bluuebunny/crossref_metadata_2025 huggingface dataset:
Small-extracellular vesicles and their microRNA cargo from porcine follicular fluids: the potential association with oocyte quality
Authors: Gad Ahmed , Murin Matej , Bartkova Alexandra , Kinterova Veronika , Marcollova Katerina , Laurincik Jozef , Prochazka Radek
Published: June 2022

Background

Ovarian follicular fluids (FFs) contain several kinds of regulatory factors that maintain a suitable microenvironment for oocyte development. Extracellular vesicles (EVs) are among the factors that play essential roles in regulating follicle and oocyte development through their cargo molecules that include microRNAs (miRNAs). This study aimed to investigate small-EV (s-EV) miRNAs in porcine FFs and their potential association with oocyte quality.

Methods

Individual aspirated oocytes were stained with lissamine green B stain (LB), a vital stain for oocyte quality, and each oocyte was classified as high-quality (unstained; HQ) or low-quality (stained; LQ). FFs corresponding to oocytes were pooled together into HQ and LQ groups. Small-EVs were isolated from FFs, characterized, and their miRNA cargo was identified using the Illumina NovaSeq sequencing platform. Additionally, s-EVs from the HQ and LQ groups were utilized to investigate their effect on oocyte development after co-incubation during in vitro maturation.

Results

A total of 19 miRNAs (including miR-125b, miR-193a-5p, and miR-320) were significantly upregulated, while 23 (including miR-9, miR-206, and miR-6516) were downregulated in the HQ compared to the LQ group. Apoptosis, p53 signaling, and cAMP signaling were among the top pathways targeted by the elevated miRNAs in the HQ group while oocyte meiosis, gap junction, and TGF-beta signaling were among the top pathways targeted by the elevated miRNAs in the LQ group. The supplementation of small-EVs during maturation does not affect the oocyte developmental rates. However, LQ s-EVs increase the proportion of oocytes with homogeneous mitochondrial distribution and decrease the proportion of heterogeneous distribution.

Conclusion

Our findings indicated that FF-EVs contain different miRNA cargos associated with oocyte quality and could affect the mitochondrial distribution patterns during oocyte maturation.
Developmental trajectories of eating disorder symptoms: A longitudinal study from early adolescence to young adulthood
Authors: Breton Édith , Dufour Rachel , Côté Sylvana M. , Dubois Lise , Vitaro Frank , Boivin Michel , Tremblay Richard E. , Booij Linda
Published: June 2022

Background

Adolescence is a critical period for the development of eating disorders, but data is lacking on the heterogeneity of their evolution during that time-period. Group-based trajectories can be used to understand how eating disorders emerge and evolve over time. The aim of this study was to identify groups of individuals with distinct levels of eating disorder symptoms between 12 and 20 years and the onset of different types of symptoms. We also studied sex differences in the evolution and course of eating disorder symptoms from early adolescence to adulthood.

Methods

Using archival data from the QLSCD cohort, trajectories of eating disorder symptomatology were estimated from ages 12 to 20 years using semiparametric models. These trajectories included overall eating disorder symptomatology as measured by the SCOFF (Sick, Control, One Stone, Fat, Food), sex, and symptom-specific trajectories.

Results

Two groups of adolescents following distinct trajectories of eating disorder symptoms were identified. The first trajectory group included 30.9% of youth with sharply rising levels between 12 and 15 years, followed by high levels of symptoms between 15 and 20 years. The second trajectory group included 69.1% of youth with low and stable levels of symptoms between 12 and 20 years. Sex-specific models indicated that the proportion of girls in the high trajectory group was 1.3 times higher than the proportion of boys (42.8% girls vs. 32.3% boys). Trajectories of SCOFF items were similar for loss-of-control eating, feeling overweight, and attributing importance to food. The weight loss item had a different developmental pattern, increasing between 12 and 15 years and then decreasing between 17 and 20 years.

Conclusions

The largest increase in eating disorder symptoms in adolescence is between the ages of 12 and 15 . Yet, most prevention programs start after 15 years of age. Our findings suggest that, unlike common practices, eating disorder prevention programs should aim to start before puberty.
Desmoplastic infantile astrocytoma with atypical phenotype, PTEN homozygous deletion and BRAF V600E mutation
Authors: Megías Javier , San-Miguel Teresa , Sánchez Mirian , Navarro Lara , Monleón Daniel , Calabuig-Fariñas Silvia , Morales José Manuel , Muñoz-Hidalgo Lisandra , Roldán Pedro , Cerdá-Nicolás Miguel , López-Ginés Concha
Published: June 2022

