Handbook of Disabled Children's Childhoods: Building Understandings: Child, Youth, Family and Disability. Palgrave Macmillan:Disabled Children in Out-of-Home Care: Issues and Challenges for Practice Kelly, B., Sandra, D. & Winter, K. 2016

This chapter provides an overview of some of the key findings from a large mixed methods study regarding disabled children in care in Northern Ireland

Improving the wellbeing of staff who work in palliative care settings: a systematic review of psychosocial interventions

Background: Staff in palliative care settings perform emotionally demanding roles which may lead to psychological distress including stress and burnout. Therefore, interventions have been designed to address these occupational risks.

Aim: To investigate quantitative studies exploring the effectiveness of psychosocial interventions that attempt to improve psychological wellbeing of palliative care staff.

Design: A systematic review was conducted according to methodological guidance from UK Centre for Reviews and Dissemination.

Data sources: A search strategy was developed based on the initial scans of palliative care studies. Potentially eligible research articles were identified by searching the following databases: CINAHL, MEDLINE (Ovid), PsycINFO and Web of Science. Two reviewers independently screened studies against pre-set eligibility criteria. To assess quality, both researchers separately assessed the remaining studies using the Quality Assessment Tool for Quantitative Studies.

Results: A total of 1786 potentially eligible articles were identified – nine remained following screening and quality assessment. Study types included two randomised controlled trials, two non-randomised controlled trial designs, four one-group pre–post evaluations and one process evaluation. Studies took place in the United States and Canada (5), Europe (3) and Hong Kong (1). Interventions comprised a mixture of relaxation, education, support and cognitive training and targeted stress, fatigue, burnout, depression and satisfaction. The randomised controlled trial evaluations did not improve psychological wellbeing of palliative care staff. Only two of the quasi-experimental studies appeared to show improved staff wellbeing although these studies were methodologically weak.

Conclusion: There is an urgent need to address the lack of intervention development work and high-quality research in this area.

The OpenPMU Project: Challenges and perspectives:Challenges and Perspectives

The OpenPMU project is a platform for the development of Synchrophasor measurement technology, Phasor Measurement Units (PMU), in an open source manner. The project has now been operating for a number of years and has seen increased adoption at Universities and interest from electrical utilities. The OpenPMU device has recently been tested against the IEEE C37.118 standard and shown to operate within the specification. This paper discusses the OpenPMU project from the perspective of the past two years of experience and evaluates successes and opportunities for improvements in both the OpenPMU device and the philosophy of the design.

Minimising harm from alcohol misuse: Challenges to the development of effective policy

Successive substance misuse strategies in Northern Ireland and elsewhere have
been underpinned by the goal of minimising the harm accruing from the use of alcohol and other drugs. However, what it means for a person’s alcohol use to cause harm is an evolving concept. As the understanding of harm changes, the type of evidence needed to estimate the scale of harm and to evaluate the success of a given initiative changes also.
This paper does three things. We first highlight a recent model by Laslett and
colleagues for estimating the harm of one individual’s alcohol use to other individuals, the centrepiece of a report to the Alcohol Education and Research Foundation (AERF) in 2010. This model has been hugely influential in identifying areas where harms from alcohol use accrue and in attempting to quantify those harms (e.g. the cost of injuries inflicted during intoxication). We suggest three ways in which this model could be improved by accounting for: (a) the influence of one individual’s drinking on the drinking behaviour of their peers; (b) the level of use which triggers a given harm; and (c) the degree of time-lag in each of
the domains of harm.
Secondly, we explore specific challenges to developing effective policy on
adolescents’ drinking behaviours, drawing on research which specifically elicits the perspectives of young people on why they drink.
Thirdly, we examine the relative harms of allowing moderate levels of drinking
among mid-adolescents versus promoting zero use up until late adolescence.

Child-focused psychosocial interventions for anger and aggression in children under 12 years of age (Protocol)

This is the protocol for a review and there is no abstract. The objectives are as follows:

To evaluate the effectiveness of child-focused psychosocial interventions for anger and aggression in children under 12 years of age.

