Development and psychometric evaluation of a new team effectiveness scale for all types of community adult mental health teams:a mixed-methods approach

Defining 'effectiveness' in the context of community mental health teams (CMHTs) has become increasingly difficult under the current pattern of provision required in National Health Service mental health services in England. The aim of this study was to establish the characteristics of multi-professional team working effectiveness in adult CMHTs to develop a new measure of CMHT effectiveness. The study was conducted between May and November 2010 and comprised two stages. Stage 1 used a formative evaluative approach based on the Productivity Measurement and Enhancement System to develop the scale with multiple stakeholder groups over a series of qualitative workshops held in various locations across England. Stage 2 analysed responses from a cross-sectional survey of 1500 members in 135 CMHTs from 11 Mental Health Trusts in England to determine the scale's psychometric properties. Based on an analysis of its structural validity and reliability, the resultant 20-item scale demonstrated good psychometric properties and captured one overall latent factor of CMHT effectiveness comprising seven dimensions: improved service user well-being, creative problem-solving, continuous care, inter-team working, respect between professionals, engagement with carers and therapeutic relationships with service users. The scale will be of significant value to CMHTs and healthcare commissioners both nationally and internationally for monitoring, evaluating and improving team functioning in practice.

Mental health pharmacists views on shared decision-making for antipsychotics in serious mental illness

Background People diagnosed with serious mental illnesses (SMIs) such as schizophrenia and bipolar affective disorder are frequently treated with antipsychotics. National guidance advises the use of shared decision-making (SDM) in antipsychotic prescribing. There is currently little data on the opinions of health professionals on the role of SDM. Objective To explore the views and experiences of UK mental health pharmacists regarding the use of SDM in antipsychotic prescribing in people diagnosed with SMI. Setting The study was conducted by interviewing secondary care mental health pharmacists in the UK to obtain qualitative data. Methods Semi-structured interviews were recorded. An inductive thematic analysis was conducted using the method of constant comparison. Main outcome measure Themes evolving from mental health pharmacists on SDM in relation to antipsychotic prescribing in people with SMI. Results Thirteen mental health pharmacists were interviewed. SDM was perceived to be linked to positive clinical outcomes including adherence, service user satisfaction and improved therapeutic relations. Despite more prescribers and service users supporting SDM, it was not seen as being practised as widely as it could be; this was attributed to a number of barriers, most predominantly issues surrounding service user’s lacking capacity to engage in SDM and time pressures on clinical staff. The need for greater effort to work around the issues, engage service users and adopt a more inter-professional approach was conveyed. Conclusion The mental health pharmacists support SDM for antipsychotic prescribing, believing that it improves outcomes. However, barriers are seen to limit implementation. More research is needed into overcoming the barriers and measuring the benefits of SDM, along with exploring a more inter-professional approach to SDM.

Avaliação de usabilidade em materiais interativos de ensino a distância da UFRN-SEDIS

This study aims to assess the usability of Interactive Materials developed for the courses offered by UFRN SEDIS the modality of distance education (DE), using the techniques of focus group cooperative evaluation and assessment of satisfaction. The Interactive Materials are intended to serve as an avenue where the course content reaches the student in an educational, stimulating and self-instructive enough for the student to engage and find no difficulty in using it so. After the survey data in this context were selected four Interactive Materials ("Introduction to Applied Calculus", "Science, Technology and Society", "studies the Semi-Arid" and "Cultural Geography") that adopt the framework established by UFRN for SEDIS be evaluated for their usability. Initially, a preliminary test was conducted from cooperative assessment with a student interacting with the four learning objects in order to reveal and map the major failures of usability, supporting deeper questions later. The recordings of this preliminary test were analyzed by a focus group composed of two graphic designers and two multimedia designers, and developers responsible for these objects, which helped to analyze the gap between "what was designed" and "as was used "structuring and supplementing the roadmap for cooperative evaluation and assessment of subsequent satisfaction. The cooperative evaluation was applied individually to ten students of undergraduate UFRN that tested each of the four materials. At the end, every student completed a questionnaire assessing satisfaction form adapted Wanted (Questionnaire for User Interaction Satisfaction). The analysis of the data collected in this study revealed positive, negative and notes to be considered to guide the future development of Interactive Materials, in the context of UFRN SEDIS, feedback to the process of design and evaluation with user participation

Design and protocol for the Focusing on Clozapine Unresponsive Symptoms (FOCUS) trial : a randomised controlled trial

Acknowledgements Thank you to all the participants who agreed to take part in the trial. This study was supported NHS Research Scotland (NRS), through Chief Scientist Office (CSO) and the Scottish Mental Health Research Network, and the Clinical Research Network-Mental Health. We are grateful to the Psychosis Research Unit (PRU) Service User Reference Group (SURG) for their consultation regarding the design of the study and contribution to the developments of study related materials. We are grateful to our Independent Trial Steering Committee and Independent Data Monitoring Committee for provided oversight of the trial. Funding This project was funded by the National Institute for Health Research Health Technology Assessment (NIHR HTA) programme (project number10/101/02) and will be published in full in Health Technology Assessment. Visit the HTA programme website for further project information. The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the HTA programme, NIHR, NHS or the Department of Health.

