What outcomes in community mental health research are important to caregivers of people with schizophrenia? An exploratory qualitative analysis of an online survey

AIMS

This study investigated outcomes in community mental health research that were important to caregivers of people with schizophrenia.

METHODS

Using an online survey conducted from August 1 to 31, 2020, data were collected from caregivers belonging to the LINE Schizophrenia Family Association. Caregivers identified outcomes important in community mental health research. Two researchers categorized caregivers' statements into research outcomes.

RESULTS

A total of 132 caregivers completed the online selfreported questionnaire, and 296 caregiver statements were identified. Qualitative analysis identified 17 outcome categories. The caregivers tended to value having more free time, maintaining an appropriate relationship with people with schizophrenia, and being able to cope with their symptoms.

CONCLUSIONS

This exploratory study newly demonstrates the outcomes that caregivers of people with schizophrenia consider important in community mental health research. The findings may be useful in selecting outcomes for future studies of caregivers.

Multicenter survey clarifying phrases in emergency radiology reports

PURPOSE

Interactions between radiologists and emergency physicians are often diminished as imaging volume increases and more radiologists read off site. We explore how several commonly used phrasings are perceived by radiologists and emergency physicians to decrease ambiguity in reporting.

METHODS

An anonymous survey was distributed to attendings and residents at seven academic radiology and emergency departments across the USA via a digital platform as well as to an email group consisting of radiologists across the country with an interest in quality assurance. Physicians were asked to assign a percent score to probabilistic phrases such as, "suspicious of," or "concerned for." Additional questions including, "how often the report findings are reviewed," "what makes a good radiology report," and "when is it useful to use the phrase 'clinical correlation are recommended.'" Median scores and confidence intervals were compared using an independent Student's T-test.

RESULTS

Generally, there was agreement between radiologists and emergency room physicians in how they interpret probabilistic phrases except for the phrases, "compatible with," and "subcentimeter liver lesions too small to characterize." Radiologists consider a useful report to answer the clinical question, be concise, and well organized. Emergency physicians consider a useful report to be concise, definitive or include a differential diagnosis, answer the clinical question, and recommend a next step. Radiologists and emergency physicians did not agree on the usefulness of the phrase, "clinical correlation recommended," in which radiologists found the phrase more helpful under particular circumstances.

CONCLUSION

The survey demonstrated a wide range of answers for probabilistic phrases for both radiologists and emergency physicians. While the medians and means of the two groups were often different by statistical significance, the actual percent difference was minor. These wide range of answers suggest that use of probabilistic phrases may sometimes lead to misinterpretation between radiologist and emergency room physician and should be avoided or defined if possible.

Multiple stakeholders' perspectives on patient and public involvement in community mental health services research: A qualitative analysis

Background

Patient and public involvement (PPI) has become essential in health research. However, little is known about multiple stakeholders' perspectives on the implementation of PPI in community mental health research settings. The present study aimed to qualitatively analyse multiple stakeholders' views on PPI, including potential concerns, barriers and approaches.

Methods

This study involved conducting focus group interviews and collecting qualitative data from 37 participants in multiple stakeholder groups (patients = 6, caregivers = 5, service providers = 7, government staff = 5 and researchers = 14) in the community mental health field. The data were qualitatively analysed using a data‐driven approach that derived domains, themes and subthemes related to perspectives on PPI and to specific challenges and approaches for implementing PPI.

Results

The qualitative analysis identified four domains. The ‘Positive views and expectations regarding PPI’ domain consisted of themes related to supportive views of PPI in a mental health service research setting and improvements in the quality of research and service. The ‘General concerns about PPI’ domain included themes concerning the need for non‐PPI research and tokenism, excessive expectations concerning social changes and use of evidence from PPI research, and heavy burdens resulting from PPI. The ‘Specific issues regarding the implementation of PPI’ domain consisted of four themes, including academic systems, selection methods (e.g., representativeness and conflict of interest issues), relationship building, and ambiguous PPI criteria. In particular, all stakeholder groups expressed concerns about relational equality during PPI implementation in Japan. The ‘Approaches to PPI implementation’ domain included themes such as facilitating mutual understanding, creating a tolerant atmosphere, establishing PPI support systems (e.g., training, ethics and human resource matching) and empowering patient organizations.

