1
|
Warraitch A, Killalea M, Murphy J, Barrett E. Creating competent and confident volunteers for inclusive water sports. Ir Med J 2024; 117:943. [PMID: 38682672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2024]
|
2
|
Rafferty C, O'Donnell A, Campbell S, Sun B, King J, Ali Z, Lynch D, Barrett E, Richardson S, Clifford M, McNicholas F. Eating disorders and COVID-19 - different or just more? Ir J Med Sci 2024:10.1007/s11845-024-03649-x. [PMID: 38492150 DOI: 10.1007/s11845-024-03649-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 02/26/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND COVID-19 saw an increase in child mental health presentations internationally. Clinicians analogised the exponential increase in anorexia nervosa to a 'tsunami' or 'outbreak', raising parallel concerns regarding medical and psychological risks (Marsh in The Guardian, 2021; Leask in NZ Herald, 2021; Monteleone et al. in Eat Weight Disord 26(8):2443-2452, 2021) . It is unclear whether Ireland emulated this picture of increased referrals with increased medical compromise. AIMS This paper examines both rates and clinical profiles of child eating disorder presentations in the Republic of Ireland (ROI), across different clinical settings. METHODS Following ethical approval, retrospective chart reviews were conducted in a community eating disorder service and in two paediatric hospital settings. The time frame of the different studies ranged from January 2016 to December 2022. RESULTS Community eating disorder services saw significantly higher referral rates post COVID-19 (3.78/month vs. 2.31/month, p = 0.02), with a shorter duration of illness (4.8 months vs. 7.4 months, p = 0.001), but no significant difference in ideal body weight % (IBW%) at referral (85.32% vs. 83.7%, p = 0.1). Both paediatric hospitals witnessed significantly increased referrals post-COVID-19 (hospital 1; 4.38/month vs. 1.93/month, p = 0.0001; hospital 2; 2.8/month vs. 0.92/month, p < 0.0001), but no significant difference in IBW% at assessment (hospital 1; 82.7% vs. 81.39%, p = 0.673; hospital 2; 81.5% vs. 83%, p = 0.563). There was no significant difference in clinical profile, management, or duration of hospital stay. CONCLUSIONS This study supports the growing consensus of a pandemic specific increase in eating disorder referrals to both medical and psychiatry services. However, there was little to indicate a change in clinical profile or severity. Ongoing monitoring of referrals is necessary to ensure adequate service availability and expertise.
Collapse
Affiliation(s)
- Cathal Rafferty
- School of Medicine, University College Dublin, Dublin, Ireland.
| | | | - Sally Campbell
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Bohan Sun
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Jenny King
- Department of Paediatric Liaison Psychiatry, Children's Hospital Ireland, Crumlin Dublin 12, Dublin, Ireland
| | - Zeinab Ali
- Department of Paediatric Liaison Psychiatry, Children's Hospital Ireland, Crumlin Dublin 12, Dublin, Ireland
| | - Diarmuid Lynch
- Department of Paediatric Liaison Psychiatry, Children's Hospital Ireland, Crumlin Dublin 12, Dublin, Ireland
| | - Elizabeth Barrett
- School of Medicine, University College Dublin, Dublin, Ireland
- Department of Paediatric Liaison Psychiatry, Children's Hospital Ireland, Temple St. Dublin 2, Dublin, Ireland
| | - Sarah Richardson
- Department of Paediatric Liaison Psychiatry, Children's Hospital Ireland, Crumlin Dublin 12, Dublin, Ireland
| | | | - Fiona McNicholas
- School of Medicine, University College Dublin, Dublin, Ireland
- Department of Paediatric Liaison Psychiatry, Children's Hospital Ireland, Crumlin Dublin 12, Dublin, Ireland
- Lucena CAMHS, SJOG, Rathgar Dublin 6, Dublin, Ireland
| |
Collapse
|
3
|
Langer AJ, Saeed Z, Barrett E, Maxwell RA, Dhanraj DN, Towers GD, Agudu EA. Vaginal Calculus Formation on Exposed Midurethral Sling Mesh. Case Rep Obstet Gynecol 2024; 2024:8287400. [PMID: 38524759 PMCID: PMC10960646 DOI: 10.1155/2024/8287400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 04/25/2023] [Accepted: 01/30/2024] [Indexed: 03/26/2024] Open
Abstract
The presence of a vaginal calculus is a rare clinical entity which may develop in the setting of vaginal urinary stagnation. Numerous factors contribute to stone formation, and management can be complicated by variations in size, location of the stone, and location of adjacent structures. Generally, once diagnosed, vaginal calculi should be removed and surrounding anatomy should be evaluated thoroughly for secondary fistula, erosion, or presence of an instituting foreign body. This report presents a case of vaginal calculus formation on exposed midurethral sling mesh in an elderly patient with hemorrhagic cystitis. This report emphasizes contributing pathophysiology, diagnostic factors, and treatment.
