma-informed assessment in an emotionally unstable personality disorder inpatient population
Authors: Reynolds Katharine , Holmes Jessica , Morris Deborah , Fox Emily
Published: January 2023

This paper explores service user and staff experiences of a diagnostic trauma assessment within an emotionally unstable personality disorder inpatient population. Findings highlight strengthened therapeutic relationships with minimal adverse effects and support the implementation of trauma-diagnostic assessments within inpatient settings.
What is useful to know as a psychologist working with deaf children in education?
Authors: Cryer Sarah
Published: January 2023

Key issues

It is beyond the scope of this article to cover all the complexities within deaf education in the detail they deserve and so I have outlined five aspects that I think it is useful to know about before working psychologically with a deaf child. For my paper I have chosen to use the term deaf which encompasses any level of hearing loss from profound to mild. I use the term child to encompass all children and young people aged between 0–25.
Reflections on involving Experts by Experience in interviews for the Doctorate in Clinical Psychology
Authors: Clarkson Lucy , Brooks Edmund , Hares Stephanie F. , Mitchell Emma , Roberts Eva
Published: January 2023

A discussion of the value of having Experts by Experience involved in interviews and assessments of trainees for the DClinPsy course at the University of Bath, especially in the context of digital interviewing due to the Covid-19 pandemic.
‘Making a small difference in a time of seismic change’
Authors: Denly Susannah , Marsden-Loftus Isaac , Dauhoo Farah
Published: January 2023

This article describes and reflects upon the experiences of offering psychological input to help support staff during a time of organisational change in response to the pandemic.
The effectiveness of an emotional regulation psychoeducation group, in promoting emotional regulation and addressing alexithymia in adult mental health
Authors: Brownless Briony , Scott Jennifer
Published: January 2023

The aim of this service evaluation was to evaluate the effectiveness of a psycho-educalion group intervention for clients presenting with emotion dysregulation difficulties within a secondary care adult community mental health setting. Following the seven-week intervention, individuals showed a significant improvement in emotion regulation, a significant reduction in alexithymia and an increase in overall wellbeing.
Evaluating the effectiveness of an online group programme to manage Multiple Sclerosis-related fatigue
Authors: Watts Kerry , Davenport Brittany , King Lorraine
Published: January 2023

Background and aim: A group-based fatigue management programme called FACETS has typically been delivered face-to-face to people living with MS within a neuropsychology service. In response to Covid-19 government guidelines, this service adapted to online delivery of their fatigue management group intervention. This study aims to evaluate two FACETS group interventions which were delivered online consecutively within this service. Methods: Group 1 was delivered face-to-face for the first three sessions before being adapted for virtual delivery for the final three sessions. Group 2 was delivered virtually for all six sessions. Quantitative data was collected from outcome measures collected pre -and post-group. Qualitative feedback was gathered to explore participants’ experience of the group as well as the adapted virtual delivery. A thematic analysis was undertaken to identify key themes.

Results: Participants in both groups felt they had more control over managing their fatigue and it was having less of an impact on their quality of life. Five themes were identified from participants’ qualitative feedback (knowledgeable content, awareness and learning, validating experience, accessible amendments, patient choice). Discussion: Feedback was largely positive from both groups following the adaptation to online delivery as it offered a cost- and time-effective solution. Participants reflected on the value of a mixed delivery option for future group interventions to facilitate rapport with other participants and empower self-management of their fatigue. Keywords: MS-related fatigue, online support, quality of life, patient choice.
The inside-out group: A mentalisation-based choose-your-own adventure
Authors: Bamford Lauren , Ennis Liam
Published: January 2023

This article describes the evaluation of a novel, single-session group intervention which was offered on an acute inpatient mental health unit. The intervention was based on the principles of Mentalisation Based Therapy. We called this intervention the inside out group.

In the group, attendees used their mentalising skills to discuss and decide on the course of action taken by characters in a fictional story. Hence we referred to the group as a ‘choose-your-own adventure’.

Our evaluation showed that attendees were less committed to critical, self-focused explanations for others’ actions after the intervention than they had been prior to the intervention. Our findings therefore suggest that Mentalisation Based Therapy principles can be successfully adapted to produce effective, short term talking treatments on acute inpatient mental health wards.
We want to lift the barriers facing people with learning disabilities
Authors: John Richie , Theodore Kate
Published: January 2023

Easy read summary

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We have written this together, to tell you a bit about our work.

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Since 2016, we have been teaching psychology trainees and students at universities, to help them understand the experiences of people with learning disabilities.