Desmoplastic infantile astrocytoma (DIA) is rare, cystic and solid tumor of infants usually found in superficial cerebral hemispheres. Although DIA is usually benign, uncommon cases bearing malignant histological and aggressive clinical features have been described in the literature. We report a newborn patient who was diagnosed with a DIA and died postresection. Pathologic examination revealed that the main part of the tumor had benign features, but the internal region showed areas with a more aggressive appearance, with higher-proliferative cells, anaplastic GFAP positive cells with cellular polymorphism, necrosis foci, vascular hyperplasia with endothelial proliferation and microtrombosis. Genetic study, performed in both regions of the tumor, showed a BRAF V600E mutation and a homozygous deletion in PTEN, without changes in other relevant genes like EGFR, CDKN2A, TP53, NFKBIA, CDK4, MDM2 and PDGFRA. Although PTEN homozygous deletions are described in gliomas, the present case constitutes the first report of a PTEN mutation in a DIA, and this genetic feature may be related to the malignant behavior of a usually benign tumor. These genetic findings may point at the need of further and deeper genetic characterization of DIAs, in order to better understand the biology of this tumor and to obtain new prognostic approaches, a better clinical management and targeted therapies, especially in malignant cases of DIA.
Spatial and temporal influence of sea level on inland stress based on seismic velocity monitoring
Authors: Andajani Rezkia Dewi , Tsuji Takeshi , Snieder Roel , Ikeda Tatsunori
Published: June 2022

Earth’s crust responds to perturbations from various environmental factors. To evaluate this response, seismic velocity changes offer an indirect diagnostic, especially where velocity can be monitored on an ongoing basis from ambient seismic noise. Investigating the connection between the seismic velocity changes and external perturbations could be useful for characterizing dynamic activities in the crust. The seismic velocity is known to be sensitive to variations in meteorological signals such as temperature, snow, and precipitation as well as changes in sea level. Among these perturbations, the impact of variations in sea level on velocity changes inferred from seismic interferometry of ambient noise is not well known. This study investigates the influence of the ocean in a 3-year record of ambient noise seismic velocity monitoring in the Chugoku and Shikoku regions of southwest Japan. First, we applied a bandpass filter to determine the optimal period band for discriminating among different influences on seismic velocity. Then, we applied a regression analysis between the proximity of seismic station pairs to the coast and the ocean influence, as indicated by the correlation of sea level to seismic velocity changes between pairs of stations. Our study suggests that for periods between 0.0036 to 0.0155 cycle/day (64–274 days), the ocean’s influence on seismic velocity decreases with increasing distance of station pairs from the coast. The increasing sea level deforms the ocean floor, affecting the stress in the adjacent coast. The stress change induced by the ocean loading may extend at least dozens of kilometers from the coast. The correlation between sea level and inland seismic velocity changes is negative or positive. Although it is difficult to clearly interpret the correlation based on a simple model, they could depend on the in situ local stress, orientation of dominant crack, and hydraulic conductivity. Our study shows that seismic monitoring may be useful for evaluating the perturbation in the crust associated with an external load.

Graphical abstract
Simplified dosimetry for kidneys and tumors in 177Lu-labeled peptide receptor radionuclide therapy
Authors: Ardenfors Oscar , Nilsson Joachim N. , Thor Daniel , Hindorf Cecilia
Published: June 2022

Purpose

To evaluate if satisfactory post-therapeutic image-based dosimetry can be achieved for Lu-177-DOTATATE treatments using a reduced number of image acquisitions to improve patient comfort and reduce economical costs.

Methods

39 patients who underwent 147 treatment cycles of Lu-177-DOTATATE for neuroendocrine tumors were included in the study. A total of 291 and 284 absorbed doses were calculated to kidneys and tumors, respectively. Single-point dosimetry was performed using one SPECT/CT image acquired at 1 d or 7 d post-treatment using a fixed effective half-life (Teff) or using a patient-specific Teff determined for the initial cycle. Also, dose-per-activity values, (D/A)1, were determined from the first cycle and used to calculate doses for subsequent cycles. All absorbed doses were evaluated against “true” doses calculated using both the 1 d and 7 d images. The relation between tumor grade and absorbed doses was also investigated. All dosimetry was performed on SPECT images.

Results

Absorbed doses to kidneys were most accurate when single-point dosimetry was performed using 1 d images with median ratios in relation to “true” doses in total dose of 1.00 (IQR: 0.97–1.03) when using fixed Teff and 1.01 (IQR: 0.98–1.04) when using Teff from the initial cycle. Calculations based on the 7 d image were most accurate for tumors with corresponding ratios in total absorbed dose of 0.98 (IQR: 0.96–1.00) and 1.00 (IQR: 0.99–1.01) when using a fixed Teff or Teff from the first cycle, respectively. The (D/A)1 approach performed worse, as 2 of 77 total absorbed doses to the kidneys deviated with > 30%, and tumor-absorbed doses were increasingly overestimated with every cycle. Absorbed doses, Teff and 1 d uptake were higher for G1 tumors than G2 tumors.