What's in the Numbers? Child Welfare Statistics and the Children (NI) Order

This article draws attention to the importance of routinely collected administrative data as an important source for understanding the characteristics of the Northern Ireland child welfare system as it has developed since the Children (Northern Ireland) Order 1995 became its legislative base. The article argues that the availability of such data is a strength of the Northern Ireland child welfare system and urges local politicians, lobbyists, researchers, policy-makers, operational managers, practitioners and service user groups to make more use of them. The main sources of administrative data are identified. Illustration of how these can be used to understand and to ask questions about the system is provided by considering some of the trends since the Children Order was enacted. The “protection” principle of the Children Order provides the focus for the illustration. The statistical trends considered relate to child protection referrals, investigations and registrations and to children and young people looked after under a range of court orders available to ensure their protection and well-being.

Staff training in autism: The one-eyed wo/man….

Having well-trained staff is key to ensuring good quality autism services, especially since people affected with autism generally tend to have higher support needs than other populations in terms of daily living as well as their mental and physical health. Poorly-trained staff can have detrimental effects on service provision and staff morale and can lead to staff burn-out as well as increased service user anxiety and stress. This paper reports on a survey with health, social care, and education staff who work within the statutory autism services sector in the UK that explored their knowledge and training with regards to autism. Interview data obtained from staff and service users offer qualitative illustrations of survey findings. Overall, the findings expose an acute lack of autism specific training that has detrimental impacts. At best this training was based on brief and very basic awareness raising rather than on in-depth understanding of issues related to autism or skills for evidence-based practice. Service users were concerned with the effects that lack of staff training had on the services they received. The paper concludes with a discussion of policy routes to achieving quality staff training based on international best practice. The focus is on improving the quality of life and mental health for services users and staff as well as making potentially significant cost-savings for governments.

The Family Model - A transgenerational approach to mental health in families: personal, clinical, educational, research, systems and policy perspectives

The Family Model – A transgenerational approach to mental health in families This workshop will provide an overview on The Family Model (TFM) and its use in promoting and facilitating a trans­generational family focus in Mental Health services, over the past 10­ - 15 years. Each of the speakers will address a different perspective, including service user/consumer, clinical practice, education & training, research and policy. Adrian Falkov (chair) will provide an overview of TFM to set the scene and a ‘policy to practice’ perspective, based on use of TFM in Australia. Author: Heide Lloyd. The Family Model ­ A personal (consumer/patient) perspective | United Kingdom Heide will provide a description of her experiences as a child, adult, parent & grandparent, using TFM as the structure around which to ‘weave’ her story and demonstrate how TFM has assisted her in understanding the impact of symptoms on her & family and how she has used it in her management of symptoms and recovery (personal perspective). The Family Model ­ Education & training perspective ­ Marie Diggins | United Kingdom PhD Bente Weimand | Norway Authors: ­ Marie Diggins | United Kingdom PhD Bente Weimand | Norway This combined (UK & Norwegian) presentation will cover historical background to TFM and its use in eLearning (the Social Care Institute for Excellence)and a number of other UK initiatives, together with a description of the postgraduate masters course at the University Oslo/Akershus, using TFM. The Family Model ­ A research perspective PhD Anne Grant | Northern Ireland Author: PhD Anne Grant | Ireland Anne Grant will describe how she used TFM as the theoretical framework for her PhD looking at family focused (nursing) practice in Ireland. The Family Model ­ A service systems perspective ­ Mary Donaghy | Northern Ireland Authors: PhD Adrian Falkov | Australia ­ Mary Donaghy | N Ireland Mary Donaghy will discuss how TFM has been used to support & facilitate a cross service ‘whole of system’ change program in Belfast (NI) to achieve improved family focused practice. She will demonstrate its utility in achieving a broader approach to service design, delivery and evaluation.

