bluuebunny/crossref_metadata_2025_split huggingface dataset:
The mental health of elite rugby players (a literature review)
Authors: Musgrave Kirk 
Published: June 2021

AimsPlayers are Rugby's key asset, what recent research has been conducted into the Mental Health of rugby players/former players?MethodInitially a Literature Search using HDAS, Ebsco, Researchgate and Googlescholar followed by a Literature Review of relevant articles.ResultA significantly higher prevalence of anxiety and depressive symptoms in Professional rugby players (compared to the general population) is something that authors agree on. This review considers some of the rugby specific variables not limited to injuries (including concussion), retirement from the sport and finally alcohol abuse.In 2014, Sullivan looked at the role of potential mediators between concussion and later life depression. Sullivan suggested that the effects of concussion on later life depression may be directly neurological.Chronic Traumatic Encephalopathy (CTE) is a neurodegeneration which is only definitively diagnosed by post-mortem examination of brain tissue at this time. Today, Chronic Traumatic Encephalopathy is a very controversial subject, for every piece of research which claims to prove CTE, there is another piece of research apparently disproving it.Alcohol Misuse - Whilst it is well known in general adult psychiatry that alcohol has a significant negative impact on depression and anxiety in the general population, this review summarises findings from research into alcohol misuse in elite rugby players.ConclusionIn addition to personal variables (which include personality, perfectionism, ability to cope with stress, optimism, pessimism, ability to utilise mental skills, burnout and career satisfaction) there are rugby specific variables which are not limited to injuries, retirement from the sport and finally alcohol abuse.As mentioned in the paragraph on depression and anxiety, numerous recently published authors agree that a significantly higher prevalence of anxiety and depressive symptoms are seen in Professional rugby players (compared to the general population).As alcohol misuse has already been researched, there would seem to be an opportunity for future research into the extent of illicit drug use by elite rugby players and potentially the effect of illicit drug use on depressive symptoms and anxiety. As mentioned in the paragraph on depression and anxiety, numerous recently published authors agree that a significantly higher prevalence of anxiety and depressive symptoms are seen in Professional rugby players (compared to the general population).Finally, given the limited recent published literature on suicide in elite rugby players and former elite rugby players, a significant research gap exists in this particular field.
The role of animal-assisted therapy in the management of people with dementia: a systematic literature review
Authors: Javaid Syed Nabeel 
Published: June 2021

AimsThe aim of this systematic literature review was to determine the evidence-based effectiveness of animal assisted interventions and to look at the factors that limit implementation of this intervention.BackgroundDementia is a major health issue worldwide impacting not only on the people diagnosed with dementia, but also on their families and caregivers, and the healthcare professionals. The symptoms of dementia include cognitive impairment that can range from mild to severe, and behavioural and psychological symptoms which have debilitating effects on functional capacity and quality of life. A number of non-pharmacological interventions are being developed to help people with dementia. Animal assisted therapy is one of those interventions that has demonstrated positive effects on various aspects of dementia (Filan and Llewellyn-Jones, 2006). However, there are limitations to its use and feasibility of animal assisted therapy programmes is unclear.MethodOnly randomised-controlled trials (RCTs) were to be included to evaluate high quality evidence. A systematic literature search was carried out to find using the PubMed and Cochrane databases and a search of the NICE website. Literature was screened according to inclusion and exclusion criteria. Eight randomised-controlled trials were selected to be used in this systematic review to assess the effectiveness of animal-assisted therapy.ResultThe results regarding the effectiveness of animal assisted therapy were variable. There was some improvement demonstrated in symptoms of depression, agitation, behaviour and cognitive impairment. Quality of life and activities of daily living also demonstrated positive outcomes. There was a reduction in the risk of falls in people with dementia. However, the studies conducted demonstrated limited methodologies. The factors limiting the use of animal assisted therapy were found to be concerns around adverse events to animals, issues of animal welfare and economic feasibility of animal assisted therapy programmes.ConclusionFurther research needs to be done using properly conducted randomised controlled trials with larger sample sizes to formally assess people's perceptions regarding therapy animals and develop clear guidelines and protocols for integrating these interventions in healthcare.
The feasibility and acceptability of a peer-support group for mental health in Filipino prisons
Authors: Platford Bethany 
Published: June 2021

