bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Influence of Social Media on the Body Image of First Year Female Medical Students of University of Khartoum, 2022
Authors: Farah Razan 
Published: August 2024

AimsFacebook, Instagram, TikTok and other social media applications have become an integral component of everyone's social life, particularly among younger generations and adolescents. These social apps have been changing a lot of conceptions and beliefs in the population by representing public figures and celebrities as role models. The social comparison theory, which says that people self-evaluate based on comparisons with similar others, is commonly used to explore the impact of social media on body image. There is a need to study the influence of those social platforms on the body image as there has been an increase in body dissatisfaction in the recent years.MethodsThis was a cross sectional study that used a self administered questionnaire on a simple random sample of 133 female medical students of the first year. Data were analyzed using SPSS.ResultsFinding shows that the response rate was 75%. There was an association between social media usage and noticing how the person looks (p value = 0.022), but no significant association between social media use and body image influence or dissatisfaction was found.ConclusionThis study implies more research under this topic in Sudan as the literature are scarce.
The Role of Rare Copy Number Variants in the Functional Outcomes of Individuals With Neurodevelopmental Conditions
Authors: Flanagan Maria , Dennison Charlotte , Martin Joanna , Thapar Anita 
Published: August 2024

AimsCopy number variants (CNVs) are large changes in the structure of DNA. Certain rare CNVs are associated with elevated chance of neurodevelopmental conditions and difficulties (NDs), including autism spectrum disorder (ASD) and intellectual disability, alongside various physical health complications. Currently, CNV testing in children with NDs is only recommended under limited circumstances, in part because their impact on outcomes and prognosis remains unknown. We aimed to investigate whether individuals with NDs in childhood, with and without rare pathogenic CNVs, differ in terms of functional outcomes in early adulthood.MethodsPathogenic CNV carriers were identified in the Avon Longitudinal Study of Parents and Children (ALSPAC), a UK birth cohort of individuals born in 1991–1992. Individuals with the following childhood NDs were identified through parent-reported diagnostic interviews and questionnaires, and assessment with the child: Attention Deficit Hyperactivity-Disorder (ADHD), ASD, reading difficulties, coordination difficulties, language difficulties, and chronic tics. Outcomes were measured at age 25 and included: presence of an emotional disorder, being in receipt of sickness/disability benefit, ability to make and maintain friendships, not being in education, employment, or training (NEET), and self-reported life satisfaction. We will use logistic regression to measure the association between carrying a pathogenic CNV and each functional outcome in ALSPAC. Sensitivity analyses will be conducted on all large (>250kb), rare (<1%) CNVs, as opposed to only pathogenic CNVs.Results983 individuals with probable NDs (39.4% female, n = 387) were identified in ALSPAC, including 495 people with ASD, 163 with ADHD, 16 with Tourette's syndrome, 210 with reading difficulties, 295 with language difficulties, and 166 with coordination difficulties. Many individuals met criteria for more than one ND.43 (4.4%) of individuals with an ND carried a pathogenic CNV. CNV carrier status amongst individuals with a ND was not associated with sex (4.4% of females vs 4.4% of males, OR = 1.007 [0.539–1.882] p = 0.981). Analysis of CNV carrier status on outcomes in NDs will be conducted between February and April 2024.ConclusionEvidence in support of poorer outcomes in CNV carriers could suggest that neurodiverse young people with CNVs may benefit from intervention to improve outcomes, and thus more individuals may benefit from genetic testing. Conversely, evidence indicating that CNVs do not impact outcomes may suggest that current clinical guidelines are appropriate within the current research landscape, and that further research is needed to understand the impact of carrying a pathogenic CNV in young people with NDs.
What Is the Evidence for Cognitive Behavioural Therapy for Insomnia (CBTI) in Improving Sleep in People With Mild Cognitive Impairment or Dementia?
Authors: Forbes Charlotte , Butterworth Jo , Fox Chris , Allan Louise 
Published: August 2024

