bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pilot Study Examining the Potential Efficacy of Music-Based Activities for People Living With Dementia in a Hospital Setting
Authors: Abeywickrama Neha , Ellul Miraval Mel N. , Subramaniam Hari , Arshad Qadeer , Mukaetova-Ladinska Elizabeta B. 
Published: August 2024

AimsPharmacological treatment of Behavioural and Psychological Symptoms of Dementia (BPSD) is of limited benefit. The addition of non-pharmacological interventions is often essential for optimal symptom control. Music is a viable way to help patients communicate and improve quality of life. This study aims to find the most effective way to use music on a busy dementia ward.Methods17 inpatients (aged 63–93 years) took part over a five-week period. Music with projected lyrics was individualised and based on their preferences. Instruments (e.g., maracas) were used in some group sessions. We used the Neuropsychiatric Inventory Questionnaire (NPI-Q) and Music in Dementia Assessment Scales (MiDAS) to evaluate patients’ behaviour before and after musical intervention.ResultsOf NPI-Q scores, a significant difference between mean scores before and after the music intervention was found. Specifically, Delusion, Motor Disturbances, and Agitation scores were significantly reduced after music intervention. Of MiDAS, significant differences were found in Interest, Response, and Enjoyment during specific intervals.ConclusionA multisensory inpatient environment was effective in delivering music-based activities and managed behavioural symptoms in the short term to people with advanced dementia. Its use for inpatient wards must be further investigated as an economical and personalised non-pharmacological therapeutic tool for patients with dementia.
Perceived Stress and Food Consumption Among Pakistani Medical Students – a Survey Study
Authors: Azam Saad , Shahbaz Haania , Azam Fiza 
Published: August 2024

AimsThe aims of this study included investigating the relationship between perceived stress levels and food consumption patterns amongst Pakistani medical students. Additionally, the study meant to determine whether there is a significant difference in food choice between high-stress and low-stress groups of students. Lastly, the study aimed to identify the specific food types most commonly consumed by medical students under high stress conditions.The investigators of this study hypothesised that there is a significant difference in food choices between high-stress and low-stress groups of medical students.Among the common health problems reported by medical students, stress stands out as one. Factors related to educational and psychological domains result in the development of stress. Changing dietary patterns is a commonly employed strategy used to deal with stress.MethodsThis study utilised an online survey administered among medical students across Pakistan. The data collection period was 4 weeks from 5th July to 5th August 2023. The survey was distributed conveniently using social media platforms. Sampling was done via the snow-ball method. Data analysis was done via SPSS.ResultsOur results from the population of 138 females (68.6%) and 63 males (31.3%) concluded that there were no significant differences in the perceived stress score between genders (p-value = 0.377) and between hostelites and non-hostelites (p-value = 0.816) using the Mann–Whitney test. We found statistically significant differences in the perceived stress score among the different frequencies for the consumption of snacks (p = 0.02) and fast foods (p = 0.008), but the stress score remained non-significant for fruits and vegetables (p-value = 0.089), ready-to-eat foods (p-value = 0.134), and sweets (p-value = 0.051) with the Kruskal–Wallis test.ConclusionWhile previous studies have shown a difference in perceived stress across genders and living arrangements, ours found none. In addition, we found snacks and fast foods to be the go-to for students in times of stress, but the consumption of healthier foods was not associated with a lower level of stress.
Review of Published ECTAS Data Set From 2012/2013 to 2021
Authors: Badrakalimuthu Vellingiri Raja 
Published: August 2024

AimsElectroconvulsive Therapy Accreditation Service (ECTAS) publishes minimal data set collected from ECT services subscribing to ECTAS accreditation. The aim of this study is to review minimal data set published by ECTAS towards understanding trends and statistically significant changes between 2013 and 2021.MethodsECTAS minimal data set has been published for years 2012/13, 2014/15, 2016/17 and 2021. Number of courses, age, gender, diagnoses, legal status, number of treatments, and score on Clinical Global Impression Scale (CGI) for acute treatments has been analysed for trends and statistical differences.ResultsECTAS data set was not published for the years 2018, 2019 and 2020. In terms of number of courses of treatment per year, 2014/15 was highest with 2148 courses and lowest was in 2016/2017 with 1821 courses. Average number of treatments was 1995 and there was no statistical difference between the years. There was no statistical difference with mean age (61), gender (female 66%), and diagnosis (depression 87.5%). In terms of diagnosis though, there is better documentation of diagnosis in 2021, rather than broad categories such as catatonia used previously, and this has led to schizophrenia as diagnosis in 4% and mixed affective disorder in 5%.There has been a gradual but not statistically significant trend to increase in treatments per course from 9.3 in 2012/13 to 10.1 in 2021. There is significant increase in number of patients detained at the start of treatment from 42% in 2012/13 to 57% in 2021. Percentage of people in moderate to amongst severely ill categories on CGI at the start has remained the same through the years (mean 96%). CGI at the end of treatment minimal improved to much improved has similarly remained through the year (mean 91%).The 2021 data set includes subjective memory score with categories showing increases after ECT were 2 (“occasional increased lapses of memory”) and the yet milder category of 1.ConclusionBetween the published data sets, there is no statistical difference apart from number of patients commencing ECT under the Mental Health Act. This may reflect increasingly better practice in assessing mental capacity, with a greater tendency to appropriate application of Mental Health Act legal framework ensuring legal safeguards for the patient such as right to appeal and statutory access to second opinion.
Integrated Moving on After Breast Cancer and Culturally Adapted Cognitive Behaviour Therapy Intervention for Depression and Anxiety Among Pakistani Women With Breast Cancer: Randomised Controlled Trial
Authors: Sherzad Silsila , Kiran Tayyeba , Chaudhry Imran Bashir , Hussain Nusrat , Chaudhry Nasim 
Published: August 2024

