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In the field of Educational Psychology, consultation is both a core competency to be achieved by the end of pre-service training and a practice that infuses all aspects of service delivery post-qualification. The present study aimed to explore the perspectives of university educators on preparing trainee educational psychologists to consult, especially following significant systemic change at social-political and professional standard levels. A qualitative exploratory design was chosen to inform semi-structured interviews with 14 participants from 16 universities in the United Kingdom providing post-graduate training. These interviews were analyzed thematically, with 10 over-arching themes identified. Themes are discussed across three aspects: (i) systemic factors, (ii) facilitators and barriers in consultation training in the current UK context and (iii) curriculum content and pedagogic methods used in consultation training at pre-service level. Strengths, limitations, and implications for applied practice and future research are discussed.

Aims: Digital living is now an integral part of many children and young people's (CYP) everyday experience. Practitioners who work with them are increasingly focused on effectively deploying technology to help those with social, emotional and mental health (SEMH) needs. Throughout all aspects and phases of work, practitioners must adhere to legal and professional best practice standards in involving service users, person-centred working and in enhancing accessibility for all. Methods: Measures introduced to reduce the spread of COVID-19 triggered significant service delivery change in a specialist multi-disciplinary child and adolescent mental health service (CAMHS) team. The majority of assessment and intervention work moved to an online audio and web conferencing platform. A shared decision-making approach was developed to support service user understanding of online appointments and to giving informed consent, in line with the i-THRIVE Framework for system change (Wolpert et al., 2019). Three Guides were developed and distributed ahead of online appointments: written, easy-read and video. Findings: Data collected within a Quality Improvement (QI) framework indicated that the Guides supported practitioners to prepare service users, as well as themselves, for digital working. The Guides supported service access, collaborative decision-making and increased CYP autonomy. Their introduction also led to conversations about equity and cultural responsiveness, as well as serving as a model for the development of aids to support shared decision-making for autism diagnostic assessments. Limitations: This paper outlines the first phase of the QI project with a small participant sample and requires further engagement with service users to review the use of Guides and shared decision-making decision aids. Conclusions: Digital approaches present new possibilities and are rapidly changing service delivery across CAMHS. The importance of involving service users in shared decision-making when developing digital practices must be held in mind as part of this change process.

Climate‐driven alterations to disturbance regimes are increasingly disrupting patterns of recovery in many biomes. Here, we examine the impact of disturbance and subsequent level of recovery in live hard coral cover on the Great Barrier Reef (GBR) across the last three decades. We demonstrate that a preexisting pattern of infrequent disturbances of limited spatial extent has changed to larger and more frequent disturbances, dominated by marine heatwaves and severe tropical cyclones. We detected an increase in the impact (measured as coral loss) across 265 individual disturbance impacts on 131 reefs in a 36‐year dataset (1985–2022). Additionally, the number of survey reefs impacted by disturbance has increased each decade from 6% in the 1980s to 44% in the 2010s, as has the frequency of mass coral bleaching across the GBR, which has increased between 19% and 28% per year, and cyclones (3%–5% per year), resulting in less time for recovery. Of the 265 disturbance impacts we recorded, complete recovery to the highest levels of coral cover recorded earlier in this study (the "historical benchmark") occurred only 62 (23%) times. Of the 23% of disturbance impacts that resulted in complete recovery to historical benchmarks, 34/62 recovered to their benchmark in 2021 or 2022. Complete recovery was more likely when the historical benchmark was <25% live hard coral cover. The lack of recovery was attributed to recovery time windows becoming shorter due to increases in the frequency of cyclones and of thermal stress events that result in mass coral bleaching episodes. These results confirm that climate change is contributing to ecosystem‐wide changes in the ability of coral reefs to recover. [ABSTRACT FROM AUTHOR]

Aims: As the number of people aged 16-25 referred to mental health services rises, the increasing complexity of their presenting needs is apparent. For those with additional communication and interaction differences, psychological assessment may be especially challenging. They often have long-standing histories of interpersonal challenge, do not find making relationships with others easy and can find conventional information-gathering assessments difficult and at times, even unhelpful. Method/rationale: Educational psychologists (EPs) can make a distinctive contribution in this area because of: (1) their knowledge of adolescent and young adult development; (2) their skills in relational connection in time-limited assessment contexts; and (3) the value they place on person-centred approaches. This paper outlines one approach to psychological assessment that prioritises collaboration with clients aged 16-25 and emphasises understanding the meaning they make of their subjective experience of the world. Findings/implications: The use of projective techniques, where a free-flowing response to a stimulus was used as the basis of a dialogue with the client, is described in the broader context of collaborative assessment. Illustrative case studies that serve as the basis for reflection on experience are explored, with common themes identified. The benefits of the approach, especially in terms of supporting clients and for practitioner learning, are highlighted. Limitations: This approach, whilst facilitated by qualified and trainee EPs, has been developed in a specialist multidisciplinary clinical context. Challenges in using projective techniques as part of collaborative assessments, as well as capacity concerns as regards ongoing training and supervisory requirements, are examined. Conclusions: There are opportunities for the future development of EP practice in this area, as well as promising lines of practice-based research inquiry.

