bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pre-operative Mental Health and Adverse Outcomes Following Total Knee Replacement: A Prospective Cohort Study
Authors: Gibb Jonathan , Lenguerrand Erik , Wylde Vikki , Bhaskaran Krishnan , Whitehouse Michael 
Published: August 2024

AimsTotal knee replacements (TKRs) are effective procedures for severe osteoarthritis. Some studies suggest that people with common pre-operative mental health problems are more likely to experience complications following joint replacement. This study aimed to determine whether people who described pre-operative anxiety or depression were more likely to report an adverse event, or outcome, following a TKR.MethodsA prospective cohort of people undergoing TKR at a surgical centre in England between 2012–2013 as part of service evaluation were studied. Following informed consent, participants completed pre-operative sociodemographic questionnaires alongside several patient-reported outcome measures (PROMs): the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), EuroQoL Five-dimensions Descriptive System (EQ-5D-3L), and the Self-Administered Patient Satisfaction Scale for Primary Knee Arthroplasty. Participants were classified as exposed if they described moderate or extreme problems with anxiety or depression in the mental health subset of the EQ-5D-3L. The primary outcome was the presence of a patient-reported adverse event (bleeding, infection or fracture) at 3 months post-surgery measured through a short postal questionnaire. Repeat PROMs were assessed at 3- and 12-months post-surgery. Logistic regression was used to model the association between pre-operative mental health status and probability of an adverse event, or outcome, occurring following adjustment for age, sex and body mass index.ResultsOf the 206 individuals studied, over a third (n 72/206, 35%) had reported problems with anxiety or depression before surgery. Among those returning completed follow-up questionnaires, 20% (n 34/168) described an adverse event at 3 months. Pre-operative anxiety or depression was not associated with an increased odds of reporting an adverse event (aOR 0.85, 95% CI 0.35–2.05) at 3 months post-surgery. People who described problems with anxiety or depression were more likely to have a greater degree of pre-operative functional impairment. Even after adjusting for a higher pre-operative symptom burden, exposed participants were more likely to report problems with activities of daily living (aOR 2.32, 95% CI 1.09–4.94) and pain or discomfort (aOR 5.58, 95% CI 1.77–17.60) at 3 months post-surgery. However, they did not have an increased odds of describing worse function, reduced health-related quality of life, or being dissatisfied with their TKR at 12 months post-surgery.ConclusionDespite having a higher burden of morbidity prior to undergoing surgery, pre-operatively anxious or depressed participants did not have an increased odds of reporting an adverse event at 3 months and went on to experience comparable improvements in PROMs at 12 months post-surgery.
Exploring the Distinction Between Jinn Possession and Serious Mental Disorders Through the Lens of the Traditional and Faith-Based Healers in Korail Slum
Authors: Soron Tanjir Rashid , Azmery Kazi Shammin , Ahmed Helal Uddin , Sagar Jilka 
Published: August 2024

AimsThe cultural narratives around Jinn Possession are deeply intertwined with the societal understanding of mental health in Bangladesh, often blurring the lines between supernatural beliefs and clinical psychiatric diagnosis. This study aims to delineate the community-based differentiation between Jinn Possession and serious mental disorders such as schizophrenia, bipolar mood disorders and major depressive disorders with psychotic symptoms, as perceived by traditional and faith-based healers in Korail slum. We attempted to unravel the nuanced approaches the healers use to distinguish spiritual afflictions from psychiatric conditions and to explore potential collaborations between traditional healing practices and biomedical mental health services as a part of TRANSFORM Research.MethodsAdopting an ethnographic and participatory approach, this study engaged in a comprehensive qualitative exploration involving community engagement meetings, 45 key informant interviews, 8 naturalistic interviews with 56 participants, year-long observations of the community and healing practices, 5 co-designing workshops with 46 participants, and 2 pilot training programmes from 2021 to January 2024. We discussed with the traditional and faith-based healers, community health workers, medicine sellers, person with lived experience and their caregivers. The continuous discussion and observation of the community help us to develop a trusted relation and explore the healing practices in the korail slum. Data collected from interviews and workshops were meticulously transcribed and analysed using NVivo software to uncover underlying patterns and distinctions made by traditional and faith-based healers in diagnosing Jinn Possession versus serious mental disorders.ResultsWe found a stepwise diagnostic framework utilized by healers, initially categorising conditions based on the symptom's onset and presentation. Sudden and rapid symptoms onset, especially during specific times of the day, was often attributed to Jinn Possession. Specific symptoms such as sudden onset convulsions, disorganised speech and self-laughing further supported this distinction. Moreover, they used traditional diagnostic tests, including the use of holy water and recitation of the Quran, if the patient improves immediately following these interventions was considered as confirmation of Jinn Possession. We observed a few of the healers refer cases perceived as non-spiritual to biomedical facilities when they confirmed it was not the case of Jinn Possession, indicating a potential for collaborative mental health-care modelsConclusionThis cultural understanding offers a unique perspective on community-based mental health care in Bangladesh, emphasising the importance of integrating traditional and biomedical approaches to foster a more inclusive and culturally sensitive mental health-care ecosystem.
Malawi Mental Health Guide: Overview and Evaluation of a Mental Health Quick Reference Guide and Phone App for Use in Non-specialist Settings
Authors: Mullin Donncha , Kulisewa Kazione , Mwale Owen , Lee Rui-Shian , Stewart Rob 
Published: August 2024

