bluuebunny/crossref_metadata_2025_split huggingface dataset:
Redeveloping Leadership Training for Higher Trainees in the West Midlands
Authors: Patel Devika , Pantall Shay-Anne , Aziz Humaira , Nainar Feroz 
Published: June 2022

AimsMany of the competencies that trainees in psychiatry are required to achieve can be linked to leadership in the broadest sense, yet specific training is not often systematically provided. The West Midlands Psychiatry Leadership Development Programme aims to support the acquisition of important leadership skills already set out in the curriculum through provision of high-quality specialist leadership content within the existing programme. Here we present the findings of a scoping exercise exploring the views and attitudes towards leadership training held by higher trainees in psychiatry within the West Midlands.MethodsAll psychiatry higher trainees within West Midlands Deanery were invited to complete an anonymous online survey using Survey Monkey in November 2021. This survey incorporated questions about their preferred learning styles, confidence in their leadership skills and barriers to accessing leadership opportunities, generating both quantitative and qualitative data.ResultsKey results included:
•37 responses were received. All subspeciality training programmes were represented. Almost half of respondents (46%) were ST6 or above and most were in training full time (84%).•Trainees expressed a preference for experiential learning about leadership (87%) as well as small group teaching (62%) and interactive workshop style content (62%).•Awareness of leadership opportunities was typically via their peer group (81%) or clinical supervisor (60%). Only 52% of trainees were aware of leadership opportunities within the Deanery.•Only 54% felt that existing leadership training met their curriculum requirements. Less than half of trainees (46%) felt confident to evidence their leadership experience within their training portfolio.•One-fifth of trainees (21%) reported experiencing barriers to leadership development. These included: inadequate awareness of opportunities, lack of senior support, time constraints and difficulty matching interests with available opportunities.ConclusionTrainees expressed interest in the redevelopment of a regional leadership training programme which would support them to achieve their curriculum competencies and prepare them for life as a consultant psychiatrist. The new multi-faceted regional leadership programme will offer resources in a variety of formats including webinars, podcasts, optional interactive workshops and action learning sets. It is hoped that this flexible programme, linked to the Medical Leadership Competency Framework, will better meet the needs of higher trainees as they pursue their own personal leadership journeys.
Setting Up a Cultural Psychiatry Group (CPG) at Birmingham and Solihull Mental Health Foundation Trust (BSMHFT) – the Achievements, the Pitfalls and What We Have Learnt
Authors: Parsons Megan , Saeed Razan , Fathima Zulfiquar 
Published: June 2022

AimsWhilst psychiatry training is both demanding and enjoyable, we feel that the theory does not fully capture what we see in our everyday work. For many of our patients, it fails to contextualise their experience within their socio-politico-economic environment. Working with patients with different ways of seeing, knowing and being necessitates an awareness of one's own and the other's sociocultural world in order to build an empathetic and empowering doctor-patient partnership.We started a CPG with the hope of exploring resources from those whose perspectives are often left out of our training experience, with a view towards integrating these voices together with our clinical experiences and training program. We aimed to create a space where we could regularly explore the experiences of ourselves, our patients, and the societies in which we work, reflecting on the conscious and unconscious roles we inhabit.Our aims for the space were to: recognise that everyone will have something valuable to contribute. Cultivate a space where people feel able to share openly. Maintain the safety of the space through compassion and accountability. - Show willingness to be uncomfortable but continue engaging in order to learn together.MethodsIn Spring 2021, four Core Psychiatry Trainees from BSMHFT met together to plan a trust-wide CPG. There were three clear cycles of CPG meetings, the first consisting of member led sessions, the second outside speaker led sessions and the third an amalgamation of the two. Meetings were continually reviewed throughout each cycle with more formal evaluation and alteration at the end.ResultsThe first part of the discussion focuses on what went well with the themes being:
–Developing habits of lifelong learning–Developing relationships with peers and the community–Creating space for self and group reflection–Developing transferable skills (leadership, management, teamwork).The second part of the discussion focusses on the problems that the group encountered and how they were overcome. The main themes being:
–Technology–Communication–Engagement–Management.ConclusionAt an individual level, this experience has been challenging but rewarding and we have received overwhelmingly positive feedback. Locally, the BSMHFT CPG has been invited to work with our trust on their “inequality strategy”, as well as universities and organisations represented by outside speakers. Nationally, the blueprint laid out in our conclusion aims to help those wanting to set up a similar group in their area benefit from our experience.
Improving Clinical Skills in Psychiatry Using Online Simulation
Authors: Rudra Sonya , Swerdlow Abigail 
Published: June 2022

