Nursing students’ reflections on an interprofessional placement in ambulatory care

Reflection has been identified as key to interprofessional education as it facilitates a focus on interprofessional communication, collaborative practice and professional roles, while contributing to debunking ingrained understandings of roles and behaviours. The aim of this study is to explore the written reflections of nursing students following an interprofessional placement in ambulatory care. A deductive analysis of nursing student reflective journal entries mapped against the university interprofessional framework was conducted. A purposeful sample of 19 graduate entry Master of Nursing Science students participating in a two-week interprofessional educational placement completed a reflective journal relating to an interprofessional placement in ambulatory care. The analysis of the journals found that all students were able to reflect on their interprofessional clinical experience, but the ability to reflect varied between students. Despite the challenges that some nursing students experienced in achieving deep levels of reflection, the study demonstrated the usefulness of incorporating reflective journals into nursing curriculums and as part of interprofessional practicums.     

Socio-Cultural Determinants of Physical Activity among Latin American Immigrant Women in Alberta,Canada

Acculturation has been associated with decreased physical activity among immigrants. This study assessed the process of changing physical activity patterns within the context of Latin American immigrant women’s migration experiences to Canada. Using the ecological model of health promotion, we applied a mixed methods research design. Thirty-six Latin American immigrant women, 18 recent (<10 years in Canada) and 18 non-recent (>10 years in Canada), participated. Six focus groups and 14 in-depth individual interviews were conducted. The Godin Leisure-Time Exercise Questionnaire was administered. Overall, 86 % of the participants reported gaining weight since coming to Canada. Participants reported becoming more sedentary upon arriving in Canada. Only 27.3 % of recent and 41.7 % of non-recent immigrant women were considered sufficiently physically active. Lack of time, resources, social support, and migration stress were identified as key barriers to physical activity. Migration stress associated with social integration barriers strongly influence physical activity among Latin American immigrant women.     

Similarity bias in credit decisions for entrepreneurs on the brink of bankruptcy

For entrepreneurs in financial distress, it is of vital importance that investors and bankers accurately assess the viability of their business, free of unwanted biases that bear no relevance to the assessment of the chance of survival. Despite the prevalence of entrepreneurs facing financial distress, little research has yet investigated the role of cognitive biases in funding decisions in this important context. The current research attends to this issue and investigated whether entrepreneurs who are perceived by a banker as more similar are more likely to receive capital to save their business from bankruptcy than entrepreneurs who are perceived as less similar to the banker. Additionally, we investigated whether similarity bias affected bankers' attributions of what caused the financial distress as well as their perceptions of entrepreneurs' trustworthiness. Using an experimental research design, we found a similarity bias in bankers' causal attributions and trustworthiness judgments, but not in their credit decisions. We contrast our findings with similarity bias research among equity investors and discuss the implications for theory and practice.     

Development of an Internet Intervention to Promote Wellbeing in College Students

Objective

While tertiary students commonly experience distress that substantially impacts functioning and performance, few seek help. Innovative strategies are needed to promote wellbeing and address this distress. The current article describes the development, acceptability testing, and use of an Internet intervention to promote student wellbeing and resilience—thedesk.

Method

Acceptability and useability of the program were evaluated by user analytics and focus groups.

Results

In the first 3.5 years, 118,000 individuals accessed the website and had 163,000 sessions averaging 5.3 min and 6.9 accessed pages. Users’ wellbeing scores were positively skewed, suggesting that the engaged content has broad relevance. While the percentage of people leaving the site after viewing the homepage was considered acceptable at 50%, there is significant room to improve engagement. Responses from consumer focus groups suggested high acceptability, perceived usability, and likely utility. Concerns included data security and, for international students, the need for greater direction on program use.

Conclusions

While further research is needed to evaluate the effects of thedesk on wellbeing and distress, the current results suggest that it provides highly accessible support that is well accepted by most tertiary students and has the potential for use as a stand‐alone intervention or, adjunctively, to increase the impact of other student support.     

