bluuebunny/crossref_metadata_2025_split huggingface dataset:
Equality, Diversity & Inclusion in the Workplace: Exploring the Experiences of Psychiatry Trainees Across the North West of England
Authors: Ozidu Victoria , Hosein Claire-Marie , Sparasci Oli , dos Santos Catarina Rodrigues , Inkster Clare 
Published: July 2023

AimsEveryone in the NHS deserves to work in an environment that is safe, welcoming, and free from discrimination, however recent surveys have highlighted that this is often not the case. Alarmingly, it has been recognised that few psychiatrists report any forms of discrimination and of those who have, there is often dissatisfaction with the response received from their employer. Due to a paucity of data relating to the experiences of psychiatry trainees in the North West, we sought to understand their lived experience and to co-design proposals for future work that may improve the status quo.MethodsAll psychiatry trainees across the North West of England in 2022 and early 2023 have been invited to complete an electronic, core training or sub-specialty specific higher training survey. Basic demographic details were collected. Respondents were asked a range of questions around their experience of discrimination in the workplace and good practice observed in managing this. Subsequently, each group of higher sub-specialty trainees were invited to a two-hour reflective session held face-to-face or via an online platform. Two further reflective sessions were arranged in Liverpool and Manchester for core trainees. During reflective sessions, attendees were presented with vignettes of workplace discrimination, developed from the results of the initial survey. Session facilitators guided a discussion on the feelings evoked by each vignette, whether attendees wanted to discuss their lived experience of similar incidents and to consider ideas for what may be done to support a trainee in these situations. A post session questionnaire was circulated.ResultsOver 100 individuals have completed the pre-session survey and attended a reflective session. Survey respondents were predominantly trainees who identified as Asian, Asian British, Black, Black British, Caribbean or African ethnicity, with a roughly 50:50 split between Male and Female.Themes highlighted include:That the vignettes used in the reflective sessions are representative of everyday workplace discrimination.That training in microaggressions should be given to trainers, trainees and other clinical staff on a regular basis.That the burden of managing discriminatory behaviour should be on the institution and not the trainee experiencing discrimination.ConclusionMany psychiatry trainees across the North West have lived experience of workplace discrimination and systems need to be implemented to improve trainees’ experience. Proposals for future improvements; such as the formation of a deanery wide reporting and management system for trainees who have faced workplace discrimination; are being co-developed to address current challenges.
INSIGHT: Evaluation of the Psychological Medicine Student Placements at HMP Berwyn, North Wales: Year One Findings
Authors: Nafees Sadia , Matusiak Jakub , Taylor-Clutton Andrea , Newman Simon , Poole Rob 
Published: July 2023

Aims/BackgroundSocial determinants of health (SDOH) are social factors that have a causal role in ill health and have an adverse effect on health outcomes. SDOH are part of the UK medical student curriculum but mainly discusses epidemiologically. There are few educational approaches that aim to incorporate an understanding of SDOH into the experiential and competency-based elements of undergraduate medical education. Prisoners are a population who experience high levels of stigma, social adversity and health disadvantage. Clinical attachments in prison may teach students about the impact of SDOH in a vivid and memorable way. Aims: We aim to explore changes in medical students' knowledge/attitude towards SDOH during and after psychiatry placements at HMP-Berwyn prison.MethodsAll year four medical students on psychiatry placement in North East Wales during 2021–2022 participated. In each of the six placement cohorts, one student did their psychiatry placement in prison. All the other students visited for one day. All students participated in two seminars focused on their prison experience and SDOH in psychiatry. Baseline and mid-placement bespoke questionnaires were completed, and all students participated in end-of-placement individual interviews.Results29 students participated. Student assessment of the importance of SDOH did not show a significant change between baseline and mid-placement. However, student attitudes to experience in prison became more positive at end-of-placement. Comparing baseline to mid-placement questionnaires showed a 14% increase in students' rating of prison placements as educationally beneficial. 14% of students mentioned improved confidence in dealing with challenging patients, and 28% commented on the benefits of exposure to incarcerated patients. Interestingly, only 3% of students considered hospital placement more beneficial than prison placement. Prison placement was considered an exceptional experience than other settings by 17%.ConclusionThere are no previous UK empirical studies on medical student placements in prison. Overseas studies identify reduced anxiety over dealing with demanding patients. Our findings so far lack statistical power but show positive satisfaction and knowledge trends amongst participants. Prison placement appears to be acceptable and educationally valuable. It offers opportunities for experiential teaching about SDOH. In addition, it may improve student understanding of a marginalised and stigmatised population.Implication for practice, policy and researchOn completion, this study may provide evidence on one method of improving attitudes toward marginalised people and understanding SDOH in the medical profession.This research was funded by Betsi Cadwaladr University Health Board and sponsored by Bangor University.
Improving the Interface Between Substance Misuse and Mental Health Services by Equipping Junior Doctors Working Within Mental Health Services, With Tools to Help Improve Competence in Assessment and Management of Dual Diagnosis(co-Occurrence of Substance Misuse and Mental Health problems)
Authors: Samad Samreen , Dugmore Lois , Hurton Nicola 
Published: July 2023