Collapse
Affiliation(s)
- Adam J. Langer
- Department of Obstetrics and Gynecology, Wright State University, Dayton, USA
| | - Zenab Saeed
- Boonshoft School of Medicine, Wright State University, Dayton, USA
| | - Elizabeth Barrett
- Department of Obstetrics and Gynecology, Wright State University, Dayton, USA
| | - Rose A. Maxwell
- Department of Obstetrics and Gynecology, Wright State University, Dayton, USA
| | - David N. Dhanraj
- Department of Obstetrics and Gynecology, Wright State University, Dayton, USA
| | - Geoffrey D. Towers
- Department of Obstetrics and Gynecology, Wright State University, Dayton, USA
| | - Eyra A. Agudu
- Department of Obstetrics and Gynecology, Wright State University, Dayton, USA
| |
Collapse
|
4
|
Greene CM, Ryan KM, Ballantyne L, Barrett E, Cowman CS, Dawson CA, Huston C, Maher J, Murphy G. Unringing the bell: Successful debriefing following a rich false memory study. Mem Cognit 2024:10.3758/s13421-024-01524-9. [PMID: 38286945 DOI: 10.3758/s13421-024-01524-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2024] [Indexed: 01/31/2024]
Abstract
In rich false memory studies, familial informants often provide information to support researchers in planting vivid memories of events that never occurred. The goal of the current study was to assess how effectively we can retract these false memories via debriefing - i.e., to what extent can we put participants back the way we found them? We aimed to establish (1) what proportion of participants would retain a false memory or false belief following debriefing, and (2) whether richer, more detailed memories would be more difficult to retract. Participants (N = 123) completed a false memory implantation protocol as part of a replication of the "Lost in the Mall" study (Loftus & Pickrell, Psychiatric Annals, 25, 720-725, 1995). By the end of the protocol, 14% of participants self-reported a memory for the fabricated event, and a further 52% believed it had happened. Participants were then fully debriefed, and memory and belief for the false event were assessed again. In a follow-up assessment 3 days post-debriefing, the false memory rate had dropped to 6% and false belief rates also fell precipitously to 7%. Moreover, virtually all persistent false memories were found to be nonbelieved memories, where participants no longer accepted that the fabricated event had occurred. Richer, more detailed memories were more resistant to correction, but were still mostly retracted. This study provides evidence that participants can be "dehoaxed", and even very convincing false memories can be retracted.
Collapse
Affiliation(s)
- Ciara M Greene
- School of Psychology, University College Dublin, Dublin, Ireland.
| | - Katie M Ryan
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Lisa Ballantyne
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Elizabeth Barrett
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Conor S Cowman
- School of Applied Psychology, University College Cork, Cork, Ireland
| | | | - Charlotte Huston
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Julie Maher
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Gillian Murphy
- School of Applied Psychology, University College Cork, Cork, Ireland
| |
Collapse
|
5
|
Adkins EN, Barrett E, D'Amato J, Maxwell RA, Kindig M. Learning Pelvic Anatomy and Pathology Through Drawing: An Interactive Session in the Obstetrics and Gynecology Clerkship. MedEdPORTAL 2023; 19:11363. [PMID: 38058493 PMCID: PMC10696139 DOI: 10.15766/mep_2374-8265.11363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 09/08/2023] [Indexed: 12/08/2023]
Abstract
Introduction Within undergraduate medical education, there is a gap between students' understanding of anatomy and application of that knowledge within surgical specialties. The integration of drawing, in conjunction with traditional learning, has been shown to increase retention and understanding of information. Currently, no educational curriculum integrates drawing to aid in medical students' understanding of surgical pelvic anatomy. We anticipated that the utilization of drawing anatomy in an OB/GYN clerkship would enhance students' ability to explain surgical pelvic anatomy and pelvic pathology. Methods At the beginning of the OB/GYN clerkship, third-year medical students participated in an interactive, 1.5-hour session requiring them to draw pelvic anatomy, present their work, and explain topics related to pelvic surgery and pathology to the other clerkship students. At the end of their clinical rotation, the students were invited to complete a five-item survey to assess long-term retention and understanding of concepts presented in the session. Frequencies and percentages were calculated for all categorical/ordinal variables to describe survey participants and question responses. Results Thirty-seven of 44 respondents (84%) reported that the anatomy interactive session prepared them for the surgical portion of the OB/GYN clinical rotation. Thirty-five respondents (80%) reported that drawing the pelvic structures helped their understanding of pelvic pathology; 33 respondents (75%) reported they had a thorough understanding of pelvic anatomy after taking the OB/GYN anatomy interactive educational session (p < .001). Discussion Our session shows that integrating drawing and anatomy increases students' ability to discuss pelvic pathology and surgical anatomy.
Collapse
Affiliation(s)
- Elisabeth N. Adkins
- First-Year Resident, Department of Obstetrics and Gynecology, Vanderbilt University Medical Center
| | - Elizabeth Barrett
- Fourth-Year Resident, Department of Obstetrics and Gynecology, Wright State University Boonshoft School of Medicine
| | - Josette D'Amato
- Assistant Professor, Department of Obstetrics and Gynecology, Wright State University Boonshoft School of Medicine
| | - Rose A. Maxwell
- Associate Professor and Research Director, Department of Obstetrics and Gynecology, Wright State University Boonshoft School of Medicine
| | - Marilyn Kindig
- Assistant Professor and Clerkship Director, Department of Obstetrics and Gynecology, Wright State University Boonshoft School of Medicine
| |
Collapse
|
6
|
Ganotice FA, Shen X, Yuen JKY, Chow YMA, Wong AMY, Chan KMK, Zheng B, Chan L, Ng PY, Leung SC, Barrett E, Chan HYC, Chan WN, Chan KWS, Chan SLP, Chan SCS, Chan EWY, Cheuk YYJ, Choy J, He Q, Jen J, Jin J, Khoo US, Lam HYA, Lam MPS, Law YW, Lee JCY, Leung FCY, Leung A, Liu RKW, Lou VWQ, Luk P, Ng ZLH, Ng AYM, Pun MWM, See MLM, Shen J, Szeto GPY, Tam EYT, Tso WWY, Wang N, Wang R, Wong JKT, Wong JYH, Yuen GWY, Tipoe GL. Students' interaction anxiety and social phobia in interprofessional education in Hong Kong: mapping a new research direction. Ann Med 2023; 55:2210842. [PMID: 37166406 PMCID: PMC10177675 DOI: 10.1080/07853890.2023.2210842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND Interprofessional education (IPE) has been promoted as a breakthrough in healthcare because of the impact when professionals work as a team. However, despite its inception dating back to the 1960s, its science has taken a long time to advance. There is a need to theorize IPE to cultivate creative insights for a nuanced understanding of IPE. This study aims to propose a research agenda on social interaction by understanding the measurement scales used and guiding researchers to contribute to the discussion of social processes in IPE. METHOD This quantitative research was undertaken in a cross-institutional IPE involving 925 healthcare students (Medicine, Nursing, Social Work, Chinese Medicine, Pharmacy, Speech Language Pathology, Clinical Psychology, Food and Nutritional Science and Physiotherapy) from two institutions in Hong Kong. Participants completed the Social Interaction Anxiety Scale (SIAS-6) and Social Phobia Scale (SPS-6). We applied a construct validation approach: within-network and between-network validation. We performed confirmatory factors analysis, t-test, analysis of variance and regression analysis. RESULTS CFA results indicated that current data fit the a priori model providing support to within-network validity [RMSEA=.08, NFI=.959, CFI=.965, IFI=.965, TLI=.955]. The criteria for acceptable fit were met. The scales were invariant between genders, across year levels and disciplines. Results indicated that social interaction anxiety and social phobia negatively predicted behavioural engagement (F = 25.093, p<.001, R2=.065) and positively predicted behavioural disaffection (F = 22.169, p<.001, R2=.057) to IPE, suggesting between-network validity. CONCLUSIONS Our data provided support for the validity of the scales when used among healthcare students in Hong Kong. SIAS-6 and SPS-6 have sound psychometric properties based on students' data in Hong Kong. We identified quantitative, qualitative and mixed methods research designs to guide researchers in getting involved in the discussion of students' social interactions in IPE.Key MessagesThe Social Anxiety Scale (SIAS-6) and Social Phobia Scale (SPS-6) scales have sound psychometric properties based on the large-scale healthcare students' data in IPE in Hong Kong.Social interaction anxiety and social phobia negatively predicted students' behavioural engagement with IPE and positively predicted behavioural disaffection. The scales are invariant in terms of gender, year level and discipline.Quantitative, qualitative and mixed methods studies are proposed to aid researchers to contribute in healthcare education literature using the SIAS-6 and SPS-6.
