Measuring competence in systemic practice: development of the ‘systemic family practice – systemic competency scale’ (SPS)

Ensuring that practitioners are competent in the therapies they deliver is important for training, therapeutic outcomes and ethical practice. The development of the Systemic Practice Scale (SPS) is reported - a measure to assess the competence of novice systemic practitioners trialed by Children and Young Person’s Improving Access to Psychological Therapies (CYP-IAPT) training courses. Initial reliability assessment of the SPS with twenty-eight supervisors of systemic practice evaluating students’ competence using an online recording of a family therapy session is detailed. The SPS was found to be a reliable measure of systemic competence across training settings. Rating variability was noted, with training and benchmarking to improve rating consistency recommended. Further research using the SPS to further establish the reliability and validity of the scale is required

Clinical Ethics Consultation: Examining how American and Japanese experts analyze an Alzheimer's case

Background: Few comparative studies of clinical ethics consultation practices have been reported. The objective of this study was to explore how American and Japanese experts analyze an Alzheimer's case regarding ethics consultation. Methods: We presented the case to physicians and ethicists from the US and Japan (one expert from each field from both countries; total = 4) and obtained their responses through a questionnaire and in-depth interviews. Results: Establishing a consensus was a common goal among American and Japanese participants. In attempting to achieve consensus, the most significant similarity between Japanese and American ethics consultants was that they both appeared to adopt an "ethics facilitation" approach. Differences were found in recommendation and assessment between the American and Japanese participants. In selecting a surrogate, the American participants chose to contact the grandson before designating the daughter-in-law as the surrogate decision-maker. Conversely the Japanese experts assumed that the daughter-in-law was the surrogate. Conclusion: Our findings suggest that consensus building through an "ethics facilitation" approach may be a commonality to the practice of ethics consultation in the US and Japan, while differences emerged in terms of recommendations, surrogate assessment, and assessing treatments. Further research is needed to appreciate differences not only among different nations including, but not limited to, countries in Europe, Asia and the Americas, but also within each country

The decision to opt for abortion

Key message points - Most women reach a decision to have an abortion rapidly. - Most women have reached their decision before the consultation with the abortion provider. - Certain women who have risk factors for post-abortion psychological reactions should be targeted and offered counselling. - Pregnancy options counselling should not be mandatory. - 'Cooling-off' periods lead to abortions at later gestation

Performance comparison of charcoal cookstoves for Haiti: Laboratory testing with Water Boiling and Controlled Cooking Tests

Charcoal cooking accounts for a large portion of Haiti's energy usage and leads to severe economic, health, and environmental hardships. Organizations are hoping that fuel-efficient cookstoves can help solve the problem. In this study, four charcoal cookstoves intended for dissemination in Haiti were rigorously assessed and compared using Water Boiling and Controlled Cooking Tests.Due to the poor thermal efficiency of the traditional stove, all improved stoves saved fuel on average over the traditional with the majority also reducing the total emissions released. However, the traditional stove could be difficult to replace because it had the fastest time-to-boil, an important consideration for end users. Through the testing, the number of trials conducted was found to be an important consideration for error analysis. Also, noticeable differences in stove performance were seen between the two protocols, supporting arguments by prior researchers of the necessity to use multiple test protocols for practically useful comparisons