Conclusion

Dosimetry can be performed with satisfactory accuracy when using single SPECT/CT images acquired at 1 d for kidneys or at 7 d for tumors.
Protocol for a scoping review to map patient engagement in scoping reviews
Authors: Oravec Nebojša , Monnin Caroline , Gregora April , Bjorklund Brian , Dave Mudra G. , Schultz Annette S. H. , Chudyk Anna M.
Published: June 2022

Background

Scoping reviews of health research are increasing in popularity. However, only a minority of scoping reviews in this sector engage patients and caregivers as co-producers of the research. Despite developments in scoping review methodology, which insist that stakeholder consultation is essential, no guiding methods exist to instruct the conduct of this stage. Thus, it is necessary to understand how patients and caregivers have been engaged as part of scoping reviews, toward a unifying methodology.

Methods

We have developed a protocol for a scoping review of methods used to engage patients and caregivers in scoping reviews of health research. The search strategy will comprise two phases: the first will involve a secondary analysis of retrieved articles from a prior scoping review, and the second will identify articles that cite Levac et al.’s update to the original scoping review framework by Arksey and O’Malley. Titles and full texts of retrieved articles will be screened in duplicate. Inclusion will be limited to articles related to heath research that follow the six-stage scoping review framework by Arksey and O’Malley and that report patient engagement activities during at least one stage. The method of analysis of charted variables will be decided once data have been collected. Two patients will be engaged as collaborators throughout this review. We will also consult with patients, caregivers, and researchers upon completion of preliminary analyses.

Discussion

We anticipate that our scoping review will provide guidance for researchers seeking to involve health care stakeholders as co-producers of scoping reviews.
Regional years of life lost, years lived with disability, and disability-adjusted life-years for severe mental disorders in Guangdong Province, China: a real-world longitudinal study
Authors: Tan Wenyan , Chen Lichang , Zhang Yuqin , Xi Junyan , Hao Yuantao , Jia Fujun , Hall Brian J. , Gu Jing , Wang Shibin , Lin Haicheng , Lin Xiao
Published: June 2022

Background

To understand the magnitude and spatial–temporal distribution of the regional burden attributable to severe mental disorders is of great essential and high policy relevance. The study aimed to address the burden of severe mental disorders by evaluating the years of life lost, years lived with disability, and disability-adjusted life-years (DALYs) in Guangdong, China.

Methods

We undertook a longitudinal study based on a multicenter database established by the Health Commission of Guangdong, involving a total of 21 prefectures and four economic regions in the Guangdong province. A total of 520,731 medical records from patients with severe mental disorders were collected for 2010–2020. Data were analyzed via an integrated evaluation framework by synthesizing prevalence estimates, epidemiological adjustment as well as comorbidity assessment to develop internally consistent estimates of DALY. DALY changes during 2010–2020 were decomposed by population growth and aging and further grouped by Socio-demographic Index (SDI). DALYs were projected to 2030 by the weighted median annualized rate of change in 2010–2020.

Results

In 2010–2020, the average DALYs for severe mental disorders reached 798,474 (95% uncertainty interval [UI]: 536,280–1,270,465) person-years (52.2% for males, and 47.8% for females). Severe mental disorders led to a great amount of disease burden, especially in Guangzhou, Shenzhen, and Foshan cities. Schizophrenia and mental retardation with mental disorders were the two leading sources of the burden ascribed to severe mental disorders. Population growth and aging could be accountable for the increasing burden of severe mental disorders. Economic regions with higher SDI carried a greater burden but had lower annualized rates of change in DALYs. The overall burden of severe mental disorders is projected to rise modestly over the next decade.

Conclusions

The findings urge prioritization of initiatives focused on public mental health, prevention strategies, health resources reallocation, and active involvement of authorities to effectively address the anticipated needs.
Cognitive after-effects and associated correlates among post-illness COVID-19 survivors: a cross-sectional study, Egypt
Authors: Abdelghani Mohamed , Atwa Samar A. , Said Amira , Zayed Niveen E. , Abdelmoaty Ahmed A. , Hassan Mervat S.
Published: June 2022

Background

COVID-19’s after-effects among survivors are of increased concern. The cognitive aftermath of COVID-19 virus infection was underrated. This study aimed to identify and compare the cognitive impairment (CI) and its correlates among COVID-19 survivors and control subjects. A total of 85 adults who survived COVID-19 virus infection and an equal number of control subjects (matched for age, sex, education, and socioeconomic level) were included in this study. They were recruited from Zagazig University Hospitals, Sharkia Province, Egypt. All subjects were interviewed utilizing a semistructured demographic and clinical checklist, the Montreal Cognitive Assessment (MoCA) test, and the Hospital Anxiety Depression Scale (HADS).

Results

More than half of COVID-19 survivors experienced CI (compared to only 8% of control subjects). Individuals who survived COVID-19 virus infection were more likely to have impairments in visuo-executive functions (OR: 0.3, 95% CI 0.2–0.5), attention (OR: 0.4, 95% CI 0.3–0.7), language (OR: 0.2, 95% CI 0.1–0.5), delayed recall (OR: 0.5, 95% CI 0.4–0.6), and total MoCA Scores (OR: 0.1, 95% CI 0.04–0.2). Among COVID-19 survivors, those who experienced CI were likely to be older (OR: 1.1, 95% CI 1.03–1.2), and of low-to-moderate education (OR: 4.9, 95% CI 1.6–15.1).