AimsThe COVID-19 pandemic impacted medical education with teaching moving online. The aim of this study was to evaluate whether online simulation is an effective tool for the delivery of student psychiatric clinical skills teaching. This has important implications for the future planning of psychiatric clinical skills teaching.Methods162 students were divided across nine online psychiatric simulation sessions held over a four month period. The sessions lasted 3.5 hours and consisted of three simulated scenarios with a professional actor and experienced facilitator. Students were asked to rate: confidence in taking a psychiatric history, conducting a mental state exam, formulating treatment plans, conducting risk assessment, assessing capacity and communicating with patients in psychiatry. Confidence ratings were completed pre and post session on Likert scale (1 = least confident, 10 = most confident). Students were also given the opportunity to provide qualitative feedback after the sessions. The study was conducted with permission from Associate Dean for Undergraduate Teaching and QMUL Centre Lead for Psychiatry.Results137 (92.7%) of students attending the workshop completed pre-session questionnaire and 122 (82.4%) completed post-session questionnaire. 95.1% students rated workshops as good/very good. Pre and post confidence comparisons showed significant increases in average confidence for all questions from pre (M = 5.1, SE = 0.2) to post (M = 7.1, SE = 0.2), t = 10.7 p < 0.001. Paired t-tests were used to compare average pre and post-session results for individual questions from the same session. All questions showed significant increases in scores. Qualitative feedback indicated that students valued the opportunity to practice, obtain feedback and requested more sessions.ConclusionResults show significant increases in confidence in psychiatric clinical skills using online psychiatric simulation. This supports our hypothesis that online simulation is an effective tool for delivery of student psychiatric clinical skills teaching. Students may benefit from online simulation increasing their confidence prior to attending psychiatric placements. This teaching method will also provide an additional method for practising clinical skills with increasing student numbers and demands on psychiatric placements. It therefore has important implications in the future of psychiatric education and could be adapted for use across clinical years and medical schools.
Face-to-Face Psychiatry Placements and Their Impact on Student Attitudes to Psychiatry
Authors: Swerdlow Abigail , Rudra Sonya 
Published: June 2022

AimsLast year the COVID-19 pandemic meant that there could not be any face-to-face psychiatry placements for medical students at QMUL (Queen Mary University of London). This year there has been a return to face-to-face placements within psychiatric settings. The aim of this project was to evaluate whether face-to-face placements have an impact on medical student attitudes to psychiatry. This will have implications for recruiting students into the specialty, once they qualify.Methods128 students were placed in face-to-face psychiatric settings at the beginning of their 4th year of medical school. The placements were 3 days a week for 5 weeks. The placements varied with some students being placed in inpatient services and others within the community, across a broad range of subspecialties including child and adolescent, general adult and forensic. Students were given the Attitudes To Psychiatry Questionnaire to fill out before and after their placement. Students were also given the opportunity to provide open text feedback on their placement in the form of a weekly feedback form. Results were analysed using simple descriptives of data and paired t-tests. The study was conducted with permission from Associate Dean for Undergraduate Teaching and QMUL Centre Lead for Psychiatry.Results115 students (89.8%) completed pre-placement attitudes to psychiatry questionnaire and 51 students (39.9%) completed the post-placement questionnaire.Paired t-tests were used to compare average pre and post-placement results for individual questions. There were significant changes in student responses to questions about psychiatric undergraduate training being valuable, attitudes to psychiatrists and psychiatric treatment. Lots of students gave positive feedback on their placements citing interesting experiences, helpful seniors and varied learning opportunities.ConclusionStudents having face-to-face psychiatry placements has objectively changed some attitudes to psychiatry and is very important for their experience and interest in the specialty. The students have valued the exposure and contact with patients and the varied experiences. This will hopefully lead to more students considering psychiatry as a career as well as keeping mental health as a priority for any patient that they see.
Implementation of Traffic Light System on Food Sold at Brockfield House Medium Secure Unit to Help Improve Healthy Food Options
Authors: Agunwamba Ngozi , Ho David , Deo Raman , Duffy Maniya , Madenlidou Stavroula , Larkin Fintan 
Published: June 2022