AimsTo assess the feasibility and acceptability of implementing and facilitating a peer-support group for mental health in Filipino prisons.ObjectivesTo identify the logistical issues faced in implementing and facilitating healthcare in Filipino PrisonsTo explore attitudes of potential participants towards the implementation of a peer-support group for mental health in the prisonsTo provide logical recommendations from my findings to inform future mental health support for prisoners in the PhilippinesMethodEthical approval was granted by the University of Leeds prior to data collection. In-country ethical approval was granted through my host Dr Rachael Pickering. Data collection occurred through observations and semi-structured interviews. Participants recruited included six secure-environment healthcare workers, eight prisoners and six ex-prisoners. Both prisoners and ex-prisoners were identified through gatekeepers and informed consent was gained. Interviews were transcribed before coding and themes identified.ResultFeasibility: Bureaucracy and corruption were the main barriers to the potential successful implementation of a peer-support group, which were emergent themes. Space, time and staff were all themes identified that may help facilitate the group.Attitudes: It was noted that there is a significant lack of knowledge surrounding what mental health is and its causes. Stigma and discriminatory actions were also noted by many participants as barrier to the group. However, seven prisoners and five ex-prisoners said they would join.ConclusionThe findings highlighted many barriers but with perservance and local cultural competence this peer-support group could be feasible and be accepted in Filipino prisons. It will be reducing a high unmet need for mental health services in these prisons and if ran successfully with positive effects, will be an example for other prisons across the Philippines and other low-middle income countries.
Exploring the influence of wilderness on conscious awareness
Authors: Purnell Oli 
Published: June 2021

AimsThis study examined what effect wilderness has on our conscious awareness, and by extension of that meta-cognition; our physical, mental and spiritual health.BackgroundMethodIt reviews available scientific and artistic literature and integrates this with interviews in order to generate original grounded theory.ResultIt was found that intensity of wilderness experience varied proportionally with four mediators; Challenge, Immersion, Beauty and Time. With these maximised, experiences broadly within four themes occurred; Increased Awareness, Confidence, Perspective and Connectedness. When sufficiently intense, these four experiences amalgamated to elicit what Maslow described as 'Peak Experience'.ConclusionAs such, this thesis unexpectedly provides a pragmatic recipie towards peak experience, and a map of one's potential psychological journey, in the context of wilderness.
Obsessive-compulsive disorder: does CBT with exposure and response (ERP) prevention work?
Authors: Reid Jemma , Fineberg Naomi A , Drummond Lynne , Laws Keith , Vismara Matteo , Grancini Benedetta , Mpavaenda Davis 
Published: June 2021

AimsSince the 1970s treatment for obsessive Compulsive Disorder (OCD) has consisted of the the application of drugs acting on the serotonin system of the brain or psychological treatments using graded exposure. Although there is a large number of studies on psychological treatments, they often are underpowered. Other major methodological issues include ignoring the effects of medication during the trial, using a variety of techniques and using waiting list data as controls.We decided to systematically review and perform a meta-analysis on randomised controlled trials (RCTs) of CBT with ERP (abbreviated to ERP)1.MethodThe study was preregistered in PROSPERO (CRD42019122311). RCTs incorporating ERP were examined. The primary outcome was the end-of-trial symptoms scores for OCD. In addition, factors which may have influenced the outcome including patient-related factors, type of control intervention, researcher allegiance and other potential forms of bias were examined. The moderating effects of patient-related and study-related factors including type of control intervention and risk of bias were also examined.ResultOverall, 36 studies were included in the analyses, involving 537 children/adolescents and 1483 adults (total 2020 subjects). A total of 1005 received ERP and the remainder a variety of control treatments. Initial results showed that ERP had a large effect size compared with placebo treatments. This was more marked in younger than older persons. However, whereas ERP was markedly more effective than waiting list or psychological control, this positive effect size disappeared when it was compared with other psychological treatments.When ERP was compared against psychopharmacological treatment it initially appeared significantly superior but this reduced to marginal benefit when compared with adequate doses of appropriate medication.The majority of studies were performed where there may be expected to be researcher allegiance to ERP and in these studies the effect size was large. In contrast, in the 8 studies considered to have low risk of researcher bias, ERP was found to be ineffective.ConclusionAlthough on initial sight CBT incorporating ERP seems to be highly efficacious in the treatment of OCD, further analysis revealed that this varied depending on the choice of comparator control. In addition there are considerable concerns about methodological rigour and reporting of studies using CBT with ERP. Further studies examining the role of researcher bias and allegiance are needed.Ref : 1 Jemma E Reid, Keith R Laws, Lynne Drummond, Matteo Vismara, Benedetta Grancini , Davis Mpavaenda, Naomi A Fineberg (2021) Cognitive Behavioural Therapy with Exposure and Response Prevention in the treatment of Obsessive-Compulsive Disorder: A systematic review and meta-analysis of randomised controlled trials. Comprehensive Psychiatry , in press.
The neurobiology of attachment and the influence of psychotherapy: a literature review
Authors: Romano Graziella , Patrascu Daniela , Tharian Priyanka , Burbridge-James William 
Published: June 2021

