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Feasibility, acceptability and preliminary effectiveness of a culturally adapted nonspecialist delivery Problem-Solving Therapy: Friendship Bench Intervention for perinatal psychological distress in Sierra Leone
Get PDFAbdulai Jawo Bah - ORCID: 0000-0002-3334-7882
https://orcid.org/0000-0002-3334-7882Alastair Ager - ORCID: 0000-0002-9474-3563
https://orcid.org/0000-0002-9474-3563In low- and middle-income countries like Sierra Leone, there is a significant gap in the treatment of perinatal mental health disorders such as anxiety, depression and somatization. This study explored the feasibility, acceptability and preliminary effectiveness of a culturally adapted Problem-Solving Therapy - Friendship Bench Intervention (PST-FBI) delivered by nonspecialists, mother-to-mother support groups (MMSGs), to perinatal women experiencing psychological distress. MMSGs provide 4 weeks of home-based, individual PST-FBI, followed by a peer-led group session called col at sacul (circle of serenity). The intervention targeted peri-urban pregnant women and new mothers screened for psychological distress. This was a two-armed, pre-post, waitlist-controlled study that employed the Sierra Leone Perinatal Psychological Distress Scale (SLPPDS) to screen and measure their outcomes. Feasibility and acceptability were examined through in-depth interviews using the Consolidated Framework for Implementation Research, analyzed thematically, while preliminary effectiveness was evaluated with chi-squared analysis for categorical and t-test for continuous variables. Twenty of the 25 women completed all four PST-FBI sessions delivered by five MMSGs. The individual PST and the peer-led session were viewed as beneficial for problem-sharing and skill building. The SLPPDS scores significantly dropped by 58.9% (17.1-8.4) in the intervention group, while the control group showed a 31.6% (18.0-12.3) decrease. The intervention's effect size was d = 0.40 (p < 0.05). The MMSG-led PST-FBI, including the col at sacul session, proved feasible, acceptable and with preliminary effectiveness in improving the mental health of peri-urban pregnant women and new mothers in Sierra Leone. Further randomized-controlled trials are recommended before nationwide implementation. © Queen Margaret University, 2025.https://doi.org/10.1017/gmh.2025.612pubpu
Implementing sport and physical activity across each layer of the Mental Health and Psychosocial Support (MHPSS) pyramid for populations affected by displacement
Get PDFFrom Elsevier via Jisc Publications RouterHistory: accepted 2025-06-13, issued 2025-06-19Article version: AMPublication status: AcceptedAlastair Ager - ORCID: https://orcid.org/0000-0002-9474-3563 https://orcid.org/0000-0002-9474-3563Physical activity (PA) and sport are increasingly recognized as integral parts of mental health and psychosocial support (MHPSS) programming within humanitarian response, for people affected by forced displacement. Nonetheless, the programming and implementation of physical activity within MHPSS responses remains inconsistent and largely ad hoc.. In this Short Communication, our team of multidisciplinary authors including academics, and practitioners from disciplines of psychiatry, psychology, physical therapy and sport for development, examine the implementation of sport and PA more broadly, across each layer of the Inter Agency Standing Committee (IASC) MHPSS Pyramid. We demonstrate how PA can be implemented at each layer, to improve MHPSS outcomes in humanitarian settings. We outline examples of how PA is being implemented across the IASC MHPSS pyramid, from ensuring access to inclusive and enabling environments (Layer 1), to strengthening participation in community-based PA and sport initiatives (Layer 2), delivering targeted programs with intentional mental health outcomes (Layer 3), and providing specialized physical activity promotion within clinical mental health services (Layer 4). This Short Communication provides guidance for humanitarian actors on integrating sport and PA across each layer of the IASC MHPSS pyramid.pubpu
Learning from the experiences of autistic professionals working in health and education
Get PDFEleanor Curnow - ORCID: 0000-0001-9332-8248
https://orcid.org/0000-0001-9332-8248Item is not available in this repository.Donald Maciver - ORCID: 0000-0002-6173-429X https://orcid.org/0000-0002-6173-429XLorna Johnston - ORCID: 0009-0005-5161-2108
https://orcid.org/0009-0005-5161-2108Marion Rutherford - ORCID: 0000-0002-2283-6736
https://orcid.org/0000-0002-2283-6736AAM added on 22/01/2025.
