bluuebunny/crossref_metadata_2025_split huggingface dataset:
Audit of follow-up within 7 days on discharge from the mental health unit, Forth Valley Royal Hospital
Authors: Turner Matthew , Love Shaun , Douds Fergus , Zebda Anyssa 
Published: June 2021

AimsTo determine compliance with the new discharge policy of review within 7-days for all General Adult Psychiatry patients discharged from Forth Valley Royal Hospital.BackgroundIt is well established that there is an increased risk of suicide following discharge from Inpatient Psychiatric Wards. This risk is significantly increased in the first month, and particularly high in the first week.In their 2016 Guidance, NICE recommends follow-up within 7 days of discharge. It is not known whether seven day follow-up reduces suicide risk but it is clearly an opportunity for risk assessment and management during a particularly risky period.This standard was adopted by the General Adult Wards in Mental Health Unit at Forth Valley Royal Hospital in April 2019.MethodAll discharges from Wards 1, 2 and 3, Forth Valley Royal Hospital were reviewed during three distinct, month-long periods:November 2018 (prior to the introduction of the new discharge policy)May 2019 (shortly after the introduction of the new discharge policy)September 2019 (six months after the introduction of the new discharge policy)A list was obtained from Medical Records of all General Adult patients discharged in these periods. The paper and electronic records were checked for each patient, and the first scheduled care episode post discharge was taken as follow-up.ResultIn the1st round of audit (November 2018): 41 patients were discharged and 26 patients (64%) received follow-up within 7 days.In the 2nd round of audit (May 2019): 46 patients were discharged, 39 patients (84%) received follow-up within 7 days.In the 3rd round of the audit (September 2019), 50 patients were discharged and 49 (98%) received follow-up within 7 days.ConclusionThere has been a clear improvement in the provision of follow-up on discharge from the General Adult Psychiatry Wards in Forth Valley Royal Hospital.The new discharge policy was implemented in April 2019 and a “Discharge Pause” was introduced (initially a sticker, now an electronic form) to be completed by the medical team at the point when it was decided to discharge.Community Mental Health Teams have also been reminded of their need to facilitate seven day follow-up as a priority. A flowchart was produced in May 2019, which provided guidance as to who should provide the seven day follow-up.
Mental health clothing bank - adDressing the issue
Authors: Ward Louisa 
Published: June 2021

AimsWe often have patients who are admitted to the ward wearing only the clothes they came in. These patients have no way of going to get more clothes due to being detained, poverty/ homelessness or covid restrictions. Many do not have friends or family who can bring them clothes. As such they might wear one set of clothes for a number of weeks which is bad for their physical and mental health. We are creating a clothes bank to provide a change of clothes for these patients, and help their recovery back into the community. Many have clothes that are inappropriate for the current weather, or do not have a set of smart enough clothes for a job interview. We feel that this simple intervention will have a big community impact.MethodWe have obtained support from a number of charities and companies to supply donations. The project will be led by a team of staff and patients.ResultWe will review the usage of this scheme in 6 months timeConclusionWe hope this intervention will tackle the issue of clothing on mental health wards. In the future we wish to expand this to outpatient mental health service users. We would then like to expand this project countrywide as are unaware of any other areas providing something similar.
Site downsizing: a blessing or a curse?
Authors: Waterhouse Benjamin , Attwood Ben 
Published: June 2021

