bluuebunny/crossref_metadata_2025 huggingface dataset:
Development and characterization of solid dispersion-based orodispersible tablets of cilnidipine
Authors: Mohana Murugesan , Vijayalakshmi Sankaranarayanan
Published: June 2022

Background

Cilnidipine, a calcium channel blocker, is the first-line drug for hypertension and belongs to Biopharmaceutics Classification System II. To mitigate its extensive first-pass metabolism and improve patient compliance, the present study was performed to develop and characterize solid dispersion-based orodispersible tablets.

Results

The phase solubility study with polyvinyl pyrrolidone 15% has shown a 140-fold increase in solubility. X-ray diffraction and differential scanning calorimetry studies emphasized the conversion of solid dispersion from crystalline to amorphous state. Solid dispersion 3 resulted in 142-fold improvement in solubility, 96% of drug content, and percentage drug release was 71.9% at 60 min. F11 containing crospovidone (10 mg) and sodium starch glycolate (16 mg) in combination at higher concentration as super-disintegrants showed the least disintegration time of 26.6 s. In vitro dissolution results are subjected to statistical analysis and found that the formulation (F11) has shown an increased dissolution rate (88.62% at 10 min), compared to the marketed formulation (83% at 60 min).

Conclusions

Solid dispersion prepared by a solvent evaporation method using PVP as a carrier can be utilized for enhancing the solubility of cilnidipine. The incorporation of super-disintegrants in combination improves the dissolution rate of orodispersible tablets. Further, the study can be substantiated by performing stability and in vivo studies in the future.

Graphical Abstract
Investigation of tensile and flexural properties of kenaf fiber-reinforced acrylonitrile butadiene styrene composites fabricated by fused deposition modeling
Authors: Han Syaza Najwa Mohd Farhan , Taha Mastura Mohammad , Mansor Muhd Ridzuan , Rahman Muhamad Arfauz A.
Published: June 2022

Employment of natural fiber for the filament of fused deposition modeling (FDM) can be found in numerous studies from different areas. However, the presence of fiber such as kenaf in polymer filament could cause mechanical properties degradation with regard to the fiber loading owing to low compatibility between natural fiber and polymer matrix. Therefore, this study aims to study the mechanical properties of three-dimensional (3D)-printed structures of composites specimens with varying volume percentages of kenaf fiber. From the tensile and flexural testings, the findings revealed decrements in the tensile strength and modulus of kenaf fiber-reinforced ABS (KRABS) composites from 0 to 5% contents of kenaf fiber which were 23.20 to 11.48 MPa and 328.17 to 184.48 MPa, respectively. The raising amount of kenaf fiber at 5 to 10% raised the tensile strength and modulus from 11.48 to 18.59 MPa and 184.48 to 275.58 MPa, respectively. Flexural strength and modulus of KRABS composites were decreased at to 5% from 40.56 to 26.48 MPa and 113.05 to 60 MPa, respectively. With further kenaf fiber addition from 5 to 10%, the flexural strength and modulus were increased from 26.48 to 32.64 MPa and 60 to 88.46 MPa, respectively. These results were supported by the finding from the morphological analysis, where the presence of porosity and fiber pull out implied the poor interfacial bonding between kenaf fiber and ABS matrix. This study has successfully demonstrated the tensile and flexural performances of different volume percentages of KRABS composites filament for FDM through experimental research.
African swine fever virus MGF505-3R inhibits cGAS-STING-mediated IFN-β pathway activation by degrading TBK1
Authors: Cheng Mingyang , Luo Jiawei , Duan Yuetong , Yang Yu , Shi Chunwei , Sun Yu , Lu Yiyuan , Wang Junhong , Li Xiaoxu , Wang Jianzhong , Wang Nan , Yang Wentao , Jiang Yanlong , Yang Guilian , Zeng Yan , Wang Chunfeng , Cao Xin
Published: June 2022

African swine fever virus (ASFV) is an important pathogen causing acute infectious disease in domestic pigs and wild boars that seriously endangers the global swine industry. As ASFV is structurally complex and encodes a large number of functional proteins, no effective vaccine has been developed to date. Thus, dissecting the mechanisms of immune escape induced by ASFV proteins is crucial. A previous study showed that the ASFV-encoded protein is an important factor in host immunity. In this study, we identified a negative regulator, MGF505-3R, that significantly downregulated cGAS/STING- and poly (dG:dC)-mediated IFN-β and interferon stimulation response element (ISRE) reporter activity and suppressed IFNB1 and IFIT2 mRNA levels. In addition, TBK1, IRF3 and IκBα phosphorylation levels were also inhibited. Mechanistically, MGF505-3R interacted with cGAS/TBK1/IRF3 and targeted TBK1 for degradation, thereby disrupting the cGAS-STING-mediated IFN-β signaling pathway, which appears to be highly correlated with autophagy. Knockdown MGF505-3R expression enhanced IFN-β and IL-1β production. Taken together, our study revealed a negative regulatory mechanism involving the MGF505-3R-cGAS-STING axis and provided insights into an evasion strategy employed by ASFV that involves autophagy and innate signaling pathways.
Potential survival benefit and early recovery from organ dysfunction with polymyxin B hemoperfusion: perspectives from a real-world big data analysis and the supporting mechanisms of action
Authors: Shoji Hisataka , Ferrer Ricard
Published: June 2022