AimsThere is a well-established association between sleep disturbance and cognitive decline. Poor sleep can have a significant effect on patient and carer wellbeing and is a potentially modifiable risk factor for dementia. Sleep medications are problematic in cognitive impairment due to the increased risk of adverse events such as falls and confusion. There is good evidence for Cognitive Behavioural Therapy for Insomnia (CBTI) in older adults but its effectiveness in cognitive impairment is unclear. In 2021, only one RCT on CBTI in cognitive impairment was identified (Cassidy-Eagle et al. 2018). This review seeks to establish if there is any new evidence.MethodsOvid Medline (1946 to present) and clinicaltrials.gov were searched for all interventional trials testing CBTI including RCTs, single-arm studies and protocols, written in English. Inclusion criteria:
1.Adults with a diagnosis of MCI or Alzheimer's dementia;2.Sleep as a primary outcome, using a validated outcome measure.Systematic reviews were tracked for references.Results172 citations were screened by the first author and 26 underwent full text review. Eight papers were eligible for inclusion. Four of these studied MCI, three looked at people living with dementia (PLWD) and caregivers as a dyad and one combined MCI and Alzheimer's (protocol only).The search found two pilot RCTs and two protocols for MCI. Cassidy-Eagle et al. (2018) found a highly significant positive effect on four of five sleep outcome measures with large effect sizes. The Insomnia Severity Index (ISI) decreased from 15.29 to 3.25 (p < 0.001; Cohen's d −4.22). Mattos et al. (2021) also found significant improvements on all sleep outcome measures; ISI decreased from 13.5 to 8.3 (p < 0.01).Three papers study joint CBTI for PLWD and their care partners (one pilot RCT and two protocols). Song et al. (2024) reported improvements in sleep parameters for both participants in the dyad but were not statistically significant. They are recruiting for a larger trial.ConclusionThis review identified 7 new RCTs in progress. In MCI, new data continue to show a significant association between CBTI and improved sleep. Published data for people with dementia have not found a significant relationship, although the data set remains very limited. It is not yet possible to synthesise the results and future systematic reviews are needed. If effective, CBTI could offer a lower risk alternative to medications in managing sleep disturbance in people with cognitive impairment.
Disparities in Access to Group Parenting Training Programmes: A Cross-Sectional Analysis of Local Authorities Across England
Authors: Gorringe Rosemary , Woods Peter , Giardino Manuel , Solano Juan Luque , Hodson Nathan 
Published: August 2024

AimsTo compare the funding, courses and delivery modalities of parenting training delivered across London borough councils, metropolitan district councils, and county councils in England.MethodsFreedom of Information requests were piloted on 5 local authorities. Following optimisation, requests were sent out to 74 local authorities across England requesting information on funding for parenting training programmes (26 London Borough Councils, 16 County Councils, and 29 Metropolitan Borough Councils). 26/32 London Boroughs, 16/21 County Councils, and 29/36 Metropolitan Boroughs were sent requests. No follow-up emails were sent chasing responses; however, clarification was provided where necessary. Data were analysed on Excel to observe patterns and disparities.ResultsWe received responses from 74 local authorities, and 50 were usable. The mean amount of funding spent across local authorities was £881,254 (standard deviation 1,627,921). There were 18 parenting programmes used, the most common was Triple-P. The average number of parents supported by parenting programmes per local authority was 949 (standard deviation 1410). Local authorities reported spending an average of £27,430 (standard deviation 41005) on digital parenting programmes. The mean number of parenting staff was 36 (standard deviation 59).ConclusionWe found wide disparities in spending, staffing, and programme choices representing a fragmented landscape of parenting training provision. Several local authorities could not separate spending on parenting training, and parental engagement was not reported consistently. We recommend more consistent reporting of parental initiation, engagement, and completion of training programmes to ensure equitable access and provision of parenting training nationwide.
The Impact of Rare Copy Number Variants on Real-World Functional Outcomes in Individuals With Psychosis
Authors: Kendall Kimberley 
Published: August 2024