AimsBreast cancer is major cause of mortality in females, affecting 2.1m women annually. Annual mortality rates are double within south Asian women compared with high-income countries. Pakistan has very high rates of breast cancer. Co-morbid depression and anxiety is reported in more than one third of breast cancer survivors and predict higher recurrence and poorer survival.Objective:To evaluate the clinical effectiveness of Moving on After Breast Cancer Plus Cognitive Behaviour Therapy (Moving on ABC Plus) to reduce depression and anxiety in breast cancer survivors in Pakistan.MethodsA mixed method randomized controlled trial with 354 survivors of breast cancer recruited from the in- and out-patient services of oncology departments both from public and private hospitals of 5 major cities in Pakistan.Individuals scoring 10 or higher on either the Patient Health Questionnaire-9 (PHQ-9) or the Generalized Anxiety Disorder scale (GAD-7) were enrolled. All participants underwent assessments using the PHQ-9, GAD-7, Functional Assessment of Cancer Therapy—Breast; EuroQol-5D; Multidimensional Scale for Perceived Social Support; Intrusive Thoughts Scale; and Rosenberg Self-Esteem Scale at the baseline and were randomly assigned to one of two trial groups: Moving on ABC plus or routine care. Those in the intervention group received 12 individual sessions of Moving on ABC plus, facilitated by trained master-level psychologists over 4 months. Follow-up assessments were conducted at 3- and 6-months after randomization. Individuals in routine care group continued their standard care. Qualitative interviews were conducted with 15 participants from the intervention group upon completion of the intervention.ResultsThe trial established the effectiveness of the integrated intervention, at 6-month follow up preserving 96% of retention. Intervention group reported a significantly higher reduction in depression, anxiety and intrusive thoughts, and improvement in health-related quality of life and self-esteem compared with routine care arm at end of the intervention. They endorsed the usefulness of intervention during qualitative interviews with improvement in psychological well-being, social support network, and interpersonal relationships. Fatigue was reported as a potential barrier to participating in the intervention.ConclusionResults of this trial are in favour of psychological intervention; therefore, such programs should be implemented as part of routine care to reduce psychological distress and improve quality of life of this vulnerable population.
Culturally Adapted School-Based Suicide Prevention Program for Pakistani Adolescents: Feasibility, Acceptability, and Preliminary Outcomes
Authors: Irshad Sehrish , Kiran Tayyeba , Chaudhry Nasim , Husain Nusrat , Panagioti Maria 
Published: August 2024

AimsSuicide is one of the leading causes of death among young people. For adolescents, schools are considered as the best place to identify and respond to youth suicide risk but evidence on culturally sensitive, school-based suicide prevention programs is limited in low-resource settings such as Pakistan. This study aims to explore the perspectives of students, parents, teachers, and general practitioners regarding cultural adaptation, participation experiences, identified areas for improvement, and recommendations for scaling up the school-based suicide prevention program in Pakistan.MethodsThis qualitative study was nested in a pilot randomized controlled trial that aimed at exploring the feasibility, acceptability and preliminary effectiveness of three suicide prevention interventions: (1) Linking Education and Awareness of Depression and Suicide-LEADS training for students (12–17 years), (2) Question-Persuade-Refer (QPR) training for teachers and parents and (3) Professional screening of at-risk students (ProfScreen) for health practitioners. A total of 8 focus group discussion (FGDs) were conducted at pre- and post-intervention stage with each type of stakeholder (students, teachers, parents and health professionals) by trained qualitative researchers using the semi-structured topic guides. Each FGDs involved a detailed presentation on intervention, sharing videos and educational posters.ResultsAs a result of pre-intervention FGDs, adaptations were made in the content of the interventions and were further refined through consultations with Patient and Public Involvement and Engagement group. All stakeholders who participated in post-intervention FGDs marked this suicide prevention program as feasible, acceptable and helpful in both identifying the risk of and preventing self-harm and suicide among young individuals, while also enhancing treatment pathways. Stakeholders perceived the interventions as valuable in augmenting knowledge about mental health, understanding the impact of mental health challenges on functioning, reducing stigma, and providing stakeholders with the necessary skills to identify and guide at-risk individuals. Teachers and parents endorsed the importance of discussing issues with children. Improvement in clinical practice of clinicians and teaching practice of teachers as well as understanding others’ behaviors were also reported.ConclusionThis study highlights potential role of culturally adapted school-based youth suicide prevention program for settings where rates of suicide are high and there are limited mental healthcare resources in addition to limited access to healthcare. School-based suicide prevention program is perceived as helpful in improving knowledge, attitudes, and help-seeking behaviours in adolescents.
Culturally Adapted Manual Assisted Problem-Solving Intervention for Older Adults With Suicidal Ideation (E-CMAP): A Study Protocol From Pakistan
Authors: Tofique Sehrish , Chaudhry Nasim , Chaudhry Imran Bashir , Miah Jahanara , Husain Nusrat 
Published: August 2024

