Counselor Education Training Clinic Performance: An Archival Outcome Study

A tele-mental health model called Head to Health was implemented in the state of Victoria, Australia to address the crisis caused by the COVID-19 pandemic. It was a free centralized intake service that adopted a targeted approach with several novel elements, such as stepped care and telehealth. This study examines the views and experiences of clinicians and service users of the tele-mental health service in the Gippsland region of Victoria during the COVID-19 pandemic. Data from clinicians were obtained via an online 10-item open-ended survey instrument and from service users through semi-structured interviews. Data were obtained from 66 participants, including 47 clinician surveys and 19 service user interviews. Six categories emerged from the data. They were: 'Conditions where use of tele-mental health is appropriate', 'Conditions where tele-mental health may not be useful', 'Advantages of tele-mental health', 'Challenges in using tele-mental health', 'Client outcomes with tele-mental health', and 'Recommendations for future use'. This is one of a few studies where clinicians' and service users' views and experiences have been explored together to provide a nuanced understanding of perspectives on the efficacy of tele-mental health when it was implemented alongside public mental health services.

Evidence based practice guidelines for the nutritional management of malnutrition in adult patients across the continuum of care

This study focuses on two objectives: revising and validating the Supervisory Style Inventory (SSI; Friedlander & Ward, 1984) for use in China, and examining how supervisory style match predicts trainee clinical performance manifested by their client symptom outcomes. Participants included 173 beginning therapist trainees who saw 1,916 clients under the supervision of 73 supervisors in a Chinese mental health counseling training program. Clients completed measures of their symptom distress before every session; trainees completed the SSI for their expected supervisory style at the beginning of practicum and their perceived actual supervisory style at the end of the practicum; supervisors completed the SSI at the beginning of practicum to report their self-rated supervisory style. Results show that (a) factor analysis reduced the 33-item SSI to 21 items with two subscales: Task-Focused and Organized (TFO) and Relationship-Focused and Supportive (RFS). This structure demonstrated measurement invariance across trainee and supervisor versions. (b) Trainee-perceived RFS scores significantly predicted greater client symptom improvement, while supervisor-self-rated RFS scores negatively correlated with client outcomes. No significant effects were found for TFO scores. (c) Regarding supervisory style match, greater mismatch between trainee-expected and supervisor-self-rated styles predicted poorer client outcomes. Mismatches between trainee-expected and trainee-perceived or trainee-perceived and supervisor-self-rated styles did not significantly predict client outcomes. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Conclusion: Our findings show that all cochlear implanted temporal bones had a varied degree of trauma and inflammatory reaction from cochlear implantation. No definitive relationship was observed from our limited number of specimens between residual spiral ganglion cells (SGCs) in implanted temporal bones and clinical speech performance. Objectives: We hypothesize that there is a relationship between residual SGCs in cochlear implanted temporal bones and clinical speech performance. Our aim was to examine the histopathology of multi-channel cochlear implant temporal bones and to evaluate the relationship of residual SGC counts to clinical hearing performance. Methods: Temporal bones from four cochlear implant patients were examined histologically. Comparisons were made between implanted and nonimplanted temporal bones. Clinical performance data were obtained from patient charts. Results: There were varying amounts of inflammation in the basal turn of the cochleae in all four implanted temporal bones. Trauma to the facial nerve at the facial recess was noticed in one case. Surviving dendrites varied from 5% to 30% among four cases, with no relationship to clinical performance. The speech recognition scores, measured with Central Institute of the Deaf (CID) sentence score, varied among patients from 4% to 89%, while the patient with the highest SGCs had the best clinical outcome.

In their provision of acute care services, emergency department (ED) providers in critical access hospitals (CAHs) are uniquely challenged by limitations in personnel, facility resources, and available expertise. We sought to define the impact of team behaviors among ED staff in CAHs on clinical performance by studying the relationship between team and clinical performance scores across 100 simulated scenarios. Team and clinical performance scores were calculated for each scenario using standardized checklists to quantify goal achievement and aggregated across teams and scenario types. These scores were compared using bivariate analysis and correlated with clinical and team performance outcomes using Pearson's correlation (r coefficient). There was a positive correlation between team and clinical performance across all scenarios; the relationship was statistically significant (p<.05) in 3 scenarios: acute coronary syndrome (r=.69; p=.027); abdominal aortic aneurysm (r=.77; p=.009); and nonaccidental trauma (r=.75; p=.013). The wide correlation between clinical and team performance may be a function of the critical care event itself or the unique characteristics of CAHs that make them more vulnerable when faced with high acuity, complex, and infrequently encountered clinical scenarios.

Flexible airway endoscopy, for diagnostic and therapeutic purposes, is a vital aspect of pediatric pulmonology practice, and has become an integral aspect of formal training in pediatric pulmonology. This article is protected by copyright. All rights reserved.