Conclusions

CI was prevalent among COVID-19 survivors. The visuo-executive functions, attention, language, and delayed recall were the most affected domains. Older age and lower educational level predicted CI in COVID-19 survivors.
Bone loss in aseptic revision total knee arthroplasty: management and outcomes
Authors: Bieganowski Thomas , Buchalter Daniel B. , Singh Vivek , Mercuri John J. , Aggarwal Vinay K. , Rozell Joshua C. , Schwarzkopf Ran
Published: June 2022

Background

Although several techniques and implants have been developed to address bone loss in revision total knee arthroplasty (rTKA), management of these defects remains challenging. This review article discusses the indications and management options of bone loss following total knee arthroplasty based on preoperative workup and intraoperative findings.

Main text

Various imaging modalities are available that can be augmented with intraoperative examination to provide a clear classification of a bony defect. For this reason, the Anderson Orthopaedic Research Institute (AORI) classification is frequently used to guide treatment. The AORI provides a reliable system by which surgeons can classify lesions based on their size and involvement of surrounding structures. AORI type I defects are managed with cement with or without screws as well as impaction bone grafting. For AORI type IIA lesions, wedge or block augmentation is available. For large defects encompassing AORI type IIB and type III defects, bulk allografts, cones, sleeves, and megaprostheses can be used in conjunction with intramedullary stems.

Conclusions

Treatment of bone loss in rTKA continues to evolve as different techniques and approaches have been validated through short- and mid-term follow-up. Extensive preoperative planning with imaging, accurate intraoperative evaluation of the bone loss, and comprehensive understanding of all the implant options available for the bone loss are paramount to success.
Perception of Doctors Attending Association of Black Psychiatrists-UK Led CASC Preparatory Course
Authors: Adeyemo Suraju , Manuwa Olufikunayo , Ugalahi Theresa , Asiodu Nneamaka , Awhangansi Sewanu , Odebiyi Babatunde , Akhator-Eneka Nwife , Adeniji Mojisola , Oraegbunam Chukwuma
Published: June 2022

Aims

Within the United Kingdom, there has been differential attainment in academic performance and career progression between International Medical graduates (IMG) and UK medical school graduates. Reasons reported for these differences include; poor relationships with trainers, cultural differences, and inadequate support. To close this differential attainment, effective interventions to support IMGs are indicated. This need for diversity led to the creation of the Association of Black Psychiatrists-UK Tutorial group (The-Tutors). The Tutors is a free online CASC preparatory group that started about 2-years ago and is tailored to meet the specific needs of black doctors sitting the Royal College of Psychiatrists examination. over 100-black Doctors have benefited from the group. This study was conducted to evaluate the experience of these doctors.

Methods

The sampling frame was the population of doctors who attended The-Tutors before sitting the CASC examination. Data were collected on socio-demographic characteristics, past psychiatry training experiences, and participants' experience toward preparation and passing CASC.

An online questionnaire was completed and this was distributed through social media (closed WhatsApp groups).

Responses were anonymous.

Results

Total participants were 33, out of which 20 (60.6%) had passed the CASC examination while 13 (39.4%) are still awaiting results.

The majority (51.5%) of the participants had only international training in Psychiatry, 27.3% had their training in the UK, and 12.1% had both, while 9.1% had no formal-psychiatric training.

Most 21(63.6%) participants indicated that the group was ‘extremely useful’ for CASC preparation.

In terms of comparing experience in this group with other CASC preparatory groups, all the respondents found The Tutors group more helpful; 16(48.5%) indicated that the group was ‘extremely helpful’, 14(42.4%) ‘very helpful’ and 9.1% “moderately helpful”.

Most of the participants (75.8%) indicated that they were “extremely likely” to recommend the group to others.

The majority (>65%) of respondents reported that The-Tutors helped in improving their knowledge, communication skills, confidence approaching the examination, and motivation to study.

Close to half (48.5%) of participants who had passed the CASC examination indicated that The-Tutor was “extremely helpful” toward their success.

Conclusion

This study has shown positive experiences of IMG especially of Black ethnic group attending an all- Black-led CASC preparatory group. This could be an indication that support groups specifically targeted toward the needs of IMG could help lead to an increase in success rates in UK examinations.
A Survey of Long Case Psychotherapy Experiences of Psychiatric Trainees Working in South London and Maudsley NHS Trust
Authors: Askari Famia , Brown Gillian
Published: June 2022

Aims

Psychotherapy is a mandatory component of the Royal College of Psychiatrists training curriculum. The long-term benefits of psychotherapeutically-informed practice to both patients and doctors are well recognised. In the face of regular service configurations, there was a wish to gather evidence to ensure continued provision of this training experience to a high quality. The purpose of this survey was to obtain feedback from trainees regarding their experience of the psychodynamic psychotherapy long case to evidence the relevance and value of this component of the training programme.