AimsSuicide poses a significant public health issue, and the presence of suicidal thoughts stands out as a prominent risk factor, highlighting the importance of addressing this aspect for early intervention and prevention efforts. While older adults face an elevated risk of attempted suicide, research in this domain is currently constrained. This study aims to enhance and evaluate the efficacy of an E-CMAP (Culturally Manual Assisted psychological intervention for Elderly) in mitigating suicidal ideation among individuals aged 55 years and older in Pakistan.MethodsThe study will be carried out in 2 phases. Phase 1 is cultural adaptation and refinement of the intervention and phase 2 is exploratory randomised control trial. In Phase 1, focus groups were conducted (N = 2) with Health professionals and service users and carers for adaptation of CMAP manual for suicidal ideation. In Phase 2 randomized exploratory trial will be conducted with 192 older adults with suicidal ideation randomized either to 1) E-CMAP added to Treatment As Usual (TAU) or TAU arm. ECMAP is a problem solving intervention comprising 6 sessions delivered one to one over 3 months by trained therapists. All participants will be assessed at baseline and after intervention (i.e. 3 months) for suicidal ideation, hopelessness, depression, health-related quality of life, coping resources, satisfaction with intervention, and episodes of self-harm.ResultsThematic Analysis of focus group discussions indicates that participants expressed a preference for incorporating a religious element into distraction techniques, delivering information about the significance of medical treatment, showcasing recorded sessions illustrating problem-solving techniques, and involving family throughout the intervention period.ConclusionA culturally tailored psychosocial intervention that incorporates problem-solving and cognitive components has the potential to decrease the risk of suicide among older adults.
Identifying Effective Psychotherapies for Older Adults in an Inpatient Setting: A Narrative Review and Synthesis
Authors: Sequeira Inês , De Souza Stephen 
Published: August 2024

AimsWe sought to review the evidence available to answer the question: Which psychological therapies are effective in the treatment of depression in older adults in an inpatient setting?MethodsAn advanced literature search and systematic review was conducted using Web of Science and PubMed. A set of keywords were identified around depression, older age and the inpatient setting. These were combined with a wide range of keywords around psychological therapies.Non-English language articles were translated using Google translate.Articles were reviewed for the relevance to the study question by reviewing the title and abstract. Full text articles were retrieved for those felt to be relevant to the study question.ResultsOf 709 articles identified from both databases, 20 articles were retrieved for full text review. Five studies were identified that appeared to offer insight into the study question. These papers focused on interpersonal therapy, cognitive behavioural therapy, or behavioural group therapy.Brand and Clingempeel (1992) investigated the incremental implementation of group behavioural therapy in a randomized control trial. The study did not show statistically significant differences between treatment groups, but clinical significance differences supported this intervention's efficacy.A case study by Soller (1997) followed the journey of a 69-year-old man through inpatient CBT sessions over three and a half months. This was followed with outpatient follow up. There was improvement but this was primarily subjective reporting.A randomized controlled trial by Snarski et al. (2011) looked at the efficacy of behavioural therapy. The authors' overall conclusion was that patients benefit from this intervention and that further investigations should be done to strengthen their findings further.A pilot study by Cabanel et al. (2017) focused on determining the feasibility of a multi-professional adaptation of group behavioural therapy sessions. This paper provides a signal towards the effectiveness of multi-professional approach to treatment.Bollmann et al. (2020) focused on the implementation of interpersonal skills groups. It showed good feasibility as well as good patient adherence. Self-reported and observer-reported depression ratings saw improvement throughout the study.ConclusionAlthough the studies showed a signal towards improvement for a range of therapies, the evidence from these studies is not convincing.There is a lack of high quality research in this area. More studies are needed to determine the most appropriate psychological therapy to use and how this might be adapted to the transient nature of the inpatient setting.
Unlocking Optimal Strategies: A Systematic Review Exploring the Efficacy of Physical Exercise vs Cognitive Training for Enhancing Executive Functions in Mild Cognitive Impairment and Dementia
Authors: Grover Geetanjali , Edney S.M. , Tayyaba Saadia 
Published: August 2024