AimsTo measure staff wellbeing and morale, which in 2015 was described by CQC as 'low', following a downsizing of premises.BackgroundIn 2019, due to loss of mental health funding, Camden & Islington NHS Foundation Trust controversially sold the much-loved Queen Anne-style mansion Lyndhurts Gardens. The Rehab & Recovery team caring for those with serious mental illness were relocated to one floor of the much smaller Daleham Gardens. It was hypothesed by the authors that this would impact negatively on the already unhappy workforce.MethodThe same staff wellbeing survey was used as in in 2015 (following CQC's description of 'poor' morale), nearly 5 years on and following the site relocation. All clinical, managerial and administrative staff members were encouraged to participate by posting their survey anonymously in a make-shift postbox. Sweet treats were used to encourage participation within the busy team.ResultQualitative and quantitative data were collected from the team (response rate 44%). Exact tables will be shown but in summary; in the new building there was an increase in the number of staff who felt they could use initiative at work, make improvements at work, looked forward to going into work and felt enthusiastic about their job. Improvement cited were 'increased socials after work' and consequent 'wellbeing', in addition to 'good team atmosphere', 'good team work' and 'good relationships' in the new space. Further ideas were generated for additional improvements going forward.ConclusionWhilst caseloads and workloads are often cited as the cause of burnout, and indeed other changes in the 5 years could act as confounders, the design of work buildings is not to be underestimated. Contrary to what the authors had suspected, 'bigger' was not necessarily 'better' and a more condensed working environment made for greater togetherness amongst the team. In this age where economically desperate NHS trusts are forced to sell off their prized assets, observations that this is not always at the detriment of staff morale will provide some cause for optimism.
Increasing participation in the 2019 UK general election amongst patients on a high intensity rehabilitation ward
Authors: Wood Aaron , Shetty Amrith 
Published: June 2021

AimsTo increase participation in the 2019 UK general election amongst inpatients on a high intensity rehabilitation ward, by supporting patients to both register to vote (RTV) and vote.BackgroundIn 2000, the franchise was extended to those under section 2 or 3 as well as informal inpatients. Unfortunately, voting rates remain low: studies of the 2010 general election show voting rates amongst psychiatric inpatients to be 14%, compared to 65% for the general population. Engaging patients in the democratic process is not only just, it has been shown to be an effective avenue for rehabilitation through increasing social capital. The 2019 UK general election represents a singular opportunity for biopsychosocial rehabilitation.MethodIn the three weeks up until 26/11/19 – the deadline to RTV – visual displays and verbal information were used to notify patients of:
The electionTheir eligibilityThe need to RTV before casting a ballotThe registration deadlineVoting methods (in person, by post, by proxy)We gathered patients’ intention to RTV and offered impartial, personalised support to register online or by paper, and to apply for a postal or proxy ballot if wished. Patients with no fixed abode were supported to use the ward as their declared place of residence.ResultOf the 17 patients on the ward there were:Four informal patients11 patients under section 3One patient each under a section 37 and a section 37/41, both ineligible to voteOf the 15 eligible patients, one (6.7%) had already registered, six patients (40%) wanted to register and eight (53.3%) stated they did not want to register. Those wanting to register were supported according to individual patient preference. Of the registered seven, five (33.3%) reported voting, one (6.7%) reported not having voted and one (6.7%) declined to say. Two (13.3%) voted in person and five (33.3%) voted by postal ballot.ConclusionOur intervention corresponded with an increase in number of patients registering – from one patient (6.7%) to seven (46.7%), with 5-6 (33.3-40%) casting their ballot. While the causal relationship should not be overstated, the uptake of assistance supports the intervention's efficacy.Good rehabilitation increases a person's social capital, empowering them to actively participate in societal life. Registering to vote is a tacit assertion of this principle. Our study shows that brief interventions that are easily incorporated into everyday care are a simple, effective and ultimately necessary tool in holistic mental health rehabilitation.
Impact of community treatment orders on inpatient bed usage in assertive outreach team
Authors: Al-Uzri Mohammed , Harvey Zena , Noushad Fabida , Iheonu Chinyere , Abbas Mohammed 
Published: June 2021