The Impact of Community Mental Health Programs for Australian Youth: A Systematic Review

Australia has undergone significant youth mental health reform over the past 10 years, leading to numerous studies examining the effects of community-based mental health care programs for Australian youth. However, no synthesis of this literature currently exists. Therefore, this systematic review aimed to: (1) describe the types of community-based mental health programs that have been delivered to Australian youth in the past 10 years; and (2) examine their impact in improving young people’s mental health symptomology and psychosocial functioning. A systematic search of the peer-reviewed literature was conducted. Studies were included if they evaluated the extent to which such programs improved mental health symptomology (e.g., depression, anxiety, substance use) and/or psychosocial outcomes (e.g., social functioning, school engagement, employment) for Australian youth aged 10–25 years. Thirty-seven studies were included. Four types of community-based youth mental health care programs were identified: therapy (n?=?16), case management (n?=?9), integrated ‘one-stop-shop’ (n?=?6) and lifestyle (n?=?6) programs. The majority of therapeutic programs were effective in reducing mental health symptomology. Case management and integrated approaches consistently yielded significant improvements in both symptomology and psychosocial outcomes. Lifestyle programs were effective in alleviating depressive symptoms, but inconclusive for other outcomes. This review provides support for youth-friendly, systemic, multidisciplinary and integrated assertive outreach models of community mental health care to improve outcomes for young Australians experiencing mental health concerns. Several recommendations for future research are provided to strengthen the local evidence-base supporting community mental health programs to ultimately enhance young people’s life trajectory.

     

African Immigrant Parents’ Perspectives on the Factors Influencing Their Children’s Mental Health

Journal of Child and Family Studies - African immigrant children experience some of the poorest mental health outcomes in Canada, yet limited research has systematically mental health determinants...     

The validation of an active control intervention for Mindfulness Based Stress Reduction (MBSR)

Most of the extant literature investigating the health effects of mindfulness interventions relies on wait-list control comparisons. The current article specifies and validates an active control condition, the Health Enhancement Program (HEP), thus providing the foundation necessary for rigorous investigations of the relative efficacy of Mindfulness Based Stress Reduction (MBSR) and for testing mindfulness as an active ingredient. 63 participants were randomized to either MBSR (n = 31) or HEP (n = 32). Compared to HEP, MBSR led to reductions in thermal pain ratings in the mindfulness- but not the HEP-related instruction condition (η² = .18). There were significant improvements over time for general distress (η² = .09), anxiety (η² = .08), hostility (η² = .07), and medical symptoms (η² = .14), but no effects of intervention. Practice was not related to change. HEP is an active control condition for MBSR while remaining inert to mindfulness. These claims are supported by results from a pain task. Participant-reported outcomes (PROs) replicate previous improvements to well-being in MBSR, but indicate that MBSR is no more effective than a rigorous active control in improving these indices. These results emphasize the importance of using an active control condition like HEP in studies evaluating the effectiveness of MBSR.     

A preliminary exploration of predictors of outcome and cognitive mechanisms of change in cognitive behaviour therapy for psychosis in people not taking antipsychotic medication

BackgroundCognitive behaviour therapy (CBT) has been shown to be effective in an open trial for people with psychotic disorders who have not been taking antipsychotic medication. There is little known about predictors of outcome in CBT for psychosis and even less about hypothesised mechanisms of change.Method20 participants with schizophrenia spectrum disorders received CBT in an exploratory trial. Our primary outcome was psychiatric symptoms measured using the PANSS. Secondary outcomes were dimensions of hallucinations and delusions, self-rated recovery and social functioning, and hypothesised mechanisms of change included appraisals of psychotic experiences, dysfunctional attitudes and cognitive insight. We also measured patient characteristics that may be associated with outcome.ResultsT-tests revealed that several of the hypothesised mechanisms did significantly change over the treatment and follow-up periods. Correlational analyses showed that reductions in negative appraisals of psychotic experiences were related to improvements on outcome measures and that shorter duration of psychosis and younger age were associated with greater changes in symptoms.ConclusionsCBT based on a specific cognitive model appears to change the hypothesised cognitive mechanisms, and these changes are associated with good outcomes. CBT may be more effective for those who are younger with shorter histories of psychosis.     

Scaffolding a community of competent practitioners: positioning and agency in a training program for narrative counseling

This article explores the scaffolding of learning experiences in a postgraduate program in New Zealand that offers training in narrative counseling. The authors draw on positioning theory to identify student shifts in learning, and in agency, that help build an increasingly skilled and peer-generated context for learning. We describe a selection of exercises and one key assignment, introduced in the course in a particular order, that we believe enable students to step into positions of agency which ultimately allow a competent community of learner-practitioners to emerge. We also describe a dance of positioning for ourselves as teachers in this program. We suggest that, at any given time, our own positioning is tied up with possibilities for student positioning. Acknowledging relationships of power in classrooms, we explore ways to align poststructuralist counseling practices and the teaching of these practices.