Background

Endotoxin (ET) removal therapy with polymyxin B-immobilized fiber column hemoperfusion (PMX-HP) has been used for the treatment of septic shock. Some observational studies reported clinical benefits, particularly in specific subgroups of patients. However, larger randomized controlled trial results have been disappointing.

Main body

The four studies that revealed the survival benefit of PMX-HP were based on the Japanese Diagnosis Procedure Combination (DPC) national inpatient database (J-DPC study). Nevertheless, one J-DPC study and a randomized controlled trial (RCT) conducted in France evaluated PMX-HP in patients with abdominal septic shock and did not report a significant survival benefit. In both studies, the severity of illness was too low to find substantial significant differences in mortality. The results of the J-DPC studies further suggest that some subpopulations of patients could benefit from PMX-HP. Based on these results, this review revisited prior RCTs and other large-scale studies on PMX-HP. In addition, four J-DPC studies and one large-scale study reported a survival benefit with PMX-HP. A secondary analysis of the EUPHRATES trial, the most recent double-blinded RCT of PMX-HP conducted in North America, suggested a survival benefit in patients with high levels of endotoxemia. In the J-DPC studies and the EUPHRATES trial, ventilator-free days, vasoactive drug-free days, and renal replacement-free days were significantly improved in the PMX-HP groups. These findings suggest that PMX-HP can contribute to early recovery from organ dysfunction. The reduction of supportive care likely provides important health and economic benefits for managing patients with septic shock. Finally, the blood levels of mediators or biomarkers related to respiratory, cardiovascular, and renal dysfunction have been reported to be normalized with PMX-HP.

Conclusions

These results support the biological rationale for the improvement in organ dysfunction observed in the J-DPC studies and other large-scale studies, including the EUPHRATES trial. Real-world evidence from large data sets suggests an appropriate patient population that are likely to benefit from the utility of PMX-HP for septic shock.
A New Trainee-Run Insomnia Treatment Service for Patients Under Community Mental Health Teams
Authors: Waterman Lauren , Creed Michael
Published: June 2022

Aims

Chronic insomnia is a common mental disorder that severely impacts the quality of life of those affected, increases the risk of comorbid mental disorder and physical illness, and makes treatment of other mental disorders less effective. It is particularly common in patients under secondary care mental health services. Once chronic, insomnia rarely resolves spontaneously. Cognitive behavioural therapy for insomnia (CBT-I) is a highly effective treatment that is recommended by the UK's National Institute of Health and Care Excellence as the first-line treatment. Despite this, CBT-I is not universally available or accessible throughout the UK. Therefore, LW obtrained training at a sleep clinic and then initiated, ran and evaluated a new CBT-I service for existing community patients within her NHS trust.

Methods

Patients received individual holistic assessments with a psychiatry trainee, a 5-session weekly virtual group intervention run by LW, and an individual 3-month follow-up. LW also trained other psychiatry trainees to run future groups, initially under supervision. Clinical rating scales were employed at initial assessment, following the final workshop and at follow-up.

Results

Seven patients completed all sessions, with five completing a 3-month follow-up review. All had suffered with chronic insomnia for over 5 years. All had moderate-to-severe insomnia on the Insomnia Severity Index (ISI) at assessment (mean 21.3), which had improved by the end of treatment (mean 14.3). All patients seen at follow-up either no longer had insomnia or had sub-threshold insomnia on the ISI (mean 7.2). From assessment to post-treatment to follow-up, mean scores on the Dysfunctional Beliefs and Attitudes About Sleep Scale reduced from 6.6 to 3.7 to 2.5, and mean scores on the Clinical Outcomes in Routine Evaluation–Outcome Measure reduced from 2.18 to 2.01 to 1.27. Mean scores on the Work and Social Adjustment Scale reduced from 23.6 (severe impairment) at assessment to 7.0 (low impairment) at follow-up. Two patients stopped taking sleeping tablets during the treatment, and remained off them at follow-up.