AimsDual diagnosis (i.e. co-occurrence of substance misuse and mental health problems) is a norm rather a rarity making it vital for service users to receive high quality, patient focused and integrated care. That being said, patients with dual diagnosis often feel excluded from services with neither of the services taking overall responsibility. Lack of broad spectrum of expertise required to treat both conditions, has been identified as reason for gaps in service provision where NICE guidance emphasizes the need for staff training and supervision. This was highlighted during survey with doctors in LPT as baseline assessment to assess training needs. This project aims to upskill junior doctors in the assessment and management of patients with Dual Diagnosis by delivery of a training package to each round of junior doctors during the induction period. The training package includes an ebook as pre-requisite for attending induction followed by teaching and short video clip. The training module aims to:1)afford junior doctors the opportunity to assess and manage patients with dual diagnosis effectively. 2) minimise prescription errors, missed diagnosis and missed referrals to substance misuse services 3) improve compassion and reduce stigmaMethodsTraining package was delivered to new cohort of junior doctors Jan 2023during their induction period.We used pre teaching and post teaching questionnaires a means to measure the change in level of confidence that the junior doctors experienced across three domains:
1.Assessment of service users for substance misuse2.Using validated tools for screening of service users for substance misuse3.Making referrals to appropriate services using substance misuse pathway.Results14 responses have been collected from junior doctors to date.There was an improvement in level of confidence from across the three main domains.In carrying out assessment for substance misuse, 86% reported “somewhat confident” (after teaching) compared to 7.1% (before teaching).In using validated tools, 78% reported “somewhat confident” (after teaching) compared to 7.1% (before teaching).In making referral to substance misuse services, 64% “somewhat confident” (after teaching) compared to 14% (before teaching).ConclusionThe training package helped in improving the confidence level of junior doctors in carrying out assessment , using validated tools and making referral to substance misuse services. However, whether this translates to making them adept at assessment and management of substance misuse will need to be corroborated by measuring prescription errors and number of referrals to substance misuse services.
Experience and Well-being of Trainees in a Rural Mental Health Trust
Authors: Huntington Kate , Rajkumar Beena , Titova-Chaudhry Elena 
Published: July 2023

AimsTrainee doctors may find it difficult to express their thoughts and feelings concerning their workplace experience. It is important to gain feedback on their experiences allowing potential issues to be addressed and rectified. Identifying and managing concerns at an early stage with the provision of support may have a positive impact on trainee well-being and workforce retention in the future. This project aims to survey trainee doctors working in a rural mental health trust (Lincolnshire Partnership Foundation Trust - LPFT) on aspects relating to their experience, well-being and effect of rurality. This may allow greater insight into issues affecting trainees and allow improvements to be made.MethodsAn electronic survey, created on the website SurveyMonkey, was distributed to 43 trainee doctors within the LPFT. This sample represented all the trainees on placements in Lincolnshire.ResultsTwenty-three out of forty-three trainee doctors (53.49%) submitted responses. Analysis of responses showed some common themes of trainees reporting on supportive workplace supervisors and good relationships with staff in general. Other key findings highlighted those living a greater distance from their workplace found longer commutes difficult, especially if there was reliance on public transport. This had a significant impact on stress levels and well-being. Some trainees reported feelings of loneliness, conversely, other trainees felt fulfilled and settled in their current training programme.ConclusionThis survey identified both positive and negative factors affecting the experience and well-being of trainees. Despite some long commutes, isolation from family and friends and other stressors (exams, fuel costs), positive factors were recognised. This included good supervisor support and relationships. Overall, 78.26% of trainees reported they felt the benefits of their training in the LPFT outweighed the drawbacks. However, it is important to recognise these conclusions are drawn from trainees responding to the survey and are not necessarily fully representative of all trainees’ perspectives.
Service Evaluation of Medical Undergraduate Psychiatry Placement
Authors: Zahreddine Nada , Beezhold Julian , Axford Jenny , Adebayo Ayomide , Theruvath-Chalil Rahna , Jenkins Oliver , McCormack Kristian , Abrar Sohail 
Published: July 2023