The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: An evidence synthesis

DESIGN We will address our research objectives by searching the published and unpublished literature and conducting an evidence synthesis of i) studies of the effectiveness of psychosocial interventions provided for children and adolescents who have suffered maltreatment, ii) economic evaluations of these interventions and iii) studies of their acceptability to children, adolescents and their carers. SEARCH STRATEGY: Evidence will be identified via electronic databases for health and allied health literature, social sciences and social welfare, education and other evidence based depositories, and economic databases. We will identify material generated by user-led,voluntary sector enquiry by searching the internet and browsing the websites of relevant UK government departments and charities. Additionally, studies will be identified via the bibliographies of retrieved articles/reviews; targeted author searches; forward citation searching. We will also use our extensive professional networks, and our planned consultations with key stakeholders and our study steering committee. Databases will be searched from inception to time of search. REVIEW STRATEGY Inclusion criteria: 1) Infants, children or adolescents who have experienced maltreatment between the ages of 0 17 years. 2) All psychosocial interventions available for maltreated children and adolescents, by any provider and in any setting, aiming to address the sequelae of any form of maltreatment, including fabricated illness. 3) For synthesis of evidence of effectiveness: all controlled studies in which psychosocial interventions are compared with no-treatment, treatment as usual, waitlist or other-treated controls. For a synthesis of evidence of acceptability we will include any design that asks participants for their views or provides data on non-participation. For decision-analytic modelling we may include uncontrolled studies. Primary and secondary outcomes will be confirmed in consultation with stakeholders. Provisional primary outcomes are psychological distress/mental health (particularly PTSD, depression and anxiety, self-harm); ii) behaviour; iii) social functioning; iv) cognitive / academic attainment, v) quality of life, and vi) costs. After studies that meet the inclusion criteria have been identified (independently by two reviewers), data will be extracted and risk of bias (RoB) assessed (independently by two reviewers) using the Cochrane Collaboration RoB Tool (effectiveness), quality hierarchies of data sources for economic analyses (cost-effectiveness) and the CASP tool for qualitative research (acceptability). Where interventions are similar and appropriate data are available (or can be obtained) evidence synthesis will be performed to pool the results. Where possible, we will explore the extent to which age, maltreatment history (including whether intra- or extra-familial), time since maltreatment, care setting (family / out-of-home care including foster care/residential), care history, and characteristics of intervention (type, setting, provider, duration) moderate the effects of psychosocial interventions. A synthesis of acceptability data will be undertaken, using a narrative approach to synthesis. A decision-analytic model will be constructed to compare the expected cost-effectiveness of the different types of intervention identified in the systematic review. We will also conduct a Value of information analysis if the data permit. EXPECTED OUTPUTS: A synthesis of the effectiveness and cost effectiveness of psychosocial interventions for maltreated children (taking into account age, maltreatment profile and setting) and their acceptability to key stakeholders.

Família e aconselhamento genético: o caso dos cancros hereditários

Os desenvolvimentos associados à medicina genómica e biologia molecular representam novas possibilidades no diagnóstico, tratamento e prevenção de doenças comuns, confrontando indivíduos e famílias com complexos desafios à integração da informação genética na gestão da saúde e nas suas vidas. Este estudo centra-se em famílias com suscetibilidade genética acrescida a cancros hereditários e pretende contribuir para o conhecimento da experiência individual e familiar do aconselhamento oncogenético, incluindo como pode ser contemplada no desenvolvimento de intervenções de apoio psicossocial e na organização dos cuidados de saúde na era (pós)genómica. O processo de investigação incorpora perspetivas da genética psicossocial e da teoria dos sistemas familiares. Engloba metodologias qualitativas de recolha e análise de dados, envolvendo indivíduos, famílias e profissionais de saúde num formato de investigação-ação participativa. Os principais resultados permitem: i) conceptualizar a experiência do aconselhamento oncogenético, através da caracterização das suas implicações instrumentais, emocionais, relacionais e desenvolvimentais para o indivíduo e sistema familiar; ii) conhecer o desenvolvimento, implementação e avaliação de um programa psicoeducativo multifamiliar, enquanto intervenção de apoio psicossocial a indivíduos com suscetibilidade acrescida a cancros hereditários e suas famílias; e iii) integrar a perspetiva dos profissionais de saúde quanto à incorporação de apoio psicossocial na provisão dos serviços oncogenéticos. As conclusões gerais sustentam a importância do aprofundamento da pesquisa sobre o funcionamento familiar face ao aconselhamento e risco oncogenético, e a incorporação de uma orientação familiar nesses serviços. As implicações decorrentes da suscetibilidade acrescida a doenças genéticas impõem uma discussão alargada aos vários agentes envolvidos no planeamento, provisão e utilização dos cuidados de saúde, no sentido do desenvolvimento de serviços atuantes no continuum biopsicossocial indivíduofamília- sistema de saúde-comunidade.