Conclusion

Group CBT-I can be a highly effective treatment for insomnia for patients under CMHT services. In this service run by a psychiatry trainee without formal sleep medicine or CBT qualifications, the efficacy of the intervention on insomnia symptoms, as well as on anxiety and depressive symptoms, was similar to the efficacies found in clinical trials and in specialist sleep clinics. CBT-I can be easily learnt by psychiatry trainees and likely other professionals with psychological expertise, which could increase the availability and accessibility of this effective treatment.
An Audit on the Monitoring and Management of Hyperprolactinemia in Inpatient Adults on Regular Antipsychotics in 8 Acute Wards in an NHS Mental Health Trust
Authors: Zhang Peter , Li Zhen Dong
Published: June 2022

Aims

The aim of the audit is to ascertain how well hyperprolactinemia is being monitored and managed across all acute adult inpatient wards in a mental health NHS Trust, for patients on regular antipsychotic mediation. The objectives of the audit are to: 1) Assess whether prolactin is being monitored according to local guidelines for patients on regular antipsychotic medication, 2) Determine whether hyperprolactinemia is being identified and managed according to appropriate guidelines, 3) Assess the standard of documentation around the decisions made.

Methods

Data were collected retrospectively from the electronic notes and records for 78 patients, who were discharged from 8 acute wards in February 2021. For checking prolactin test results, the relevant reporting systems were accessed. Two data collection forms were used, which separated patients between those already taking antipsychotics prior to their admission and those who were newly initiated on an antipsychotic.

Patients who were prescribed at least one regular antipsychotic were included. Patients with pre-existing medical conditions that cause hyperprolactinaemia, ongoing pregnancy or breastfeeding were excluded. The monitoring for and management of hyperprolactinaemia was assessed against NICE and local guidance.

Results

From the reviewed data, 41 patients were prescribed at least one regular antipsychotic drug during their admission. 32 patients were already established on an antipsychotic prior to their admission and 9 individuals were started on their first antipsychotic. Hyperprolactinaemia was identified in 9 patients. 19 patients had no prolactin assay performed during their whole admission.

44.4% of antipsychotic naïve patients had a baseline prolactin level taken prior to starting an antipsychotic. 9.1% of patients with hyperprolactinaemia had their symptoms assessed by a clinician. 27.3% of patients with hyperprolactinaemia had actions discussed and undertaken to address this.

Conclusion

This audit identified that patients are at risk of suffering from hyperprolactinaemia and are being insufficiently monitored. The symptoms of hyperprolactinaemia are not adequately screened or assessed for. This may increase the side effect burden and decrease medication adherence among patients. There is a need to increase the awareness among clinicians about the importance of regular prolactin monitoring to improve patient outcomes.
A Perinatal Mental Health Education Programme for Maternity, Neonatal and Other Allied Multidisciplinary Teams in NHS Lothian: Why, How, and What's Next
Authors: Argent Vikki , Sherratt Megan , Nelson Marian
Published: June 2022

Aims

Throughout the development of the NHS Lothian Perinatal Mental Health Service, their goals alongside maternity and neonatal teams, family nurse and health visiting services have been to strengthen interdisciplinary working and improve the quality of perinatal mental health care delivered to birthing people. The aims of developing a programme of multidisciplinary education sessions were to develop the knowledge and confidence of non-mental health professionals in caring for birthing people experiencing mental health difficulties, and aid understanding of available services and referral pathways to facilitate appropriate care.

Methods

The programme has been delivered by a Perinatal Psychiatrist and Clinical Midwifery Educators in bimonthly sessions lasting two hours. Sessions have included scenario-based learning, education regarding illnesses and disorders, and promotion of infant mental health and trauma-informed care.

Participants have attended virtually via Microsoft Teams or in person. Sessions have been recorded and accessed following teaching. Confidentiality is upheld throughout. A standard operating procedure utilising multi-modal methods has been designed to maximise staff engagement with sessions. Feedback accessed via a QR code has been collated via a Microsoft Forms questionnaire comprising of Likert scale and free-text answer questions. Feedback has guided programme development and topic selection.

Initially, sessions were open to inpatient maternity services, but now outpatient maternity services, neonatology, and health visiting and family nursing colleagues are invited to maximise the reach of the staff delivering sessions.

Results

Sessions have been well accessed by a variety of professionals, with increasing attendance at each session. Feedback has been obtained from 43% of those attending. Results have been very positive: 100% of respondents strongly agreed or agreed that the format of the session worked well with 92% of respondents strongly agreeing or agreeing that the session content was pitched at the appropriate level. 100% of respondents felt that the content covered was useful in their clinical role which supports the emphasis of the sessions on linking knowledge to clinical application to build confidence. 100% of respondents would recommend these education sessions to a colleague.

Conclusion

Feedback to date has shown that participants have found the sessions to be accessible and the content appropriately pitched and clinically valuable. Despite launching the programme amidst the challenges of COVID-19, participants have found the delivery of the sessions to be supportive and collaborative.