AimsTo review the existing scientific literature on the neurobiology of caregiver-infant attachment and the effects of psychotherapy on neurobiological structures. We hypothesised that the therapeutic relationship is a new attachment relationship that can model and re-map neural networks involved in emotional self-regulation.Understanding attachment is relevant to working with women and families in the perinatal period and has an impact on treatment outcomes. Evolutionary perspectives show that the infant's attachment to the caregiver is important for survival, development of self and relational patterns. Mother's attachment predicts the infant caregiving behaviour in perinatal period and psychotherapeutic interventions at this time have a role in modifying the risk of intergenerational transmission of trauma and further pathological attachment styles.MethodWe performed a MEDLINE search focussing on the past 10 years. Keywords used were attachment, neurobiology and psychotherapy. We included original studies and existing reviews looking at all types of formal psychotherapy used and focussing on human research. Exclusion criteria were non psychotherapeutic interventions and attachment based on couples only.ResultThere has been an increasing focus in the literature on studying the neurobiology of attachment in caregivers and infants both in healthy cases and in psychopathology over the past decade. Existing studies concentrate on care givers, there is growing evidence on the effects of attachment styles on the infant's brain, mostly from animal studies. Some authors looked at the effects of parental childhood trauma on later parenting styles and intergenerational transmission of trauma. A few studies highlighted neurobiological changes as a result of psychotherapeutic interventions in various psychiatric disorders.ConclusionThere is growing evidence on the neurobiology of attachment focussing on specific neurotransmitters and brain pathways. The modulating effect of psychotherapy has also been studied, albeit with more focus on recovery from psychiatric illness. The literature on neurobiological changes with psychotherapy remains scarce and heterogeneous and further research may be needed in the neurobiology of therapeutic relationship itself as there is increasing recognition that this may be the agent of change, with evidence in the role of linking cortical structures to subcortical limbic systems.
Virtual reality cognitive & functional assessment in psychosis
Authors: Shergill Sukhwinder , Porffy Lilla , Whomersley Gabriella , Szentgyorgyi Timea , Mouchlianitis Elias , Patchitt Joel 
Published: June 2021

AimsTo compare the MATRICS Consensus Cognitive Battery (MCCB) and a novel Virtual Reality (VR) task, called VStore, in assessing cognition and functional capacity (FC) in schizophrenia. We hypothesise that VStore reliably discriminates between patients and controls, correlates with the MCCB, and is well-tolerated. Additionally, VStore is expected to strongly correlate with FC measures.BackgroundCognitive and functional deficits in schizophrenia have a major impact on everyday functioning of patients. The gold-standard cognitive assessment is the MCCB, while the USCD Performance-Based Skills Assessment (UPSA) is used to assess FC in this patient group. Neither of which are without limitations. For example, both take a long time to administer, and the MCCB alone cannot give clear indications of FC. We propose the use of a novel VR task to simultaneously measure cognition and FC in a single assessment. VStore is a shopping task, which involves a verbal learning task followed by buying items from a predetermined shopping list in a virtual minimarket.MethodTen patients with schizophrenia or schizoaffective disorder and ten age/gender-matched healthy controls recruited from South London, completed the following assessments: VStore, MCCB, UPSA & Global Assessment of Functioning (GAF), and VR-Symptom Questionnaire (VRSQ); while controls only completed the VR task. To test whether VStore can differentiate between patients and controls we employed unpaired t-test. To explore associations between VStore Total Time, MCCB composite score and FC measures Pearson's r was used. Finally, mean differences between pre/post-VR symptoms scores were tested using paired t-test.ResultThere was a significant difference between patients and controls on the verbal learning task (t16.38=−4.67,p < .001), and total time spent completing the VR task (t11.41 = 2.67, p = .023). In addition, VStore had a strong association with MCCB composite score (r=−.80,p = .010). While both VStore (r=−.82, p < 001) and MCCB (r = .77,p = .010) had significant correlation with the UPSA, only VStore had a significant association with the GAF (r=−.68,p = .030). Finally, VStore appears to be well-tolerated, causing no measurable side effects in the VRSQ (Pre-VR Mean =12.1[SD = 13.5], Post-VR Mean = 9.6[SD = 11.5],t9 = 0.49,p > .05).ConclusionResults suggest that VStore can discriminate between schizophrenia patients and healthy controls. In addition, VStore and MCCB seem to be strongly associated, suggesting that they tap into identical cognitive domains. VStore seems to be strongly correlated with FC, more so than the MCCB, and cause no measurable side effects. Taken together, this suggests that this novel VR task has the potential to reliably measure cognition and FC simultaneously.
Audit of the use of the physical health improvement (PHIT) to document physical health examination on an electronic health record at a mental health trust in Manchester
Authors: Baynham Anthony 
Published: June 2021