VoR added to record 19/03/225.This is the accepted version of the following article: Curnow, E., Maciver, D., Johnston, L., Murray, M., Johnstone-Cooke, V., Utley, I., Jenkins, N., Meff, T., Muggleton, J. and Rutherford, M. (2025) ‘Learning from the experiences of autistic professionals working in health and education’, Autism in Adulthood, p. aut.2024.0168. Available at: https://doi.org/10.1089/aut.2024.0168. , which has now been formally published in final form at Autism in Adulthood at https://doi.org/10.1089/aut.2024.0168. This original submission version of the article may be used for non-commercial purposes in accordance with the Mary Ann Liebert, Inc., publishers’ self-archiving terms and conditions.Background: This study aimed to explore the experiences of autistic professionals working in the public sector in Scotland and investigate the factors that supported them in achieving employment in their chosen career.
Methods: We interviewed 34 autistic adults employed in professional roles in the health and education sectors in Scotland about their successes and challenges during training, recruitment, and employment. Interview conversations of 60–90-minute duration were transcribed verbatim. The research team, which included autistic and non-autistic researchers, conducted inductive thematic analysis.
Results: Resultant themes included complexity of disclosure; navigating differences in social communication and across employment stages; and control of the environment. Autistic professionals face inequalities and unsupportive environments. Participants described multifaceted decision-making processes behind choices to disclose or withhold their autism diagnosis, which could determine their right to workplace accommodations or provoke unfavorable treatment. The styles of communication preferred by colleagues could engender misunderstanding and lead to challenges negotiating social situations, recruitment processes, and organizational culture. Participants’ needs and preferences for predictability and routine required them to use strategies to overcome the negative impacts of suboptimal social and physical environments.
Conclusion: Findings confirm the importance of acceptance and inclusion and demonstrate that there is a need for culture change within public sector education and health workplaces to improve accessibility. Applying minor changes to the environment and individual communication styles can enhance workplace conditions for autistic employees.pubpu
The context, mechanisms and outcomes of intergenerational programmes involving people living with dementia in Scotland: A realist, qualitative study
Get PDFFiona Kelly - ORCID: 0000-0002-5608-0332
https://orcid.org/0000-0002-5608-0332Intergenerational programmes, involving activity-based interventions designed to promote mutually beneficial interactions between participants, have been used in Scotland and further afield as a means of generating social inclusion between different age groups. There is growing interest in the potential outcomes of intergenerational programmes for people living with dementia in particular, with policy in Scotland recognising that people living with dementia and their carers may be at greater risk of loneliness and social isolation. Given this interest, there is a need to explore what ‘intergenerational best practice’ may look like for people living with dementia. Using data from semi-structured interviews with thirteen stakeholders involved in intergenerational practice and/or dementia policymaking, this study explored the contextual factors, mechanisms, and outcomes of intergenerational programmes in the Scottish context. Stakeholders perceived the concerns of carers, perceptions of risk, along with inaccessible venues and transportation to be important contextual factors. Mechanisms that helped ensure programmes offered full and appropriate participation opportunities included ongoing, flexible programme planning; the provision of purpose and roles; and the use of older participants’ preferences, lived experience, and personhood. Overall intergenerational programmes were perceived to have the potential to promote beneficial outcomes for older participants living with dementia in Scotland.The author disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by a PhD bursary from Queen Margaret University.https://doi.org/10.1177/14713012251317767pubpu
Waiting Times and Influencing Factors in Children and Adults Undergoing Assessment for Autism, ADHD, and Other Neurodevelopmental Differences
Get PDFFrom Wiley via Jisc Publications RouterHistory: received 2024-08-19, rev-recd 2025-02-06, accepted 2025-02-12, epub 2025-02-24Article version: VoRPublication status: PublishedFunder: Scottish Government; doi: http://dx.doi.org/10.13039/100012095Donald Maciver - ORCID: 0000-0002-6173-429X https://orcid.org/0000-0002-6173-429XAnusua Singh Roy - ORCID: 0000-0002-5483-8832 https://orcid.org/0000-0002-5483-8832Lorna Johnston - ORCID: 0009-0005-5161-2108 https://orcid.org/0009-0005-5161-2108Eleanor Curnow - ORCID: 0000-0001-9332-8248 https://orcid.org/0000-0001-9332-8248Victoria Johnstone-Cooke - ORCID: 0000-0002-0162-1226