The next phase in the development of the programme will be to understand in more detail what participants are learning and the impact on their practice.
Are Single Doctors More Focussed in Career Progression?
Authors: Metwali Ramy , Chandrika Divya Vikraman , Baiju Siddhartha
Published: June 2022

Aims

It is commonly assumed that single doctors are more focused on career progression than doctors in a relationship/ or having dependents. In this study, we tried to find out if it's true. We measured this among doctors in Psychiatry (from training – to consultants’ level) across Wales.

Methods

We designed an anonymized online survey and distributed it among Psychiatry doctors.

We categorized the relationship status as

a.

Single

b.

In a relationship – committed, engaged, married, living together

c.

Separated, Divorced, Widowed

d.

Others

We measured the career progression on the basis of the following criteria:

1.

Why they were interested in Psychiatry

2.

Number of years taken to complete or intending to complete training.

3.

Having met the portfolio criteria for their level.

4.

Undertaking RCPsych Exams

5.

Having missed any opportunities related to career.

We analysed the data from the survey using an online tool.

The survey included questions that measured the link between career progression/choices and relationship Status/responsibilities. We used the Likert Scale, yes or no questions, and free text boxes.

Results

We received 66 responses and we divided them into three groups according to their relationship status which are the single group, relationship group, Divorced/ Separated/ Widowed group, and compared the results between them. We got some interesting results as follows.

◦

Single participants seem to be less limited in choosing the specialty, Exam Preparation, and overall career progression.

◦

A significant proportion of people in relationships felt limited in choosing the Specialty and workplace. Had less time for Exam preparation and have missed career opportunities.

◦

Females in Relationships were more restricted.

◦

The divorced / Separated / Widowed group did not feel limited, however, affected their exams, and have missed opportunities.

Conclusion

Single doctors seems to have overall better opportunities in career progression compared to people in relationship. However, our sample size was small especially in single group. A bigger study is needed to conclude the impact of relationship in career progression.
Is the Grass Greener on the Other Side? A Qualitative Comparison Study of Psychiatry Trainee Views in England Compared to New Zealand
Authors: Bansal Neha
Published: June 2022

Aims

The Royal College of Psychiatrists census (2019) highlighted that 10% of all consultant psychiatrist roles remain unfilled. This pattern is replicated elsewhere in the UK with 7.8% in Northern Ireland, 9.6% in Scotland and 12.7% in Wales. This increase in consultant vacant posts is indicative of the recruitment challenges to psychiatry. On the other hand, the 2017 New Zealand Medical Workforce survey report showed recruitment to psychiatry was up by 8.2% in 2018 compared to 2017. I conducted a qualitative comparison study to look at psychiatry trainee views regarding their training in a UK and New Zealand deanery at similar stages of their psychiatric training.

Methods

Questionnaires were distributed to current psychiatry trainees in the Capital and Coast District Health Board (CCDHB) based in Wellington, New Zealand and Birmingham and Solihull Mental Health Foundation Trust (BSMHFT), UK who were between years 1–3 of their psychiatry training. Qualitative information was collated from the questionnaires regarding various aspects of their training. Areas of focus were; pros and cons of psychiatry training, suggestions for improvements, supervision, access to annual leave and study leave, teaching, encouragement to attend courses and involvement in research.

Results

Of the 33 current trainees working in CCDHB, 48% were immigrants from the UK, previously having worked in the NHS.

17% of BSMHFT trainees felt valued in their organisation, compared to 64% in New Zealand.

27% in New Zealand considered switching to another training programme, whereas none considered switching in the UK. Burn out was quoted as a problem in both New Zealand and the UK. 100% were able to take annual leave with ease in New Zealand, compared to 0% in BSMHFT.

Conclusion

This small study gives a closer insight into the views of trainees in New Zealand, a place often thought as being more attractive for doctors to work in. What this study shows is 2 key factors; there are shocking differences in the quality of trainee experiences between New Zealand and the UK, however New Zealand is not free from issues around trainee retention, although the study does show overall trainee satisfaction being greater in New Zealand. Feeling valued, supported and leading a life with better work-life balance appear to be key driving factors for UK graduates leaving the UK and there is more that could be done to make trainees in the UK feel more valued and prevent burn out.
Generating Recommendations for Medical Curricula to Reduce Stigma Towards Psychiatry From Medical Students
Authors: Blake Jack , El-Nimr George
Published: June 2022

Aims

In 2021, we completed a project entitled: ‘Stigma Towards Psychiatry: Correlating Personal Experience with Existing Literature’ – ‘International Congress Award Winning’. We aim to use the themes generated from this to inform recommendations to medical educators to reduce stigma in their curricula towards psychiatry.