AimsThe audit aimed to identify: The percentage of patients with Initial Physical Examination (IPE), ECG and bloods on admission being completed; If IPE, bloods and ECG result are documented on PHIT; To identify reasons for these interventions not being completed and review if refusal is being appropriately documented.Background“The Five Year Forward View for Mental Health NHS” report highlighted the poor physical health of those with mental health problems when compared to those without. In order to improve the identification and treatment of physical health problems within mental health inpatients, blood test results, physical examination and ECG results should be recorded and reviewed regularly. Within Greater Manchester Mental Health trust, the electronic records system PARIS contains a specific care document to record physical health interventions, known as the PHIT tool. The inpatient unit Park House, had recently changed to the PARIS system prior to this audit and the use of PHIT tool to monitor physical health parameters was considered a priority by the management team.MethodAll admissions to Park House inpatient unit, Manchester in April 2019 were audited. Patients were identified using a report prepared by Business Intelligence. Electronic notes were reviewed for evidence of physical interventions on admission and input of these data to the PHIT tool. Using a retrospective review of electronic notes, relevant information was anonymised and collected to a spreadsheet for further analysis. Inclusion/exclusion criteria was based on local conditions and practical consideration.ResultAn initial sample of 140 was reduced to 89 patients following application of inclusion/exclusion criteria. Of the 89 patients included, 73% had an IPE, 84% of patients had admission blood tests and 74% had an admission ECG. Recording of parameters on the PHIT tool was lower than expected with information recorded in 33–42% of patients. Where patients had refused IPE, ECG or bloods, a valid reason for refusal was documented between 63–91% of patients.ConclusionThe initial audit identified that most patients had IPE, ECG and bloods but this was documented appropriately in less than 42% had this appropriately documented.Interventions to improve this rate were developed, focussing on increasing completion of IPE, ECG and bloods as well as improving documentation. The completion of PHIT document is now monitored regularly. The re-audit to identify the magnitude of improvements from these interventions is currently underway.
A systematic review of the effects of nicotine replacement therapy on agitation among nicotine-dependent psychiatric inpatients
Authors: Toms Joseph , King Jacob 
Published: June 2021

AimsThis systematic review aims to evaluate the effect of nicotine replacement therapies (NRTs) on measures of agitation amongst nicotine-dependent adult psychiatric inpatients.BackgroundSince the introduction of the smoke-free policy for all psychiatric facilities, a psychiatric admission is likely to upset a nicotine-dependent individual's normal routine of nicotine consumption. In addition to the physiological effects of nicotine withdrawal (NW), the interpersonal dynamic which nurse-led guardianship of nicotine products constructs presents stressors to the nicotine dependent patient.Several systematic reviews evaluating changes in objective measures of agitation amongst smoking patients in medical critical care units have found varied results, with some demonstrating worsening agitation with NRT use. We therefore believe that there is sufficient equipoise in the use of NRT to prompt a review of studies amongst psychiatric inpatients.MethodThis review identified English language studies through developed search strategies in PubMed/MEDLINE, EMBASE, PyschINFO, PSYCHLit, Cochrane databases, and Google scholar. The bibliographies of notable papers were explored. Hand searches of five major psychiatric journals were conducted. Peer reviewed studies of any study design were included if they reported primary data of adult psychiatric inpatients. Studies were extracted from 1990 – present, this was felt appropriate as nicotine replacement patches became available in 1992.Search strategies were informed by MeSH search terms and included multiple conceptions of “agitation”, including variations on; agitation, irritability, and arousal to capture the concept from broad academic constructions. The quality of studies was assessed with the Newcastle-Ottawa and Cochrane Collaboration tools.This review follows PRISMA guidelines, and an application for PROSPERO registration has been submitted pending acceptance.ResultTwo studies were identified which matched inclusion criteria. A double-blinded randomised placebo-controlled trial of 40 nicotine-dependent inpatients from Allen et al. reported a significant 23% reduction in Agitated Behaviour Scores at 24 hours following NRT administration on admission compared to their matched placebo controls. Yet a retrospective cross-sectional analysis from Okoli using scores for NW identified more severe withdrawal symptoms including “restlessness” and “anger/irritability” than nicotine-dependent patients not provided with NRT.ConclusionDespite considerable commentary within literature there is presently only one study providing moderate evidence of a positive benefit to measures of agitated behaviour from the use of NRT amongst nicotine-dependent psychiatric inpatients. There is currently very low evidence whether NRT improves or exacerbates the agitation associated with NW amongst nicotine-dependent psychiatric inpatients.