AimsIn Malawi, there are three Consultant psychiatrists for a population of approximately 20 million people. We cannot rely solely on specialists to provide mental health care. We produced the Malawi Quick Guide to Mental Health (the Guide) to improve the psychiatric health-care resources available to frontline mental health workers in Malawi, thus improving service provision to patients. We aimed to evaluate its impact on the frontline non-specialists who provide most mental health care in Malawi.MethodsIn collaboration with the Malawi Ministry of Health, the University of Malawi, St John of God Malawi, and a Malawian user group, a group of psychiatrists with experience working in Malawi co-produced the Malawi Quick Guide to Mental Health. It provides practical information for assessing and managing mental disorders in Malawi. We distributed the Guide to over 400 health centres in Malawi. Next, we converted the Guide into a freely available phone app in both Android and Apple stores.To study its impact, we baseline surveyed frontline mental health professionals regarding their access to basic psychiatry guidelines and information in clinics, as well as their confidence in delivering mental health care. We repeated this survey six months after the distribution of the printed Guide and six months after the app launch.ResultsBaseline survey: 20 health-care professionals representing regions throughout Malawi responded. 70% of respondents were between 25–40 years old and 45% were female. All respondents either agreed or strongly agreed that they needed more support caring for mentally unwell patients. 15% had no access to any resources whatsoever to guide their care.Printed guide survey: 95% agreed or strongly agreed that having a printed copy of the Guide increased their confidence in caring for patients. Information resource accessibility, availability and usage in mental health clinics had improved from baseline. The respondents found the Guide helped their day-to-day practice, with 95% rating it either extremely helpful or very helpful. 95% either agreed or strongly agreed that it had improved the care they provided their patients.App survey: 66% of respondents prefer using the app over the textbook version. All agreed that the app made them more confident in caring for their patients and that their care had improved because of the app. They were all likely to recommend it to a colleague. It has now been downloaded almost 1000 times.ConclusionA free, co-produced mental health book and phone app have helped to address the issue of limited access to basic psychiatry guidelines and information in clinics in Malawi. This has improved clinicians’ confidence and their perceived patient care.
The Ten-Point Treatment Programme: Design and Evaluation of an Easy Read Document in a Forensic Learning Disability Unit
Authors: Amiola Ayomipo , Marler Holly Anna , Weeks Carly , Barnes Vanessa , Alexander Regi 
Published: August 2024