Methods

Using previously identified themes, we generated a set of recommendations aimed at the pre-admission, pre-clinical and clinical phases of learning. Pre-admission themes include: misconceptions of the role of the psychiatrist and disinterested medical applicants. Pre-clinical themes include: dissociation of psychiatry from medicine and clinical role modelling. Our final category, clinical, includes: cross-speciality support for psychiatry, pathophysiology in de-stigmatisation of psychiatric disease, discrimination of the aspiring psychiatrist, psychiatric exposure in training not seeing conversion of students to psychiatrists and the role of unofficial mentors in continuing enthusiasm for the speciality. Division in this way gave us multiple opportunities to look for areas of potential intervention in influencing medical student's views on psychiatry. Further influencing our recommendations was the feedback from a group of consultant psychiatrists this project was presented to.

Results

Addressing the themes driving stigma from the previous project saw us producing a list of recommendations targeted at each phase of medical school. (1) Pre-admission stage: selecting candidates who are more psychologically minded by recognition of A level psychology as a core subject; encouraging people with experience in mental health settings to apply for medical training (Srivastava et al, 2018); highlighting psychiatry as a medical career in the prospectus. (2) Pre-clinical stage: making students aware of their unconscious stigma towards psychiatry; clearer links made to psychiatry in early medical school to relevant biochemistry, anatomy, physiology and pharmacology (Mahli et al, 2003); tutor / doctor led psychiatry based extracurricular groups; highlighting mental health aspects of functional neurological disorders and disorders within rheumatology such as fibromyalgia. (3) Clinical stage: making clinicians aware of their unconscious stigma towards psychiatry; encouraging cross-speciality support for psychiatry; improving contact with psychiatrists on mental health placements (Archdall et al, 2013).

Conclusion

Stigma towards psychiatry extends from medical school and into clinical practice. It feels important that medical school curricula should be altered in order to change students’ experience of psychiatry within medical school. The recommendations target each stage the themes were identified within. Our local medical school has agreed to let us present this at their curriculum meeting which may pave the way for further refinement and implementation of our suggestions.
Providing Mental Health First Aid Training to Hatzola
Authors: Brennan Ailbhe , Hubbett Jack , Buckland Rosalyn , Grant-Peterkin Hugh
Published: June 2022

Aims

Hackney is home to the largest Charedi Orthodox Jewish community in Europe. According to the Census 2011, 7% of the population of Hackney are Charedi. Hatzola is a non-profit, volunteer organisation established in 1979 to provide pre-hospital emergency medical response and transportation to acute hospitals at no cost, to those living in and around the North London Charedi community. Given the large Charedi population served by Homerton University Hospital it is a common occurrence for psychiatry liaison staff to work side by side with Hatzola in delivering care to those in mental health crisis. Our aim was to create and nurture a professional relationship between Homerton University Hospital Psychiatry Liaison Service and Hatzola ambulance. We wanted to gain an understanding of the perception of mental illness within the Charedi community, and identify issues faced by members of Hatzola when working with those with mental illness. We wanted to identify the learning needs of Hatzola around psychiatric illness as well as increasing confidence within team members when called to manage mental health crises.

Methods

We scheduled an initial meeting with Hatzola to gain an understanding of their service. We used questionnaires to ascertain their level of knowledge on managing mental health patients. We set out to provide teaching sessions to address Hatzola's learning needs.

We designed interactive teaching sessions based on providing mental health first aid, discussing case studies, considering the legal framework around emergency mental health. We ensured coverage of working with both adults and children with mental health difficulties. We delivered these teaching sessions in person over four consecutive weekly meetings, with the sessions being recorded to serve as an educational resource.

Results

We gathered qualitative evidence reflecting the impact of our intervention. We were able to compare levels of confidence among Hatzola members before and after our teaching programme.

Conclusion

Our training programme was well received by Hatzola, and it was an excellent opportunity to develop links with members of the community.

We have learned that mental health is a taboo subject for members of the Charedi community, and have identified a need for more support to Hatzola in coping with the emotional toll working with mental health patients can take. There may be scope for providing further training on developing reflective practice and more emotional support for Hatzola members in future.
Buddhist Philosophy and Mental Health: Lessons for the 21st Century
Authors: Briggs Patrick
Published: June 2022

Aims

The aim of this research was to highlight the aspects of Buddhist philosophy which may help to improve mental health. COVID-19 has had a considerable psychological impact on healthcare staff and the general population, emphasizing the importance of treatments and techniques to aid their mental health.

Methods

Mindfulness, Impermanence and Non-self were discussed as core aspects of Buddhist philosophy and how these relate to mental well-being. Reference was made to peer-reviewed studies that show the positive effects of these concepts.

Results

This research highlighted the wealth of evidence that Mindfulness, Impermanence and Non-self has in improving mental well-being. However, there were also risks, including depersonalisation and increased anxiety in certain mindfulness practitioners.