AimsTo examine the impact of using Communty Treatment Orders (CTO) of the Mental Health Act on use of inpatient care in Assertive Outreach team.BackgroundCurrently there is little evidence of the efficacy of community treatment orders (CTOs), and in particular with patients who use the Assertive Outreach service. One large randomised controlled study found no impact on use of inpatient care while a naturalistc study found significant impact.MethodOur primary outcome was the number of admissions with and without a CTO comparing each patient with themselves before CTO and under CTO(“mirror-image”). Our secondary outcomes were the number of bed days, and the percentage of missed community visits post-discharge. We also looked at the potential cost savings of a reduction in inpatient bed usage.ResultAll the 63 patients studied over period of 6 years had a severe and enduring mental illness. The use of a CTO was linked to a significant reduction in the number of admissions (mean difference = 0.89, 95% CI = 0.53–1.25, P < 0.0001) and bed days (mean difference = 158.65, 95% CI = 102.21–215.09, P < 0.0001) There was no significant difference in the percentage of missed community visits post-discharge. Looking at the costs, an average cost for an inpatient Assertive Outreach bed per day in the local Trust was £250, and there were 8145 bed days saved in total, making a potential saving of just over £2million, during the study period.ConclusionThis study suggests that the implementation of CTOs using clinical judgment and knowledge of patients can significantly reduce the bed usage of Assertive Outreach patients. The financial implications of CTOs need to be reviewed further, but this study does suggest that the implementation of CTOs is a cost-effective intervention and is economically advantageous to the local Trust.
Relationship between bullying victimisation and post-traumatic stress disorder among public junior secondary school students in Abeokuta, Nigeria
Authors: Awhangansi Sewanu , Salisu Titilayo , Akanji Oluwayemisi , Okewole Adeniran , Sowunmi Oladipo , Amosu Sunday , Adeosun Increase , Owoeye Olugbenga 
Published: June 2021

AimsTo determine the relationship between bullying victimization and PTSD among students attending public Junior Secondary Schools in Abeokuta. The Prevalence of Bullying victimization and PTSD as well as some socio-demographic correlates were also assessed.MethodAbout 411 junior students from five randomly selected public secondary schools were approached for the study and given consent forms to take home to their parents/guardians. Those who subsequently returned signed consent forms and who gave assent to participate in the study were administered the Socio-demographic questionnaire and the Multidimensional Peer Victimisation Scale (MDPVS). They were thereafter interviewed with the PTSD module of the MINI KID.ResultA total of 351 students completed the study to yield a response rate of 85.4%. The age range of the respondents was 9–17 years with mean (SD) of 12.48 (1.50) years. The gender distribution was 49.3% males and 50.7% females. 68.7% of the respondents were from a monogamous home, 22.2% had divorced parents, 74.3% lived with both parents, and 6% reported being an only child. 14.8% of the respondents reported having experienced higher levels (moderate & high) of victimization by peers. The mean score of the overall bullying victimization level was 9.6 (±6.5). Verbal victimization subscale had the highest mean score of 3.2 (±2.0), while physical victimization had the lowest mean of 1.9 (±2.1). Seventy (19.9%) students admitted to the experience of a significant traumatic event, with only 7.1% of these meeting the current diagnosis of PTSD in the past month. There was no statistically significant association between bullying victimization and PTSD (χ2 = 2.666; df = 2; p = 0.261). Traumatic event experience was however significantly associated with high levels of bullying victimization experience (χ2 = 4.266; p = 0.039). None of the assessed socio-demographic, familial or self-perceptual factors was found to be significantly associated with either bullying victimization or PTSD.ConclusionThe experience of bullying victimization among secondary school students remains a prevailing problem in our local setting, as it is across the globe. Verbal bullying is the most common while physical bullying is the least common peer victimization experience in this study. The study points out that PTSD among high school students in our environment may be more prevalent than had previously been reported. Given the high rates of peer victimization experiences reported by students, there is a need for policy changes to make the school environment safer for students, thereby promoting their mental health.
Evaluation of self-esteem in adolescents of secondary school level
Authors: Begum Farhana , Zubair Usama , Afridi Iqbal , Toufique Fatima , Dars Jawed , Lal Chunni 
Published: June 2021