Collapse
Affiliation(s)
- Fraide A Ganotice
- Bau Institute of Medical and Health Sciences Education, The University of Hong Kong, Hong Kong
| | - Xiaoai Shen
- Bau Institute of Medical and Health Sciences Education, The University of Hong Kong, Hong Kong
| | | | - Yin Man Amy Chow
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Anita M Y Wong
- Faculty of Education, The University of Hong Kong, Hong Kong
| | - Karen M K Chan
- Faculty of Education, The University of Hong Kong, Hong Kong
| | - Binbin Zheng
- Bau Institute of Medical and Health Sciences Education, The University of Hong Kong, Hong Kong
| | - Linda Chan
- Bau Institute of Medical and Health Sciences Education, The University of Hong Kong, Hong Kong
| | | | - Siu Chung Leung
- Emergency Medicine Unit, The University of Hong Kong, Hong Kong
| | | | - Hoi Yan Celia Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Wing Nga Chan
- School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong
| | | | | | - So Ching Sarah Chan
- Bau Institute of Medical and Health Sciences Education, The University of Hong Kong, Hong Kong
| | - Esther W Y Chan
- Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong
| | | | - Jacky Choy
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Qing He
- Bau Institute of Medical and Health Sciences Education, The University of Hong Kong, Hong Kong
| | - Julienne Jen
- Department of Professional Legal Education, The University of Hong Kong, Hong Kong
| | - Jingwen Jin
- Department of Psychology, The University of Hong Kong, Hong Kong
| | - Ui Soon Khoo
- Department of Pathology, The University of Hong Kong, Hong Kong
| | | | - May P S Lam
- Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong
| | - Yik Wa Law
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | | | | | - Ann Leung
- Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong
| | - Rebecca K W Liu
- Bau Institute of Medical and Health Sciences Education, The University of Hong Kong, Hong Kong
| | - Vivian Wei Qun Lou
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong
| | - Pauline Luk
- Bau Institute of Medical and Health Sciences Education, The University of Hong Kong, Hong Kong
| | - Zoe Lai Han Ng
- School of Nursing, The University of Hong Kong, Hong Kong
| | | | | | | | - Jiangang Shen
- School of Chinese Medicine, The University of Hong Kong, Hong Kong
| | | | - Eliza Y T Tam
- Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong
| | - Winnie Wan Yee Tso
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong
| | - Ning Wang
- School of Chinese Medicine, The University of Hong Kong, Hong Kong
| | - Runjia Wang
- Bau Institute of Medical and Health Sciences Education, The University of Hong Kong, Hong Kong
| | - Janet Kit Ting Wong
- Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong
| | | | | | - George Lim Tipoe
- Bau Institute of Medical and Health Sciences Education, The University of Hong Kong, Hong Kong
| |
Collapse
|
7
|
Bailey S, Newton N, Perry Y, Grummitt L, Baams L, Barrett E. Trauma-informed prevention programmes for depression, anxiety, and substance use among young people: protocol for a mixed-methods systematic review. Syst Rev 2023; 12:203. [PMID: 37907971 PMCID: PMC10617188 DOI: 10.1186/s13643-023-02365-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 10/07/2023] [Indexed: 11/02/2023] Open
Abstract
BACKGROUND Mental ill-health and substance use bear a substantial burden and harm on young people and often arise from co-occurring and compounding risk factors, such as traumatic stress. Trauma-informed prevention of mental ill-health and substance use demonstrates significant promise in reducing this burden. A systematic literature review is required to identify and summarise the effectiveness, feasibility, acceptability, and design principles underpinning existing trauma-informed mental ill-health and/or substance use prevention programmes for young people aged 12-24 years. METHODS MEDLINE, Embase, CINAHL, PsychINFO, and Cochrane Library will be searched from 2012 through September 2022. Reference lists of included articles will be citation-chained. Title and abstracts will be screened and two reviewers will review articles full-text. One reviewer will extract data from eligible articles using a piloted data extraction form, and 20% of the data will be verified by a second reviewer. Risk of bias will be assessed using the Cochrane risk-of-bias tool for randomised trials (RoB 2), Risk of Bias in Non-randomised Studies of Interventions (ROBINS-I), and The Joanna Briggs Institute Critical Appraisal Checklist for Quasi-Experimental Studies and The Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research (CASP), depending on the study type. Characteristics of existing trauma-informed mental ill-health and/or substance use prevention programmes for young people will be summarised narratively. Effectiveness, feasibility, and acceptability will be qualitatively described and summarised, with proportions and effect sizes quantitatively synthesised, where possible. DISCUSSION Trauma-informed approaches to prevention demonstrate significant promise, yet to date, no study has systematically summarised and synthesised the available literature. To fill this gap, the present review will systematically identify and summarise the effectiveness, feasibility, acceptability, and design principles underpinning existing trauma-informed mental health and/or substance use prevention programmes for young people aged 12-24. This review will inform the development, adaptation, evaluation, and implementation of future trauma-informed mental ill-health and substance use prevention programmes for young people. Findings will inform critical efforts to interrupt and prevent already elevated trajectories of mental ill-health, substance use, and related harms among those young people exposed to adversity. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42022353883.