Methods

The anonymous survey, including questions, numerical rating scales and free text boxes, was sent to 294 trainees on a combined mailing list. This number may be slightly inaccurate due to incorrect email addresses and duplicates. A reminder email was sent one week later to encourage a higher fill rate.

Results

There were 35 responses: a fill rate of approximately 12%. The largest group of respondents were Core Trainees (3rd year) of whom just over half had completed the long case.

92% of respondents found the long case to be at least ‘slightly useful’, of whom almost a third found it ‘extremely useful’. 94% of trainees found the experience to be at least ‘slightly helpful’ in understanding psychodynamic concepts and 75% found supervision ‘very’ or ‘extremely useful’.

Qualitative responses described it as a unique experience not offered elsewhere in the curriculum that provided important transferable skills.

Difficulties mentioned were similar to those found by previous studies, including practical concerns relating to patient and service factors. There were suggestions for more in-depth training and suggested reading to increase trainees’ confidence. An email was sent signposting trainees to further support in response to some specific concerns.

Conclusion

Overall, the responses suggest that the majority of trainees find the long case a valuable training opportunity. These data are useful to evaluate and improve trainees’ experience within the trust, and could be helpful for other training programmes nationally.

Due to the nature of psychotherapy, there is inevitable variation in trainee experiences but attempts to clarify and/or standardise some elements may result in greater trainee satisfaction. Trainees suggested improvements including addressing practical issues, patient factors, supervision content, and educational resources. A future survey following implementation of some suggested improvements would be helpful; the impact of the COVID-19 pandemic and the switch to remote working is another area that may be useful to explore.
Educational Supervision – Backbone of Training: How Do We Make It Effective?
Authors: Bandawar Mrunal , Ali Zahra , Carone Laura Jayne , Sain Kallol
Published: June 2022

Aims

Assess and improve the educational supervision for the core psychiatry trainees (CT) in the west midlands.

Methods

The data were collected from core psychiatry trainees in West Midland (CT1 – 3) through a Microsoft form sent via the Faculty support team and data are collected (June 2021) from CT's perspective. It involved demographics and questions evaluating quantitative and qualitative overview of educational supervision. We used HEE guidelines and RCPsych recommendations. Similarly, we used a modified questionnaire to anonymise educational supervisors’ (ES) perspectives in the West Midlands School of psychiatry annual Education day conference (January 2022).

Results

Trainees Perspective: 40% out of 123 trainees responded, of which 35% were CT1, 40% were CT2, and 25% were CT3. 59% said that CT in psychiatry was their first training job in the UK. In the quantitative overview, 25% of the trainees responded their 1st contact with their ES was more than six weeks after beginning their 1st post, and 29% expressed their 1st meeting more than six weeks following the start of their 1st post in the academic year. 67% met adequate standards in the quantity of educational supervision in an academic year. In qualitative overview, 19% didn't understand the role of ES, and 54% didn't know how to raise concerns about ES. The thematic analysis of the feedback suggested points of improvement as supervisions not being ‘tick-box’ exercises and accessibility of ES.

The trainer's perspective: 60% of attendees responded, 71.4% were ES. All the responding ES answered that they would arrange their 1st meeting six weeks before the start of the academic year. Almost all suggested the most common difficulty in educational supervision as availability of time, considering clinical workload for both ES and CTs. All respondents knew that the number of meetings would be as many as trainees wanted in an ideal/needful situation. From the thematic analysis of free text, almost all responded lack of time was a barrier in providing the supervision reflecting on their ability to engage with the trainees.

Conclusion

Suggested recommendations were to raise awareness among the trainees through workshops at induction to explain the aim and objective of educational supervision and to have a guided list of suggested topics to discuss in supervision. For trainers, further training about HEE & RCPsych guidance about Educational supervision would be helpful. Educational leads need to engage in job planning. A comparison between Trainees and trainers feedback through the GMC survey may help to compare with the national picture.
Quality Assurance of the ‘MRCPsych Course’ in Wales
Authors: Davies-Kabir Megan , Collins Ann , Walton Catherine
Published: June 2022

Aims

The ‘MRCPsych Course’ (Membership of the Royal College of Psychiatrists) is provided to all core trainees in psychiatry in Wales by the School of Psychiatry, Health Education and Improvement Wales (HEIW), now delivered online since the start of the COVID-19 pandemic. The aims of the HEIW MRCPsych course are: to prepare core trainees for the MRCPsych exams and to set a ‘robust platform’ for speciality training at the higher level in psychiatry. We undertook a quality assurance of the 2020/21 academic year to see how content and delivery of the course were serving these aims and make recommendations for improvement.

Methods

Over the course of one academic year we triangulated trainee feedback, lecturer feedback and peer review. Trainee and trainer feedback forms were sent out following every session. We developed standards and criteria for peer review and reviewed 10% of sessions. We conducted focus groups with trainees using mentimeter to structure a real time, anonymous interaction with parallel verbal and written discussions using a virtual meeting.

Results

Trainee feedback forms were received for 31 lectures from an average of 11 trainees per session. 14 Lecturer feedback forms were received, and 48 trainees attended the two focus groups. 15 hours of teaching underwent peer review.

