bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cognitive Behavioral Therapy Optimizing Post-Operative Outcomes Among Coronary Artery Bypass Graft Surgery Patients: A Systematic Review
Authors: Ibrahim Danya , Elkhidir Ibrahim H. , Mohammed Zainab , Abdalla Da'ad , Mohammed Omer A. 
Published: August 2024

AimsThis review aims to evaluate the lasting advantages of cognitive behavioral therapy (CBT) in alleviating anxiety and depression and improving overall health outcomes post-CABG.MethodsA comprehensive search across databases including Science Direct, PsycINFO, PubMed, Google Scholar, VHL, Cochrane, and Scopus was conducted up to October 2023. The study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and Cochrane guidelines. Inclusion criteria involved randomized controlled trials reporting on CBT or CBT-based interventions tailored for CABG patients and control groups had usual care, with anxiety and depression symptoms, as well as quality of life, as primary outcomes. Outcome variations were analyzed through standard deviation, while efficacy was measured via confidence intervals. Evaluation of the intervention process included examining feasibility, adherence, acceptability, inclusion rates, safety, and tolerability.ResultsThree randomized controlled trials including a pilot study in America and Denmark, encompassing a total of 286 patients, were reported in this review. The participants' pooled mean age was 63.19 years (intervention) and 63.9 years (control), the male-to-female ratio was approximately 2:1 [males n = 174 (intervention n = 101; control = 73) while females n = 91 (intervention n = 60; control n = 31)], and cardiac as well as non-cardiac comorbidities including psychiatric diagnosis have been reported. The array of therapies ranged from education on anxiety and depression management skills to a combination of CBT and supportive stress management (SSM), and psychoeducational interventions paired with physical therapy. Results indicated that both CBT and SSM led to improvements in anxiety and depression symptoms, accompanied by reduced hospital stays, decreased hopelessness, lower scores in dysmorphic mood and irritability, lowered perceived cognitive impairment and stress, and increased satisfaction with therapy. The cognitive behavioral therapy demonstrated commendable feasibility, acceptability, safety, and efficacy, with some concerns raised about potential issues of low adherence.ConclusionThis systematic review emphasizes the positive impact of CBT on depression, anxiety, and quality of life in individuals post-CABG surgery. Future studies should adopt standardized CBT protocols, comprehensively evaluating CBT's influence on overall patient prognosis, considering cardiovascular outcomes across diverse ethnic groups, exploring cost-effectiveness, and specific patient cohorts that could benefit the most from CBT interventions.
Familial Clustering of Adolescent Emotional Problems in a Nationally Representative Sample in Britain: A Multilevel Investigation
Authors: Jordan Kate , Patel Kishan , Srinivasan Ramya , Lewis Glyn 
Published: August 2024

AimsThe prevalence of emotional problems, such as depressive and anxiety disorders, increases sharply during adolescence. There is evidence for familial clustering of mental health problems during early childhood and adulthood, however no studies have investigated whether adolescent mental health problems cluster within families. This study tests the hypotheses that i) emotional problems during adolescence cluster within families, and that ii) conduct, peer and hyperactivity problems, prosocial behaviour and overall emotional and behavioural difficulties during adolescence also cluster within families.MethodsWe used cross-sectional data from a nationally representative survey of UK households, collected between 2019 and 2021, with 4,088 participants aged 10–16 years. Analyses included 1,241 participants who had complete outcome data and complete data on all covariates of interest. The Strengths and Difficulties Questionnaire (SDQ) was used to examine emotional problems, as well as conduct, peer and hyperactivity problems, prosocial behaviour and total difficulties. Multilevel modelling was used to: estimate clustering of i) emotional problems and ii) conduct, peer and hyperactivity problems, prosocial behaviour and total difficulties, within families, after adjusting for several individual- and family-level covariates associated with adolescent mental health problems (including individual and family demographics, school and sibling bullying, quality of parent-child relationship, parent mental health and parent romantic relationship satisfaction).ResultsAfter adjusting for known covariates of adolescent mental health problems, there was substantial clustering of adolescent emotional problems (ICC: 0.439; CI95%: 0.36–0.52; SE: 0.042) and overall adolescent emotional and behavioural difficulties (ICC: 0.417; CI95%: 0.34–0.50; SE: 0.043) within families. There was also evidence of clustering of adolescent peer problems (ICC: 0.374; CI95%: 0.28–0.48; SE: 0.051), hyperactivity (ICC: 0.332; CI95%: 0.25–0.42; SE: 0.044), prosocial behaviour (ICC: 0.263; CI95%: 0.18–0.37; SE: 0.048) and conduct problems (ICC: 0.232; CI95%: 0.14–0.35; SE: 0.053) within families after adjustment.ConclusionWe found strong evidence that adolescent emotional problems cluster within families even after accounting for individual- and family-level covariates which are associated with adolescent mental health problems. Over 40% of the variation was accounted for at the family level. This indicates how the contextual characteristics of the family environment may influence the mental health of young people. As such, social policy aiming to prevent or improve the mental health of young people should focus on family context.