Fast and accurate hand pose detection for human-robot interaction

[EN]Enabling natural human-robot interaction using computer vision based applications requires fast and accurate hand detection. However, previous works in this field assume different constraints, like a limitation in the number of detected gestures, because hands are highly complex objects difficult to locate. This paper presents an approach which integrates temporal coherence cues and hand detection based on wrists using a cascade classifier. With this approach, we introduce three main contributions: (1) a transparent initialization mechanism without user participation for segmenting hands independently of their gesture, (2) a larger number of detected gestures as well as a faster training phase than previous cascade classifier based methods and (3) near real-time performance for hand pose detection in video streams.

Folksonomia: análise das tags no site Last.fm

A partir da web 2.0, com a maior participação do usuário, destaca-se a mudança nas mídias tradicionais, como rádio e televisão, que ganharam caráter social, permitindo a participação do público com algo mais além de só ouvir e ver, mas contribuir das mais diversas maneiras, dente elas está a folksonomia. Este trabalho teve como objetivo analisar as tags no site Last.fm por meio do modelo proposto por Sen et al. (2006) que as identifica em três categorias: fatuais, subjetivas e pessoais. Acredita-se que este estudo é importante para compreender como se dá a representação da informação em linguagem livre pelo usuário, assim como considera-se relevante a folksonomia como prática social, democrática e inclusiva que aproxima o usuário da informação. Como hipótese, considerou-se o predomínio de tags subjetivas. A pesquisa teve caráter descritivo-exploratória, e uma abordagem qualiquantitativa. A partir de uma pesquisa do IBOPE (2013), foram escolhidas 12 artistas e 12 músicas como amostra da pesquisa. Analisou-se 1109 tags, com os resultados: 759 (68%) fatuais; 232 (21%) subjetivas; 85 (8%) pessoais e 33 (3%) com tipologia não-identificada, desta maneira a hipótese de predomínio de tags subjetivas foi refutada. Como um desdobramento do modelo de Sen et al. (2006), distribuiu-se as tags em categorias descritivas, adaptadas do modelo de Laplante (2015), que mostraram que os gêneros/estilos musicais são predominantes da descrição dos itens. Conclui-se que mesmo com o predomínio de tags fatuais e de gêneros/estilos musicais, nem sempre a representação contida nessas etiquetas é fidedigna à realidade descritiva do item, contudo a folksonomia tem a contribuir com novos pontos de vista e de pensar uma informação.

Attachment Style, Therapeutic Alliance and Recovery in forensic mental health: the A-STAR study and clinical research portfolio

Background: Research suggests that forensic mental health services and staff can play an important role in the recognition and intervention with attachment-related behaviours to promote engagement and recovery. There is a lack of literature exploring whether the attachment needs of forensic service-users are recognised and, associations between attachment style and factors predictive of recovery. Aims: This study aimed to examine the extent to which service-users and keyworkers agree about service-users’ attachment and to identify whether attachment was associated with service attachment, working alliance, ward climate and recovery. Methods: Twenty-two service-users from low and medium secure forensic services, completed questionnaire measures of their attachment style, service attachment, working alliance, ward climate and experiences of recovery. Nineteen keyworkers completed measures of the service-users attachment style and working alliance. Results: There was strong agreement between service-users and staff for attachment anxiety (ICC=0.71) but poor agreement for attachment avoidance (ICC=0.39). Service attachment was associated with more positive perceptions of staff support (r=0.49) and avoidant attachment was associated with lower ratings of recovery (r=-0.51). Correlations between attachment style and service attachment, working alliance and ward climate were small and non-significant. Conclusions: A focus on staff training to support recognition of the nature and impact of avoidant attachment styles is indicated. The findings suggest that interventions to enhance staff - service-user relationships may be important for service attachment and indeed promotion of a recovery focused orientation amongst service-users high in avoidant attachment may improve wellbeing and outcomes.

Whose health, whose care, whose say? Some comments on public involvement in new NHS commissioning arrangements

Recent health policy in England has demanded greater involvement of patients and the public in the commissioning of health and social care services. Public involvement is seen as a means of driving up service quality, reducing health inequalities and achieving value in commissioning decisions. This paper presents a summary and analysis of the forms that public involvement in commissioning are to take, along with empirical analysis from a qualitative study of service-user involvement. It is argued that the diversity of constituencies covered by the notion of ‘public involvement’, and the breadth of aims that public involvement is expected to achieve, require careful disaggregation. Public involvement in commissioning may encompass a variety of interest groups, whose inputs may include population needs assessment, evaluation of service quality, advocacy of the interests of a particular patient group or service, or a combination of all of these. Each of these roles may be legitimate, but there are significant tensions between them. The extent to which the structures for public involvement proposed recognize these possible tensions is arguably limited. Notably, new Local Involvement Networks (LINks), which will feed into commissioning decisions, are set as the arbiters of these different interests, a demanding role which will require considerable skill, tenacity and robustness if it is to be fulfilled effectively.