Conclusion

Lecture content was universally accurate and up to date and all teachers were fluent and engaging, with almost all incorporating research data, guidelines and inspiration for further learning.

Several lecturer feedback forms requested a curriculum be provided. Some trainees requested a more exam focused approach with more MCQs.

Trainees found online sessions more accessible and convenient. The major downside being that they no longer get to know each other and feel very anonymous, which makes peer support and interaction more difficult.

Interactive engagement was the lowest scored domain overall. Interaction seemed to work best when done as a continuous process from the start and when a variety of techniques were engaged. Trainee's suggestions for increasing interactivity included quizzes, polls, breakout rooms, use of interactive tools, and a general encouragement of cameras and microphones on and active discussion throughout the session.

Speakers had no problems using the technology to deliver an online session, this triangulated with their high confidence and high satisfaction reported by lectures with HEIW practical support. Trainees reported a high satisfaction with the quality of teaching on the course.

Our conclusions have informed changes which are currently being implemented and tested.
Virtual Simduction Programme Improves Junior Doctor Confidence and Knowledge for Psychiatry Rotation
Authors: Di Francesco Daniel , Vaughn Robert
Published: June 2022

Aims

To design a virtual simulation training session for junior doctors starting their psychiatry rotation, to be delivered virtually at induction. To measure how this changes doctors' confidence and knowledge about the rotation.

Methods

A small committee of experienced psychiatric trainees decided on a set of 5 common on call scenarios. Focus was given to clinical scenarios that involve the use of good communication skills with patients and with other clinical staff encountered on call such as Nurses and HCAs.

The 5 stations focused on:

Using section 5(2), risk assessment

rapid tranquilisation

neuroleptic malignant syndrome

alcohol detoxification

managing self harm and ligatures.

Each scenario utilised real world documentation as tools for the candidate to utilise (drug charts, NEWS charts etc) to increase fidelity. Detailed actor briefs were drawn up with instructions for the facilitators.

During delivery of the sessions, a ‘safe learning space’ was set before individual learners took on the scenarios. ‘Time outs’ were utilised to allow the candidate to think through the scenario with the facilitator.

After each scenario, the facilitator then used crib sheets to lead ‘mini tutorials’ for 10 minutes around each scenario to flesh out the theoretical and practical learning points. The simulation-trained actors gave feedback on communication skills. Candidates were provided with feedback forms at the conclusion.

Results

Feedback from the sessions was overwhelmingly positive. Every single candidate (n = 30) either agreed or strongly agreed that the session met the learning outcomes of increasing confidence, creating a realistic setting, being a fun and enjoyable introduction to psychiatric services.

Blank space feedback was also excellent, with many doctors asking for further expansion of the development of the session into a rolling program, and expansion of the scenarios to include more complex clinical situations that involve other members of the MDT.

Conclusion

The virtual simduction programme is an effective way to improve confidence and knowledge of common scenarios faced for junior doctors new to a psychiatry rotation. Further development will involve a transition to a face-to-face programme and integration of the wider MDT, including nurses, support workers and pharmacists.
Psychodynamic Psychiatry Education and Training for Doctors
Authors: FitzGerald James , Arends Fraser , Peters Pamela , Christmas David
Published: June 2022

Aims

Background and Aim: Psychodynamic psychiatry training seminars are a blended supervision and experiential style approach to training health care professionals in reflective practice and formulation. They apply psychodynamic theory through case formulations, seminars, and Balint groups so that health care staff can improve their communication style, formulation skills and enhance their appreciation for patients with complex mental health problems. Our aim is to evaluate the provision of our psychodynamic psychiatry training sessions for doctors in psychiatry, gastroenterology, and emergency medicine, and to evaluate the perceived benefits of attending in terms of personal and professional development.

Methods

Methods: The evaluation used a standardized mixed-methods approach, with the sample consisting of psychiatry core trainees (n = 9), gastroenterology higher trainees (n = 4), and emergency medicine doctors (n = 10). The evaluation period was between October 2021 and January 2022. Data were gathered via a survey tool, adapted from the literature using Likert scales and free text questions to identify barriers and facilitators to the sessions.

Results

Results: All participants (n = 23) scored the group highly across the board in terms of acceptability, clinical impact, and fidelity measures. All participants reported that they have a better appreciation of group dynamics, the impact of the doctor's humanity and personality on their clinical work, and the symbolic meaning of the patient's symptoms. Notably, approximately 60% reported that the sessions were relevant to their ongoing training needs and that 95% of participants felt the sessions were a safe place to express and process anxieties and frustrations about their work. All participants either agreed or strongly agreed the group had changed the way they think and practice, and that they felt able to consider their clinical encounters in a new light.