In the current context, effectively including children and young people with additional needs is a challenge for school staff. Conflicting demands placed on teachers, support staff and those who lead them often derail strategic planning for the successful inclusion of all learners. School leaders have to work with complexity and 'mess', whilst containing the often powerful and distressing feelings of children, parents/carers and the staff who care for them. Supporting head teachers to take up their role within complex systems, in ways that promote their on-going learning and development, is vital. Critical are the ways in which their own experiences and feelings can be held to aid thinking. This article outlines some of the constraints currently experienced by head-teachers in England, as well as one potential approach to containment: the provision of relational supervision. The experience of relational supervision, for both supervisee and supervisor, is explored through a case study and some suggestions for future developments offered.

Introduction: Understanding of the needs of people with stroke at hospital discharge and in the first six-months is limited. This study aim was to profile and document the needs of people with stroke at hospital discharge to home and thereafter. Methods: A prospective cohort study recruiting individuals with stroke, from three hospitals, who transitioned home, either directly, through rehabilitation, or with early supported discharge teams. Their outcomes (global-health, cognition, function, quality of life, needs) were described using validated questionnaires and a needs survey, at 7–10 days, and at 3-, and 6-months, post-discharge. Results: 72 patients were available at hospital discharge; mean age 70 (SD 13); 61% female; median NIHSS score of 4 (IQR 0–20). 62 (86%), 54 (75%), and 45 (63%) individuals were available respectively at each data collection time-point. Perceived disability was considerable at hospital discharge (51% with mRS ≥ 3), and while it improved at 3-months, it increased thereafter (35% with mRS ≥ 3 at 6-months). Mean physical health and social functioning were "fair" at hospital discharge and ongoing; while HR-QOL, although improved over time, remained impaired at 6-months (0.69+/-0.28). At 6-months cognitive impairment was present in 40%. Unmet needs included involvement in transition planning and care decisions, with ongoing rehabilitation, information, and support needs. The median number of unmet needs at discharge to home was four (range:1–9), and three (range:1–7) at 6-months. Conclusion: Stroke community reintegration is challenging for people with stroke and their families, with high levels of unmet need. Profiling outcomes and unmet needs for people with stroke at hospital-to-home transition and onwards are crucial for shaping the development of effective support interventions to be delivered at this juncture. ISRCTN registration: 02/08/2022; ISRCTN44633579. [ABSTRACT FROM AUTHOR]

Supervision is a critical component of initial training and continuing professional development for applied psychology practitioners, and effective supervision is significantly related to the quality of the relationship between supervisor and supervisee. The core task of supervision is to engage in a relational process that provides containing and security, thus facilitating professional growth through reflection on experience. Two key arguments are proposed in this paper: (i) models that support theory-to-practice connections are essential for both supervisees and supervisors and (ii) models informed by psychological theory that place relating and reflecting at the heart of the supervisory process promote practitioner development and effective outcomes for clients. One model -- the Relational Model of Supervision for Applied Psychology Practice (RMSAPP) -- is outlined, and the systemic, psychodynamic and attachment lenses privileged within it are explored. The paper concludes with the strengths and challenges of the model, along with suggestions for future research directions.

Extracellular domain (ECD) antigens are crucial components for antibody discovery, in vitro assays, and epitope mapping during therapeutical antibody development. Oftentimes, those antigens are difficult to produce while retaining the biologic function/activity upon extracellular secretion in commonly used expression systems. We have developed an effective method to cope with the challenge of generating quality antigen ECDs. In this method, a monoclonal antibody (Mab) or antibody fragment antigen‐binding (Fab) region acts as a "chaperone" to stabilize the antigen ECD through forming an antibody:antigen complex. This methodology includes transient co‐expression of the complex in Chinese hamster ovary cells and then dissociation of the purified complex into individual components by low pH treatment in the presence of arginine. The antigen is then separated from the chaperone on a preparative size exclusion chromatography (pSEC) followed by an optional affinity chromatography process to remove residual Mab or Fab. We demonstrate this co‐expression/disassociation methodology on two difficult‐to‐express antigen ECDs from cluster‐of‐differentiation/cytokine family and were successful in producing stable, biologically active antigens when the common methods using Histidine‐tagged and/or Fc‐fused protein failed. This can be applied as a general approach for antigen production if a Mab or binding partner is available. [ABSTRACT FROM AUTHOR]

