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There is a growing trend of adult diagnosis of Autism Spectrum Disorder (ASD). Research has found that diagnosis can prompt a process of sense-making which may be disrupted by lack of post-diagnostic support. Given the continued involvement of many parents in supporting their adult son or daughter with ASD, it is vital to understand their experiences to meet their needs in adapting to the diagnosis. Eleven parents of recently diagnosed adults participated in semi-structured interviews which were analysed thematically. Findings demonstrate that the new knowledge of diagnosis facilitates changes in attributions, interactions and relationships, but can result in unmet emotional and relational support needs. Findings are relevant to those involved in adult diagnosis, and the provision of post-diagnostic support.

Objectives: The present demand for child and adolescent mental health services exceeds the capacity for service provision. Greater research is required to understand the utility of accessible self‐help interventions, such as mobile apps. This study sought to investigate whether use of a mental health app, underpinned by CBT, led to changes in psychological distress amongst adolescents. Mechanisms of change were examined, specifically whether changes are attributable to cognitive strategies. Design: This study utilised a multiple‐baseline single‐case experimental design, tracking variables across baseline and intervention phases. Surveys assessing participant experience were also administered. Methods: Five participants with moderate‐to‐severe levels of psychological distress engaged with a CBT‐based app over five weeks. Participants were recruited from both a well‐being service and the general population. Supplementary weekly calls to participants offered clarification of app content. Results: A small overall effect of the intervention of psychological distress was evident; however, outcomes were dependent on the analysis conducted. The intervention appeared to promote an increase in use of adaptive cognitive strategies but not negative thinking styles. The CBT app did not promote changes in participant well‐being. Participant feedback highlighted practical challenges of utilising the app. Conclusions: The clinical benefits of app‐based CBT were small, and a range of barriers to engagement were recognised. While further research is required, caution should be exercised in the interpretation of studies reporting on app effectiveness. [ABSTRACT FROM AUTHOR]

Introduction : It has been hypothesized that certain persistent physical symptoms (PPS) may be linked to unresolved traumatic or distressing somatic-symptom related memories. EMDR intervention targets and reintegrates distressing memories, thus reducing the re-experiencing of physical sensations. The primary aim of this review was to examine effectiveness of EMDR for PPS. Secondary aims were to investigate effectiveness of EMDR on secondary outcomes (post-traumatic stress, anxiety, and depression), and to evaluate the acceptability of EMDR for this client group. Method : Six electronic databases (PsycInfo, PsycArticles, CINAHL, MEDLINE, Web of Science and SCOPUS) were searched for peer-reviewed literature, with no restrictions on publication dates. Twenty-eight studies met inclusion criteria. Studies were included if the primary aim of EMDR intervention was to reduce intensity, frequency or reported distress associated with PPS. Studies were quality appraised using the MMAT tool prior to narrative synthesis of key findings. Results : Studies varied in design and included RCT, UCT, case study and case series. EMDR treatment length varied between studies; 1–20 sessions. All studies reported significant improvement in PPS at post-test. Effect sizes were available to report in five studies and ranged from moderate to large. Improvement in secondary outcomes were reported in all repeated measure studies. Where available, large effect sizes were reported for reduction in anxiety and depression. Overall drop-out rates in studies with representative samples was low (10.6%). Quality of research varied; low (42.8%), medium (21.4%), and high (35.7%). Conclusions : There is promising emerging evidence for effectiveness and acceptability of EMDR for a range of PPS. However, firm conclusions on efficacy cannot be made. While comparisons between PPS presentations cannot be drawn due to methodological differences, the findings for pain and tinnitus are the most compelling due to methodological quality. High-quality sufficiently powered RCTs are recommended to determine efficacy. [ABSTRACT FROM AUTHOR]

Glioblastoma multiforme (GBM) is the most aggressive central nervous system tumor, and standard treatment, including surgical resection, radiation, and chemotherapy, has not significantly improved patient outcomes over the last 20 years. Temozolomide (TMZ), the prodrug most commonly used to treat GBM, must pass the blood–brain barrier and requires a basic pH to convert to its active form. Due to these barriers, less than 30% of orally delivered TMZ reaches the central nervous system and becomes bioactive. In this work, we have developed a novel biomaterial delivery system to convert TMZ to its active form and that shows promise for intracellular TMZ delivery. Self-assembling peptides were characterized under several different assembly conditions and evaluated for TMZ loading and conversion. Both solvent and method of assembly were found to affect the supramolecular and secondary structure of peptide assemblies. Additionally, as peptides degraded in phosphate-buffered saline, TMZ was rapidly converted to its active form. This work demonstrates that peptide-based drug delivery systems can effectively create a local stimulus during drug delivery while remaining biocompatible. This principle could be used in many future biomedical applications in addition to cancer treatment, such as wound healing and regenerative medicine. [ABSTRACT FROM AUTHOR]