https://orcid.org/0000-0002-0162-1226Marion Rutherford - ORCID: 0000-0002-2283-6736 https://orcid.org/0000-0002-2283-6736This study explored waiting times and the factors influencing them in child and adult populations undergoing assessment for autism, ADHD, and other neurodevelopmental differences. The analysis focused on a retrospective review of 408 cases with assessments completed between October 2021 and May 2022, conducted by 30 diagnosing teams in Scotland. Data included age, final diagnosis, demographics, medical and developmental history, contact frequency, and assessment service adherence to best‐practice standards. Waiting times were calculated, and relationships were analyzed using linear regression. Median waiting times were 525 days (IQR 329–857) for children/adolescents and 252 days (IQR 106–611) for adults. Only 20% of children's and 47% of adult assessments met the proposed 252‐day diagnostic time target. Autism and ADHD were the most common diagnoses. Receiving > 1 neurodevelopmental diagnosis on completion was uncommon. Demographic factors did not significantly affect waiting times. Children/adolescents with more complex developmental and medical histories experienced longer waits (100.3 weeks vs. 67.7 weeks; p < 0.001), while adults with similar histories had shorter waits (32.7 weeks vs. 57.4 weeks; p = 0.016). Adults with ADHD experienced longer waits than autistic adults (63.4 weeks vs. 38.6 weeks, p = 0.002). Adherence to best‐practice quality standards was associated with shorter waits for children (β = 0.27, p = 0.002), but the relationship between standard adherence at different stages and for adults was less clear. More frequent appointments correlated with shorter adult waits (33.7 weeks vs. 59.2 weeks, p = 0.015). Gender distribution was balanced among adults, but children's services included more boys. The study highlights long waits and the need for improvement in processes.18pubpub
Your Expert Guide: Chemistry for Young Scientists
No full textItem is not available in this repository.Kit Chapman - ORCID: 0000-0002-5945-0554 https://orcid.org/0000-0002-5945-0554inpressinpres
The Arts Therapies in Palliative and End-of-Life Care: Insights from a Cross-Cultural Knowledge Exchange Forum
Get PDFGiorgos Tsiris - ORCID: 0000-0001-9421-412X
https://orcid.org/0000-0001-9421-412XIn October 2023, a Knowledge Exchange Forum was established, bringing together arts therapies staff and students from three different palliative and end-of-life care (PEoLC) settings: St Columba’s Hospice Care in Edinburgh, the Brookdale Department of Geriatrics and Palliative Medicine at Mount Sinai Hospital and the Mount Sinai Kravis Children’s Hospital in New York. Adopting a practice-led approach, the Forum offers a space to unpack questions and challenges that arts therapists face in PEoLC. In this dialogical paper, we outline the development of the Forum and share emerging insights from our cross-cultural discussions. When working in PEoLC settings, arts therapists are commonly required to work across a continuum of care. This continuum extends from individual sessions with patients, families and bereaved carers, to groups and community-oriented initiatives. It often requires a capacity to work flexibly and fluidly with regard to, for example, therapeutic boundaries, consistency of location, and time. Discussion of emerging insights leads to a consideration of their implications for education and practice, and for future directions in professional networking and knowledge exchange.This research received no external funding.https://doi.org/10.3390/bs1505060215pubpub
Transitional Care
No full textItem is not available in this repository.Transitional care continues to be a neglected area of practice in both adult and children’s services, with persisting confusion between the concepts of transition and transfer, often leading to unsatisfactory experiences and poorer long-term outcomes for adolescents and young adults (AYA). Unlike transfer, which is a one-off event, transitional care is a gradual, coordinated and developmentally appropriate, holistic approach, that not only prepares the young person for the eventual transfer to adult services, but attends to wider psychosocial aspects of their life, and other co-occurring transitions related to education, work, home life and other personal and culturally relevant transitions. Importantly, transitional care is person centred and responsive to the unique needs of the AYA which requires effective interpersonal skills, leadership, and flexibility on the part of the health provider, as well as robust policy and protocols. With permission, it also involves the young person’s care givers and supports them to develop their skills and knowledge in supporting AYA during this period. In practice, transitional care requires excellent multidisciplinary and multiagency teamwork, communication, and coordination, which should be planned and documented to ensure consistency with continued AYA support and skill development.