Conclusion

The study replicated most of the barriers and approaches to PPI reported by qualitative research in Western counties. However, utilization of evidence produced by PPI research and partnership in the PPI process may be particularly serious issues in Japan. Future PPI studies should carefully address solutions that fit each culture.

Patient or Public Contribution

A patient‐researcher was involved in all stages of this project, from development of the research topic and the protocol to manuscript preparation.

A six-fold difference in structure results in a six-order difference in conductivity: silica shell nanoarchitectonics on carbon black particles

Carbon black (Ketchen Black with a particle size of several tens of nm) was coated with silica with a varied thickness of 2 and 12 nm. Carbon/silica core-shell particles were grafted with the γ-methacryloxypropylsilyl group to be homogeneously dispersed into a poly(methyl methacrylate) film. The electrical conductivity of the poly(methyl methacrylate) films containing carbon/silica particles was successfully controlled by the thickness of the silica layer; silica coating with 2 nm thickness gave a conducting film, while that with 12 nm thickness gave a less conducting film with a remarkable difference on the order of 10⁶ (in volume conductivity).

Handlebody decompositions of three-manifolds and polycontinuous patterns

We introduce the concept of a handlebody decomposition of a three-manifold, a generalization of a Heegaard splitting, or a trisection. We show that two handlebody decompositions of a closed orientable three-manifold are stably equivalent. As an application to materials science, we consider a mathematical model of polycontinuous patterns and discuss a topological study of microphase separation of a block copolymer melt.

Organophilic Clay with Useful Whiteness

An organophilic clay was obtained by the intercalation of dioctadecyldimethylammonium ions into the interlayer space of a purified bentonite. The organophilic clay was characterized by its excellent whiteness, which originated from the used purified bentonite with a low content of colored impurities, suitable for its practical application in paints, cosmetics, polymer additives, etc. The dioctadecyldimethylammonium-bentonite clay was applied as a support to accommodate polyaromatic molecules to afford luminescent hybrids with high luminescence efficiency, showing its usefulness as a component of photofunctional hybrid materials.

Depression prevention in healthcare workers during the COVID-19 pandemic

BACKGROUND

Few studies have assessed depression in healthcare workers (HCWs) in Japan owing to the coronavirus disease 2019 (COVID-19) pandemic, and no studies have proposed effective interventions to help support their mental health.

AIMS

To test the hypothesis that enhancing access to mental healthcare professionals helps to improve HCWs' mental health.

METHODS

This cross-sectional study assessed depressive symptoms in HCWs at three hospitals in Osaka prefecture between May and July, 2020. The survey obtained information on HCWs' mental state and related situations/perceptions. Multivariable logistic regression analysis was performed to identify factors associated with depressive symptoms.

RESULTS

Of the 3291 eligible HCWs, 1269 (39%) completed the survey. Of all HCWs, 87 (7%) were physicians, and 700 (55%) were nurses. A total of 181 (14%) HCWs had moderate-to-severe symptoms of depression. Being a frontline worker was not significantly associated with depressive symptoms (odds ratio: 0.86 [95% confidence intervals: 0.54-1.37], P = 0.50). The unwillingness to consult with anyone was significantly associated with more severe depressive symptoms (1.70 [1.10-2.63], P < 0.01). HCWs who had no opportunity to confide in family/friends (1.66 [1.10-2.52], P < 0.01) or colleagues/supervisors (3.19 [2.22-4.58], P < 0.001) were significantly more likely to have depressive symptoms.

CONCLUSIONS

Being a frontline HCW in a Japanese hospital treating patients with COVID-19 was not significantly associated with having depressive symptoms. The study highlights that encouraging daily communication with close persons (family, friends, colleagues and supervisors), rather than improving access to mental health professionals, might help to prevent depression in HCWs during the COVID-19 pandemic.

Mechanochromic Luminescence of Bionanocomposite Hydrogel

Bionanocomposite hydrogels were prepared from gelatin hydrogel and subsequent ionic crosslinking in the presence of the smectite with adsorbed cyanine dye (pseudoisocyanine). In addition to the improved mechanical properties achieved...

A novel geo-photocatalyst, an iron-containing layered clay mineral, for photocatalytic H2 evolution from water

An iron-containing layered clay mineral was discovered as a novel geo-photocatalyst found in nature for hydrogen evolution from water.