Conclusion

Conclusion: This evaluation reports early findings on psychodynamic psychiatry teaching for different medical groups. Overall, the participants felt the sessions were relevant to their training and improved their personal and professional development. Key benefits of the group were highlighted and included increased insight into the emotional and symbolic aspects of the patient's symptoms and clinical issues, team working through cohesion, and the humanity of the doctor in the clinical relationship with the patient. This suggests that the sessions provide a much-needed space to process and reflect on the often-intense demands of clinical work, individually and as a team. The main theme within barriers to the group processes was external in terms of other clinical demands requiring prioritization.
How Are Special Interest Sessions Used by Higher Psychiatry Trainees in Wessex Deanery?
Authors: Gee Claire
Published: June 2022

Aims

The aim of this survey was to establish how higher psychiatry trainees are using special interest sessions. Special interest sessions provide trainees with the opportunity to gain additional experience and are defined as ‘a clinical or clinically related area of service which cannot be provided within the training post but which is of direct relevance to the prospective career pathway of the trainee.’ The Curriculum for Specialist Training in Psychiatry states that two sessions every week must be devoted during each year of Specialty training for such personal development, which may be taken in research or to pursue special clinical interests.

Methods

All higher psychiatry trainees working within Health Education England (HEE) Wessex Deanery were invited to complete a survey using Google Forms between 1st March 2021 and 1st April 2021. The survey included multiple choice and open questions relating to the accessibility, use and content of special interest sessions. Participants were asked to comment on their experiences. Quantitative data were analysed using Excel and qualitative data were collated and reviewed.

Results

20 of the total 42 higher psychiatry trainees responded with the highest response rates from trainees in Old Age Psychiatry and dual training posts. 25% were using all their entitled special interest sessions. The remaining trainees were not able to use them consistently due to clinical service demands and 10% were not using any due to being unaware of opportunities available.

The majority of trainees were using special interest sessions for research, followed by postgraduate qualifications and psychotherapy. Other special interests included medical education, management experience and psychiatric liaison. 70% found their special interest sessions straightforward to arrange and supervisors were highlighted as a useful support.

Most trainees did not have a good awareness of special interest opportunities available within their specialty. 90% would like to be better informed of opportunities for special interest sessions.

Conclusion

The survey indicated that the majority of higher psychiatry trainees are having difficulty accessing special interest sessions due to clinical service demands and a lack of awareness of opportunities available. In order to meet Curriculum requirements, it is important that trainees are supported by supervisors and trusts to access special interest sessions. Specialty training job descriptions should allow for special interest time with appropriate cover arrangements. To improve awareness of special interest sessions, I have developed an information booklet listing opportunities available for higher psychiatry trainees in HEE Wessex Deanery.
Late to the Party: Mental Health Professionals’ Knowledge on Party Drugs and Harm Reduction Advice
Authors: Gibson Nataly
Published: June 2022

Aims

Knowledge of illegal substances has long revolved around addictions in psychiatry training and not of party drugs or harm reduction. Reasons for this could include it being a fairly taboo subject, and it being an area where information and advice change frequently. However, drug related deaths are at their highest since records began, and as our patients use them, it is important that professionals are knowledgeable and can offer sound harm reduction advice. The aims were to establish whether there was a deficit in mental health professionals’ knowledge and understanding of party drugs and harm reduction, to give education on this subject, and to gain feedback on whether it is useful and/or important.

Methods

A questionnaire of 10 questions on party drugs and harm reduction was devised using resources from charities ‘The Loop’ and ‘Talking Drugs’. These questions aimed to test general knowledge in this area that would be expected from professionals. The study was carried out using Mental Health professionals (MDT) in a busy South London Trust in November 2019 and March 2020.The questionnaires were given before and after teaching sessions on the subject. Feedback was then collected from the attendees on their experiences.

Results

Before the teaching sessions, professionals answered 44% of the questions correctly, 48% incorrectly, and 8% were ‘don't know’. However, after the sessions these scores went up to 77% correct, 19% incorrect, and 4% were ‘don't know’. Feedback was extremely positive, with an Addictions Consultant even commenting that she didn't know a lot of what was being taught! Professionals recognised the gap in their knowledge and were keen for more teaching.

Conclusion

Party drugs and harm reduction knowledge is lacking in Mental Health professionals despite it being commonly seen in our patients. Informed, tailored teaching sessions can help improve this and it seems most professionals would welcome it. In the future it may be useful to include this type of teaching as part of the official Psychiatry curriculum.
A Virtual Introduction to Mental Health Tribunals: A Pilot Project
Authors: Halawa Razan , Duroux Seona
Published: June 2022

Aims

This training aimed to familiarise the trainee of the mental health tribunal process and its delivery in the virtual form, improve the trainee's ability to provide targeted and succinct evidence both in written and verbal form.

Methods

This project followed a PDSA cycle. We targeted core trainees in their 3rd year (CT3s) for this pilot for practical reasons, we've also asked one third year nursing student to participate. We have started with a pre-intervention survey to obtain knowledge and confidence levels with regard to tribunals and identify further training needs. We used one of the slots available on Thursday MRCPsych course schedule to conduct the pilot. We have identified several people who are willing to participate in the teaching process, including an inpatient unit consultant, a judge, an experienced panel psychiatrist.