Role of Parental Supervision on Digital Screen Use and Its Effects on Children's Mental Health and Wellbeing in Bangladesh: A Cross Sectional Study
Authors: Kakon Hafiz Shahria , Soron Rashid Tanjir , Hossain Mohammad Shorif , Haque Rashidul , Tofail Fahmida 
Published: August 2024

AimsThe younger generation of today is highly dependent on digital technologies worldwide. Studies on young children's cognitive and socio-emotional development have shown that there can be conflicting effects from using screen-based media or from exposing them to it. The study explored the relation between unsupervised use of digital screen time with student mental health and behavioral problems.MethodsIt was a cross sectional descriptive study approached primary and secondary school going children from grades 2–8 (age 6 to 14 years), purposively selected six schools consist of three English and Bangla medium schools from Dhaka city. A total of 420 students along with their parents were enrolled by clustered random sampling. Study explored the effect of the unsupervised screen time on student mental health and social wellbeing through semi structured questionnaires, Strength and Difficulties Questionnaire (SDQ), Pittsburgh Quality of Sleep Scale (PSQI), Spencer Children Anxiety Scale (SCAS) and Development and Wellbeing Assessment Scale (DAWBA).ResultsStudents used various forms of digital screens for 4.6 hours every day, and 56% of them used these devices without parental supervision or monitoring. English Medium students spend significantly more time on screens on a daily average (5.5 hours) compared with students at Bangla Medium schools (3.7 hours). 21.2% students had mental health concern, this percentage was higher in the unsupervised group (56.2%) than in the supervised group (43.8%). In the unsupervised group, students experienced higher levels of emotional difficulties (15.7%), behavioral difficulties (28.3%), hyperactivity behavior difficulties (17.4%), peer relations difficulties (28.8%), and pro-social behavior difficulties (6.7%) compared with supervised group. 83.3% of students in the supervised group found higher levels of anxiety compared with the unsupervised group (16.7). In the unsupervised group, 15.4% of the students had experienced sleeping problems, compared with 14% in the supervised group.ConclusionThese results suggest an impact of unsupervised screen time on the prevalence of mental health problems among students. Appropriate screen usage may be a major intervention target to improve children's mental health and wellbeing.
Understanding the Issue of Alcoholism in the British Sikh Punjabi Community. Based on This, How Can the Medical School Curriculum Be Improved So Clinicians Can Better Meet the Needs of the British Sikh Punjabi Community and Diverse Communities in General?