Collapse
Affiliation(s)
- S Bailey
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
| | - N Newton
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Y Perry
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - L Grummitt
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - L Baams
- University of Groningen, Groningen, Netherlands
| | - E Barrett
- The Matilda Centre for Research in Mental Health and Substance Use, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| |
Collapse
|
8
|
Wong BHC, Cross S, Zavaleta-Ramírez P, Bauda I, Hoffman P, Ibeziako P, Nussbaum L, Berger GE, Hassanian-Moghaddam H, Kapornai K, Mehdi T, Tolmac J, Barrett E, Romaniuk L, Davico C, Moghraby OS, Ostrauskaite G, Chakrabarti S, Carucci S, Sofi G, Hussain H, Lloyd ASK, McNicholas F, Meadowcroft B, Rao M, Csábi G, Gatica-Bahamonde G, Öğütlü H, Skouta E, Elvins R, Boege I, Dahanayake DMA, Anderluh M, Chandradasa M, Girela-Serrano BM, Uccella S, Stevanovic D, Lamberti M, Piercey A, Nagy P, Mehta VS, Rohanachandra Y, Li J, Tufan AE, Mirza H, Rozali F, Baig BJ, Noor IM, Fujita S, Gholami N, Hangül Z, Vasileva A, Salucci K, Bilaç Ö, Yektaş Ç, Cansız MA, Aksu GG, Babatunde S, Youssef F, Al-Huseini S, Kılıçaslan F, Kutuk MO, Pilecka I, Bakolis I, Ougrin D. Self-Harm in Children and Adolescents Who Presented at Emergency Units During the COVID-19 Pandemic: An International Retrospective Cohort Study. J Am Acad Child Adolesc Psychiatry 2023; 62:998-1009. [PMID: 36806728 PMCID: PMC9933093 DOI: 10.1016/j.jaac.2022.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 10/09/2022] [Accepted: 02/09/2023] [Indexed: 02/17/2023]
Abstract
OBJECTIVE To compare psychiatric emergencies and self-harm at emergency departments (EDs) 1 year into the pandemic, to early pandemic and pre-pandemic, and to examine the changes in the characteristics of self-harm presentations. METHOD This retrospective cohort study expanded on the Pandemic-Related Emergency Psychiatric Presentations (PREP-kids) study. Routine record data in March to April of 2019, 2020, and 2021 from 62 EDs in 25 countries were included. ED presentations made by children and adolescents for any mental health reasons were analyzed. RESULTS Altogether, 8,174 psychiatric presentations were recorded (63.5% female; mean [SD] age, 14.3 [2.6] years), 3,742 of which were self-harm presentations. Rate of psychiatric ED presentations in March to April 2021 was twice as high as in March to April 2020 (incidence rate ratio [IRR], 1.93; 95% CI, 1.60-2.33), and 50% higher than in March to April 2019 (IRR, 1.51; 95% CI, 1.25-1.81). Rate of self-harm presentations doubled between March to April 2020 and March to April 2021 (IRR, 1.98; 95% CI, 1.68-2.34), and was overall 1.7 times higher than in March to April 2019 (IRR, 1.70; 95% CI, 1.44-2.00). Comparing self-harm characteristics in March to April 2021 with March to April 2019, self-harm contributed to a higher proportion of all psychiatric presentations (odds ratio [OR], 1.30; 95% CI, 1.05-1.62), whereas female representation in self-harm presentations doubled (OR, 1.98; 95% CI, 1.45-2.72) and follow-up appointments were offered 4 times as often (OR, 4.46; 95% CI, 2.32-8.58). CONCLUSION Increased pediatric ED visits for both self-harm and psychiatric reasons were observed, suggesting potential deterioration in child mental health. Self-harm in girls possibly increased and needs to be prioritized. Clinical services should continue using follow-up appointments to support discharge from EDs. DIVERSITY & INCLUSION STATEMENT One or more of the authors of this paper self-identifies as a member of one or more historically underrepresented racial and/or ethnic groups in science. We actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our author group. While citing references scientifically relevant for this work, we also actively worked to promote inclusion of historically underrepresented racial and/or ethnic groups in science in our reference list. The author list of this paper includes contributors from the location and/or community where the research was conducted who participated in the data collection, design, analysis, and/or interpretation of the work.
