bluuebunny/crossref_metadata_2025_split huggingface dataset:
Identifying Molecular Biomarkers in Attention-Deficit/Hyperactivity Disorder (ADHD) – a Systematic Review of Literature and Appraisal of Evidence
Authors: Yusuff Ayobami 
Published: August 2024

AimsAt the core of medical diagnosis lies specific blood tests, urine analysis, microscopic and histologic examination of tissues, and as well radiological investigations that are usually confirmatory of the presence of a disease. However, the diagnosis of ADHD currently relies on reports of clinical symptoms which is usually subjective, with variable interpretations by different professionals, thus posing issues of misdiagnosis and reliability. This study set out to explore, appraise and summarize molecular biomarkers in literature over the past 30 years, which can be applied for the diagnosis of ADHD.Attention-deficit/hyperactivity disorder (ADHD) is a common neuropsychiatric and neurobehavioral disorder that affects children and adolescents, and more recently, gaining recognition in adults. It is characterized by a pervasive pattern of inattention, hyperactivity, and impulsivity or a mixture of the three, that cuts across the individual's multiple domains of life.MethodsOne-thousand articles collated across multiple sources and databases were systematically reviewed and analysed for this project. The keywords for the search criteria in the Boolean operators are “biomarkers and ADHD”, “molecular biomarkers and ADHD” and “biomarkers and ADHD and Diagnosis”.Results5.6% of the articles from several types of studies were included in the final analysis after the inclusion and exclusion criteria were applied. The results revealed various heterogeneity across age, gender, ethnicity, medication status, comorbidities, and study type, in applying biomarkers to assist in the diagnosis of ADHD. Genetics and epigenetics studies were the most common type of molecular biomarkers studied and identified, accounting for 25% of the results. 80% of the studies analysed blood samples with a few others focusing on saliva, urine, cerebrospinal fluid, hair, and stool samples. All the studies identified focused on diagnostic biomarkers with 25% of them combining either prognostic or response-monitoring subtypes of biomarkers.ConclusionThis study identified several potential molecular biomarkers in ADHD. However, most of the results showed only associations between the findings and the diagnosis/occurrence of ADHD. It remains a scientific goal to identify a specific and reliable biomarker for ADHD to assist psychiatrists in making accurate diagnosis. Lastly, it would be pragmatic to explore other types of biomarkers such as radiologic and electro-neurologic markers; given that diagnosis is a constellation of signs and symptoms together with appropriate tests. Combining them logically would increase the specificity of diagnosis of ADHD. This study was completed in partial fulfilment of Master of Science (MSc) in Clinical Psychiatry with the University of South Wales.
Mental Health, Religion, and Spirituality: Knowledge, Attitude, and Practice Among Psychiatrists and Religious Leaders in Baguio City, Philippines
Authors: Agustin Cristina 
Published: August 2024

AimsTo assess the knowledge, attitude and practices of psychiatrists and religious leaders in Baguio City, Philippines regarding mental health, religion, and spirituality.MethodsTwo sets of questionnaires were adapted from the study of Foskett et al. (2004). Some questions and choices for the corresponding choices for answer were modified according to the objectives of this project. The questionnaires were prepared to collect data on knowledge, attitude and practices of psychiatrists and religious leaders regarding mental health, religion/spirituality (R/S). The questionnaire covered three main areas: (1) the links between mental health, R/S, (2) the state of collaboration between psychiatrists and religious leaders, and (3) the training each had received that was relevant to this area of their work. The platform used in the Data Collection is via Google Forms. In this method, identity of the responders were anonymized. Data like the name, clinic or office address, age, sex, religious affiliation of the responders were not collected. Descriptions and interpretations of the results were done using frequency and percentages and histograms.ResultsAmong the psychiatrists in Baguio City, only 58.8% responded to the questionnaire. Percentage of R/S leaders who responded could not be accounted due to insufficient data on the registry of all religions/spiritual groups in Baguio.Neither disciplines has any doubts that there is a link between mental health, and R/S.Majority of the psychiatrist respondents recognize the relevance of their own religion and spirituality. Their belief and inner resources were integral for their coping and implicitly affects their work.Although majority of the psychiatrists think that referring a patient to R/S leaders should always be the case, and referring the terminally ill will be useful.Majority (80%) of the psychiatrist respondents are not familiar with their institution's chaplain coordinator/unit. Also, majority (80%) never made a referral to the chaplain. It is also noted that 50% of the psychiatrist respondents did not receive referral from R/S leaders.Majority of psychiatrists responders did not receive training on R/S aspect of mental health prior and during their qualification.On the other hand, about 35% of the R/S leaders have a training on mental health prior and during their qualification. Religious/spiritual leader respondents equally think that they need further training on mental health.ConclusionPsychiatrist and religious/spiritual leaders both recognize the role of R/S in mental health. The relationship of the two professions in collaborating still needs strengthening by collaboration, education, and training.
Oxford-Based Clinically Relevant Interview Skills in Psychiatry Course (Ox-CRISP)
Authors: Ahmed Fatima , Tarfarosh Shah , Reid Katherine , Cooper Heidi 
Published: August 2024