Background: Theraplay is a relationship‐focused model of treatment based on attachment theory involving both adult and child. The study aims to review the quality of Theraplay research and Theraplay's effectiveness for children aged 12 years and under with a range of presenting difficulties, to inform future practice and identify areas for further research. Methods: A systematic literature search was conducted using PsycINFO, CINAHL, MEDLINE and Web of Science. Quantitative studies using Theraplay only as a treatment for children aged 12 years and under with any presenting difficulty were identified. Additional manual searching was conducted, including eligible studies' reference lists. Critical appraisal tools were used to provide a narrative synthesis of Theraplay's effectiveness and research quality. Results: Only six eligible articles were identified, meaning there was a lack of rigorous evidence eligible to offer conclusions into Theraplay's effectiveness. The review highlighted the small evidence base, mixed quality research methodology and high levels of heterogeneity in how Theraplay is practiced and evaluated. Of the eligible studies, Theraplay was found promising in its effectiveness when used with internalising and externalising difficulties, dual diagnoses and developmental disabilities. Conclusions: Theraplay is regularly practiced across the world; however, the evidence base of rigorous research to inform Theraplay's effectiveness and mechanisms of change is lacking. Firm conclusions could not be offered, although Theraplay was shown to be promising intervention for some presentations. Further research into Theraplay's effectiveness and key mechanisms of change are recommended to enhance the quality and depth of Theraplay literature. [ABSTRACT FROM AUTHOR]

Harmful sexual behaviour by young people against their peers is a significant issue. Pressure is placed upon professionals responsible for the care and treatment of young people who exhibit harmful sexual behaviour, yet no systematic exploration of the impact of this work has been conducted. This review uses meta-ethnography to synthesise professionals' experiences, specifically addressing psychological or emotional impact. Ten studies were identified across five databases. Studies included 116 participants across multiple contexts in the USA, UK, and Australia. Four third-order constructs were generated: (1) Emotional and visceral reactions to the work; (2) When work follows you home; (3) Staying well in the work; and (4) Systemic challenges. Professionals report a range of feelings associated with their work. Further attention should be paid to strategies that prevent burnout, including access to external clinical supervision, as well as the systemic impact of societal attitudes towards harmful sexual behaviour in children. [ABSTRACT FROM AUTHOR]

Background: Transition between Child and Adolescent Mental Health Services (CAMHS) and Adult Mental Health Services (AMHS) can be stressful for the young person and family alike. Previous reviews have focused on specific aspects of transition or perspectives of young people, or have not used systematic approaches to data identification and analysis. The objective of this review was to develop the understanding of the transition between CAMHS and AMHS by systematically identifying and synthesising evidence regarding professionals' and parents/carers' perspectives. Method: A systematic search in July 2018 was conducted on Medline, PsycINFO and CINAHL. Google Scholar and references of selected articles were also searched. Papers were included if they presented empirical qualitative research in peer‐reviewed journals with a primary focus on experiences of parents/carers and/or mental health professionals in relation to adolescents making the CAMHS‐AMHS transition. Data were extracted from each full‐text paper. The quality of included studies was appraised using an expanded Critical Appraisal Skills Programme (2018) tool, and studies' results were synthesised using meta‐ethnography. Results: Fourteen studies of variable quality were identified. Four main third‐order constructs were developed through synthesis: (a) Service cultures; (b) Service resources and gaps; (c) Working relationships between the services; and (d) Leaving secure relationships for new ones. Conclusions: Professionals and parents experience adolescents' transition from nurturing and comprehensive CAMHS to more individualistic AMHS as having many barriers. There is desire for better preparation for transition between services and relationships, more joint working and better CAMHS‐AMHS communication. AMHS service gaps exist, for example for those with neurodevelopmental conditions. [ABSTRACT FROM AUTHOR]

The article focuses on a model for utilizing empathetic listening to build client relationships in the communication center in the U.S. The consultants provide one-on-one and group consultations as well as create and facilitate interactive workshops on topics related to group and interpersonal communication and public speaking for faculty, staff, and students across campus. The relationship between therapist and client directly correlates to the relationship between the University Speaking Center staff and their clients.

Discusses current trends in treating hemorrhage and the possible serious complications that can occur within the obstetric theater environment. Risk factors for obstetric hemorrhage; Causes of hemorrhage; Blood transfusion guidelines; Knowledge required by the perioperative staff about surgical interventions utilized in the obstetric theater to facilitate effective management of a potentially catastrophic hemorrhage.

Compartment syndrome affecting the limbs is a well-documented condition and there are cases where it has become evident following surgery undertaken with the patient in the Lloyd Davies position. This article explores the contributory factors and the devastating effect it can have on the patient, and questions whether we practise evidence-based care when patients are undergoing certain types of surgery. It also discusses factors related to abdominal compartment syndrome, a condition usually affecting the critically ill patient. [ABSTRACT FROM AUTHOR]

Massive haemorrhage remains a serious complication of childbirth despite advances in knowledge and surgical technique, with the number of mothers dying in the UK from haemorrhage appearing to be on the increase.

Compartment syndrome affecting the limbs is a well-documented condition and there are cases where it has become evident following surgery undertaken with the patient in the Lloyd Davies position. This article explores the contributory factors and the devastating effect it can have on the patient, and questions whether we practise evidence-based care when patients are undergoing certain types of surgery. It also discusses factors related to abdominal compartment syndrome, a condition usually affecting the critically ill patient.