Collapse
Affiliation(s)
- Ben Hoi-Ching Wong
- East London NHS Foundation Trust, London, United Kingdom; King's College London, United Kingdom.
| | | | - Patricia Zavaleta-Ramírez
- Children's Psychiatric Hospital Dr. Juan N. Navarro., Servicios de Atención Psiquiatrica, Mexico City, Mexico
| | - Ines Bauda
- Medical University of Vienna, Vienna Austria
| | - Pamela Hoffman
- Yale Child Study Center, Child Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Patricia Ibeziako
- Boston Children's Hospital, Boston, Massachusetts, and Harvard Medical School, Boston, Massachusetts
| | - Laura Nussbaum
- Victor Babeş University of Medicine and Pharmacy, Timisoara, Romania
| | | | - Hossein Hassanian-Moghaddam
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran, and Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Tauseef Mehdi
- Berkshire Healthcare NHS Foundation Trust, Berkshire, United Kingdom
| | - Jovanka Tolmac
- Harrow Child and Adolescent Mental Health Service, Central and North West London NHS Foundation Trust, London, United Kingdom
| | | | | | | | - Omer S Moghraby
- King's College London, United Kingdom; South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | | | | | - Sara Carucci
- "A. Cao" Pediatric Hospital, "ARNAS G. Brotzu" Hospital Trust, Cagliari, Italy, and the University of Cagliari, Italy
| | - Gyula Sofi
- Heim Pál National Institute of Pediatrics, Budapest, Hungary
| | - Haseena Hussain
- Hertfordshire Partnership University NHS Foundation Trust, Hertfordshire, United Kingdom
| | - Alexandra S K Lloyd
- Lister Hospital, East and North Hertfordshire NHS Trust, Hertfordshire, United Kingdom
| | | | - Ben Meadowcroft
- NHS Lothian, Child and Adolescent Mental Health Services, Edinburgh, United Kingdom
| | - Manish Rao
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | | | | | - Hakan Öğütlü
- Cognitive Behavioral Psychotherapies Association, Ankara, Turkey
| | - Eirini Skouta
- South London and Maudsley NHS Foundation Trust, London, United Kingdom; Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom
| | - Rachel Elvins
- Manchester University Hospitals NHS Foundation Trust, Manchester, United Kingdom
| | - Isabel Boege
- ZfP Suedwuerttemberg, Child and Adolescent Psychiatry, Ravensburg, Germany, and University of Graz, Graz, Austria
| | | | - Marija Anderluh
- Child Psychiatry Unit, University Children's Hospital Ljubljana, Ljubljana, Slovenia
| | | | | | - Sara Uccella
- DINOGMI, University of Genoa, Genoa, Italy, and IRCCS Istituto Giannina Gaslini, Genova, Italy
| | - Dejan Stevanovic
- Clinic for Neurology and Psychiatry for Children and Youth, Belgrade, Serbia; Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Marco Lamberti
- Child and Adolescent Psychiatry Unit, "Franz Tappeiner" Hospital, Merano, Italy
| | - Amy Piercey
- Berkshire Healthcare NHS Foundation Trust, Berkshire, United Kingdom
| | - Peter Nagy
- Bethesda Children's Hospital, Budapest, Hungary
| | - Varun S Mehta
- Central Institute of Psychiatry, Ranchi, Jharkhand, India
| | | | - Jie Li
- Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University
| | | | | | - Farah Rozali
- NHS Lothian, Child and Adolescent Mental Health Services, Edinburgh, United Kingdom
| | - Benjamin J Baig
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Isa M Noor
- Dr. Soeharto Heerdjan Teaching Mental Hospital, Jakarta, Indonesia
| | - Saori Fujita
- Tokyo Metropolitan Children's Medical Center, Tokyo, Japan
| | - Narges Gholami
- Loghman-Hakim Hospital, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Anna Vasileva
- V. M. Bekhterev National Medical Research Center for Psychiatry and Neurology, Saint Petersburg, Russia
| | - Katie Salucci
- Berkshire Healthcare NHS Foundation Trust, Berkshire, United Kingdom
| | - Öznur Bilaç
- Manisa Celal Bayar University, Manisa, Turkey
| | | | | | | | | | - Fatima Youssef
- Dubai Department of Medical Education, Dubai, United Arab Emirates
| | - Salim Al-Huseini
- Psychiatry Residency Program, Oman Medical Specialty Board, Muscat, Oman
| | | | | | | | | | - Dennis Ougrin
- King's College London, United Kingdom; Queen Mary University of London
| |
Collapse
|
9
|
Engel CS, McNicholas F, O'Flaherty K, Barrett E. Can brief interventions and enrichment programmes improve medical students' attitudes towards careers in psychiatry? Ir J Psychol Med 2023; 40:532-534. [PMID: 34433504 DOI: 10.1017/ipm.2021.53] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
| | - Fiona McNicholas
- School of Medicine, University College Dublin, Dublin, Ireland
- Lucena Clinic, Dublin, Ireland
| | | | - Elizabeth Barrett
- CHI, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
| |
Collapse
|
10
|
McNicholas F, Parker S, Barrett E. A snapshot in time: a 1-month review of all referrals to paediatric liaison psychiatry services in Dublin following emergency department presentation. Ir J Psychol Med 2023; 40:378-386. [PMID: 33908338 DOI: 10.1017/ipm.2021.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
INTRODUCTION An emerging picture has seen increasing numbers of young people with mental health crisis attend paediatric emergency departments in Ireland. Following paediatric review, many are referred to in-house paediatric liaison psychiatry (PLP) services. This pilot study describes referral patterns and practice over a 1-month period across three Dublin centres. METHODS Case notes of all referrals to PLP were reviewed to extract relevant clinical and administrative data. For those admitted, costs associated with length of stay were estimated. Clinical profile, management and intra-hospital pathway differences were explored. RESULTS Fifty-nine young people under 16 years presented to one of the three EDs with an acute MH presentation. The sample consisted of 39 females (66%) with a mean age of 13.7 years. The majority (n = 34, 58%) presented out of hours. A substantial portion of youths presenting (n = 37, 63%) were admitted, and had a mean duration of stay of 4.51 days. There were differences between hospitals in terms of frequency of presentation with self-harm, admission rates and length of stay. DISCUSSION Different PLP service configuration, staffing and funding streams may explain some of the differences observed across centres, although the findings should be interpreted with caution given the limited sample size. Standardisation of service provision and management is needed for PLP services. Additional community CAMHS resourcing is needed to support the development of alternative pathways for youth in need of urgent MH review.