AimsWhile there is research on physical exercise and cognitive training on cognitive improvement in older adults, there is none comparing these two interventions for their efficacy on executive functioning specifically in the population with a diagnosis of Mild Cognitive Impairment (MCI) or dementia. This study aims to bridge this gap and determine the superiority between the two interventions to enhance executive functions among individuals with MCI or dementia. Besides establishing evidence for the benefits of these socially prescribed interventions, it also aims to highlight their differential effects on executive functions. Additionally, it seeks to evaluate the feasibility of implementing these interventions to provide evidence-based insights that inform clinical practice.MethodsSixteen randomised control trials were meticulously selected using the Cochrane selection manual and PRISMA guidelines from an extensive search across prominent academic databases. Stringent quality assessment was conducted for each study using the modified Centre for Reviews and Dissemination checklist, Jadad and PEDro scales and the Cochrane Risk of Bias tool ensuring methodological rigour. The studies provided a total of 1593 participants with a mean age of 74.36 (SD = 5.54), randomly allocated in various intervention groups. Each study was critically appraised, analysed and the findings presented as a narrative synthesis and a meta-analysis performed with the available data.ResultsPhysical exercise showed statistically insignificant improvement on the Stroop Test (p = 0.19) while no significant correlation was seen in Verbal Fluency (p = 0.032). Cognitive Training intervention had a significant improvement in both Stroop test (P = 0.0009) and Verbal Fluency (p = 0.00). The study also found that diverse contextual and personal factors like socioeconomic levels, education, personal preferences, general health conditions, mood, dependence on others, and genetics, are some factors that influence an individual's response to intervention and hence determine its efficacy.ConclusionThere is limited statistical evidence to conclude the superiority of one intervention over the other. However, this systematic review highlights that the effectiveness of an intervention cannot be assessed solely on its statistical effect size. Rather, one must go beyond numerical assessments for a comprehensive understanding of individual circumstances that may pose barriers to engagement with the interventions, thus influencing their acceptability and effectiveness. A holistic and multidimensional perspective of the disease with a personalised intervention plan may be the new solution.
An Investigation Into the Acceptability of the SAFER-YMH Care Bundle for Transitions Out of CAMHS Crisis and Liaison Services
Authors: Holland Josephine , Majumder Pallab , Roe James , Jones Neve , Sayal Kapil 
Published: August 2024

AimsThe NHS long-term plan focuses on the improvement of Child and Adolescent Mental Health (CAMHS) community services including the roll out of 24/7 Crisis teams universally across the country. Crisis and Liaison teams form an important alternative to inpatient admission, offering intense, short-term support to young people in mental health crisis and often high levels of risk. The number of referrals to Crisis and Liaison services are rising. In order to maintain patient flow and meet demand, these teams also need safe, evidence-based protocols for efficient discharge, transition and handover of young people to community teams and services. The SAFER care bundle was designed to facilitate discharges from hospital, and this has been adapted to the SAFER-YMH bundle for discharges from adolescent mental health wards. A similar care bundle for discharge from teams offering alternatives to inpatient care has not yet been developed.This study aimed to investigate the acceptability and necessary adaptations required for the use of the SAFER-YMH care bundle to facilitate transitions out of CAMHS Crisis and Liaison teams.MethodsThis study used stakeholder feedback from multiple sources through focus groups to adapt the SAFER-YMH care bundle for use in young people in transitions out of CAMHS Crisis and Liaison teams. Normalisation process theory was utilised as the theoretical foundation upon which the development of the adapted care bundle, and its potential implementation in the complex multifaceted healthcare landscape was based.ResultsInitial focus groups were held with young people, parents/carers, healthcare professionals from CAMHS crisis and liaison teams, CAMHS NHS management, NHS IT services, community CAMHS teams and NHS commissioners in two trusts in England. Following each focus group adaptations were made to the care bundle in an iterative manner. In the second round of focus groups, the adapted care bundle was presented to a mixed group of participants and agreed to be acceptable.ConclusionThrough stakeholder feedback this study has adapted the SAFER-YMH to create the SAFER-YCL care bundle; an acceptable version for use in discharges from CAMHS crisis and liaison services. End-user design and involvement is vital in the development of clinical applications and pathways which are user-friendly and time-saving for healthcare professionals and also helpful for young people and their families.