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We are sharing our work to help others to understand what we think is important for psychologists to know about when working with people with learning disabilities.
The ‘Coping with COVID-19’ Newsletter: People with learning disabilities share their stories through collective narrative documents
Authors: Grant Paula , Grieve Alice
Published: January 2023

We begin this article by reviewing some of the common discourses relating to people with learning disabilities across the Covid-19 pandemic. We then discuss some of the narratives that we have observed people with learning disabilities creating about themselves across the Covid-19 pandemic. We go on to discuss a project aimed at documenting some of these narratives. We reflect on the communication models and collective narrative practices used in the project as well as how these were adapted to meet the needs of people with learning disabilities. We conclude this article with reflections on the effects and outcomes of this project.
Adverse childhood experiences (ACEs) in young people who experienced sexual abuse
Authors: Russell Amanda , Eley David , McEwan Craig
Published: January 2023

Adverse Childhood Experiences (ACEs) have a wide range of negative outcomes including physical and mental health difficulties. Research shows the impact of ACEs are greater for those who face four or more traumatic events in their childhood, with strong associations between ACEs and sexual risk-taking, offending behaviour, and reduced education. It is likely those are at-risk of certain trauma, like sexual abuse, are more likely to have had other traumas as well. The current project screened through family assessments of young people involved in CSATS (Child Sexual Abuse Therapeutic Service) to look for all ACEs experienced by the cohort, as other factors could be contributing to difficulties for this group of young people. The CSATS cohort experiences more traumas during childhood than the general population, indicating a higher risk of physical and mental health difficulties. It was also found that the highest levels of trauma were between young people and their caregiver (parental substance use, mental health, separation, and domestic violence), indicating a lack of support from home. We also found higher levels of neurodiversity than in the general population. These results show a need to consider possible trauma during assessment and intervention while working with young people who have experienced sexual abuse to work with them in a more effective way. These results should be interpreted with caution due to possibility of underestimation of difficulties, however, is a good starting point to considering different ways we can work with the population served by CSATS.
Positive behaviour support training for managers of a learning disabilities social care provider
Authors: Durand Marianne , Hindmarsh Kelly
Published: January 2023

Managers of a learning disabilities care provider were trained in specific areas, as identified from self-assessment against the PBS Competence Framework (2015). Training the managers led to increased use of the principles of Active Support. It was reported that this in turn led to increased engagement and participation in activities of daily living for the service users. The managers assessed themselves as having made improvements in competencies on the PBS Competence Framework following the training. We therefore conclude that this method of training managers is a worthwhile supplement to training direct support workers in basic awareness of understanding behaviour / PBS. However, we believe that it was necessary that the provider was able to commit to making changes and doing the agreed tasks, and that all managers, including the director, attended all sessions to ensure that the agreed changes were implemented.
A historical reflection on prevention and public health
Authors: Brown Hayley
Published: January 2023

In this article I argue that for public health to be effective in preventing poor health outcomes we need to focus on reducing wider inequalities in society and take a collective approach to addressing health problems, rather than blaming individuals for making poor choices. We also need to consider the structure of our health systems and the role and funding of public health.
Preventing homelessness: Exploring the role of clinical psychology in adult mental health services
Authors: Yousefzadeh Hanna , Farquharson Lorna
Published: January 2023

This paper is based on the first author’s doctoral thesis, which explored the role of clinical psychology in the prevention of homelessness from the perspective of clinical psychologists working in adult mental health services. It includes consideration of current practice and the ways that the profession could contribute to the prevention of homelessness in the future.
Allowing for multiple stories of threats, meaning and ethnicity in The North of Ireland
Authors: Darcy Anne
Published: January 2023

A reflection on the complexities of anti-racist self-education from within divided white communities. The task of decolonising our understanding and interventions for trauma is both daunting and filled with opportunity. The Power Threat Meaning Framework is useful in reflecting on the systemic operation of racism and sectarianism and supporting the recovery of agency and self worth. Social change efforts towards a society that can increasingly hold multiple stories will have benefits for all.
Evaluation of an adapted form of CBT for young people with a diagnosis of Autism Spectrum Disorder (ASD) and anxiety
Authors: Jones Katy , Chapman Ashleigh , Edwards Polly , Cook Matt
Published: January 2023