We have obtained teaching material from the MHA office at the trust. On the day of the pilot, we prepared introductory material in the form of power point presentation about tribunals and how to write reports. We then introduced our virtual patient “Mike” whom we based the report writing workshop and MOCK tribunal on using theoretical nursing and doctor entries. The teaching was followed by post intervention qualitative feedback. Data of pre and post intervention were moved to an excel spreadsheet for further analysis. We will take the results from this pilot to inform the next cycle of the project.

Results

Quantitative data: The training module was conducted over Zoom. Pre and post intervention surveys indicated an improvement in the trainees’ knowledge and confidence scores of 28–44% as described in figure 1.

Qualitative data: The trainees and facilitators provided very positive qualitative feedback. Themes mentioned were related to comprehensiveness of training material, confidence gained in providing evidence, range of information covered, on hand experience, experts presence, relevance for multidisciplinary training cohort. Areas of improvement included minor technical difficulties, suggestion of more time spent on nature and degree, and involving service user and lay person representatives.

Conclusion

The above analysis and feedback suggests a successful run of the first pilot. We will aim to increase representation and allow more time for the some of the key learning points like understanding the difference between nature and degree in relation to MHA. We will continue to liaise with the department of Medical Education at Severn Deanery and We will also run the project at a wider scale including more nursing students and trainees of different levels.
Establishing an Old Age Liaison Psychiatry Network
Authors: Jenkinson Josie , Krishnan Mani , Price Annabel , Sampson Liz
Published: June 2022

Aims

Our aim is to establish a network for clinicians working in or with an interest in the growing specialty of old age liaison psychiatry to provide peer support (inclusive of disciplines and geography) and access to CPD opportunities, to raise the profile of this subspecialty and enable it to continue to develop, to facilitate collaboration and integration with related disciplines and pathways and to strengthen the voice of clinicians in lobbying for improvements in mental health services for older people in the general hospital.

Methods

Old Age Liaison Psychiatry is a growing subspecialty in the UK and nationally, following widespread investment in development of liaison services in line with Department of Health strategy. With this expansion comes an increasing need for continuous professional development, networking and collaboration opportunities in order to nurture the specialty and those working in it.

Results

Over 100 people registered for the initial webinar, and many more have watched the recording. Since the webinar the network has grown to 350 members. The webinars were received very positively, with many suggestions made for topics to be covered at future events.

Conclusion

The network has been established successfully and founders are now planning future events with the support of the Royal College of Psychiatrists, including a half day learning event in late 2022.
The Evaluation of North Wales SPiCE: Special Preparation in CASC Examination
Authors: Loo Jiann Lin , Thomas Catrin , Simiyon Manjula , Malhotra Rahul , Shankar Nikhil Gauri , Bhattacharyya Sarmishtha
Published: June 2022

Aims

As part of the effort to support core psychiatry trainees in North Wales to prepare for their CASC (Clinical Assessment and Skill Competency) exam, the North Wales SPiCE (Special Preparation in CASC Examination) Project has been initiated. This article aims to evaluate the SPiCE based on medical educational principles.

Methods

A total of five candidates preparing for the CASC exam expressed interest and an organising committee was set up. Examiners consisted of a consultant and four specialist registrars while role players were recruited from non-exam sitting junior trainees. Five mock CASC stations were written and role-players were calibrated accordingly. The stations included: History taking for a patient with FTD (frontotemporal lobe dementia), MSE (Mental state examination) of a patient with mania and psychosis, explanation of CBT (cognitive-behavioural therapy), breaking bad news of NMS (neuroleptic malignant syndrome), and explanation of ECT (electroconvulsive therapy). The mock exam was conducted virtually using Microsoft TeamsTM. The specialist registrars’ performances in feedback provision were assessed for their teaching using the AOT (Assessment of Teaching) form by the consultants. For core trainees who had played the part of organising committee members and role players, their volunteerism and educational management experience were assessed using the DONCS (Direct Observation of Non-clinical Skill) form by specialist trainees.

Results

All five candidates passed all the stations (consists of both borderline pass, pass) in the mock exam with 25% improvements in confidence level were seen among candidates in four stations, i.e. ECT explanation, breaking bad news of NMS, CBT explanation, and MSE of a patient with mania and psychosis. All candidates feel the SPiCE programme was useful in helping their final preparation and they would recommend it to other candidates. Four of the candidates sat for the immediate CASC diet after the SPiCE received a pass result. All specialist registrars received positive AOT feedback for their teaching and all non-exam sitting junior trainees received positive DONCS feedback for their spirit of volunteerism and collaborative teamwork.

Conclusion

The main strength of the SPiCE project is it utilises existing resources and volunteerism of the organising committee while its main limitation is it has only five stations rather than 16 stations in the real exam. Although the mock exam has improved the confidence of candidates and the majority of candidates pass the exam immediately after that, the causal link between the SPiCE and candidates’ results cannot be conclusively established given all candidates have a good baseline.