AimsThere has been criticism surrounding the lack of clarity regarding treatments offered within forensic inpatient units for people with learning disability and co-existing mental health problems. The Ten-Point Treatment Programme is a framework for treatments within such settings. It incorporates the four stages of assessment and motivational work, foundation and offence-specific treatments, consolidation and relapse prevention and finally discharge management. Although evidence based and evaluated in outcome studies, explaining its content to those with learning disability can be problematic. Communication difficulties affect the way information is comprehended and interpreted from both a linguistic and pragmatic perspective in this group. The provision of Easy Read information can address this difficulty.Our aim was to co-produce, with experts by experience, an easy read version of the Ten Point Treatment Programme; and to evaluate this resource.MethodsThis was a quality improvement project within an in-patient medium secure unit in England. The co-production of the easy read version was led by two speech and language therapists, two psychiatrists, one Education Manager and two experts by experience. The latter advised on content, wording, format and font. Content was adapted in line with standard easy read requirements and guidelines. Following a focus group meetings, a provisional easy read version was approved and introduced in the service. This service innovation was evaluated through semi-structured interviews with six experts by experience and ten multidisciplinary team members who had used the resource. Responses were transcribed and subjected to thematic analysis.ResultsThe three main themes covered in the evaluation responses related to accessibility, appearance and usefulness. The sub-themes under accessibility were the simplicity of vocabulary and short sentence length. Regarding appearance, the key sub-themes were about the effective use of colour, the inclusion of relevant and meaningful images, and the balance between words and pictures. On usefulness, the main sub-theme was about understanding the treatment pathway better and hence feeling motivated to engage. This was reflected by the staff group as well. There were some comments on accessibility that were less positive, including service user indications that the number and complexity of words were still high.ConclusionThe co-produced easy read version of the Ten-point treatment programme has been received positively by service users and staff. For both groups, it brings clarity about the treatment pathway and its stages. It is incorporated into the admission pack for new admissions and features in new staff induction programmes.
Improving the Completion of Capacity and Consent Assessments
Authors: Abbott Michael , Logacheva Kristina , Thompson Eleanor , Fauzi Nik Fikri bin Nik , Rangan Tarun 
Published: August 2024

AimsThe respect of a patient's autonomy and choices is one of the cornerstones of good psychiatric care. Key to this is ensuring the timely and thorough assessment of a patient's capacity to consent to admission and treatment once in contact with mental health services.The aim of this quality improvement project was to optimise the Trustwide completion of capacity assessments for all newly admitted patients within 24 hours of admission at South West London and St Georges Mental Health NHS Trust. Our goal was for 100% completion of the Trust's Brief Capacity and Consent (BCAC) form by July 2023.MethodsWe obtained a list of all new admissions to inpatient wards across the Trust's three hospital sites between 1–14 February 2023. A retrospective audit was then undertaken to establish the baseline BCAC completion rate. Following this a quality improvement strategy was created using the Plan-Do-Study-Act (PDSA) model of creating change. A series of three interventions were implemented and subsequently analysed using the PDSA model. These included creating an admission checklist and placing this in doctors' on-call rooms across the trust, distributing the checklist to wards across hospital sites and service lines and lastly, sending out reminder emails to doctors at the Trust. A re-audit was completed after each intervention.ResultsThe baseline BCAC completion rate was 60.5% (n = 76) in February 2023. This increased to 63.75% (n = 80) following the creation of the admission checklist. Distributing the checklist throughout the Trust resulted in a further improvement to 76.5% (n = 81). In July 2023, the final data collected 6 weeks post reminder email demonstrated a BCAC completion rate of 75% (n = 68).ConclusionThrough the application of the PDSA model, alongside focused interventions aimed at raising Trust-wide awareness of the BCAC form, we managed to obtain a 14.5% increase in BCAC completion rates between 13 February and 31 July 2023. Whilst not achieving the initial goal of 100% completion, this quality improvement project helped to bring a renewed focus to the timely completion of capacity and consent assessments at the Trust. Moving forward, we hope to build on this improvement by exploring additional strategies to reach a 100% BCAC completion rate, thereby promoting patient safety and autonomy.
Διδακτικό σενάριο στη Στ΄ τάξη στα Φυσικά: «Οικοσυστήματα»
Authors: Κούρου Γεωργία 
Published: August 2024

Το σενάριο αυτό δημιουργήθηκε για τις ανάγκες της διδασκαλίας της ενότητας «Οικοσυστήματα» στο μάθημα της Φυσικής στην Στ΄ τάξη. Περιγράφει με λεπτομέρειες τους στόχους και τα προσδοκώμενα μαθησιακά αποτελέσματα. Παρουσιάζεται η πορεία της σύνταξής του από τη στιγμή της σύλληψης της ιδέας δημιουργίας του, μέχρι την τελική του ολοκλήρωση και τεκμηριώνονται η μεθοδολογία που ακολουθήθηκε και οι επιλογές αναφορικά με τη χρήση των ΤΠΕ. Το σενάριο αυτό σχεδιάστηκε για να υλοποιηθεί μέσα σε μία διδακτική ώρα. Τέλος προϋπόθεση για την επιτυχή εφαρμογή του αποτελεί η εξοικείωση των μαθητών με την ομαδοσυνεργατική μέθοδο, τη δυνατότητα να χρησιμοποιούν διάφορες εφαρμογές των ηλεκτρονικών υπολογιστών καθώς και η άνεσή τους στη χρήση web2.0 εργαλείων.
Περιβαλλοντικό πρόγραμμα εκπαίδευσης για την προσχολική και πρωτοσχολική ηλικία
Authors: Μαρκοπούλου Μερόπη 
Published: August 2024