Authors: Kochhar Ankita 
Published: August 2024

Aims1)Identify the factors that shape alcohol consumption and accessing support for excessive alcohol consumption in the BSP community.2)Establish the current provision of alcohol-related education in the UK medical school curriculum and analyse if this is suitable to address alcoholism in the BSP community.3)Provide recommendations to be made to the curriculum to help medical students approach the issue of alcoholism in specific communities in a culturally competent manner.MethodsTwo narrative literature reviews were conducted. 37 studies were included. The first search underwent thematic analysis with reference to a Public Health England framework, and the second underwent inductive thematic analysis. Subsequently, the results from both searches were compared to produce appropriate recommendations.ResultsFactors Influencing Alcoholism in the BSP Community
•Experiences of racial discrimination result in psychological distress, and the need to acculturate to decrease this risk.•Loneliness, mainstream Punjabi music, and a decreased self-reported importance of religion.•The role of masculinity was emphasized, with both those who abstained and those who drink viewed as masculine.Alcohol-related Education and Medical School
•Alcohol use has increased among UK medical students.•The drinking habits of medical students are crucial to their own health, their clinical practice, and indirectly as role models in society for acceptable lifestyle behaviours.•Approximately 14 hours are dedicated to alcohol and drug-misuse teaching over the 5-year medical school degree.•Lack of alcohol-related-policies at UK medical schools.•Doctors’ negative attitudes towards patients with AUD were frequently reported.•Medical students are eager to learn about AUD.Recommendations for the Medical School Curriculum:
•Development of a comprehensive and supportive alcohol-related policy.•Pre-clinical teaching: seminars with an individual who has recovered from an AUD.•Clinical stage teaching: encourage students to write and present cases of patients with AUD.•Encourage the use of non-judgemental labels.•Lectures including speakers from voluntary AUD services.•Encourage Alcoholics Anonymous attendance for students.ConclusionOverall, the BSP population fail to access treatment services due to fear of shame and stigma. Medical schools have immense potential to make changes to their alcohol-related education to ensure that future doctors provide holistic care, leading to earlier detection and management of alcohol-use disorders. Recommendations were made with the intention of providing culturally competent services.
Healthcare Practitioners’ Views on Management Practices of Self-Harm in Older Adults: A Qualitative Study Conducted in Ireland
Authors: Lonergan Caoimhe , Troya M. Isabela 
Published: August 2024

AimsTo explore the views of healthcare practitioners from diverse clinical settings on management practices when supporting older adults with self-harm behaviour.MethodsSemi-structured interviews were conducted with healthcare practitioners with previous experience supporting older adults who self-harm, including consultant psychiatrists, general practitioners, clinical psychologists, psychotherapists, clinical nurse specialists and social workers. Purposive sampling was used to recruit participants in the Republic of Ireland to ensure a varied representation of location and clinical area. Healthcare practitioners were recruited by advertising the study via professional and clinical research networks, social media and snowballing methods. Interviews were audio-recorded and transcribed verbatim. Transcripts were uploaded to QSR NVivo Software Version 12 to facilitate analysis. Themes were identified in the data using the steps of thematic analysis which involve data familiarization, coding, theme development and revision.ResultsInterviews were conducted with 20 healthcare practitioners from April to July 2023. Healthcare practitioners offered diverse perspectives across general practice, community mental health services, liaison psychiatry, emergency department settings and inpatient mental health units. Three main themes were generated:
1.Supporting older adults after self-harm: complex and challenging.2.Multiple barriers to the management of self-harm: i) strained resources and unclear referral pathways, ii) limited awareness/health promotion, iii) unsuitable environments, iv) stigma and shame, and v) complexity of self-harm.3.Risk assessment in older adults: increased risk and the importance of safety planning.Relevant quotes from participants are provided to support these themes.ConclusionHealthcare practitioners viewed self-harm in older adults as complex, challenging and associated with high suicide risk. Increased mental health promotion and awareness of mental health and suicidal behaviour in this age group would help address current stigma and shame. Primary care was identified as a sector that older adults often access and where prevention, identification and support can be offered, with more complex cases being promptly referred to more specialist services. Several supports and therapies that could help older adults were identified; however, due to the limited availability of services, supports were often restricted due to cut-off age criteria or disparity of care at a national level. Provision of care needs to be improved upon, with standardised supports still needing to be implemented across the country. Future research can address the perspectives of older adults on how they would prefer to be supported for their self-harm.