AimsIndividuals with psychosis experience impairments in real-world functional outcomes such as employment and health. Rare copy number variants (CNVs) are established risk factors for psychosis, neurodevelopmental disorders and cognitive impairment. However, little is known about their effect on real-world functional outcomes in individuals with psychosis.I aimed to establish the effect of rare neurodevelopmental CNVs on real-world functioning in individuals with psychosis.MethodsI identified 1,932 individuals with psychotic disorders (ICD–10 F20–F29) in the UK Biobank using first-occurrence data (from primary care, hospital inpatient and death register records and self-reported conditions). I mapped UK Biobank data to two domains of real-world functional outcomes – health deficits and vocational outcomes. We previously called CNVs using PennCNV, annotating them with 53 CNVs associated with autism spectrum disorder and developmental delay. I conducted regression analyses with neurodevelopmental CNVs as the predictor, real-world functioning as outcomes and with relevant covariates (e.g. age and sex).ResultsOut of 1,932 individuals with psychotic disorders, 2.5% (n = 49) carried a neurodevelopmental CNV.Health DeficitsI used first-occurrence diagnosis data to establish comorbid psychiatric diagnoses. I summed these diagnoses and dichotomised them into one or more comorbid diagnoses versus no comorbid psychiatric diagnoses. I conducted a logistic regression analysis – neurodevelopmental CNV carrier status was associated with having at least one psychiatric diagnosis in addition to a psychosis diagnosis (OR 2.1, 95% CI 1.1 - 4.1, p 0.034). Post-hoc analyses revealed an increased rate of dissociative and conversion disorders in CNV carriers (OR 4.5, 95% CI 1.26 - 15.99, p 0.021).I used first-occurrence physical health diagnosis data to establish the burden of the 20 most prevalent chronic non-cancer illnesses. Neurodevelopmental CNV carrier status was associated with chronic physical health multimorbidity in individuals with psychosis (59.2% vs 43.5%, OR 2.30, 95% CI 1.27–4.17, p 0.006), defined as the presence of two or more chronic physical health conditions.Vocational OutcomesI conducted an ordinal regression analysis, establishing that among individuals with psychosis, CNV carriers had a lower likelihood of achieving a higher qualification (OR 0.45, 95% CI 0.27–0.77, p 0.003).ConclusionNeurodevelopmental CNVs are associated with important real-world functional outcomes in individuals with psychosis. This work provides information that can guide the assessment and management of individuals with both psychosis and neurodevelopmental CNVs.
Phenomenology of Mood Disorders in Children and Adolescents
Authors: Khadanga Poornima , Moktan Sherina , Sharma Eesha , Vijaysagar Kommu John 
Published: August 2024

AimsPsychiatrists frequently diagnose mood disorders in children. However, there is a limited understanding of clinical history and phenomenology of mood disorders in these phases of lifespan, and phenomenological variations in those with and without neurodevelopmental disorders (NDD). The primary objective of the study was to study, comparatively, the phenomenology in children clinically diagnosed with mania, depression and mixed affective disorder. The second objective was to study the phenomenological differences in diagnosed cases of mood disorder children with and without neurodevelopmental disorders.MethodsWe conducted a semi-qualitative study of the clinical history and phenomenology in 120 children recruited from a tertiary care child and adolescent psychiatry service. Children with current diagnosis of depression, mania or mixed affective state, age less than 18 years, and appropriate consent/assent were included. Children with comorbid neurological disorders, any underlying organicity, or those currently in remission from their mood episode were excluded. Descriptive summaries were calculated for socio-demographic, clinical and phenomenological data. Chi Square test was used to examine statistical differences in prevalence of various phenomena across the clinical diagnostic groups.ResultsThe most common clinical diagnosis was depression (58.3%) followed by mania (25.8%) and mixed affective state (15%). Irritable mood and emotional dysregulation were equally distributed among the three diagnostic groups. With a high prevalence of comorbid NDDs in the sample, we compared phenomena between groups with and without NDDs. In cases of depression, suicidal ideas and guilt feelings were expressed in 61% and 80% of these participants without comorbid NDD (n = 45) respectively, which was significantly high as compared with those with NDD (n = 67). The symptoms of disinhibition (78.9%), impulsivity (84.2%) and emotional dysregulation (10.5%) were more frequently seen in participants with neurodevelopmental disorder. Dissociative and obsessive phenomena were present in about a quarter of our study sample, similarly across mania, depression and mixed state.ConclusionMental status examination of mood disorders in children suggests considerable phenomenological overlap with irritable mood, emotional and behavioural dysregulation, dissociative symptoms, obsessive symptoms, sleep disturbances, nightmares and hyperarousal seen in mania, depression and mixed states. These phenomena may, therefore, not be suitable in differentiating these clinical diagnoses. Children with NDDs may report lesser cognitive phenomena of depression, and the clinician may have to rely on the affective and behavioural manifestations of depression in clinical decision-making.
A Qualitative Analysis of Contributory Factors to Serious Incidents Involving Adults With Learning Disabilities Receiving NHS Mental Healthcare
Authors: Khodabux Nusra , Kiani Reza 
Published: August 2024