Facile solvothermal synthesis of plate-like submicron NaNbO3 particles

Platy particles of NaNbO3 were successfully prepared by a solvothermal reaction using a methanol/ethanol mixed solvent, in contrast to the formation of cubic NaNbO3 particles from methanol alone.

Composition-Dependent Thermal Stability and Water-Induced Self-Healing Behavior of Smectite/Waterborne Polymer Hybrid Film

By casting an aqueous suspension containing a water-soluble polymer, polyvinylpyrrolidone, and a layered silicate, synthetic hectorite, on the solid substrate, films with varied interlayer expansion were obtained depending on the composition. The thermal stability, water resistance, water-induced self-healing behavior, and adhesion were examined to find their composition dependence, which is thought to be originated from the nanostructure variation. Polyvinylpyrrolidone was thermally stable up to 300 °C for the hybrid with the polymer/clay weight ratio of 0.36 and 260 °C for the weight ratios of 1.08 and 1.80 as shown by the changes in the appearance and structure after heat treatment. The hybrid film with the polymer/clay ratio of 0.36 maintained the film shape when it was soaked in water for 24 h. The hybrids with the polymer/clay ratios of 1.08 and 1.80 were re-dispersed/dissolved into water after the immersion, while the water resistance of the films was enhanced by the thermal treatment at 200 °C for 2 h and showed very fast water-induced self-healing.

Outcomes frequently specified in Cochrane reviews of community-based psychosocial interventions for adults with severe mental illness: A systematic search and narrative synthesis

Background

Outcome selection in intervention studies is a critical issue for synthesizing evidence. This study is aimed to investigate outcomes used in Cochrane reviews assessing community‐based psychosocial interventions for adults with severe mental illness.

Methods

Cochrane reviews that evaluated a community‐based psychosocial intervention for adults with severe mental illness were searched electronically and manually. We extracted all outcomes specified in the Methods section in each Cochrane review. Outcomes that represent the same concept and context were synthesized into an outcome term. Outcome terms were categorized according to the existing taxonomy.

Results

We included 33 Cochrane reviews. Of the 216 outcome terms identified, 13 were used in more than half of the reviews: quality of life, mental state, admission to hospital, economic outcome, leaving the study early, social functioning, satisfaction, global state, relapse, adverse events/effects, carer satisfaction, employment, and duration of admission. Most outcome terms were categorized into the life impact core area (55%), followed by the resource use area (21%).

Conclusions

Our study provides a candidate outcome list for developing a core outcome set for severe mental illness and offers a basis for comparison for future outcome investigation on mental health research.

Two hundred and sixteen outcome terms were found by investigating all the outcomes used in 33 Cochrane reviews assessing community‐based psychosocial interventions for adults with severe mental illness. Thirteen outcome terms were used in more than half of the reviews: quality of life, mental state, admission to hospital, economic outcome, leaving the study early, social functioning, satisfaction, global state, relapse, adverse events/effects, carer satisfaction, employment, and duration of admission.

Consensus development of priority outcome domains for community mental health cares by multiple stakeholders: Protocol for an online Delphi study in Japan

Background

Treatment goals for mental illness have expanded from hospital discharge and improved functioning to employment, living alone, and personal realization. These changes in treatment goals have also influenced mental health research. Recent studies have addressed the development of core outcome sets focusing on clinical aspects of mental illness such as depression and anxiety. However, a well‐developed framework of essential outcomes for people with mental illness (service users) who live in the community is lacking. In addition, recent worldwide trends suggest more patient and public involvement and the importance of considering multiple stakeholders’ views in the area of mental health research. Purpose of this study is to explore consensus on high‐priority outcome domains among multiple stakeholders in community mental healthcare fields in Japan.

Methods

A three‐step approach to developing an outcome list will be used. First, we developed a long list of outcomes for community mental health through a literature review, focus group interviews with key stakeholders, and online questionnaire surveys of service users and caregivers. Second, the long list was checked and revised in a pilot study. Third, the long list will be shortened to the outcome list through the Delphi methodology with participation from multiple stakeholders.

Discussion

Identifying important common outcome domains through collaboration with multiple stakeholders appears to contribute to the development of evidence for community mental health research in Japan. In addition, the study process itself may help promote patient and public involvement in education, practice, and research in the field of community mental health.