AimsPublic Health England published a report in 2017 on Obesity in Secure Mental Health units. A key finding of the review was that not only is obesity and overweight more prevalent in the population detained within mental health secure units (with rates of up to 80% reported) than in the general population (around 60%), patients appear to be more at risk of weight gain when detained. The report found evidence that there is a high risk of weight gain following admission, stemming from the combined effects of incarceration, ease of access to high calorific food, and the potential lack of access to recommended levels of physical activity. This project aims to; 1. Implement a traffic light system on food and confectionaries sold at the shop at a Medium secure hospital. 2. Provide healthier food options at the shop by using the traffic light system as a visual aid 3. To achieve weight reduction and promote healthy lifestyle choices in patients admitted to our medium secure Forensic unit.Methods1.Buying a new till system which is able to quantify what type of food is sold.2.Labelling food sold using a traffic light system.3.Calculate types of food sold following a three-month period after implementation.Results1.Traffic light system provides a visual aid to patients in choosing healthier food.2.Patients in our medium secure unit achieve a reduction in their weight.3.Traffic light system can be replicated/ adopted by other secure hospitals.ConclusionThe purpose of this research is to implement a traffic light system on food sold at a shop in our medium secure unit. It is hoped that by providing visual aids, patients have a means of easily identifying healthier food options. Choosing healthier food we hope will consequently result in weight reduction and overall improved lifestyle choices.
A Phenomenological Approach to Understanding the Association Between Psychosis and Violence
Authors: Anderson Coral , Nathan Rajan 
Published: June 2022

AimsAlthough there is an established but complex relationship between violence and psychosis, the nature of this relationship remains unclear. To date, there has been a predominant focus within group-level quantitative studies on specific types of psychopathology such as threat/control-override and command hallucinations. However, the literature has not produced a consensus on the profile of psychopathological predictors of violence. Furthermore, there is an emerging literature suggesting the predictive paradigm has limited clinical utility in the management of harm-related behaviour. In the way that phenomenological analysis has produced a fuller understanding of psychosis (that can inform improved aetiological and interventional frameworks), the authors assert that such an approach (with its focus on subjectivity) has the potential to advance our understanding of the relationship between psychosis and violence in a way that has clinical applicability. To test this assertion, it is necessary to develop a model of assessment and analysis. The aim of this paper is to develop an evidence-based model to explore the phenomenological underpinnings of violence in psychosis.MethodsA two-stage method was followed. Firstly, drawing on existing phenomenological accounts of psychosis and approaches to understanding the subjectivity of violence perpetration, the authors developed a pilot evaluation model. This was tested and revised by applying the model to phenomenological case reports of psychosis and violence.ResultsThe findings so far demonstrate that as well as the role of circumscribed psychopathology on the likelihood of violence, other experiences within the psychotic spectrum such as operative hyperreflexivity and disturbances of ipseity play an important role. Additionally, feelings of disconnectedness and loss of recognising others as real combined with impaired theory of mind can lead to loss of normal inhibitory processes and violent behaviour. In keeping with a recent shift in focus from strict diagnostic criteria to individual psychotic phenomena, existential analysis can be applied to explore changes in self-identity and sense of belonging in the world to develop our understanding of the association between psychosis and violence.ConclusionThe phenomenological model developed produces a fuller picture of the association between psychosis and violence. As such it may generate insight into the association between psychosis and violence that has greater clinical utility than existing psychopathology-based theories do. This needs to be evaluated by field testing of the approach.
Gross Bimodal Diurnality in Dementia Behavioural Symptoms in an Inpatient Setting: High Noon and Sundown
Authors: Anderson David , Hamza Neveen , Reid Keith , Richardson Jonathan 
Published: June 2022