Developing a Digital Therapeutic for Alcohol Reduction – a Pilot Study of Curb, an App for People Who Want to Change Their Relationship With alcohol
Authors: Anderson Helen , Gadelrab Romayne , McLaughlan David , Matcham Faith 
Published: August 2024

Aims1.Evaluate user engagement.2.Evaluate safety.3.Evaluate efficacy.
a.To reduce drinking.b.To address comorbid symptoms of anxiety and depression.MethodsStudy PopulationParticipants applied via social media, identifying as individuals seeking to change relationships with alcohol. Inclusion criteria: Aged >18, Alcohol Use Disorder Identification Test (AUDIT) score of 8–16, no history of withdrawal symptoms, or AUDIT score 16–20 but already abstinent for >14 days. Participants who had already been abstinent for >30 days excluded.The ProgrammeParticipants given unlimited access to Alma mobile application (app) for 4 weeks. Programme consisted of daily pledge to cut down drinking, drink diary to record alcohol use, weekly feedback on Generalised Anxiety Disorder-7 (GAD-7) scores and Patient Health Questionnaire-9 (PHQ-9) depression scores, unlimited access to mindfulness videos to manage cravings.Statistical analysisMixed-effects linear regression used for analysis.Results57 people volunteered for pilot study. 31 eligible to participate.EngagementProgressive weeks of programme showed attrition in user numbers. By end of 4-week programme, 77% (24/31) remained, 58% (18/31) submitted all data.SafetyAll participants asked if they had experienced no harm or distress from using app. 25 participants answered, 100% (25/25) responded “no”.EfficacySelf-reported capability to reduce drinking significantly increased over time (mean increase from baseline +0.3; p = 0.007). At week 4, 8/17 (47.1%) said that Alma had helped them cut down drinking a lot, and a further 8/17 (47.1%) said it helped them cut down a bit.There was a trend for units drunk on the heaviest drinking day to reduce over time (−0.48 units) and total weekly consumption of units to reduce (−1.01 units), however not statistically significant. There was no trend for drinking days per week to reduce over time.There was a significant reduction in PHQ-9 scores over time (−1.03; p < 0.001) and significant reduction in GAD-7 scores (−0.69; p < 0.001).A total of 22/24 (92%) respondents said they would recommend Alma to friends and family, 1/24 (4%) would not.Conclusion•Relatively high engagement with Alma compared with similar digital products.•Pilot study suggests Alma is acceptable, safe and shows potential efficacy in helping reduce alcohol intake and comorbid anxiety/depression, however interpretation limited by small sample size.•Next steps will be to widen user-base to facilitate larger studies, and gain further insights into factors influencing relapses by studying associations with health-related data from wearable devices and other user inputs.
Change in Quality of Life After Moving a National Forensic Mental Health Service: A Dundrum Forensic Redevelopment Evaluation Study (D-FOREST)
Authors: McLaughlin Paul , Nikkhah Ali , Umer Waqar M. , Kennedy Harry G , Davoren Mary 
Published: August 2024

AimsForensic psychiatric services address the therapeutic needs of mentally disordered offenders in a secure setting. Clinical, ethical, and legal considerations underpinning treatment emphasize that the Quality of Life (QOL) of patients admitted to forensic hospitals should be optimised. This study aims to examine changes in the QOL in Ireland's National Forensic Mental Health Service (NFMHS) following its relocation from the historic 1850 site in Dundrum to a new campus in Portrane, Dublin.MethodsThis multisite prospective longitudinal study is part of the Dundrum Forensic Redevelopment Evaluation Study (D-FOREST). Repeated measures were taken for all inpatients in the service at regular 6 monthly intervals. The WHOQOL-BREF questionnaire was offered to all inpatients. An anonymised EssenCES questionnaire was used to measure atmosphere in wards. Data were obtained at 5 time points for each individual patient and ward. WHOQOL-BREF ratings were obtained across 5 time points with comparisons available for 4 time intervals, including immediately before and after relocation. For 101 subjects across 4 time intervals, 215 sets of data were obtained; 140 before and 65 after relocation with 10 