Many children and young people with Autism Spectrum Disorder (ASD) experience varying levels of anxiety; in a review of 40 studies, White et al., (2009) reported that between 11 and 84 per cent of autistic children exhibited symptoms of anxiety. Cognitive Behavioural Therapy (CBT) is one approach that is used to address anxiety in autistic individuals. Autistic young people typically benefit from several adaptations to CBT as it is traditionally carried out. One such form of adapted CBT developed for autistic young people aged 12–14 is the exploring feelings work by Tony Attwood (Attwood, 2004). Families also had the opportunity to discuss their child’s ASD. For the purposes of this study, we used the Exploring Feelings for Anxiety workbook to provide six-eight sessions on an individual basis with young people and their parents. Researchers recruited participants that had received the exploring feelings sessions and had a pre-existing diagnosis of ASD. Eleven families took part in the research and contributed their feedback through a questionnaire developed by the service; including statements to rate as well as open-ended questions providing the opportunity for qualitative feedback. Data was transcribed, coded then analysed using a thematic analysis approach (Braun and Clarke, 2006). Results demonstrated several encouraging themes such as ‘others understanding the child better’ and ‘helpful strategies offered’. There are clear benefits for children and young people with ASD and their parents in receiving individual support. The researchers hope that future evaluations could provide a wider level of insight into children and young people’s experiences. Keywords: Autism Spectrum Disorder (ASD); anxiety; cognitive behavioural therapy (CBT); qualitative; evaluation.
‘Is it time to decolonise neuropsychology?’ Critical reflections on colonial structures, neuropsychology and the role of clinical psychologists
Authors: Abbas Sana , Farooq Romana
Published: January 2023

There is a longstanding history of psychological services being inaccessible for individuals from a racially minoritised background, including continuing to pathologise individuals from these communities (Fernando, 2010). There has been significant evidence that clinical psychology continues to perpetuate racism, discrimination, and marginalisation, with Pilgrim and Patel (2015) stating that clinical psychology remains ‘anything but for all’. A further exploration into the theory and practice of neuropsychology highlights a history of systematic and scientific racism which includes the inappropriate use of ‘race’ in neuropsychological assessment and testing to further marginalise, infantilise and create a narrative of individuals from racially minoritised backgrounds as ‘inferior’ (Hiermeier & Verity, 2022). In this article the authors explore the experiences of navigating neuropsychology as racially minoritised individuals. The authors reflect on their experiences of witnessing and navigating racism in the practice and application of neuropsychology. The paper also highlights that due to the significant evidence of scientific racism in neuropsychology that Whiteness, power, racism and colonisation should be a core and compulsory component of the training of clinical and neuropsychologists. As a result, there is a need to move away from centring conversations on equality, diversity and ‘cultural competence’ with a clear focus on equity, justice, Whiteness and racism.
Resilience – understanding staff needs
Authors: Stark Abbie , Dovey Laura , Jones Jimmy
Published: January 2023

Aims:The project aimed to explore how the system (e.g. the work environment and role) affects staff resilience and how the system could support staff resilience.

Background:Understanding factors impacting staff resilience and how staff can be supported is seen as important for improving staff wellbeing, increasing job satisfaction, staff retention and recruitment.

Methods:Fifteen female participants working as staff members on a dementia ward were recruited to complete a qualitative questionnaire about their resilience. All participants were of working age. Responses were transcribed and analysed using thematic analysis.

Results: Seven themes were identified from their responses as affecting resilience; staffing issues, staff stress, lack of support, not being listened to, not being valued, communication and feeling at risk. Staff also provided ideas for positive change and support that has previously been helpful which formed two additional themes. Recommendations and conclusions: Staff resilience was affected by different aspects of the system. Feedback suggested support that could be put in place to improve resilience such as drop-in sessions, debrief sessions and improved communication.
Therapeutic implications of the interactive cognitive sub-systems (ICS) model for people with dementia
Authors: James Ian A.
Published: January 2023

Recent theories of emotion inform us that therapists have too often focused exclusively on language and conscious cognitions as the mediating processes in producing effective change. This paper uses Teasdale’s Interactive Cognitive Sub-systems model (ICS) to account for the benefits often observed in approaches that do not focus mainly on language-based methods. It discusses the value of physical interventions (dance, exercise) and sensory therapies (massage, aromatherapy), explaining their mediating affects in terms of Teasdale’s ICS model.

The work discusses the model in terms of interventions for people with dementia, however, the discussion is applicable to many fields and disorders. Nevertheless, owing to the communication problems often observed in people with dementia, the work has particular relevance for those with aphasia and communication difficulties.
Loneliness and social isolation amongst older people in Mid-Devon: A new initiative
Authors: Bathurst Neil , Ward Christine
Published: January 2023

‘Interaction with the environment is as critical to thriving as a human being at the end of life as it is at the beginning.’Bowlby (1980)
The SPECAL approach in practice
Authors: Garner Penny
Published: January 2023

From a paper presented at the PSIGE Conference, 3 July 2001, at Keble College, Oxford
A qualitative investigation of the self-concept of older adults presenting with the symptoms of dementia
Authors: Reed Tracy
Published: January 2023