Long-term clinical outcomes of acute myocardial infarction based on a center's experience with IVUS in the contemporary drug-eluting stent era

Supporting mental health of healthcare staff: health economics evaluation of costs and clinical outcomes of a specialised clinic for healthcare workers

Introduction. The evaluation of students' abilities in the clinical setting requires the use of a valid and reliable assessment tool. The assessment tool currently used for this purpose in all physical therapy (PT) undergraduate programs in Israel has never been evaluated for these parameters. This study aimed to find an established assessment tool, translate it into Hebrew, and determine the inter-rater reliability of the translated version and whether it could be a viable substitute for the currently used assessment tool. Review of the Literature. Revealed that the Assessment of Physiotherapy Practice (APP) is an established, valid, and reliable assessment tool. Subjects. Assessors: 21 clinical educators; assessed: 30 undergraduate PT students. Methods. The APP was translated into Hebrew using the translation–retranslation method. Clinical educators were briefly trained to use the APP before the study. Following 8 weeks of clinical practice in an assigned outpatient clinic, each student was assessed by 2 clinical educators, each of whom used both the APP and the currently used assessment tool. Intraclass correlation coefficient (ICC) was used to measure the inter-rater reliability of the APP. Cronbach's alpha was used to measure the internal consistency of the sections of the APP. Percentage of agreement between assessors was measured for each item. Results. The ICC for the total APP was 0.88 (95% confidence interval: 0.77–0.94). The internal consistency of APP sections ranged from 0.65 to 0.93 Cronbach's alpha. Exact agreement between assessors on 12 of the 20 items was identical in 63% or more occasions. Discussion and Conclusion. The ICC for the total score on the Hebrew APP was similar to that of the original APP, and the percentage of agreement among assessors was slightly lower than that of the original version. The latter may be due to the educators' limited experience with this assessment tool. The inter-rater reliability and validity of the Hebrew APP established it as a good substitute for the currently used assessment tool.

Public Health Perspective: The Health Policy Implications of Screening for Prostate Cancer

The Uganda Ministry of Health recommends facility- and community-based differentiated antiretroviral therapy (DART) models to support person-centred care for eligible clients receiving antiretroviral therapy (ART). Healthcare workers assess client eligibility for one of six DART models upon initial enrolment; however, client circumstances evolve, and their preferences are not routinely adjusted. We developed a tool to understand the proportion of clients accessing preferred DART models and compared the outcomes of clients accessing preferred DART models to the outcomes of clients not receiving preferred DART models. We conducted a cross-sectional study. A sample of 6376 clients was selected from 113 referrals, general hospitals and health centres purposely selected from 74 districts. Clients receiving ART accessing care from the sampled sites were eligible for inclusion. Healthcare workers interviewed clients (caretakers of clients under 18), over a 2-week period between January and February 2022 using a client preference tool to elicit whether clients were receiving DART services through their preferred model. Treatment outcomes of viral load test, viral load suppression and missed appointment date were extracted from clients' medical files before or immediately after the interview and de-identified. The descriptive analysis determined the interaction between client preferences and predefined treatment outcomes by comparing outcomes of clients whose care aligned with their preferences to outcomes of clients whose care misaligned with their preferences. Of 25% (1573/6376) of clients not accessing their preferred DART model, 56% were on facility-based individual management and 35% preferred fast-track drug refills model. Viral load coverage was 87% for clients accessing preferred DART models compared to 68% among clients not accessing their preferred model. Viral load suppression was higher among clients who accessed the preferred DART model (85%) compared to (68%) clients who did not access their preferred DART model. Missed appointments were lower at 29% for clients who accessed preferred DART models compared to 40% among clients not enrolled in the DART model of their choice. Clients who accessed their preferred DART model have better clinical outcomes. Preferences should be integrated throughout health systems, improvement interventions, policies and research efforts to ensure client-centred care and client autonomy.