Mechanochemical syntheses of all-inorganic iodide perovskites from layered cesium titanate and bismuth (and antimony) iodide

All-inorganic iodide perovskites were prepared by a mechanochemical reaction between a layered cesium titanate and bismuth (or antimony) triiodide under ambient conditions. The layered cesium titanate was a sacrificial template and also acted as a milling media for the formation of the perovskite nanoparticles with the size of a few nanometres.

Important Roles of Water Clusters Confined in a Nanospace as Revealed by a Synchrotron X-ray Diffraction Study

States of water molecules confined in a nanospace designed by montmorillonite (negatively charged silicate layer) and charge compensating benzylammonium were investigated. Caffeine was used as a probe because of its compatibility for the fine structure of the interlayer water. Powder synchrotron radiation X-ray diffraction (SXRD) and adsorption isotherms of the water vapor revealed a metastable structure of bimolecular water layers (2WLs) in the interlayer space. Water molecules readily penetrated to expand the interlayer space to 0.56 nm. The interlayer space did not increase further even in the presence of excess water. According to the isosteric heat of water, the expansion was limited because of moderate hydration as forming 2WLs. Caffeine molecules replaced a part of the water molecules in the 2WLs to expand the interlayer space to 0.65 nm. Time-resolved SXRD with an accumulation time of 500 ms revealed that the interlayer expansion reached a steady state within a few minutes. The caffeine intercalation proceeded, involving a change in the molecular orientation that increased the contact area of the caffeine molecules. The interlayer expansion was limited in all the solvents examined (mixtures of water with methanol, ethanol, acetone, and tetrahydrofuran), while the packing density of the incorporated caffeine was maximized in the absence of an organic solvent. The water molecules confined in the interlayer space acted as an actuator to accommodate a large quantity of amphiphilic molecules by adapting the nanostructure, which was achieved by releasing the confined water molecules.

Hydrophobic composite foams based on nanocellulose-sepiolite for oil sorption applications

TEMPO (2,2,6,6-tetramethylpiperidin-1-oxyl)-oxidized cellulose nanofibers (CNF) were assembled to fibrous clay sepiolite (SEP) by means of a high shear homogenizer and an ultrasound treatment followed by lyophilization using three different methods: normal freezing, directional freezing, and a sequential combination of both methods. Methyltrimethoxysilane (MTMS) was grafted to the foam surface by the vapor deposition method to introduce hydrophobicity to the resulting materials. Both the SEP addition (for the normal and directional freezing methods) and the refreezing preparation procedure enhanced the compressive strength of the foams, showing compressive moduli in the range from 28 to 103 kPa for foams loaded with 20% w/w sepiolite. Mercury intrusion porosimetry shows that the average pore diameters were in the range of 30-45 µm depending on the freezing method. This large porosity leads to materials with very low apparent density, around 6 mg/cm³, and very high porosity >99.5%. In addition, water contact angle measurement and Fourier-transform infrared spectroscopy (FTIR) were applied to confirm the foam hydrophobicity, which is suitable for use as an oil sorbent. The sorption ability of these composite foams has been tested using olive and motor oils as models of organophilic liquid adsorbates, observing a maximum sorption capacity of 138 and 90 g/g, respectively.

Clarification of the aspects of tongue-palate contacts during mastication with/without stage II transport

BACKGROUND

During mastication, the tongue presses the bolus into the pharynx by a "squeeze-back" motion, known as stage II transport (St2Tr). However, the pressure of St2Tr tongue-palate contact has not been examined.

OBJECTIVES

We aimed to clarify aspects of St2Tr occurrence and tongue-palate contact during mastication by measuring tongue pressure.

METHODS

Ten healthy adults (eight men, two women, aged 26.8 ± 2.2 years) were enrolled. Tongue pressure was measured (Swallow Scan) during mastication. Sensors were placed on the palate near the incisive papilla (Ch.1), in the middle (Ch.2), at the posterior (Ch.3), and near the first molars on the habitual (Ch.H) and non-habitual (Ch.Nh) masticatory sides. Nasopharyngeal endoscopy confirmed St2Tr and swallowing. Tongue pressures were measured repeatedly, from mastication onset through the first swallow, until eight sets of data were obtained. Tongue-palate contact frequencies, integrated values of tongue pressure, and mastication times were recorded for St2Tr(+) and St2Tr(-) mastication conditions.