Με σκοπό την προώθηση της αειφόρου ανάπτυξης σε θέματα διαχείρισης του πολύτιμου αγαθού του νερού δημιουργήθηκε εκπαιδευτικό υλικό, το οποίο εντάσσεται στο πλαίσιο της υλοποίησης των Εργαστηρίων Δεξιοτήτων για μαθητές/τριες Προσχολικής και Πρωτοσχολικής ηλικίας. Το εκπαιδευτικό υλικό χωρίζεται σε επτά ενότητες/εργαστήρια με δραστηριότητες, που δίνουν έμφαση στην καλλιέργεια των δεξιοτήτων του 21ου αιώνα: κριτική σκέψη, δημιουργικότητα, επικοινωνία και συνεργασία. Οι δράσεις είναι βιωματικές με στόχο να εκμεταλλευτούν τη φυσική περιέργεια των παιδιών (πειράματα), να καλλιεργήσουν την έμφυτη τάση τους για δημιουργία (υλοποίηση μικρών έντυπων βιβλίων με τη μέθοδο Frene και ψηφιακών) και τη συνεργασία σε ψηφιακά και μη περιβάλλοντα (εκπαιδευτική ρομποτική). Η μάθηση επιτυγχάνεται μέσα από διαδικασίες που διεγείρουν γνωστικά τους/τις μαθητές/τριες, είναι ευχάριστες και εκμεταλλεύονται τις κλίσεις και τα ταλέντα τους. Σκοπός του εκπαιδευτικού προγράμματος είναι η απόκτηση γνώσεων σχετικά με το πολύτιμο αγαθό του νερού και η διαμόρφωση από τους/τις μαθητές/τριες περιβαλλοντικής συνείδησης και αειφορικής στάσης απέναντι σε όλους τους τομείς της σύγχρονης ζωής. Οι επιμέρους στόχοι αναφέρονται: α) στον προβληματισμό για τη σωστή διαχείριση του νερού, β) στην εξοικείωση με νέες έννοιες όπως λειψυδρία, υπόγεια ύδατα κ.ά., γ) στην καλλιέργεια της συνεργασίας και της ενσυναίσθησης, και δ) στην εκμάθηση της λήψης πρωτοβουλιών αναπτύσσοντας το αίσθημα της υπευθυνότητας.
CFL quark stars as a candidate for the HESS J1731-347 object with a trace anomaly and GW190814 bound implementation
Authors: Oikonomou Pavlos , Ch.C. Moustakidis  
Published: August 2024

A recent analysis on the central compact object within HESS J1731-347 suggested unique mass and radius properties, rendering it a promising candidate for a self-bound star. In this present study, we examine the capability of quark stars composed of color-flavor locked quark matter to explain the latter object by using its marginalized posterior distribution and imposing it as a constraint on the relevant parameter space. The latter space is further confined due to the additional requirement for a high maximum mass (Mtov>=2.6Msolar), accounting for GW190814’s secondary companion. Critical emphasis is placed on the speed of sound and the trace anomaly which was proposed as a measure of conformality [Y. Fujimoto et al., doi: 10.1103/PhysRevLett.129.252702.]. We conclude that color-flavor locked quark stars can reach high masses without violating the conformal or the bound, provided that the quartic coefficient α4 (a crucial parameter accounting for pQCD corrections in the matter's thermodynamic potential) does not exceed an upper limit which depends on the established . For Mtov=2.6Msolar, we find that the limit reads α4<=0.594. Lastly, a final investigation takes place on the agreement of colour-flavour locked quark stars with additional astrophysical objects including the GW170817 and GW190425 events, followed by some concluding remarks.
Hip-spine parameters change with increasing age
Authors: Kleeman-Forsthuber Lindsay , Kurkis Gregory , Madurawe Chameka , Jones Tristan , Plaskos Christopher , Pierrepont Jim W. , Dennis Douglas A. 
Published: August 2024