Conclusion

The findings of this research has generated new ways in which we discuss mental well-being and challenges our current understanding of suffering, providing individuals with further tools to assist with their mental health. This study challenges the idea that philosophy and medicine must be discussed separately and seeks to find further common ground between these two disciplines.
Catch Them Young! Changing Attitudes and Perspectives Towards Psychiatry by Using Patients as Educators Early in Medical Training
Authors: Buck S Caroline , Combs Nicola , Rashid Amina , Ozidu Victoria , Akinola Adeola
Published: June 2022

Aims

This teaching project aims to improve attitudes and perspectives towards psychiatry by using Patient as Educators (PaE) in a psychiatry teaching program early in medical training.

Methods

Following the success of a small pilot study in 2020, the project was rolled out to the entire second year medical student body in 2021. Two-hour interactive sessions were delivered online to groups of approximately twelve students. Each session was introduced by a psychiatrist, followed by PaE discussion with questions and answers. The students completed a bespoke online survey at the beginning and the end of the session, looking at attitudes towards psychiatry. Comparative analysis of attitudes pre- and post-intervention was then undertaken. Qualitative data were examined through content analysis and quantitative methods were used to compare pre- and post- attitudes on the Likert scale.

Results

The pre- and post-intervention questionnaires were completed by 373 and 305 students respectively. Both pre- and post-intervention attitudes were overwhelmingly positive. Post-intervention qualitative results demonstrate the session, especially the PaE, helped students to better understand the complexities of mental illness, the stigma faced and the potential efficacy of good treatment. There was a 25.7% increase in students’ perception of preparedness to see mentally unwell patients. The most significant findings were that the majority of students found having the PaE valuable in improving attitudes regarding the value of psychiatry (72.8% agreed/strongly agreed) and increasing interest in the speciality (84% agreed/strongly agreed).

Conclusion

Early experience to clinical placements is an essential component in medical education. In Psychiatry, apart from gentle introduction into the specialty, it is essential that students are orientated into the world of mental health and its various challenges. This project has clearly demonstrated the effectiveness of early exposure of medical students to psychiatry as a specialty. It also demonstrates the effectiveness of using PaE in medical education. Further research would aim to examine whether effect on attitudes persist and correlate the effect on early exposure on recruitment to the speciality.
How Contemporary Disney Film Can Be Used for Mental Health Teaching in Schools: A Case Study of Inside Out (2015)
Authors: Caves Charlotte , Basu-Roy Robin
Published: June 2022

Aims

Mental health disorders can be a burden on both patients and the National Health Service. With the majority of lifetime mental health problems emerging in childhood and the prevalence of childhood mental illness increasing, the need for effective, standardised mental health education and fostering healthy socio-emotional development is more important than ever before. The aim was to explore if Inside Out provides an accurate representation of depression, and thus, can it be a useful resource for teaching mental health and developing emotional awareness in the classroom?

Methods

I explored a novel educational concept: ‘edutainment’, to see if it has use in state mental health education. This project provides a quantitative coding analysis and a qualitative artistic analysis of a contemporary Disney film, Inside Out (2015), for The International Classification of Diseases 10th Edition (ICD-10) depression symptoms. Depression has been chosen as an example of a mental health disorder as it is one of the commonest mental health problems and the leading cause of disability worldwide.

Results

Inside Out provides an accurate representation of many of the ICD-10 ‘core’ and ‘cognitive’ symptoms of depression through both coding words and artistic means.

Conclusion

Inside Out, alongside teacher-led discussion, could be useful in teaching children about depression in a relaxed but educational way. Inside Out features themes that can help children develop their emotional intelligence and reduce mental health stigma. I highlight a need for standardised mental health education and suggest that film may be an effective tool for learning about common mental health conditions, such as depression.
Exploring the Role of Mindfulness in the Well-being of Junior Doctors
Authors: Cohen Matthew , Matthews Chanais , Bu Chris , Jones Marc , Hearn Jasmine
Published: June 2022

Aims

This study aims to explore the relationship between mental well-being (The Warwick-Edinburgh Mental Well-being Scale), stress (Appraisal of Life Events Scale) and mindfulness (5 Facet Mindfulness Questionnaire) by means of a questionnaire.

Methods

The questionnaire was part of a mixed-method study looking into Mindfulness Resilience and Effectiveness Training in foundation doctors. In total 144 foundation doctors across the North West of England completed the questionnaire over a period of 5 months.

Results

A Pearson's correlation coefficient was used to assess the relationships between mental well-being, appraisal of stress and mindfulness. Results show that there was a significant, negative, and somewhat weak association between mental well-being and the appraisal of stressful life events (r = (142) –.23, p = .006). A significant, positive, and strong relationship was also found between the two variables mindfulness and mental well-being (r (142) = .60, p < 0.001), in addition to a significant, weak positive relationship between mindfulness and appraisal of stressful life events (r (142) = –.18, p = .033).