AimsThere are no clear guidelines for the optimal organisation of psychiatry placements for medical undergraduates. Moreover, the UK needs to enrol more psychiatry trainees. This service evaluation aimed to show that an efficient psychiatry placement can improve attitudes of students towards psychiatry and increase their likelihood to choose psychiatry.MethodsWe evaluated the efficacy of a new strategy for the psychiatry placement of 24 fourth-year medical students from the University of East Anglia during the academic year 2021/2022. The strategy consisted of having a 4-week placement in one of 3 wards at the Norfolk and Suffolk Foundation Trust Woodlands Unit (PICU, acute male and female wards) with brief (one- to two-day) rotations across the wards, as well as the community team and individual areas of interest. This afforded students exposure to different settings, pathologies and levels of severity, with enough time in one service to allow integration into the team, participation in clinical and therapeutic activities and most important, observation of patient longitudinal improvement. Multidisciplinary teams were included by presenting the training as a win-win, and we relied on a good teaching culture at our Trust. We also offered a programmed induction day, a mid-placement meeting and an end-of-placement debrief. We evaluated the efficacy of the strategy using the Attitude Towards Psychiatry Questionnaire before and after the placement, as well as measuring overall satisfaction.ResultsThe overall satisfaction score on a 5 point Likert scale was very good (M = 4.58; SD = 0.58). Mean ATP total score significantly improved from 116.50 (SD 9.49) to 133.00 (SD 8.68) over a maximum attainable score of 150 (F(1;23) = 69.70, p < .001, ηp2= .75), with 23 out of the 30 items having significantly improved individually as well. The reliability of the scale was high with a Cronbach's alpha of .81 before and .84 after the psychiatry placement. The question “I would like to be a psychiatrist” improved significantly from 2.54 to 3.25 on the 5 point Likert scale (F(1, 23) = 16.33, p < .001, ηp2= .42) with an increase in students answering “agree” or “strongly agree” from 16.7% to 45.8%. This improvement was significantly positively correlated with the overall satisfaction score (R = .528, p < .01).ConclusionPsychiatry placement for medical undergraduates is a valuable opportunity to improve their attitudes towards psychiatry and their likelihood of choosing psychiatry as a specialty. We present our strategy as a model toward these goals.
Thematic Analysis of Inquiries Into Concerns About Institutional Health Care
Authors: Elliott Rachael , White Erin , Nathan Rajan 
Published: July 2023

AimsRecent reports and inquiries indicate that the potential, identified from the early days of the asylum era, for residents of psychiatric institutions to be subject to abuse has not been eradicated. The findings and recommendations of individual inquiries are often so specific to their unique context that it can be difficult to draw general principles that have wider operationalizability. The aims of this study are to thematically analyse available inquiry reports into health care institutions from the mid-20th century to the present using a ‘generalisable’ framework in order (i) to identify the key themes underpinning the concerns raised, and (ii) to analyse how themes change (or persist) over time.MethodsInquiries relating to concerns about the institutional care of patients over the past 70 years were identified. In this pilot study, a selection of available reports were subject to thematic analysis to address the first phase of the study (identifying themes underpinning concerns).ResultsFour overarching themes were identified. The first three themes reflect the different levels of system analysis. Thus, the first theme, ‘the proximal dynamic,’ describes the nature of the interaction between staff and patients which is influenced by staff experience, attitude, and actions. The second theme, ‘the organisational dynamic’, comprises processes, policy and culture particularly, but exclusively, within the provider organisation. The third level of analysis, ‘the system dynamic’ theme, includes the influence on the concerns raised of the way the health system is configured (e.g. commissioning arrangements, and use of 'out-of-area' placements). The fourth theme, which cuts across the first three, is ‘the response to concerns’ which ranges from identifying early warning signs to responding to overt expressions of concerns (including whistleblowing).ConclusionUsing thematic analysis to examine past inquiries into poor institutional care of patients, this study has identified a thematic structure which (i) emphasises that problems arise in a ‘dynamic’ that can be located at three levels of analysis (proximal, organisational and system) and (ii) includes a cross-cutting theme of the way concerns are responded to. This structure can be used as a learning framework for the current provision of inpatient services that has the potential to improve care in institutions, but this will require empirical testing.
Generalized Anxiety Disorder as a Precipitant to Perceived Stress and the Outcomes Associated With Academic Performance and Lifestyle: A Cross Sectional Study Among Medical Students in Sudan 2022
Authors: Ibrahim Danya , Ahmed Reem Mohamed , Bashir Moez Mohammed Ibrahim , Mohammad Ayman Zuhair , Ibrahim Basil , Mohammed Tibyan , Mohamed Mona Elfadl , Abdelgadir Tibyan , Mohammed Baraah , Ibrahim Moneib , Mirghani Kamil Shaaban 
Published: July 2023