AimsSpinopelvic pathology increases the risk for instability following total hip arthroplasty (THA), yet few studies have evaluated how pathology varies with age or sex. The aims of this study were: 1) to report differences in spinopelvic parameters with advancing age and between the sexes; and 2) to determine variation in the prevalence of THA instability risk factors with advancing age.MethodsA multicentre database with preoperative imaging for 15,830 THA patients was reviewed. Spinopelvic parameter measurements were made by experienced engineers, including anterior pelvic plane tilt (APPT), spinopelvic tilt (SPT), sacral slope (SS), lumbar lordosis (LL), and pelvic incidence (PI). Lumbar flexion (LF), sagittal spinal deformity, and hip user index (HUI) were calculated using parameter measurements.ResultsWith advancing age, patients demonstrate increased posterior APPT, decreased standing LL, decreased LF, higher pelvic incidence minus lumbar lordosis (PI-LL) mismatch, higher prevalence of abnormal spinopelvic mobility, and higher HUI percentage. With each decade, APPT progressed posteriorly 2.1°, LF declined 6.0°, PI-LL mismatch increased 2.9°, and spinopelvic mobility increased 3.8°. Significant differences were found between the sexes for APPT, SPT, SS, LL, and LF, but were not felt to be clinically relevant.ConclusionWith advancing age, spinopelvic biomechanics demonstrate decreased spinal mobility and increased pelvic/hip mobility. Surgeons should consider the higher prevalence of instability risk factors in elderly patients and anticipate changes evolving in spinopelvic biomechanics for young patients.Cite this article: Bone Joint J 2024;106-B(8):792–801.
Total knee arthroplasty using a cemented single-radius, condylar-stabilized design performed without posterior cruciate ligament sacrifice
Authors: Hall Andrew J. , Cullinan Rachael , Alozie Glory , Chopra Swati , Greig Leanne , Clarke Jon , Riches Philip E. , Walmsley Phil , Ohly Nicholas E. , Holloway Nicholas 
Published: August 2024

AimsTotal knee arthroplasty (TKA) with a highly congruent condylar-stabilized (CS) articulation may be advantageous due to increased stability versus cruciate-retaining (CR) designs, while mitigating the limitations of a posterior-stabilized construct. The aim was to assess ten-year implant survival and functional outcomes of a cemented single-radius TKA with a CS insert, performed without posterior cruciate ligament sacrifice.MethodsThis retrospective cohort study included consecutive patients undergoing TKA at a specialist centre in the UK between November 2010 and December 2012. Data were collected using a bespoke electronic database and cross-referenced with national arthroplasty audit data, with variables including: preoperative characteristics, intraoperative factors, complications, and mortality status. Patient-reported outcome measures (PROMs) were collected by a specialist research team at ten years post-surgery. There were 536 TKAs, of which 308/536 (57.5%) were in female patients. The mean age was 69.0 years (95% CI 45.0 to 88.0), the mean BMI was 32.2 kg/m2 (95% CI 18.9 to 50.2), and 387/536 (72.2%) survived to ten years. There were four revisions (0.7%): two deep infections (requiring debridement and implant retention), one aseptic loosening, and one haemosiderosis.ResultsKaplan-Meier analysis demonstrated no difference in implant survival according to sex, age, or obesity status. Ten-year PROMs were available for 196/387 (50.6%) surviving patients and were excellent: mean Oxford Knee Score 34.4 (95% CI 32.7 to 36.1); mean Forgotten Joint Score (FJS) 51.2 (95% CI 16.1 to 86.3); mean EuroQol five-dimension five-level questionnaire score 69.9 (95% CI 46.8 to 93.0); 141/196 (71.9%) achieved the 22-point FJS patient-acceptable symptom state (PASS); and 156/196 (79.6%) were “very satisfied or satisfied”.ConclusionThis is the only large study reporting ten-year implant survival and functional outcomes of TKA using a cemented single-radius design and with a CS tibial bearing construct. The findings of excellent implant survival, safety, and functional outcomes indicate that this combination is a safe and effective option in routine TKA. Further investigation of this single-radius design TKA with CS tibial bearings with well-matched patient study groups will allow further insight into the performance of these implants.Cite this article: Bone Joint J 2024;106-B(8):808–816.