AimsTo assess the frequency of low self-esteem among adolescents of secondary school level in private schools of KarachiMethodIt was a cross-sectional descriptive study done in ten private schools of Karachi for a period of 6 months. The proposal of the study was accepted by ethical committee of Jinnah Postgraduate Medical Centre, Karachi (called Institutional Review Board or IRB).The subjects fulfilling inclusion criteria were enrolled after obtaining informed consent by their parents. A semi-structured Performa was used to assess students’ particulars and included Rosenberg Self-esteem Questionnaire as a part of Performa. The data were analysed using SPSS version 17.0. Frequencies & percentages were generated for the level of self-esteem.Stratified analysis was done with a p value <0.05 taken as significant.ResultOut of the 246 students, 39.8% were of 14yrs of age, 36.2% were 15 years of age, while only 24% of adolescents were 16 years of age. Majority (64.2%) of the students were males while females were 35.8%. 70.3% of the students had normal level of self-esteem, whereas 28.9% of students had low self-esteem and only 0.8% of students had high self-esteem. Relationship of all the variables was found to be non-significant except that of educational level (p-value 0.047).ConclusionSelf-esteem was found to be normal in most of the adolescents of secondary school level but still more than 1/4th of the study participants had low self-esteem which if assessed and addressed early may save the individuals from mental health issues as well as problems at work and home life.Having a better understanding of self-esteem, can help us to identify the adolescents who have low self-esteem and are predisposed to develop mental health difficulties in future.It can lead to not only early intervention and reducing the burden of disease but also help in developing programs to help improve self-esteem in adolescents,hence increasing their overall motivation and productivity.
Impairments in theory of mind following traumatic brain injury: a systematic review
Authors: Chikramane Radhika 
Published: June 2021

AimsTo assess the nature and extent of Theory of Mind (ToM) impairments post-TBI.MethodElectronic databases searches included PubMed/MEDLINE, PubMed Central, Scopus, PsychArticles, PsychINFO, Web of Science, ProQuest Central, and Wiley Online Library databases. Only studies conducted on adult patients with TBI compared with healthy controls published in English in peer-reviewed journals were considered. Reference lists were manually checked for additional studies. 19 studies were identified.ResultMarked moderate-to-severe ToM deficits in adults post-TBI were observed across all severities of injury and chronicity. ToM deficits were documented across tasks and reflected a hierarchy where performance worsened significantly as tasks progressed in complexity. Despite supportive factors, certain aspects of ToM impairment, such as ability to detect and interpret non-literal speech and judge appropriateness of context remained affected in the subjects.ConclusionToM deficits represent a robust finding in adults with TBI. The chronicity of TBI requires a long-term view and is complicated by the fact that ToM deficits are invisible and difficult to understand. Perceptive-taking deficits faced by TBI sufferers has bio-socio-economic implications. This review also discusses implications for basic and clinical neuropsychology and rehabilitation efforts. Further research is needed, particularly in the form of large, longitudinal studies that mimic day-to-day interactions, to inform/support rehabilitation programs.
Coping with a modern pandemic-an online survey of Anesthesiologists in India during COVID-19
Authors: Chockalingam Punitha , Balakrishnan Kalpana , Natarajan Priyadarshini , Veeraiah Surendran , Rajagopal Revathy , Elumalai Vinodh Kumar 
Published: June 2021