AimsOur purpose-built dementia unit investigates temperature and Behavioural and Psychological Symptoms of Dementia (BPSD). We sought to control for diurnality. Sundown Syndrome (SS) is emergence or worsening of BPSD in the late afternoon or early evening. The literature affords debate. Our methods of controlling for time as a confounder for temperature generated contributions which we offer here.MethodsData were collected from two Older People's Organic wards within the Cumbria, Northumberland Tyne and Wear NHS Foundation Trust. Collection used the Trust's “Talk First” data system. That is an established, verified record, including “aggression” (non-contact) or “violence” (contact). Data from 16 months, September 2019 to January 2021 were analysed.Patients had moderate or severe dementia. Wards care for a maximum of 14 patients and serve either men or women. Data for the communal corridor and day room of each ward were analysed. This gave four siteWe used two methods. The first was basic, the overall histogram of incidents through the day.The second analysis counts “incident signals” from each time or temperature. Each actual occurring combination of temperature and time is assigned a “cell”. The background rate of all incidents per all cells is known. Any incident in any rare cell has low binomial probability. Low probabilities mean high “signal”. The square of sums of signals across each hour provides each hour's “incident signal”.ResultsMedian ages were 79 (women) and 82 (men). There were 99 incidents.The histogram has two peaks, around lunchtime and evening. Late afternoon is relatively safe. Thermal incident signals are summarised as moderately coherent. Diurnal incident signals controlling for temperature did not show any coherent trend.ConclusionWe proffer approaches for controlling for temperature and time of day. The project has limits. We have a small sample. We have not compared sunset times; but that is not relevant to the mid-day peak. We present secondary data from an evaluation aimed at temperature. More favourably this is an a priori sample, shows the same thing is two ways, and adds to debate on an important and critiqued construct. Though SS uses “sun” as a shorthand, any effect will be mediated bio-psychosocially via light, social interaction, heat, circadian rhythms, etc. Our data support social interaction more than time of day. This may add to or challenge SS as a construct.
The Correlation Between Parenting Styles and Self-Esteem of Medical Students: A Cross-Sectional Study
Authors: Gul Fahad , Abbas Khawar , Saeed Sajeel , Arish Muhammad , Haider Tehseen , Tousif Kashif , Basit Jawad 
Published: June 2022

AimsAmong various factors that determine an individual's self-esteem, parenting styles play a very significant role in this regard. Certain parenting styles that are practiced around the globe include authoritarian, authoritative and permissive parenting. The study aimed to investigate the co-relation between parenting styles and self-esteem among medical students.MethodsA cross-sectional study was conducted among the MBBS students of Rawalpindi Medical University, Rawalpindi from December 2020 to March 2021. 255 students took part in this study. An online survey was prepared by using Parental Authority Questionnaire-Short Version and Rosenberg Self-Esteem Scale and students were asked to fill it. Simple Random sampling technique was applied. SPSS version 26.0 was used to enter and analyze data. Pearson Correlation, Logistic regression and Hierarchal regression analysis were applied.ResultsOut of 230, 60% of the sample population experienced authoritative, 29% experienced authoritarian whereas 11% experienced permissive style of parenting. Authoritative (r = 0.283, p < 0.001) and authoritarian (r = -0.227, p < 0.001) parenting styles were significantly correlated with self-esteem. Authoritarian parenting style (AOR = 2.20, 95% CI: 1.17, 4.14) was significantly associated with self-esteem of the participants compared to authoritative parenting style.ConclusionResults indicated that authoritative parenting was only parenting style that correlates positively with self-esteem which suggest authoritative parenting is the optimum parenting style in Pakistani culture.
Association of Social Anxiety Disorder and Physical Activity With Psychological Distress During COVID-19 Imposed Lockdown: A Medical Student Survey From a Developing Country
Authors: Arish Muhammad , Arham Muhammad , Rehan Fatima , Saeed Sajeel , Tousif Kashif , Farhan Muhammad 
Published: June 2022

AimsCOVID-19 imposed lockdowns have impacted the mental health of medical students worldwide. However, the relationship of social anxiety disorder with psychological distress during the pandemic has not been studied. The objective of this study was to assess the association of social anxiety disorder and physical activity with psychological distress in medical students during COVID-19 imposed lockdown.Methods256 medical students (M/F: 144/112) took part in this online cross-sectional survey conducted in September 2020 during a government imposed lockdown. Kessler-10 (K10) questionnaire, social interaction anxiety scale (SIAS) and international physical activity questionnaire (IPAQ) - short form were used to assess psychological distress, social anxiety and physical activity, respectively. Data were analysed using SPSS v25, with application of multivariate logistic regression to assess association of various factors with psychological distress.ResultsOut of 256 medical students, 73 (28.5%) had severe psychological distress and 105 (41.0%) had mild to moderate distress. A logistic regression model to assess the effect of social anxiety disorder, level of physical activity and gender with the likelihood of having severe psychological distress was statistically significant (p < 0.001) with overall accuracy of 73.8%. The risk of developing severe psychological distress was higher among females [OR 2.13 (95% CI 1.17–3.87), p = 0.013] and those with social anxiety disorder [OR 4.56 (95% CI 2.27–9.16), p < 0.001]. Low physical activity was not a significant risk factor for psychological distress [OR 0.88 (95% CI 0.35–2.23), p = 0.794].ConclusionThis study shows that COVID-19 imposed lockdown has adversely affected the mental health of medical students. Female students and those with social anxiety disorder are at more risk of developing severe psychological distress.