The presence of three Portuguese TV news channels (RTP3, SIC NOTÍCIAS, and TVI24) on facebook

In recent decades, the national and international media contexts, in particular television, media significantly changed. Although they were not created for the purpose, the role that social networks, in particular Facebook, have taken as a content diffusion platform is unquestionable. Nowadays, traditional media (radio, newspaper, television) use the Web’s potential to distribute news content (Canelas, 2011). Currently, all TV news channels in Portugal have a website or a page on social networks. TV stations have increased communication channels with the public on digital platforms and study strategies that promote the participation and interaction with the news content (Cazajeira, 2015). The TV / Internet convergence will not only reach the content, but also the consumer, who becomes an interactive and participative audience. This reality imposes on journalism a continuous and updated news production system, dependent on a user being permanently connected to the Internet (Cazajeira, 2015). In fact, an ERC report (2015) confirms the relevance that social media has assumed in the publication and consumption of news. Social networks are recognised as one of the most important means for news media consultation, right after television, and the practice of sharing news is very common among consumers of online news in Portugal. Furthermore, when compared to other countries analysed by Reuters Institute (Newman, Levy, & Nielsen, 2015), Portuguese consumers are those who make the most comments to online news, preferring social networks to news sites. Considering the importance of new online platforms for journalism, this study aims to present a quantitative analysis of user participation on the Facebook pages of the three Portuguese TV news channels, specifically RTP3, SIC Notícias and TVI24, between 8 and 14 February 2016. To track this participation, the following parameters were used: the "like" button as a way to study the demonstration of publication interest; "sharing" of a particular element, be it a photo, a video or a text, on their own Timeline, the Timeline of a friend or by private message. This monitoring is important to understand the dissemination of news content; and the comments area. The number of comments will help understand the dynamics and the discussion that the publication has on the public. The results of 1063 posts indicate that of the analysed parameters - "Like", "Comment", and "Share" – the one with the greatest power of participation among the users of the pages of the three Portuguese TV news channels is the "Like" system, followed by "Share" and then "Comment". Analysing the thematic that create the most user participation with "Likes" and “Comments” parameters are "Science and Technology". “Education” and “Humorous/Satirical/Unusual Finally, the publications available end of the night (10pm-1am) has better participation rates.

Satisfação dos utilizadores de um serviço público: Caso: Direcção Regional de Mobilidade e Transportes do Alentejo

"A Administração Pública visa a prossecução do interesse público, no respeito pelos direitos e interesses legalmente protegidos dos Cidadãos" (art.º266 Constituição da República Portuguesa). Este estudo subordinado ao tema: "Satisfação dos utilizadores de um Serviço Público - Caso: Direcção Regional de Mobilidade e Transportes do Alentejo” centra-se na investigação, da satisfação e percepção do utilizador dos serviços, na sequência da sua utilização, como forma de satisfazer as suas necessidades. Esta investigação foi desenvolvida em duas partes, a primeira reflecte uma pesquisa teórica sobre a temática, objecto de estudo. A segunda, incidiu na análise e no tratamento dos dados, obtidos através de um questionário, distribuído aos utilizadores da D.R.M.T. Alentejo (Évora, Beja e Portalegre). /ABSTRACT: "The Government aims to further the public interest, while respecting the rights and legally protected interests of citizens" (Article 266 Constitution ofthe Portuguese). This study entitled "Users Satisfaction of a Public Service - Case: Regional Direction of Mobility and Transports of Alentejo" focuses on research, customer satisfaction and perception of the service user, following its use as a way to meet their needs. This research was conducted in two parts, the first reflects a theoretical research on the subject, the subject of study. The second, focused on analyzing and processing data, obtained through a questionnaire distributed to users.

User-generated content and the future of public broadcasting : a case study of the special broadcasting service

This thesis presents a case study of the Special Broadcasting Service documenting the broadcasting challenges posed by user-generated content initiatives and the work-place approach to strategies for participation. Using the action research method, the project findings reveal that limitations to resources and funding determined the scope for innovation and that the practice of executive editorial control over content was considered fundamental to fulfilling the responsibilities of the public service mandate. Media workers were overwhelmingly positive about the enhanced productive capabilities of the audience and willing to facilitate moderated interactions, however the effectiveness of these initiatives differed according to the level of skills required. This thesis demonstrates how participatory initiatives can enhance aspects of the public service remit relating to cultural diversity, the servicing of niche interests, and broader social representation, and help reinvigorate the relevance of public service broadcasting in the digitalised media sphere.