Conclusion

The results indicate that those with greater mental well-being were better able to tolerate stressful life events and appraise them as a challenge. Likewise, those with greater mindfulness scores showed greater well-being suggesting that improving one may improve the other. This has implications for intervention development (e.g., training in mindfulness) which can help to further improve well-being and appraisal of stressful life events in trainee doctors.
Innovations in Mentorship: Implementation of a Mentorship Program in Psychiatry That Encourages Reflection on Intersectionality and Wellness
Authors: Darani Shaheen , Esplen Mary Jane , Ho Certina , Lanctot Krista , Teshima John , Kwong Danica , Wong Jiahui
Published: June 2022

Aims

Mentorship supports professional development, academic outcomes, and wellness. Effective mentorship can develop careers of faculty through greater access, and equity, diversity, and inclusion (EDI). At a Department of Psychiatry in Canada, a recent survey showed more than 60% faculty were without mentors and would like to have one; and 75% mentors received no training nor resources to support mentorship. The aims of the Psychiatry Mentorship Program are to facilitate sharing of expertise, self-reflection, and career growth among faculty.

Methods

A Mentorship Working Group was formed in 2020–2021. The Mentorship Program design was evidence-informed by a literature review and consultation with other mentorship programs. While a traditional primary mentor-mentee relationship is at the core of the program, the mentorship dyad will be further supported by mentorship groups focused on academic roles, areas of scholarship and career development (e.g., clinician scientists; wellness) or specific groups (e.g., members of a minority group). The program offers an online mentor/mentee matching process, based on faculty self-reported scholarship interests, academic roles, and preferences related to social identity. A three-year evaluation strategy, guided by a logic model, is integrated throughout program implementation. Mentees and mentors are expected to complete a baseline assessment upon program enrolment and annual follow-up questionnaires. Continuous quality improvement of the Mentorship Program will be based on user experience collected via focus groups and interviews where perception and concepts, such as intersectionality, wellness, and EDI, will be explored.

Results

The Mentorship Program pilot was launched in fall 2021 with mentor and mentee virtual orientation workshops offering best practices and opportunities for reflection on challenges that may be encountered during a mentoring relationship. Thirty-six faculty mentors and 60 newly appointed faculty mentees attended the orientation workshops respectively. Workshop evaluations were positive. For example, 93% participating mentors indicated that the workshop met its learning objectives; 80% rated the workshop as excellent. Eighty-seven percent of mentor participants reported increased awareness of best practices to support successful mentorship, including the use of contracts and developmental plans, and indicated the workshop stimulated reflection and learning.

Conclusion

This preliminary positive feedback suggests faculty found the orientation workshops on mentorship to be useful and thus represents an effective mode of facilitating implementation of a department wide mentorship program. We anticipate the implementation of our mentorship program could be adapted to other academic settings.
Expanding the Scope of Mentoring for Psychiatry Trainees in Northern Ireland
Authors: Davidson Sarah , McGee Meta , Anderson Julie , Moore Stephen
Published: June 2022

Aims

The Northern Ireland psychiatry mentoring scheme, in which higher trainees mentor core trainee year 1 (CT1) doctors, has been running for four years. In this year's scheme, implemented in August 2021, we have expanded the scope of the scheme and implemented an online platform to match and connect mentors and mentees. Our aim was to gather baseline data regarding the experiences of mentors and mentees and to capture information regarding the content of mentoring meetings and attitudes towards format of meetings.

Methods

Higher psychiatry trainees were invited to sign up as mentors through the Northern Ireland Medical and Dental Training Agency (NIMDTA) and Royal College of Psychiatry Northern Ireland (RCPsych NI) mailing lists. Mentors were obliged to complete a theoretical module on training before meeting their mentees. Core trainees in the first and second year of training were asked to opt-out of the scheme if they preferred not to be involved. CT3 trainees were offered the opportunity to opt-in to the scheme. There were a total of 16 mentors and 22 mentees at the outset. The NIMDTA Professional Support Unit provided an online platform, Mentornet, which allowed mentors and mentees to complete a profile, for mentees to rank their preferences for mentor, and to facilitate meetings. One of the authors (M.M.) presented the developments in the scheme to a nationwide audience in the RCPsych webinar on mentoring.

Results

Six mentors and two mentees responded to the call to complete a baseline online questionnaire. 83% of mentors responded that they had found their role enjoyable and rewarding, whilst 67% of mentors indicated that their role had helped them develop in other skill areas. Both mentees responded that they had found the scheme beneficial and would recommend participation to other trainees.