Standing balance deficits are common in individuals after stroke. One way to address these deficits is to provide the individual with feedback from a force platform while balance activities are performed. The feedback can take visual and/or auditory form. To determine if visual or auditory force platform feedback improves the clinical and force platform standing balance outcomes in clients with stroke. We searched the Cochrane Stroke Group trials register (last searched December 2003), and the following electronic bibliographic databases: the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 3, 2003), MEDLINE (1966 to May 2003), EMBASE (1974 to May 2003), CINAHL (1982 to May 2003), PEDro (May 2003), CIRRIE (May 2003) and REHABDATA (May 2003). Reference lists of articles were reviewed and manufacturers of equipment were contacted. Randomized controlled trials comparing force platform with visual feedback and/or auditory feedback to other balance treatments. Two reviewers independently assessed trials for inclusion, methodological quality, and data extraction. Trials were combined for meta-analysis according to outcome and type of feedback. We included seven trials (246 participants). Force platform feedback did not improve clinical measures of balance when moving or walking (Berg Balance Scale and Timed Up and Go). Significant improvements in laboratory force platform indicators of stance symmetry were found for regimens using visual feedback (standardised mean difference (SMD) -0.68, 95% confidence interval (CI) -1.31 to -0.04, p = 0.04) and the concurrent visual and auditory feedback (weighted mean difference (WMD) -4.02, 95% CI -5.99 to -2.04, p = 0.00007). There were no significant effects on laboratory postural sway indicators, clinical outcomes or measures of function at follow-up assessment. Force platform feedback (visual or auditory) improved stance symmetry but not sway in standing, clinical balance outcomes or measures of independence.

Objective To study the effect of psychotherapy on the patients with post - stroke depression. Methods 86 patients with post - stroke depression were randomly divided into psychotherapy and non psychotherapy groups. The scores of SDS, SF - 36 and clinical outcome were evaluated between the two groups. Results The score of SDS of psychotherapy group was significantly lower than that of control group, and the evaluation of clinical outcome was significantly better than that of control group ( P < 0. 05) . While the scores of SF - 36 of psychotherapy group were significantly better than those of control group except physiological function ( P < 0.01) . Conclusions Psychotherapy could obviously decrease the degree of depression and improve clinical outcome, physical function and quality of life in patients with post - stroke depression. Key words: Psychotherapy; Stroke; Depression; Quality of life

BackgroundSupervision is widely recognised as an important form of support for lay health service providers. However, guidance in appropriate supervision practices for task-shifting health interventions within the unique context of humanitarian emergencies is lacking. This review set out to identify empirically supported features of supervisory practices for lay health care providers in humanitarian emergencies, towards a stronger evidential basis for best practice in supportive supervision.MethodsIn January 2021, six databases and five non-governmental organizations’ websites were searched for articles examining the effectiveness of supervision for health care interventions delivered by lay providers in humanitarian settings. The inclusion criteria for study selection were qualitative or quantitative primary studies, articles published in peer reviewed journals or technical reports and the availability of the studies in English. The outcomes of interest were client clinical outcomes, health service efficiency and sustainability, and lay health care providers well-being. All articles were independently reviewed by the first and last authors.ResultsA total of 3371 articles were initially identified, with a total of 11 articles retained following the systematic screening process (two quantitative, four mixed methods and five qualitative studies). All studies generally reported positive impacts of supportive supervision on client outcomes, service sustainability, staff well-being and staff performance. Only four studies offered emotional support as part of supportive supervision. No studies evaluated the effect of supportive supervision on service efficiency. The narrative synthesis suggests significant challenges with providing supportive supervision, including excessive workloads, difficult supervisory relationships, geographic dispersion of lay providers, safety concerns, poorly trained supervisors, and lack of supervisory guidelines.ConclusionsMore efforts are needed to prioritize supportive supervision in task-shifting frameworks and to ensure that supervision is regular, consistent and of high-quality, with well-trained and well-supported supervisors.

IntroductionMachine learning techniques have been leveraged to predict client psychological treatment outcomes. Few studies, however, have tested whether providing such model predictions as feedback to therapists improves client outcomes. This randomised controlled trial examined (1) the effects of implementing therapist feedback via a deep‐learning model (DLM) tool that predicts client treatment response (i.e., reliable improvement on the Patient Health Questionnaire‐9 [PHQ‐9] or Generalized Anxiety Disorder‐7 [GAD‐7]) to internet‐delivered cognitive behavioural therapy (iCBT) in routine clinical care and (2) therapist acceptability of this prediction tool.MethodsFifty‐one therapists were randomly assigned to access the DLM tool (vs. treatment as usual [TAU]) and oversaw the care of 2394 clients who completed repeated PHQ‐9 and GAD‐7 assessments.ResultsMultilevel growth curve models revealed no overall differences between the DLM tool vs. TAU conditions in client clinical outcomes. However, clients of therapists with the DLM tool used more tools, completed more activities and visited more platform pages. In subgroup analyses, clients predicted to be ‘not‐on‐track’ were statistically significantly more likely to have reliable improvement on the PHQ‐9 in the DLM vs. TAU group. Therapists with access to the DLM tool reported that it was acceptable for use, they had positive attitudes towards it, and reported it prompted greater examination and discussion of clients, particularly those predicted not to improve.ConclusionAltogether, the DLM tool was acceptable for therapists, and clients engaged more with the platform, with clinical benefits specific to reliable improvement on the PHQ‐9 for not‐on‐track clients. Future applications and considerations for implementing machine learning predictions as feedback tools within iCBT are discussed.