AimsIn 2020, India was one of the worst affected countries by COVID-19. As the pandemic spread, creating undue pressure on health care workers (HCWs), there was an urgent need for the development of appropriate interventions to protect their mental health. This study aims to study the effect of COVID-19 on the mental health of anaesthesiologists in India and factors that influence their coping behaviour.MethodThe study was designed as a semi-structured, descriptive, cross-sectional, online open survey and conducted on Google forms between 21st May and 20th June 2020, among practicing anaesthesiologists across India. The participants were recruited by sending messages to their emails and through social media platforms. It created a small number of international respondents, who were also included (India = 301, rest = 23). The self-designed questionnaire had 30 questions in the form of multiple choices, checkboxes, linear scales and short comments. Informed consent was recorded at the outset. Details such as demographic characteristics, place and nature of work, pandemic related changes in duration or pattern of work, psychological symptoms during and after working hours, fears about quarantine, were collected in the survey. Statistical Analysis was performed using Statistical Package for Social Sciences (SPSS Statistics for Mac Version 21.0 IBM Corp., USA)ResultAmong the 324 participating anaesthesiologists, a prevalence rate of 64.8% for stress, 51.2% for anxiety and 65.7% for depression was noted, which was double the rate from pre-pandemic studies. Those between the ages of 30 and 50 (p = 0.010 OR:2.191) and working in government run (p = 0.045 OR:2.564) COVID-19 hospitals in India (p = 0.002 OR:2.018), were particularly stressed (33.3%) and anxious (38%) than the rest. Increased workload, contracting the virus and becoming an infectious source to their family (88.6%) were their prime concern. Formulating standard operating procedures (SOP) (66.7%) and procuring personal protective equipment (PPE) (56.2%) were some of the challenges faced at work. Most of them recommended a congenial workplace (68.8%) and family support (60.8%) to help them work through their anxiety and fear, while a few reported considering leaving their career (34.8%) from fear of monetary loss and burn out (53.8%).ConclusionCOVID-19 has changed the professional and personal life of anaesthesiologists in India. Irrespective of their workplace, their fears and challenges remain universal. Early identification of anxiety and depression and providing appropriate psychological support will prevent deep and enduring damages to the lives of these professionals.
The effect of schizophrenia-associated CNVs on other psychiatric disorders
Authors: Farakish Lily 
Published: June 2021

AimsSchizophrenia is a highly heritable disorder, sharing genetic roots with other psychiatric disorders from both common and rare genetic variants. Copy number variants (CNVs) are one of the rare causes which increase the risk of a variety of psychiatric, medical and physical phenotypes. The role of schizophrenia-associated CNVs is becoming of increasingly scientific and clinical importance in the field of psychiatry, with new CNV-phenotype relationships opening perspectives for understanding the aetiology of psychiatric disorders. This paper aims to investigate whether 13 schizophrenia (SZ)-associated CNVs or any SZ-CNV-carrier status increase the risk for 9 psychiatric phenotypes, reduce levels of happiness, change duration of sleep, and increase the index of multiple deprivation.MethodThe study includes 421,268 participants of British or Irish descent (aged 40–69 years), containing 418,036 controls and 3232 schizophrenia-associated CNV carriers. The data are secondary from the UK Biobank, an online resource containing data on array-genotyped participants with their specific phenotypic information. Prior to analysis, CNV selection led to the exclusion of any CNV with less than 5 hits in the UK Biobank population. Incidence of each phenotype was based on self-reported diagnoses, questionnaires or hospital ICD-10 diagnoses, with a minimum of 500 cases. Both binary logistic and linear regression were used to assess the incidence of these phenotypes in relation to the CNVs, adjusted for age, sex, and ethnicity as potential cofounders.ResultOverall, 12/13 CNVs were nominally associated with at least one phenotype, including 114/168 possible associations and 54 undetectable associations as not every CNV carrier displayed one of the chosen phenotypes. 41 associations were statistically significant (p < 0.05) and 13 survived Bonferroni Correction (p < 2.98 × 10-4). All significant associations met the expected change except 15q11.2 deletion and any CNV carrier status which showed a decrease in likelihood of addiction.ConclusionThese findings suggest schizophrenia-associated CNV can affect range of psychiatric phenotypes. By building on existing reports, understanding the widespread effects of CNVs in the aetiology and pathogenicty of psychiatric disorders may overtime aid in strengthening our search for more targetted, effective treatments.Many thanks to Professor George Kirov for supervising and supporting this project.