AimsThis study aimed to analyse contributory factors to serious incidents (SIs) involving adult patients with intellectual disabilities receiving NHS care in a mental health trust. People with intellectual disabilities face considerable preventable harm and disparities in care. In-depth analysis of contributory factors to incidents involving adults with an intellectual disability, using human-factors based frameworks is lacking. Individual SI reports contain useful data, but learning is often limited without aggregated analysis.MethodsThirty anonymized serious incident reports (2014–2023) from an NHS mental health Trust's intellectual disability service were analysed qualitatively using the Yorkshire Contributory Factors Framework, followed by reflexive thematic analysis (RTA) to identify patterns across the data. This enabled nuanced themes to emerge across errors at the sharp end and systems-level factors at the blunt-end.ResultsAcross 30 reports, 606 discrete factors were identified. Situational factors such as behavioural escalations and staff competency gaps were most frequent (n = 187, 31%). Other factors included active failures, such as slips, lapses, mistakes, violations (n = 109, 18%), organisational influences (n = 107, 18%), communication breakdowns (n = 75, 12%), unfavourable working conditions (n = 62, 10%), cultural factors such as reluctance to voice safety concerns (n = 51, 8%), and external system factors (n = 15, 2%).Using RTA, we identified recurring themes across incidents involving interactions between sharp-end human and blunt-end system factors, with broader issues shaping frontline performance. Patient marginalisation, excessive workloads, lack of resources, and cultures tolerant of shortcuts aligned to permit errors. Deficient coordination across fragmented healthcare systems and overdependence on non-permanent workers and bank staff obstructed comprehensive incident reviews. Failure to adequately probe cultural influences and external pressures further reflect the limited extent of investigational efforts.ConclusionAdults with intellectual disabilities are subject to serious incidents caused by interacting human and system-level factors, including organisational, cultural and external factors. Addressing under-resourcing and improving investigation quality are paramount to enhancing safety of care for people with intellectual disabilities.
Two Years Beyond COVID-19: Unveiling the Persistence of Neuropsychiatric Symptoms and Risk Factors in a Cross-Sectional Study
Authors: Laha Poulami , Gowda Guru S , Reddi V Senthil Kumar , T Harish , Moirangthem Sydney 
Published: August 2024