RESULTS

St2Tr occurred in 43 of 80 trials (53.8%). St2Tr(+) exhibited the highest tongue-palate contact frequency at Ch.H; it exhibited higher contact frequencies at Ch.2, Ch.3 and Ch.H than St2Tr(-). St2Tr(+) exhibited higher tongue pressures at Ch.1, Ch.2 and Ch.H than at Ch.3; it exhibited higher tongue pressures at Ch.1 and Ch.2 than St2Tr(-).

CONCLUSION

The study suggested that during St2Tr, the tongue frequently touched the palate at the central and posterior regions, as well as at its habitual masticatory side. It applies the strongest pressure at the anterior and central palate to transport the bolus to the pharynx.

Formation of BiOX (X = Cl and Br) in a mesoporous silica by the infiltration of Bi salts and the subsequent reaction with HX vapor

The formation of BiOX (X = Br and Cl) nanoparticles in a mesoporous silica (SBA-15) was found by the reaction of the infiltrated bismuth oxo species with HX vapor at room temperature. The cylindrical pores of SBA-15 led to the directional growth of BiOX nanorods and control of the particle diameter.

Highly Luminescent Inorganic-Organic Hybrids with Molecularly Dispersed Perylene

A highly photoluminescent material was obtained by the incorporation of perylene into an inorganic-organic hybrid film. Octosilicate, a layered alkali silicate, was modified with a cationic surfactant, dioleyldimethylammonium ion, to accommodate perylene molecularly and uniformly. The perylene-doped dioleyldimethylammonium octosilicate films were fabricated by simply casting the toluene solution of perylene with dispersed dioleyldimethylammonium octosilicate on substrates. Near-unity photoluminescence quantum efficiency was achieved for hybrids containing a high concentration of perylene.

Skin Acceleration Levels Estimated by a Neck-surface Accelerometer during Phonation Are Affected by The Mechanical Properties of The Anterior Cervical Skin

OBJECTIVES

The aim of the present study was to assess whether skin acceleration levels (SAL) estimated by a neck-surface accelerometer (ACC) are affected by the anterior neck skin condition.

METHODS

Each of six healthy non-dysphonic participants wore a headset microphone (MIC), had an ACC sensor fitted on the skin over the cervical trachea, and were subsequently asked to gradually increase the vocal loudness during sustained phonation of the vowel /e:/ (crescendo task), while the sound pressure levels on a sound level meter (SPL_SLM) and MIC/ACC signals were simultaneously recorded. Root mean squared values were calculated from the MIC and ACC signals as the sound pressure level (SPL_MIC) and SAL, respectively, and the relationships between SPL_SLM and SAL were compared between neck anteflexion and retroflexion or between outward and inward skin retraction on both sides of the sensor.

RESULTS

In the total samples for the successful crescendo performance in a natural head position, the SPL_MIC and SPL_SLM showed a strong linear correlation (r=0.980), whereas the correlation between the SAL and SPL_SLM showed a distorted regression line (r=0.765) with individual differences. In all participants, the anteflexion and inward skin retraction decreased the SAL value at the same SPL_SLM value, whereas the retroflexion increased the SAL value at the same SPL_SLM value.

CONCLUSION

These results demonstrate that the signal intensity of a neck-surface ACC is affected by the condition of the anterior cervical skin, perhaps leading to inter-individual variability in SAL measurements.

Suppressing the Photocatalytic Activity of Titania by Precisely Controlled Silica Coating

A homogeneous thin silica layer with the thickness of a few nanometers was successfully deposited on an anatase particle by the hydrolysis and condensation of tetraethyl orthosilicate. The heat treatment of the titania/silica hybrid at 1000 °C led to the densification of the silica layer on the anatase particles. The anatase particle after the silica coating did not transform to rutile, and no change in the crystallite size was seen by the heat treatment at 1000 °C. The coating and subsequent heating were repeated to vary the thickness of the silica layer to obtain each coating with similar thickness by each coating procedure (ca. 3 and 2 nm, before and after the heat treatment). The samples were evaluated for the photocatalytic decomposition of methylene blue by the UV irradiation to find that the decomposition became slower after the coating and subsequent heat treatment, and the repeated procedures led to further suppression of the photocatalytic decomposition of methylene blue. The quite small decomposition rate constant (0.01 h^-1) was successfully achieved by the coating and subsequent heating for three times (the thickness of the dense silica layer was ca. 7 nm).