Collapse
Affiliation(s)
- Fiona McNicholas
- Child and Adolescent Psychiatry, University College Dublin School of Medicine, Belfield, Dublin 4, Ireland
- Child and Adolescent Psychiatry, Lucena Clinic, Dublin 6, Ireland
| | - Sorcha Parker
- Child and Adolescent Psychiatry, University College Dublin School of Medicine, Belfield, Dublin 4, Ireland
| | - Elizabeth Barrett
- Child and Adolescent Psychiatry, University College Dublin School of Medicine, Belfield, Dublin 4, Ireland
- Child and Adolescent Liaison Psychiatry, Children's University Hospital, Temple St., Dublin 1, Ireland
| |
Collapse
|
11
|
Murphy G, Dawson CA, Huston C, Ballantyne L, Barrett E, Cowman CS, Fitzsimons C, Maher J, Ryan KM, Greene CM. Lost in the mall again: a preregistered replication and extension of Loftus & Pickrell (1995). Memory 2023:1-13. [PMID: 37312574 DOI: 10.1080/09658211.2023.2198263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
ABSTRACTThe seminal Lost in the Mall study [Loftus, E. F., & Pickrell, J. E. (1995). The formation of false memories. Psychiatric Annals, 25(12), 720-725. https://doi.org/10.3928/0048-5713-19951201-07] has been enormously influential in psychology and is still cited in legal cases. The current study directly replicated this paper, addressing methodological weaknesses including increasing the sample size fivefold and preregistering detailed analysis plans. Participants (N = 123) completed a survey and two interviews where they discussed real and fabricated childhood events, based on information provided by an older relative. We replicated the findings of the original study, coding 35% of participants as reporting a false memory for getting lost in a mall in childhood (compared to 25% in the original study). In an extension, we found that participants self-reported high rates of memories and beliefs for the fabricated event. Mock jurors were also highly likely to believe the fabricated event had occurred and that the participant was truly remembering the event, supporting the conclusions of the original study.
Collapse
Affiliation(s)
- Gillian Murphy
- School of Applied Psychology, University College Cork, Cork, Ireland
| | | | - Charlotte Huston
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Lisa Ballantyne
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Elizabeth Barrett
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Conor S Cowman
- School of Applied Psychology, University College Cork, Cork, Ireland
| | | | - Julie Maher
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Katie M Ryan
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Ciara M Greene
- School of Psychology, University College Dublin, Dublin, Ireland
| |
Collapse
|
12
|
Wheelock H, Dickson M, Barrett E. The threads of history: why record your pandemic experiences for the RCPI archive? Ir J Psychol Med 2023; 40:296-297. [PMID: 32438930 PMCID: PMC7550883 DOI: 10.1017/ipm.2020.48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 05/13/2020] [Accepted: 05/16/2020] [Indexed: 11/07/2022]
Affiliation(s)
- Harriet Wheelock
- Keeper of Collections, Royal College of Physicians of Ireland, Dublin 2, Ireland
| | - Melissa Dickson
- Department of English Literature, University of Birmingham, Birmingham, B15 2TT, UK
| | - Elizabeth Barrett
- Children's University Hospital Temple St, Dublin 1, Ireland
- UCD Child and Adolescent Psychiatry, University College Dublin, Dublin 4, Ireland
| |
Collapse
|
13
|
Affiliation(s)
- Claire Kehoe
- The Lucena Clinic Rathgar, Dublin, Republic of Ireland,
| | - Elizabeth Barrett
- University College Dublin, Children Health Ireland, Dublin, Republic of Ireland
| |
Collapse
|
14
|
Murphy G, Dawson CA, Huston C, Ballantyne L, Barrett E, Cowman CS, Fitzsimons C, Maher J, Ryan KM, Greene CM. Lost in the mall again: a preregistered replication and extension of Loftus & Pickrell (1995). Memory 2023:1-13. [PMID: 37017540 DOI: 10.1080/09658211.2023.2198327] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
The seminal Lost in the Mall study has been enormously influential in psychology and is still cited in legal cases. The current study directly replicated this paper, addressing methodological weaknesses including increasing the sample size fivefold and preregistering detailed analysis plans. Participants (N = 123) completed a survey and two interviews where they discussed real and fabricated childhood events, based on information provided by an older relative. We replicated the findings of the original study, coding 35% of participants as reporting a false memory for getting lost in a mall in childhood (compared to 25% in the original study). In an extension, we found that participants self-reported high rates of memories and beliefs for the fabricated event. Mock jurors were also highly likely to believe the fabricated event had occurred and that the participant was truly remembering the event, supporting the conclusions of the original study.
Collapse
Affiliation(s)
- Gillian Murphy
- School of Applied Psychology, University College Cork, Cork, Ireland
| | | | - Charlotte Huston
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Lisa Ballantyne
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Elizabeth Barrett
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Conor S Cowman
- School of Applied Psychology, University College Cork, Cork, Ireland
| | | | - Julie Maher
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Katie M Ryan
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Ciara M Greene
- School of Psychology, University College Dublin, Dublin, Ireland
| |
Collapse
|
15
|
Murphy G, Maher J, Ballantyne L, Barrett E, Cowman CS, Dawson CA, Huston C, Ryan KM, Greene CM. How do participants feel about the ethics of rich false memory studies? Memory 2023; 31:474-481. [PMID: 36689341 DOI: 10.1080/09658211.2023.2170417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
ABSTRACTDeception is often a necessity in rich false memory studies, but is this deception acceptable to participants? In the current study, we followed up with 175 participants who had taken part in a replication of the Lost in the Mall childhood false memory study (Loftus & Pickrell, 1995), as either a research subject or a familial informant. We found that both participants and informants were generally very positive about their experience, did not regret taking part and found the deceptive methods acceptable. Importantly, the vast majority reported that they would still have taken part had they known the true objectives from the beginning. Participants also reported learning something interesting about memory and enjoying the nostalgia and family discussions that were prompted by the study. We would encourage other researchers to assess the ethical implications of false memory research paradigms and to incorporate the valuable feedback from participants and informants.