AimsThe neuropsychiatric morbidities associated with post-COVID status are important public health issues. The range and severity of morbidity varies with the type of clinical setting and time of assessment. There are limited studies on the long-term persistence of the post-COVID neuropsychiatric symptoms (PCNS). Hence, this study aims to determine the proportion of persistent PCNS after approximately 2 years of COVID and to find any risk factors for persistent PCNS.MethodsThis study was a cross-sectional study of randomly selected 2,281 individuals aged 18–60 years, currently living in the community, who were RT-PCR positive for COVID-19 from the National Institute of Mental Health and Neurosciences (NIMHANS) laboratory (at least 4 weeks before intake) from a period of 1 June 2020 to 31 March 2022. Among them, 927 individuals who met the study criteria were screened for PCNS through telephone interviews using a validated PCNS screening tool comprising sociodemographic details, life events inventory and 20 questions to assess for PCNS. 196 individuals who came positive for PCNS were further evaluated by in-person or web-based interviews with Structured Clinical Interviews for DSM–5-Research Version and World Health Organization-Post-COVID Case Report Form for persistent PCNS. Descriptive statistics, Chi2 test, Mann–Whitney U Test, and Binary logistic regression analysis were used for data analysis. The Institutional Ethics Committee approved this study.ResultsThe median age of study participants was 34 years, and 51.3% were female. 68 out of 196 participants (34.7%) had persistent PCNS approximately 2 years (23.84 months) after COVID-19 infection. Chronic fatigue (10.2%), depression (6.1%), cognitive symptoms (4%), hyposmia (3.6%), hypogeusia (3.6%), anxiety (2.5%), panic disorder (2.5%) and insomnia (2%) are the main persistent symptoms. The median age of the participants with persisted PCNS (40 years) is higher compared with the median age of the participants without persisted PCNS (34 years) [Mann–Whitney U = 5,225.0, P = 0.021]. Even though significant associations were found between the development of PCNS after 4 weeks of COVID and female gender, symptomatic COVID-19, severity of COVID-19 (oxygen supplementation), hospital admission, total number of times of COVID-19, and presence of life events, this association were not found with persistence of PCNS at 2 years.ConclusionThis study revealed that one-third of the individuals with PCNS had persistent symptoms after 2 years. Chronic fatigue is the most common persistent PCNS. Middle-aged and above age groups were found to be a risk factor for persistent PCNS.
Nature and Prevalence of Long-Term Conditions in People With Intellectual Disability, a Study That Combines the Powers of AI, Big Data and Lived experience
Authors: Lewin Gemma , Kousovista Rania , Abakasanga Emeka , Shivamurthy Rishika , Cosma Georgina 
Published: August 2024

AimsIndividuals with intellectual disability (ID) exhibit elevated health needs when compared with the general population. There is a higher vulnerability to long-term conditions. A scoping review identified that individuals with ID exhibit a distinct pattern of multiple long-term conditions (MLTC) that is different to the general population. Findings highlight health challenges faced by individuals with ID, emphasising the need for targeted and early interventions to address their unique healthcare needs.This study utilises a professional advisory panel (PAP) and patient and public involvement (PPI) group to form a consensus on relevant long-term conditions for people with ID. Machine learning algorithms are employed to identify long-term conditions in a large, population-based data repository covering the whole of Wales revealing a comprehensive range and prevalence of long-term conditions in a sample of 13,361 adults with ID.MethodsA consensus on relevant long-term conditions for people with ID was formulated through iterative review followed by revision by PAP and PPI group. PAP comprised a multidisciplinary team with relevant expertise including General Practitioners, a Consultant Psychiatrist, nurses, pharmacists, and data analysts. The PAP worked in collaboration with a PPI group, comprising three groups of experts by experience: people with ID, family or informal carers of people with ID, and professional carers of people with ID.This study utilises machine learning algorithms in the Secure Anonymised Information Linkage (SAIL) databank to identify the range and prevalence of long-term conditions in ID. SAIL is an anonymised, population-based data repository, comprising billions of anonymised records across Wales. This study included 13,361 ID adult patients.ResultsFollowing iterative review and revision by the PAP and PPI group, a consensus of 40 long-term conditions relevant for people with ID was identified. Prevalence rates for each condition were calculated. Ten most prevalent conditions were recorded as mental illness, reflux disorders, epilepsy, chronic airway diseases, hypertension, thyroid disorders, chronic arthritis, chronic kidney disease, diabetes, and anaemia.ConclusionConsensus on relevant long-term conditions for the general population developed through previous studies is not relevant for the ID population. This is the first effort at creating a full range of long-term conditions for individuals with ID, utilising a population-based data repository. It is possible to do this in partnership with PAP and PPI groups. Along with prevalence, impact of ageing and gender, and hospitalisation as outcome data, this study describes challenges associated with interpreting data captured by Read Codes and ICD–10 codes.