In this chapter we briefly outline key components of transitional care and how this might be implemented in a practice setting.https://doi.org/10.1007/978-3-031-82102-8_23pubpu
Play for health and wellbeing: reinforcing and reinvigorating the evidence base
Get PDFStacey Marko - ORCID: 0009-0008-4635-6674
https://orcid.org/0009-0008-4635-6674In this concluding paper to the theme edition on Play for Health and Wellbeing, we explain how the eight papers that comprise this collection have strengthened the evidence base and sharpened the thinking that supports the proposition that play enriches health and bolsters wellbeing. We also move beyond our evidence base to outline the challenges that lie ahead in exploring the play-health-wellbeing nexus, specifying priority actions that are empirical, conceptual and political.https://doi.org/10.1080/21594937.2025.250864714pubpub
Physical rehabilitation approaches for the recovery of function and mobility following stroke
Get PDFGill Baer - ORCID: 0000-0002-1528-2851 https://orcid.org/0000-0002-1528-2851Background
Various approaches to physical rehabilitation to improve function and mobility are used after stroke. There is considerable controversy around the relative effectiveness of approaches, and little known about optimal delivery and dose. Some physiotherapists base their treatments on a single approach; others use components from several different approaches.
Objectives
Primary objective: To determine whether physical rehabilitation is effective for recovery of function and mobility in people with stroke, and to assess if any one physical rehabilitation approach is more effective than any other approach.
Secondary objective: To explore factors that may impact the effectiveness of physical rehabilitation approaches, including time after stroke, geographical location of study, intervention dose/duration, intervention provider, and treatment components.
Stakeholder involvement: Key aims were to clarify the focus of the review, inform decisions about subgroup analyses, and co‐produce statements relating to key implications.
Search methods
For this update, we searched the Cochrane Stroke Trials Register (last searched November 2022), CENTRAL (2022, Issue 10), MEDLINE (1966 to November 2022), Embase (1980 to November 2022), AMED (1985 to November 2022), CINAHL (1982 to November 2022), and the Chinese Biomedical Literature Database (to November 2022).
Selection criteria
Inclusion criteria: Randomised controlled trials (RCTs) of physical rehabilitation approaches aimed at promoting the recovery of function or mobility in adult participants with a clinical diagnosis of stroke.
Exclusion criteria: RCTs of upper limb function or single treatment components.
Primary outcomes: measures of independence in activities of daily living (IADL) and motor function.
Secondary outcomes: balance, gait velocity, and length of stay.
Data collection and analysis
Two independent authors selected studies according to pre‐defined eligibility criteria, extracted data, and assessed the risk of bias in the included studies. We used GRADE to assess the certainty of evidence.
Main results
In this review update, we included 267 studies (21,838 participants). Studies were conducted in 36 countries, with half (133/267) in China. Generally, studies were heterogeneous, and often poorly reported. We judged only 14 studies in meta‐analyses as at low risk of bias for all domains and, on average, we considered 33% of studies in analyses of primary outcomes at high risk of bias.
Is physical rehabilitation more effective than no (or minimal) physical rehabilitation?
Compared to no physical rehabilitation, physical rehabilitation may improve IADL (standardised mean difference (SMD) 1.32, 95% confidence interval (CI) 1.08 to 1.56; 52 studies, 5403 participants; low‐certainty evidence) and motor function (SMD 1.01, 95% CI 0.80 to 1.22; 50 studies, 5669 participants; low‐certainty evidence). There was evidence of long‐term benefits for these outcomes.