Collapse
Affiliation(s)
- Gillian Murphy
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Julie Maher
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Lisa Ballantyne
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Elizabeth Barrett
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Conor S Cowman
- School of Applied Psychology, University College Cork, Cork, Ireland
| | | | - Charlotte Huston
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Katie M Ryan
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Ciara M Greene
- School of Psychology, University College Dublin, Dublin, Ireland
| |
Collapse
|
16
|
Mcloughlin C, Abdalla A, O'Callaghan AK, Casey S, Barrett E. The Impact of COVID-19 on Burnout, Psychological Well-being, and Work Satisfaction in Psychiatry Trainees in Ireland. Acad Psychiatry 2022; 46:701-709. [PMID: 35441349 PMCID: PMC9018053 DOI: 10.1007/s40596-022-01633-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 04/01/2022] [Indexed: 06/02/2023]
Abstract
OBJECTIVE Prior to the pandemic, trainee doctors were at higher risk of psychological ill health. There is limited evidence measuring the impact of COVID-19 on psychiatry trainees. This study evaluates levels of burnout, work satisfaction, and psychological well-being in psychiatry junior doctors in Ireland and identifies potential contributing factors. METHODS The authors carried out a cross-sectional online survey measuring demographic and work-related variables. Questions including exposure to COVID-19 and stress-related factors were included. We evaluated burnout, work satisfaction, and psychological well-being using the Abbreviated-Maslach Burnout Inventory, Basic Needs Satisfaction at Work Scale, and WHO-5 Well-being Index. RESULTS One hundred and five doctors responded (21%). The biggest stressor reported was reduced face-to-face contact with family and friends (73%). Forty one percent reported weekly supervision changes. Sixty five percent met the criteria for burnout, compared with 36.2% in 2018. Significant factors associated with burnout included staff shortages, longer hours, and less experience. Changes in supervision and working in non-European Working Time Directive compliant rotas were associated with lower scores across all subdomains of the BNSW Scale. The WHO-5 Well-being Index identified 48% scored low in personal well-being, indicating these trainees met the threshold for depression. Changes in regular supervision (p=0.010) were a significant predictor of low personal well-being. CONCLUSIONS High prevalence of burnout and low levels of well-being in this vulnerable cohort, particularly those who are inexperienced, have changes in supervision, and working longer hours is concerning. This study highlights the importance of regular supervision and support for this group.
Collapse
Affiliation(s)
| | | | | | - Sarah Casey
- Daughters of Charity Disability Services, Dublin 7, Ireland
| | - Elizabeth Barrett
- University College Dublin/Children's University Hospital, Dublin 1, Ireland
| |
Collapse
|
17
|
Bundred N, Dixon M, Acuthan R, Barrett E, Benson J, Courtney C, Skene A, Hoar F, Bhaskar P, Todd C, Macmillan D, Watterston D, Barnes N. Does the use of an Intraoperative device to assess margins reduce need for reexcison after breast conserving surgery: Multicentre Randomised Controlled Trial. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01358-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
18
|
Fay A, Synott E, McDaid E, Barrett E. 111 THE INFLUENCE OF THE ANDAGO® ON GAIT PARAMETERS AMONG OLDER ADULTS IN THE POST-ACUTE REHABILITATION SETTING: A PILOT STUDY. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Electromechanical devices incorporating body-weight support have been developed to enable a repetitive approach to gait rehabilitation whilst decreasing physical strain on treating therapists. The Andago® gait trainer provides dynamic body weight support for individuals while simultaneously enabling them to walk overground. The purpose of this study was to compare the effect of the Andago® versus conventional overground walking on gait parameters, fear of falling (FOF) and ratings of perceived exertion in a post-acute rehabilitation population.
Methods
Patients undergoing rehabilitation were randomly assigned to the Andago® or conventional walking condition on day one with the alternate testing condition completed on day two. Participants completed a 10-metre walk test where stride length, walking speed and cadence were recorded. Participants then undertook a 20-minute gait re-education session where number of steps, distance walked and number of siting breaks were recorded. Ratings of perceived exertion (BORG) and FOF scores were recorded at minutes 1, 10 and 20.
Results
Twenty-seven participants (mean age 78 (SD 9.2), female 55.6%(n=15)) completed the study. Reasons for rehabilitation included neurological (51.8%; n= 14), orthopaedic (33.3%; n=9) and medical conditions (14.8%; n=4). Forty-four percent of participants (n=12) had a mild cognitive impairment. Body weight support ranged from 10% to 17% (mean 11%, SD 2). No significant differences in the 10-metre walk test were found between conditions. A reduction in the number of sitting breaks (p <0.05) and FOF at minutes 10 (p<0.05) and 20 (p<0.05) was found in favour of the Andago® during the gait re-education session.
Conclusion
Preliminary results suggest the Andago® is a feasible modality for gait re-education in patients undergoing rehabilitation, being at least comparable to conventional overground gait training. A reduction in FOF in patients coupled with decreased physical strain on therapists may provide opportunities for more intensive practice and warrants further investigation.
