Background Various parent training interventions have been shown to have some effect on the symptoms of children with autism. We carried out a systematic review and meta-analyses to assess effectiveness of parental training for children with autism on their symptoms and parental stress. Methods Four electronic databases, CINAHL, EMBASE, MEDLINE and PsycINFO were searched until March 2020 for relevant literature. Two reviewers independently screened bibliographies using an eligibility checklist and extracted data using a structured proforma. We have also carried out meta-analyses when data were available for pooling. Results Seventeen papers from 15 studies were included for data analysis. Fifteen papers showed a positive treatment effect when compared with the control group, although not always significant. Meta-analysis based on pooled data from only two studies in each respective intervention, showed small to moderate treatment effects for three interventions, DIR/Floortime, Pivotal Response and Parent focused training respectively. Conclusions As in previous systematic reviews there was a mild to moderate treatment effects of three specific types of interventions respectively. However, it was difficult to draw any definitive conclusion about the effectiveness and generalisability of any intervention because of the wide variation in the interventions, control groups, outcome measures, small sample size, small number of studies in meta-analysis, overlap between the intervention and control procedures used in the included studies. There is an urgent need for experts in various international centres to jointly standardise a parent training intervention for children with autism and carry out a large scale RCT to assess its clinical and economic effectiveness. Research Registry Unique Identifying Number: reviewregistry915.
As there are independent reports that alcohol dependence and antisocial personality pathology (particularly psychopathy) are associated with impaired face affect recognition, we examined the relationship between antisocial personality traits and face affect recognition in 23 detoxified inpatient alcohol abusers and 26 healthy controls. All participants were rated on the Antisocial Personality Questionnaire (APQ), and the alcohol abuse sample was rated on the Psychopathy Checklist: Screening Version. A computerized face affect recognition task was used to assess the six basic emotions. Overall, alcohol abusers were significantly worse than healthy controls at recognizing emotional facial expression, particularly anger and sadness. Recognition of disgust was negatively correlated with psychopathy (particularly the social deviance factor) and with several subscales of the impulsivity/ hostility factor on the APQ. Fear recognition was also negatively correlated with a number of APQ subscales within the impulsive/hostility factor. Our findings point to the importance of assessing co-morbid antisocial personality pathology in studies looking at face affect recognition deficits in substance abusers. The work also suggests that the interpersonal difficulties seen in some alcohol abusers may be related to impairments in emotional information that are primarily due to co-morbid personality pathology.
Purpose – Handover is essential to ensure high quality care. It is also a dynamic educational opportunity for trainee doctors. In the UK, the General Medical Council's annual training survey has repeatedly highlighted handover as a major concern in the training of doctors in psychiatry. The purpose of this paper is to evaluate the handover experiences for Core Trainees (years one to three) in psychiatry in the North Western Deanery (England). Design/methodology/approach – An online questionnaire focusing on current practice, safety and the educational aspects of handover was sent to all Core Trainees (years one to three) in psychiatry from the North Western Deanery in April 2013. The questionnaire had quantitative and qualitative elements and was analysed descriptively, with free text collated into themes by the authors. Findings – The survey was completed by 77.7 per cent of trainees, and indicated a wide variety in the structure of the handover process. There were no specific safety incidents but concerns regarding the handover of medical problems and handover from peripheral hospital sites. Trainees felt that handover was an important opportunity to learn, but in practice it had limited educational value. It is important to consider the robustness of handover in the context of the types of problems handed over, multiple sites and a lack of senior involvement. There also needs consideration as to how a high quality handover can be of educational value. Originality/value – This is the first report that evaluates clinical handover between Psychiatry trainee doctors in the UK which evaluates both a clinical and educational perspective.
BackgroundClinical handover is an important aspect of patient care and medical education, as identified by trainee surveys. There is a need for robust, standardised handover systems. Situation, Background, Assessment and Recommendation (SBAR) is a communication and empowerment tool for standardised communication in healthcare. The purpose of this study was to evaluate the educational impact of a simulation-based educational session in clinical handover for trainees in psychiatry, using SBAR.MethodA 3-hour session for trainees in psychiatry was designed with the North West Simulation Education Network and took place at the North Western Deanery School of Psychiatry. Presession and postsession questionnaires were completed, followed by a 6-week follow-up questionnaire.ResultsA significant improvement in participants' confidence and skills was demonstrated following the teaching session. Qualitative feedback also highlighted improved clinical application of the SBAR tool. Following the session, trainees reported an improvement in their appreciation of the role of other professionals in the handover process and a sense of empowerment when liaising with senior colleagues.ConclusionsThe training session potentially improved patient care by giving trainees structure, confidence and empowerment when talking to other colleagues while handing over. This may also help to meet the training requirements of the various Royal College curricula. This is the first study, to the best of our knowledge, which has evaluated a simulation session specifically designed to develop handover skills for trainees in psychiatry.
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