Background: Aboriginal culture stands as the oldest continuous culture in the world. It gives paramount importance to a harmonious balance between personal connections to the body, spirit, and mind, as well as collective relationships with family, land, and community, integral to the wellbeing of Aboriginal people. However, obstacles can emerge for patients due to language barriers, cultural differences, or a historical lack of trust in the healthcare system. The establishment of Aboriginal Community Controlled Health Organisations (ACCHOs) has undoubtedly improved the healthcare experience for Aboriginal patients, yet there is limited research on the specific approaches utilised by general practitioners (GPs) working in these clinics. Methods: Twelve semi-structured interviews were conducted with two groups of GPs working in Aboriginal health. Each GP was presented with three scenarios and asked questions related to each scenario. Braun and Clarke's method of thematic analysis was applied to transcribed interviews. Results: Patient-doctor relationship, health literacy, and engagement with the health system emerged as key factors influencing communication with Aboriginal patients. Experienced GPs, despite differing clinical backgrounds, shared concise yet similar ideas to their less experienced counterparts. Notably, experienced GPs prioritised non-medical conversations and mindful body language, emphasising the importance of building strong patient relationships over other consultation aspects. Conclusions: This research provides initial insights for GPs in Aboriginal health, comparing experienced GPs with more than 10 years experience to novices. However, further research involving Aboriginal patients is needed to validate GP strategies and understand their significance from the patients' perspective. Communicating health information can be a challenging skill to clinicians especially when working in Aboriginal health. Despite Aboriginal Health Community Controlled Health Organisations having enriched the experience of Aboriginal patients, there is limited research on the approaches adopted by general practitioners (GPs) working in these clinics. Our research combines thoughts from experienced and novice GPs who worked in Aboriginal Health, and shares some of their experiences related to communicating medical information with Aboriginal patients in this highly complex field. [ABSTRACT FROM AUTHOR]

Introduction: Cough is the most common symptom leading to medical consultation. Chronic cough results in significant health care costs, impairs quality of life, and may indicate the presence of a serious underlying condition. Here, we present a summary of an updated position statement on cough management in the clinical consultation. Main recommendations: Assessment of children and adults requires a focused history of chronic cough to identify any red flag cough pointers that may indicate an underlying disease. Further assessment with examination should include a chest x‐ray and spirometry (when age > 6 years). Separate paediatric and adult diagnostic management algorithms should be followed. Management of the underlying condition(s) should follow specific disease guidelines, as well as address adverse environmental exposures and patient/carer concerns. First Nations adults and children should be considered a high risk group. The full statement from the Thoracic Society of Australia and New Zealand and Lung Foundation Australia for managing chronic cough is available at https://lungfoundation.com.au/resources/cicada‐full‐position‐statement. Changes in management as a result of this statement: Algorithms for assessment and diagnosis of adult and paediatric chronic cough are recommended.High quality evidence supports the use of child‐specific chronic cough management algorithms to improve clinical outcomes, but none exist in adults.Red flags that indicate serious underlying conditions requiring investigation or referral should be identified.Early and effective treatment of chronic wet/productive cough in children is critical.Culturally specific strategies for facilitating the management of chronic cough in First Nations populations should be adopted.If the chronic cough does not resolve or is unexplained, the patient should be referred to a respiratory specialist or cough clinic. [ABSTRACT FROM AUTHOR]

Rift Valley fever virus (RVFV) is a mosquito-borne zoonotic pathogen causing disease in livestock and humans. Whilst initially restricted to the African continent, recent spread to the Arabian Peninsula has highlighted the likelihood of entry into new regions. Due to the absence of a regulatory-approved human vaccine, work is ongoing to develop and assess countermeasures. As such, small animal models play a pivotal role in providing information on disease pathogenesis and elucidating which intervention strategies confer protection. To develop and establish the BALB/c mouse model, we challenged mice with RVFV grown from two separate cell lines: one derived from mosquitoes (C6/36) and the other mammalian derived (Vero E6). Following infection, we assessed the clinical course of disease progression at days 1 and 3 post-challenge and evaluated viral tropism and immune analytes. The results demonstrated that RVFV infection was affected by the cell line used to propagate the challenge virus, with those grown in insect cells resulting in a more rapid disease progression. The lowest dose that caused uniform severe disease remained the same across both virus preparations. In addition, to demonstrate reproducibility, the lowest dose was used for a subsequent infection study using male and female animals. The results further demonstrated that male mice succumbed to infection more rapidly than their female counterparts. Our results establish an RVFV mouse model and key parameters that affect the course of disease progression in BALB/c mice. [ABSTRACT FROM AUTHOR]

A key principle upon which the Revised Special Educational Needs and Disability (SEND) Code of Practice 0-25 (2015) is based is children's involvement in decision-making that affects them, and a significant change is the removal of the term "behaviour" and an emphasis on social, emotional and mental health (SEMH) needs. To ensure that child involvement is a practical reality for children with SEMH needs, staff in schools benefit from a range of evidence-informed strategies for engagement and participation. This article describes an approach to the provision of learning mentor services for children with SEMH in a primary school based on partnerships between the children and staff in establishing and measuring change. Limitations are noted and suggestions for future developments are also made.