Challenges in mercury speciation and fractionation in soil and sediment

This investigation focused on the development, test and validation of methodologies for mercury fractionation and speciation in soil and sediment. After an exhaustive review of the literature, several methods were chosen and tested in well characterised soil and sediment samples. Sequential extraction procedures that divide mercury fractions according to their mobility and potential availability in the environment were investigated. The efficiency of different solvents for fractionation of mercury was evaluated, as well as the adequacy of different analytical instruments for quantification of mercury in the extracts. Kinetic experiments to establish the equilibrium time for mercury release from soil or sediment were also performed. It was found that in the studied areas, only a very small percentage of mercury is present as mobile species and that mobility is associated to higher aluminium and manganese contents, and that high contents of organic matter and sulfur result in mercury tightly bound to the matrix. Sandy soils tend to release mercury faster that clayey soils, and therefore, texture of soil or sediment has a strong influence on the mobility of mercury. It was also understood that analytical techniques for quantification of mercury need to be further developed, with lower quantification limits, particularly for mercury quantification of less concentrated fractions: water-soluble e exchangeable. Although the results provided a better understanding of the distribution of mercury in the sample, the complexity of the procedure limits its applicability and robustness. A proficiency-testing scheme targeting total mercury determination in soil, sediment, fish and human hair was organised in order to evaluate the consistency of results obtained by different laboratories, applying their routine methods to the same test samples. Additionally, single extractions by 1 mol L-1 ammonium acetate solution, 0.1 mol L-1 HCl and 0.1 mol L-1 CaCl2, as well as extraction of the organometallic fraction were proposed for soil; the last was also suggested for sediment and fish. This study was important to update the knowledge on analytical techniques that are being used for mercury quantification, the associated problems and sources of error, and to improve and standardize mercury extraction techniques, as well as to implement effective strategies for quality control in mercury determination. A different, “non chemical-like” method for mercury species identification was developed, optimised and validated, based on the thermo-desorption of the different mercury species. Compared to conventional extraction procedures, this method has advantages: it requires little to no sample treatment; a complete identification of species present is obtained in less than two hours; mercury losses are almost neglectable; can be considered “clean”, as no residues are produced; the worldwide comparison of results obtained is easier and reliable, an important step towards the validation of the method. Therefore, the main deliverables of this PhD thesis are an improved knowledge on analytical procedures for identification and quantification of mercury species in soils and sediments, as well as a better understanding of the factors controlling the behaviour of mercury in these matrices.

Dealing with uncertainty: challenges and possibilities for the early childhood profession

In many countries, strategies to further develop services and institutions for the education and care of young children are linked to a discourse on professionalism. Ambitious policy goals, it is argued, can only be achieved by a skilled and qualified workforce whose practice is guided by a professional body of knowledge. This article argues that the prevailing conceptualisation of the early childhood professional is constructed out of a particular, hierarchical mode of producing and applying expert knowledge that is not necessarily appropriate to professional practice in the field of early childhood education. However, it is highly effective and contributes to forming a professional habitus that contradicts the relational core of early childhood practice. Drawing on the conceptual framework of hermeneutics, the article explores an alternative paradigm of a relational, systemic professionalism that embraces openness and uncertainty, and encourages co‐construction of professional knowledges and practices. Research, in this frame of thinking, is understood as a dialogic activity of asking critical questions and creating understandings across differences, rather than producing evidence to direct practice.

Working with the complexities of adolescent mental health problems: applying Time‐limited Adolescent Psychodynamic Psychotherapy (TAPP)

This article discusses the application in a CAMHS setting of a distinctive intervention for adolescent mental health difficulties, Time‐limited Adolescent Psychodynamic Psychotherapy (TAPP). TAPP has been developed specifically for working with adolescents and the characteristic developmental and psychosocial complexities they present to mental health services. It is widely recognised that supporting the developmental process in adolescence is central to therapeutic interventions and the therapeutic aim of TAPP is to enable recovery of the capacity to meet developmental challenges. The key factors of TAPP are described, including the formulation and working with a developmental focus, the therapeutic stance, working with transference and counter‐transference, working with time limits, and the emphasis on engagement of adolescents in therapy in TAPP. The experiences of introducing and developing TAPP in the CAMHS service are discussed with two brief and one extended case examples and this leads to a discussion of the kinds of outcomes achieved. It is concluded that TAPP is a key and relevant intervention for adolescents in complex and vulnerable situations; further work will be undertaken to continue its application in these settings and to formally assess outcomes.

Advancements and Challenges towards a Collaborative Framework for 3D Tele-Immersive Social Networking

Social experiences realized through teleconferencing systems are still quite different from face to face meetings. The awareness that we are online and in a, to some extent, lesser real world are preventing us from really engaging and enjoying the event. Several reasons account for these differences and have been identified. We think it is now time to bridge these gaps and propose inspiring and innovative solutions in order to provide realistic, believable and engaging online experiences. We present a distributed and scalable framework named REVERIE that faces these challenges and provides a mix of these solutions. Applications built on top of the framework will be able to provide interactive, truly immersive, photo-realistic experiences to a multitude of users that for them will feel much more similar to having face to face meetings than the experience offered by conventional teleconferencing systems.