AimsTo examine the prevalence of Generalized anxiety disorder (GAD), levels of anxiety and perceived stress in Sudanese medical students. Also measuring students’ academic performance, the satisfaction with the former, and lifestyle characteristics. Then investigating the different correlations between all these factors.MethodsWe conducted a cross-sectional study at University of Khartoum, among Sudanese medical students. A self-administered anonymous online questionnaire was filled by 340 medical students,which includes Generalized anxiety disorder-2 (GAD-2), and Perceived Stress Scale (PSS-10), beside academic performance and lifestyle characteristics questions.ResultsThe data obtained from 340 medical students revealed 3.8% (n = 13) had a previous GAD diagnosis and 29.1% scored ≥ 3 in GAD-2, indicating the possibility of having GAD, 7 of them have a previous GAD diagnosis. Among participants 9.7% use addictive substance, with 42% of them having a high GAD-2 score. Higher anxiety levels were associated with high stress scores (p = 0.000). High GAD-2 scores were significantly associated with those spending less than 10,000 SDG (18$)/week, increased hours of smart devices usage for entertainment (p-value = 0.004), and unhealthy diet (p-value = 0.004). Low anxiety scores were associated with improved quality of sleep (p-value = 0.00), satisfaction with religious practices (p-value = 0.00) and increased leisure /hobbies time (p-value = 0.018). Elevated stress levels were higher in females (p-value 0.035), students with lower academic performance satisfaction levels, and increased hours of smart devices usage for entertainment (p-value = 0.001). Reduced stress levels were associated with age > 23, increased time spent on leisure/hobbies (p-value = 0.002) and eating a healthier diet (p-value = 0.006). Mean academic score was positively associated with academic performance satisfaction (p-value = 0.00), making the mean academic score an indirect modulator for anxiety and perceived stress.ConclusionThe study elaborates that GAD diagnosis is quite low; with almost third of participants having the probability of developing GAD, asserting the significance of implementing periodic mental health screening programs for medical students, early diagnosis of high-risk individuals, and early interventions through confidential access to mental health services to prevent further harm to the students' health. The impact of financial burden on medical students’ elevated the GAD-2 score; as well as poor lifestyle, i.e. habits such as unhealthy diet, increased hours of using smart devices, low sleep quality and low satisfaction with religious practices, which are all modifiable risk factors of GAD.
The Effect of Perinatal Depression on Child Development
Authors: Isidore Sadie , Ramdass Prakash 
Published: July 2023

AimsPerinatal Depression is a global issue, with several studies showing that it has detrimental effects on the development of children. The aim of this paper was to review these effects according to five domains of development: Cognitive, Motor, Behavioural and Social, Emotional, and Physical. These domains were then explored at four sub-categories of age: Neonate (0–30 days), Infant (1 month – 2 years), Young Child (2–6 years), and Child (6–12 years). This paper also aimed to examine how public health programs have been used to mitigate perinatal depression as a means of reducing child developmental issues.MethodsWe conducted a narrative review and searched PubMed and ScienceDirect for peer-reviewed articles, which explored perinatal depression and child development, as well as public health programs that attempted to challenge this problem. Articles were not limited by language or date.ResultsA total of 352 titles and abstracts were screened for eligibility, with a resultant 25 articles meeting the criteria to be included in this review. The studies examined were conducted in 14 countries across different continents, with sample sizes ranging from 13 dyads (mother-child pairs) to 6550 children. At the neonatal and infant levels, there were distinct effects in most domains, including low motor scores, increased risk of neuromuscular developmental delays, and issues with emotional regulation. However, at the older stages, there was a decrease in physical deficits, as social and emotional developmental issues became more prominent. These were displayed as anxiety, depression, attention deficit hyperactivity disorder, and increased likelihood of aggression and rule-breaking behaviour.ConclusionPerinatal depression has damaging effects on child development in all five domains and during all four stages of development. Public health programs that use alternative forms of treatment as opposed to interpersonal therapy should be emphasized. There is a need to conduct more research on children in the later stages of development in order to identify the potentially long-lasting effects of perinatal depression. There are also significant challenges in investigating perinatal depression, as the effects of antenatal depression and postnatal depression on child development are often explored separately.