This study aimed to investigate whether older people recognise their symptoms of dementia and its impact on their self-concept. A cross sectional qualitative research paradigm was employed following the principles of Interpretative Phenomenological Analysis (IPA) and also drew upon Grounded Theory Methodology. The principles of content analysis were also employed to measure the participants’ recognition of their symptoms of dementia. Ten participants, five male and five female were recruited from four mental health services for older adults. The results indicate that participants spontaneously mentioned two or more symptoms of dementia and a further four or more with prompting. Themes and categories were generated from the data, namely the participants’ reactions to their symptoms of dementia, their management strategies and self-perceptions.
Voices of younger people with dementia
Authors: Whiting Susan
Published: January 2023

‘I don’t think I’m old enough to have this problem, that’s why I can’t come to terms with it. Very frightening to be told. One day working, next day in hospital. How is it different to older people? Too much to take in, so I can’t accept what’s happened. I want answers. I tell myself to accept it. How long will I be stable for? What will happen to me?(58-year-old lady diagnosed with fronto-temporal dementia for two years)
The role of cognitive measures in predicting decline in functional skills in dementia: A comparison of the MMSE and CAMCOG
Authors: Harborne Alexandra , Walker Zuzana , Clare Linda
Published: January 2023

Background:Psychosocial models of dementia suggest that functional decline does not correspond straightforwardly to the degree of cognitive impairment, and that it is related to both cognitive and non-cognitive factors.

Aims:The aims of this study were (1) to assess how much of the variance in functional skills could be accounted for by cognitive measures, and (2) to compare the predictive validity of two commonly used cognitive screening measures, the Mini Mental State Examination (MMSE), and the Cambridge Cognitive Examination (CAMCOG, which incorporates the MMSE within a longer screening assessment).

Participants:Participants were selected from a memory clinic database. Out of 281 entries, 45 met the criteria of having (1) full data on three measures at two time points, and (2) a diagnosis of dementia. The mean age of this group at baseline was 73.6 years; 22 participants were male and 73 per cent had a diagnosis of Alzheimer’s disease.

Measures: Cognitive assessment was undertaken at baseline, and functional skills were assessed one year later.

Results: Regression analyses indicated that cognitive measures significantly predicted approximately 40 per cent of the variance in performance of functional skills one year later. Both MMSE and the additional CAMCOG items not covered by the MMSE had independent effects on functional skills.

Conclusions: The results are discussed in terms of the importance of both cognitive and non-cognitive measures for predicting decline in functional skills, and the value of the CAMCOG over the MMSE in predicting decline.
Mild Cognitive Impairement (MCI): Age-related decline or an early stage of dementia?
Authors: Dimcovic Nada
Published: January 2023

Objective:One of the main tasks for a clinical psychologist, when faced with referrals for neuropsychological assessment, is to differentiate between cognitive decline due to old age and an early stage of dementia. Mild cognitive impairment, the most common initial diagnosis, is assumed to be a transitional phase through which some individuals evolve in the process of developing dementia.

Identifying dementia at an early stage is of considerable importance, given the fact that new pharmacological therapies have been made more accessible.

Background:The literature in the field is clearly growing. It is possible to identify population- based studies as opposed to studies based on clinical samples, as well as longitudinal as opposed to cross-sectional studies. The ‘clinical’ type studies investigate the most common forms of dementia, and provide a number of indicators that may help in clinical decision making. However, the clinician’s task remains to decide which ones, out of the numerous indicators, are those most relevant for decisions following assessment.

Method:This paper reviews 50 patients assessed between 1999 and 2002. They were all diagnosed as mild cognitive impairment at the time of referral. The full neuropsychological assessment was performed approximately six months later, with a prediction given for each individual as part of the neuropsychological report. Their condition was checked again in May/June 2003. At the time of follow-up the sample was split into ‘stable’ and ‘deteriorated’. Their age, education, IQ status and test results were analysed by one-way ANOVA using the SPSS. Additional analyses helped to find the association between their test results and outcome as well as between prediction and outcome.

Results:Significant differences between groups were found for IQ status, MMSE and MEAMS scores. Also, episodic memory (Story Recall and Rey Complex Figure (RCF) –Recall), letter fluency, two tests of visual-spatial/visual-constructional ability (RCF – Copy and Block Design) and one test of attention and executive function (Digits Backward) clearly differentiated ‘stable’ from ‘deteriorated’. Pearson’s chi-square revealed a significant association (p< .001) between prediction and outcome.

Conclusions:It was possible to differentiate between those who would remain stable and those who would deteriorate at the time when they were diagnosed as mild cognitive impairment. Screening procedures (MMSE and MEAMS) had moderate prediction power, whereas the full assessment, relying on more than one set of indicators, allowed a higher level of accuracy.