AimsOx-CRISP is an innovative trainee-led course using Near-Peer teaching, designed to empower new junior doctors in psychiatry to enhance their diagnostic and communication skills. The course provides patient centered simulation scenarios around interview skills in Psychiatry aiming to improve patient safety, boost confidence of junior doctors and promote effective clinical strategies. The curriculum covers a wide range of topics, including mood disorders, psychotic disorders, anxiety disorders, personality disorder, intellectual disability including CAMHS, old age psychiatry, and substance use disorders.Methods•Curriculum Content: Covers 9 prevalent psychiatric scenarios.•Teaching Strategy: Evidence-based, co-produced with experts by experience.•Teaching Approach: Near-peer teaching for safe, supportive learning.•Assessment: Pre- and post-course questionnaires to track learner progress.•Implementation: Offered to junior doctors in Psychiatry at Oxford Health NHS Foundation Trust's Medical Education department.ResultsThe qualitative data showed that the course, run through multiple sessions, resulted in improved confidence & competence of trainees in clinical practice, positive impact on trainers & trainees, and enhanced well-being of junior doctors. The cope of impact affected patient care across two counties in South-East England.ConclusionTo our knowledge, this is a unique course of its kind in the UK. The OxCRISP course represents an innovative and effective approach to mental health education that provides learners with the skills and knowledge they need to provide high-quality patient care. The success of the OxCRISP course demonstrates the value of a patient-centred approach to medical education and highlights the importance of ongoing training and mentorship for mental health professionals.
Embracing Diversity in Mental Health Education: A Primary Study on Cultivating Cultural Humility in Undergraduate Medicine
Authors: Axiaq Ariana 
Published: August 2024

AimsTraining within medical schools often neglects that mental health patients are very culturally diverse, contributing to a lack of cultural competence in future doctors. This deficiency exacerbates access to healthcare barriers for this population. To address these issues early in the course, we initiated a student-led teaching programme on Cultural Humility (CH) for first-year medical students, aiming to enhance cultural awareness (CA) about mental health patients.CH emphasises the lifelong development of skills, knowledge, and attitudes, fostering a perspective of ‘becoming the student of the patient' to address power imbalances between doctors and patients with mental illness, particularly from minority groups. It promotes culture as expansile incorporating many characteristics from race and religion to sexual orientation, disability and age.This study assessed the knowledge and perceptions of first-year medical students following the introduction of CH.MethodsAfter exposure to an author-developed CH learning resource, students participated in a baseline survey to gauge their understanding of CH. Subsequently, an interactive student-led workshop with a reflective exercise encouraged medical students to embrace their cultural diversity and that of others, emphasising the multifactorial nature of mental illness. The workshop incorporated prompts inspired by peer experiences of mental illness. Students then engaged in an early clinical contact programme, interacting with patients with mental illness to implement their understanding of CH into practice. Reflective blogs, written by students as part of the programme, were analysed for data inclusion using an author-selected framework.ResultsOut of 312 participants, 188 provided responses, revealing higher scores for perceived CH importance (4.83/5) compared with understanding (3.86/5) and perceived preparedness for CH implementation (3.98/5). Analysis of free-text survey responses identified learning gaps, particularly in demonstrating cultural sensitivity during patient interviews, and highlighted preferred pedagogies. Thematic analysis of ten collected blogs followed a 5R framework: Respect, Reflection, Regard, Relevance, and Resiliency. Findings indicated a demand for better training in identifying patient-specific sensitive topics and a preference for appreciating patient characteristics such as socioeconomic class without explicit labelling of these qualities as culturally engendered or directly linked to their diagnosis.ConclusionCH aims to foster a patient-centred approach, encouraging medical students to look beyond the diagnosis of mental illness. This study explored the multimodal integration of CH as a CA toolkit into the undergraduate curriculum, providing insights into the application of preclinical CA teaching and students’ perceptions of its clinical applicability in their learning about different patient populations experiencing mental illness.
An Audit of Core Trainees' Preferences of Teaching Format for Weekly MRCPsych Teaching at HPFT
Authors: Carno Ariela , Alihassan Afifa 
Published: August 2024