community patients who did not move. Using Generalised Estimating Equations (GEE) to correct for multiple comparisons over time, the effect of relocation, with community patients as a control, was analysed by ward cluster and whether patients moved between wards. Observations were categorised according to security level – high dependency, medium secure, rehabilitation, or community – and trichotomised based on positive moves to less secure wards, negative moves to more secure wards, or no moves.ResultsRelocation of the NFMHS was associated with a significant increase in environmental QOL (Wald X2 = 15.9, df = 1, p < 0.001), even when controlling for cluster location, positive and negative moves. When controlling for ward atmosphere, environmental QOL remained significantly increased after the move (Wald X2 = 10.0, df = 1, p = 0.002). EssenCES scores were obtained within the hospital for 3 time points before relocation and 2 time points afterwards. No significant differences were found on the three subscales before and after the move. All three EssenCES subscales progressively improved with decreasing security level (Patient Cohesion: Wald X2 = 958.3, df = 1, p < 0.001; Experiencing Safety: Wald X2 = 152.9, df = 5, p < 0.001; Therapeutic Hold: Wald X2 = 33.6, df = 3, p < 0.001).ConclusionThe GEE model demonstrated that the move of the NFMHS improved self-reported environmental QOL. The cluster location made significant differences, as expected for a system of stratified therapeutic security, with a steady improvement in scores on all three atmosphere subscales.
White Matter Microstructure Abnormalities in Individuals at High Risk for Psychosis: A Meta-Analysis of Fractional Anisotropic Changes Associated With Transition to Psychosis
Authors: Ntephe Chukwuma , Desai Dhwani , Laguna Pedro , David Anthony , Merritt Kate 
Published: August 2024

AimsRecent studies have focussed on detecting white matter abnormalities in subjects who transition to psychosis (UHR-T). Research suggests that fractional anisotropy (FA), may be decreased in UHR-T. However, global and regional findings have been inconsistent. By objectively combining data in a meta-analysis, we have investigated white matter alterations associated with transition, by comparing FA in UHR-T with subjects that do not transition (UHR-NT) and healthy volunteers.MethodsThe meta-analysis was registered on PROSPERO (ID: CRD42021265348) and followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses PRISMA guidance. A systematic database search of PUBMED and EMBASE identified reports, which were screened by 2 independent researchers (CN and DD) for inclusion, from inception to 20 July 2021. Discrepancies were decided on consensus with a third researcher (KM). Reference lists of eligible studies were also screened. Authors of screened reports were contacted to provide parametric maps. Coordinate-based meta-analysis was conducted using Seed-based d-Mapping software to combine parametric map and coordinate data from reports, using a random-effects model. Quality and risk of bias analysis were conducted using the Newcastle-Ottowa Scale. Heterogeneity and sensitivity analyses were also conducted.ResultsThe search strategy identified 889 potential studies, from which 6 met eligibility criteria. A total of 71 UHR-T, 142 UHR-NT and 148 healthy volunteers were included. Weighted-mean decreases in FA were observed in UHR-T compared with: UHR-NT (d = −0.99; p < 0.0001; 95% CI −1.43 to −0.55); and healthy volunteers (d = −0.91; p = 0.04; 95% CI −1.78 to −0.05). The level of heterogeneity for the former was not significant. For UHR-T, regional FA decreases were observed in areas including the left genu of the corpus callosum (Z-score = −1.76, 204 voxels, p < 0.0001) compared with UHR-NT, while FA increases were most observed in the white matter region adjacent to the left postcentral gyrus (Z-score = 1.64, voxels = 16, p < 0.0001). These findings persisted despite sensitivity analyses.ConclusionThe findings suggest that white matter alterations, specifically in left frontotemporal tracts, are associated with an increased risk of transition to psychosis. The neurobiological implications of these findings, and their contribution to UHR-T prediction efforts, are explored, as are avenues for further research.Additional Author: Mr Gunnar Gronlid.1