Conclusion

Mentorship is a valuable opportunity for senior psychiatry trainees to facilitate the professional development of junior trainees and to pass on their experience. This is the first year that all core trainees have been invited to participate and that a new web platform has been used to facilitate meetings. Baseline feedback response numbers have been limited although the responses were universally positive. We intend to obtain further feedback at the end of this year in order to devise quality improvement measures for the 2022/2023 cohort.
A Quality Improvement (Pilot) Project: Psychiatric Medical Education for Foundation Trainees
Authors: Nirodi Pratibha , Uwaifo Imagbe , Elisha-Aboh Christiana , Onwuchekwa Ogba , Watts Rahul , Johnson Richard , Brooks Emma , Fitzmaurice Lauren , Legg Emily , Robinson Maggie , Moncrieff Jess
Published: June 2022

Aims

Foundation Doctors are exposed to a range of specialties within the Foundation Programme, with 20.9% completing a psychiatry rotation. Those who do not have a psychiatry rotation may have little experience other than what was acquired in undergraduate training, despite being expected to care for patients with mental health problems. According to Mind (2017), one in four people will experience a mental health problem each year thus essential that our medical workforce know and understand the basic principles of psychiatry to aid their management of core psychiatric conditions. The aim of this project was to improve mental health literacy among Foundation Doctors by improving their communication, formulation and risk management skills. Another objective was to encourage uptake to Psychiatry and help plug the high number of unfilled Consultant posts.

Methods

The initial pilot was carried out between January and June 2021 over zoom and the sessions were optional. A survey was completed to find out which topics were most relevant and common themes included MCA/MHA interface, risk management and treatment of various conditions. These themes were incorporated into 90-minute sessions which included interactive case-based discussion in small breakout groups and some didactic teaching. The six session topics were EUPD, Dementia, Depression, Delirium, Substance Misuse and Alcohol Misuse. The sessions were facilitated by clinicians of mixed experience from Foundation Doctors to Consultants. Participant knowledge was tested using pre- and post-session quizzes and a working group reviewed feedback, making relevant changes subsequently.

Results

Feedback was majorly positive, and attendees valued the interactivity, breakout rooms, case studies and choice of topics. Suggested areas of improvement were having more time for discussion, technical difficulties, and less psychiatric ‘jargon’, but these tended to be isolated comments. Five out of six sessions showed an improvement in assessment scores afterwards, with an average improvement of 12.6% (average pre-session score of 70% and average post-session score of 82.6%). One session showed a decrease in the post-session quiz scores which on reflection showed that the questions in the assessment covered material not included in the session.

Conclusion

The virtual programme was an effective way of improving knowledge and confidence in psychiatry. Whilst the sessions were positively received and showed improvements in post-session scores, there were some limitations which will be addressed and used to develop future training. There is now more mental health woven throughout the new Foundation curriculum and expected that much of this content will be covered during Foundation Training.
The MSc Psychiatry at Cardiff University: Introduction of New Modules Further Supporting Continuing Professional Development in Psychiatry
Authors: Hassoulas Athanasios
Published: June 2022

Aims

The MSc Psychiatry at Cardiff University is an established postgraduate programme offering students a sound theoretical basis in psychiatry as a medical science and specialty. The programme currently offers six taught modules (focusing on mood and anxiety disorders, psychosis, old age psychiatry, forensic psychiatry, substance misuse, and child and adolescent psychiatry), as well as a dissertation module that students complete towards the end of the programme. In catering for the professional needs of clinical students and students pursuing careers in academia, two additional taught modules have been proposed exploring Leadership and Management in Psychiatry and Advances in Psychiatric Research. Feedback on the proposed introduction of the new modules was collated from the current full-time and part-time student cohorts.

Methods

A total of 57 students currently enrolled on the programme were surveyed in relation to the proposed additional taught modules. The survey was created using Microsoft Forms and deployed via the programme's virtual learning environment (i.e., Blackboard). A mixed methods design was employed, with both Likert scale and open-ended items included in the survey. Students were informed that future cohorts would be offered a choice between the existing Forensic Psychiatry & Substance Misuse module and the proposed Leadership and Management in Psychiatry module, as well as a choice between the existing Child and Adolescent Disorders module and the proposed Advances in Psychiatric Research module.

Results

Responses from the current student body were collated and analysed. A total of 29 (51%) students surveyed were medical professionals, with the remaining 28 (49%) students being science graduates or other clinical professionals. Descriptive analysis of the quantitative data revealed that an overwhelming majority of students viewed the introduction of the new modules as a positive development that would further enhance the student learning experience and continuing professional development. Content analysis of the qualitative data revealed further insights on the nature of the proposed modules and preferences on how these should be included within the existing programme schedule.

Conclusion

Students currently enrolled on the MSc Psychiatry favour the introduction of the proposed modules tailored to support professional development. Specifically, students view the proposed module on Leadership and Management in Psychiatry as catering to the needs of clinicians working in a variety of healthcare settings, whilst the proposed module exploring Advances in Psychiatric Research was considered to supplement existing course content on evidence-based medicine and caters for students with an interest in pursuing a career in academia.