AimsThe primary aim was to establish the preferences of the majority of core trainees regarding online, in-person, or hybrid teaching in order to assess if the online format created during the COVID 19 Pandemic should be maintained.Secondary aims were:
•To collect feedback regarding the barriers to in-person teaching.•To collect feedback regarding the course content.•To alter the way the course is presented (if required) and to incorporate the feedback regarding the course content into the course.•To re-audit to see if the intervention was successful.Methods•Surveymonkey was used to generate an online survey with 5 questions.•There were a mix of quantitative and qualitative questions.•Responses were collected between 26th September 2022 and 10th October 2022 and results were presented at the Tutors Committee Meeting and Junior Doctors Forum.•Changes were implemented in the curriculum:
1.Introduced specific neuroscience teaching.2.Small exam specific study groups were encouraged.3.It was decided that teaching would remain hybrid as per the majority preference and to allow equal access to teaching for all trainees (as per the GMC guidance). A second survey with the same questions was sent out and responses collected between 19th November 2023 to 29th November 2023 to establish whether opinions had changed and to see if the intervention was successful.ResultsSept – Oct 2022
•There were 20 responses overall.•50% (n = 10) preferred online teaching; 45% (n = 9) preferred hybrid; 5% (n = 1) preferred in-person.•The most common barriers to in-person teaching were the difficulty in finding parking (70%, n = 14), and being unable to leave work on time due to clinical responsibilities (50%, n = 10).•The most common preferred frequency of in-person attendance for the hybrid model was monthly (45%, n = 9).•Topics requested to be covered (free-form question) included psychopharmacology, CAMHS, perinatal, geriatric, neuroanatomy and neuroscience.Nov 2023
•There were 22 responses overall, including new trainees that had not done the survey last year.•50% (n = 11) preferred online teaching, 41% (n = 9) preferred in-person; 9% (n = 2) preferred in-person.•The most common barriers were the same: difficulty finding parking (64%, n = 14) and clinical responsibilities (55%, n = 12).•It was commented that neuroscience related teaching had improved.ConclusionThere was a clear preference in both surveys amongst trainees for either online or hybrid teaching formats. Hence a decision was made to continue the current format of flexible teaching.
Medical Coaching for Psychiatrists
Authors: Forge Jenny , Cornwall Peter L 
Published: August 2024

AimsPromoting recruitment and retention in psychiatry is one of the core objectives for the Royal College of Psychiatrists and coaching initiatives are recognised as a means of improving retention. We developed a programme of medical coaching, available to all career-grade doctors in an NHS Trust in Northern England to support professional development. This overview describes the results of the first 4 years of the programme.MethodsThe setting was a large NHS Trust covering County Durham, Teesside and North Yorkshire employing around 150 consultants and 60 SAS psychiatrists (mean age = 49 years, 51% female). Coaching was promoted to all these doctors through the feedback form sent following their annual appraisal meeting. This coaching was later also made available to locally employed doctors and core and higher specialist trainees working temporarily in the Trust. The intervention was initially provided as a single session coaching event delivered by a consultant psychiatrist trained in medical coaching, and the programme evolved following requests from doctors. It was stated explicitly that the purpose was professional development, not an attempt to retain doctors considering their future. The outcome was measured using a post-coaching questionnaire.ResultsData was collected from coaching delivered from May 2019 to January 2024. 145 doctors (84 consultants, 23 SAS doctors, 6 Trust doctors, 26 training-grade doctors, 6 grade not-stated) took up the coaching offer. 524 sessions were provided in all. The mean (SD) number of sessions was 3.8 (3.7), for consultants 3.5 (3.9) and for SAS doctors 4.8 (4.4). 48 doctors accessed a single coaching session. 56% of the career-grade doctors receiving coaching were female. Data was collected from 127 post-coaching questionnaires with 116 strongly agreeing and 11 agreeing with the statement that the coaching provided was useful and many reporting a positive impact on well-being.ConclusionFindings show that the programme was popular with the medical workforce, with about half of career grade psychiatrists taking up the offer. It evolved following requests to both provide follow-up sessions and to extend the offer to trust doctors and trainees. The sessions were highly valued by the doctors with reported benefits to their well-being, but we cannot measure the impact on retention. The programme is valued by the Trust with an intention to make the programme sustainable into the long term and it now forms part of the Trust's medical workforce charter.
Elevating Interest and Expertise: Integrating Co-Design and Co-Production Into Foundation Year Development Initiatives During Psychiatry Rotations
Authors: Mallick Hassan Aquil , Doyama Mana , Ayeni Itunuayo , Obeng Isaac 
Published: August 2024