Physical rehabilitation may improve balance (MD 4.54, 95% CI 1.36 to 7.72; 9 studies, 452 participants; low‐certainty evidence) and likely improves gait velocity (SMD 0.23, 95% CI 0.05 to 0.42; 18 studies, 1131 participants; moderate‐certainty evidence), but with no evidence of long‐term benefits.
Is physical rehabilitation more effective than attention control?
The evidence is very uncertain about the effects of physical rehabilitation, as compared to attention control, on IADL (SMD 0.91, 95% CI 0.06 to 1.75; 2 studies, 106 participants), motor function (SMD 0.13, 95% CI ‐0.13 to 0.38; 5 studies, 237 participants), and balance (MD 6.61, 95% CI ‐0.45 to 13.66; 4 studies, 240 participants).
Physical rehabilitation likely improves gait speed when compared to attention control (SMD 0.34, 95% CI 0.14 to 0.54; 7 studies, 405 participants; moderate‐certainty evidence).
Does additional physical rehabilitation improve outcomes?
Additional physical rehabilitation may improve IADL (SMD 1.26, 95% CI 0.82 to 1.71; 21 studies, 1972 participants; low‐certainty evidence) and motor function (SMD 0.69, 95% CI 0.46 to 0.92; 22 studies, 1965 participants; low‐certainty evidence). Very few studies assessed these outcomes at long‐term follow‐up.
Additional physical rehabilitation may improve balance (MD 5.74, 95% CI 3.78 to 7.71; 15 studies, 795 participants; low‐certainty evidence) and gait velocity (SMD 0.59, 95% CI 0.26 to 0.91; 19 studies, 1004 participants; low‐certainty evidence). Very few studies assessed these outcomes at long‐term follow‐up.
Is any one approach to physical rehabilitation more effective than any other approach?
Compared to other approaches, those that focus on functional task training may improve IADL (SMD 0.58, 95% CI 0.29 to 0.87; 22 studies, 1535 participants; low‐certainty evidence) and motor function (SMD 0.72, 95% CI 0.21 to 1.22; 20 studies, 1671 participants; very low‐certainty evidence) but the evidence in the latter is very uncertain. The benefit was sustained long‐term.
The evidence is very uncertain about the effect of functional task training on balance (MD 2.16, 95% CI ‐0.24 to 4.55) and gait velocity (SMD 0.28, 95% CI ‐0.01 to 0.56).
Compared to other approaches, neurophysiological approaches may be less effective than other approaches in improving IADL (SMD ‐0.34, 95% CI ‐0.63 to ‐0.06; 14 studies, 737 participants; low‐certainty evidence), and there may be no difference in improving motor function (SMD ‐0.60, 95% CI ‐1.32 to 0.12; 13 studies, 663 participants; low‐certainty evidence), balance (MD ‐0.60, 95% CI ‐5.90 to 6.03; 9 studies, 292 participants; low‐certainty evidence), and gait velocity (SMD ‐0.17, 95% CI ‐0.62 to 0.27; 16 studies, 630 participants; very low‐certainty evidence), but the evidence is very uncertain about the effect on gait velocity.
For all comparisons, the evidence is very uncertain about the effects of physical rehabilitation on adverse events and length of hospital stay.
Authors' conclusions
Physical rehabilitation, using a mix of different treatment components, likely improves recovery of function and mobility after stroke. Additional physical rehabilitation, delivered as an adjunct to 'usual' rehabilitation, may provide added benefits. Physical rehabilitation approaches that focus on functional task training may be useful. Neurophysiological approaches to physical rehabilitation may be no different from, or less effective than, other physical rehabilitation approaches.
Certainty in this evidence is limited due to substantial heterogeneity, with mainly small studies and important differences between study populations and interventions. We feel it is unlikely that any studies published since November 2022 would alter our conclusions. Given the size of this review, future updates warrant consensus discussion amongst stakeholders to ensure the most relevant questions are explored for optimal decision‐making.https://doi.org/10.1002/14651858.CD001920.pub4pubpub
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