AimsTo provide a bespoke development program for foundation year (FY) trainees on rotation at CNWL NHS trust.To increase interest in foundation trainees in choosing Psychiatry as a career.Specific: 100% self-reported satisfaction with the FY development program by April 2024.50% increase from baseline of self-reported interest in choosing psychiatry as a specialty by April 2024.MethodsWe designed an online, 12 session teaching program for each 4 month cohort of foundation year doctors on rotation at St Charles Hospital, CNWL. We collect data at baseline, after each teaching session and at exit via online questionnaires. These are reviewed at PDSA meetings (including nominees from foundation cohort) by team quarterly. First cohort started in May 2023, we are currently in our 3rd cohort of this project. Each cohort has approximately 15 Foundation year Trainees. Our curricula integrates principles of Co-Design: 2 of the 12 teaching slot topics are voted by each cohort of foundation trainees. Co-Production: 2 of the 12 slots are always for a carer, service user or expert by experience. Bespoke: Each teacher is provided a written guide outlining the training grade of foundation trainees and highlights the needs for transferrable skills as FY trainees may not pursue psychiatry as a career. Quality Improvement: iterative learning from each cohort, with robust data collection methods (dedicated time set aside for feedback completion) and regular reviews by team. Teachers are canvassed via trust emails, trainee Whatsapp groups and patient liaison services at CNWL.ResultsCohort 1= no data collected. Data collection methods required improvement.Cohort 2= data collection of 3 responses (23% completion rate). Data collected insufficient. Data collection method improved.Cohort 3= data collection of 13 responses (87% completion rate).Self-reported satisfaction with training program: 95.3% Interest in choosing psychiatry as a specialty: 30.4% at baseline to 76.2% at time of submission.ConclusionThis Foundation Year Development initiative provides a well-liked, bespoke and innovative approach to train foundation year doctors on placement at NHS trusts.The majority of Foundation doctors (some surveys show 60%) are undecided on their specialty during foundation training and this is a unique opportunity to increase recruitment into psychiatry.
A Qualitative and Quantitative Analysis of a Pilot Psychotherapy Training and Simulation Workshop for a Cohort of Psychiatry Core Trainees Starting Their Long Case in SABP Foundation Trust
Authors: Fulmali Amit , Reddi Neelima 
Published: August 2024

AimsBackground: The uncertainty and anxieties about psychotherapy long case among trainees was high. This training was designed to alleviate stress and to increase knowledge and confidence among trainees.The Primary aim of this project was to improve individual skills and awareness for Psychodynamic Psychotherapy. Secondary aim was to get feedback from trainees to improve future psychotherapy training.The Null hypothesis (H0): There is no difference between the Pre and Post training questionnaire scores.MethodsThis is a blinded study where the researcher cannot identify the participants. A mixed study approach is taken, with both quantitative and qualitative analysis used for this study. A pre training and post training questionnaire was provided to participants. This study collected quantitative data in the form of Likert scale questionnaire as a primary approach to test the hypothesis. The qualitative data was collected by open ended questions. The qualitative part is to understand the trainee's problems and what improvements have to be made in the workshop, to generate a structural model for effective practical psychotherapy training.The sample consists of 13 Psychiatry Core Trainees at different levels of their training and 1 speciality doctor. 14 feedback questionnaires were available, 1 questionnaire was excluded as it did not fit the inclusion criteria.ResultsThe paired t-test was used for all the three quantitative questions: Knowledge of psychotherapy, Theoretical and Clinical Application of Psychotherapy. The t-test showed the difference between pre-and post-questionnaires scores to be statistically significant (p value < 0.05). So, we reject the Null Hypothesis. The effect size was large, with Cohen's d score > 0.8 for all three questionnaires.Thematic analysis of Qualitative data was done. Codes were formed from the supporting quotes. Themes were derived from the similar codes. Four themes were created:
•Challenges experienced by core trainees.•Emotions and confidence.•Knowledge acquired.•Suggestions for improvements.Conclusion1.We can conclude that the Psychotherapy workshop was effective, and the Core Trainees have better insight than before.2.The qualitative analysis results were in accordance with the quantitative analysis.3.Challenges experiences by trainees in managing their own emotions were addressed in the training. Quote (IV) “it was very good! calmed nerves.”4.There was increase in knowledge and confidence among trainees.5.Suggestions were full day of training and to have more role playing; to demonstrate the psychological concepts like transference, countertransference, defences, resistances in role play.