Collapse
Affiliation(s)
- A Fay
- Trinity College Dublin , Dublin, Ireland
| | - E Synott
- Royal Hospital Donnybrook , Dublin, Ireland
| | - E McDaid
- Royal Hospital Donnybrook , Dublin, Ireland
| | - E Barrett
- Trinity College Dublin , Dublin, Ireland
| |
Collapse
|
19
|
Bjella TD, Collier Høegh M, Holmstul Olsen S, Aminoff SR, Barrett E, Ueland T, Icick R, Andreassen OA, Nerhus M, Myhre Ihler H, Hagen M, Busch-Christensen C, Melle I, Lagerberg TV. Developing “MinDag” – an app to capture symptom variation and illness mechanisms in bipolar disorder. Front Med Technol 2022; 4:910533. [PMID: 35935144 PMCID: PMC9354925 DOI: 10.3389/fmedt.2022.910533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 06/29/2022] [Indexed: 11/13/2022] Open
Abstract
IntroductionThe illness course of bipolar disorder (BD) is highly heterogeneous with substantial variation between individuals with the same BD subtype and within individuals over time. This heterogeneity is not well-delineated and hampers the development of more targeted treatment. Furthermore, although lifestyle-related behaviors are believed to play a role in the illness course, such mechanisms are poorly understood. To address some of these knowledge gaps, we aimed to develop an app for collection of multi-dimensional longitudinal data on BD-relevant symptoms and lifestyle-related behaviors.MethodsAn app named MinDag was developed at the Norwegian Center for Mental Disorders Research in Oslo, Norway. The app was designed to tap into selected areas: mood, sleep, functioning/activities (social, occupational, physical exercise, leisure), substance use, emotional reactivity, and psychotic experiences. Ethical, security and usability issues were highly prioritized throughout the development and for the final app solution. We conducted beta- and pilot testing to eliminate technical problems and enhance usability and acceptability.ResultsThe final version of MinDag comprises six modules; three which are presented for the user once daily (the Sleep module in the morning and the Mood and Functoning/Activities modules in the evening) and three which are presented once weekly (Substance Use, Emotional Reactivity, and Psychotic Experiences modules). In general, MinDag was well received in both in the beta-testing and the pilot study, and the participants provided valuable feedback that was taken into account in the final development. MinDag is now in use as part of the research protocol at the NORMENT center and in a specialized treatment unit for BD at Oslo University Hospital in Norway.DiscussionWe believe that MinDag will generate unique longitudinal data well suited for capturing the heterogeneity of BD and clarifying important unresolved issues such as how life-style related behavior may influence BD symptoms. Also, the experiences and knowledge derived from the development of MinDag may contribute to improving the security, acceptability, and benefit of digital tools in mental health.
Collapse
Affiliation(s)
- Thomas D. Bjella
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- *Correspondence: Thomas D. Bjella
| | - Margrethe Collier Høegh
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Stine Holmstul Olsen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Sofie R. Aminoff
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Early Intervention in Psychosis Advisory Unit for South East Norway, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Elizabeth Barrett
- Early Intervention in Psychosis Advisory Unit for South East Norway, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Torill Ueland
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Romain Icick
- INSERM, UMR_S1144, Paris University, Paris, France
- FondaMental Foundation, Créteil, France
| | - Ole A. Andreassen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Mari Nerhus
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Special Psychiatry, Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway
| | - Henrik Myhre Ihler
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Marthe Hagen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Cecilie Busch-Christensen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ingrid Melle
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Trine Vik Lagerberg
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital and Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
20
|
Wong BHC, Vaezinejad M, Plener PL, Mehdi T, Romaniuk L, Barrett E, Hussain H, Lloyd A, Tolmac J, Rao M, Chakrabarti S, Carucci S, Moghraby OS, Elvins R, Rozali F, Skouta E, McNicholas F, Baig B, Stevanovic D, Nagy P, Davico C, Mirza H, Tufan E, Youssef F, Meadowcroft B, Ougrin D. Lockdown stringency and paediatric self-harm presentations during COVID-19 pandemic: retrospective cohort study. BJPsych Open 2022; 8:e75. [PMID: 35322782 PMCID: PMC8963968 DOI: 10.1192/bjo.2022.41] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Lockdown during the pandemic has had significant impacts on public mental health. Previous studies suggest an increase in self-harm and suicide in children and adolescents. There has been little research on the roles of stringent lockdown. AIMS To investigate the mediating and predictive roles of lockdown policy stringency measures in self-harm and emergency psychiatric presentations. METHOD This was a retrospective cohort study. We analysed data of 2073 psychiatric emergency presentations of children and adolescents from 23 hospital catchment areas in ten countries, in March to April 2019 and 2020. RESULTS Lockdown measure stringency mediated the reduction in psychiatric emergency presentations (incidence rate ratio of the natural indirect effect [IRRNIE] = 0.41, 95% CI [0.35, 0.48]) and self-harm presentations (IRRNIE = 0.49, 95% CI [0.39, 0.60]) in 2020 compared with 2019. Self-harm presentations among male and looked after children were likely to increase in parallel with lockdown stringency. Self-harm presentations precipitated by social isolation increased with stringency, whereas school pressure and rows with a friend became less likely precipitants. Children from more deprived neighbourhoods were less likely to present to emergency departments when lockdown became more stringent. CONCLUSIONS Lockdown may produce differential effects among children and adolescents who self-harm. Development in community or remote mental health services is crucial to offset potential barriers to access to emergency psychiatric care, especially for the most deprived youths. Governments should aim to reduce unnecessary fear of help-seeking and keep lockdown as short as possible. Underlying mediation mechanisms of stringent measures and potential psychosocial inequalities warrant further research.
Collapse
Affiliation(s)
| | | | - Paul L Plener
- Medical University of Vienna, Vienna, Austria, and Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany
| | - Tauseef Mehdi
- Berkshire Healthcare NHS Foundation Trust, Bracknell, Bracknell Forest, UK
| | - Liana Romaniuk
- The University of Edinburgh Centre for Clinical Brain Sciences, Edinburgh, UK
| | | | - Haseena Hussain
- Hertfordshire Partnership University NHS Foundation Trust, Child and Adolescent Mental Health Services, Hatfield, Hertfordshire, UK
| | - Alexandra Lloyd
- Hertfordshire Partnership University NHS Foundation Trust, Child and Adolescent Mental Health Services, Hatfield, Hertfordshire, UK
| | - Jovanka Tolmac
- Central and North West London NHS Foundation Trust, London, UK
| | - Manish Rao
- South London and Maudsley Mental Health NHS Trust, London, UK
| | | | - Sara Carucci
- Facoltà di Medicina e Chirurgia, Università degli Studi di Cagliari, Sardegna, Italy
| | - Omer S Moghraby
- South London and Maudsley Mental Health NHS Trust, London, UK
| | - Rachel Elvins
- Manchester University NHS Foundation Trust, Greater Manchester, UK
| | | | | | | | - Benjamin Baig
- South London and Maudsley Mental Health NHS Trust, London, UK
| | - Dejan Stevanovic
- Clinic for Neurology and Psychiatry for Children and Youth, Belgrade, Serbia
| | - Peter Nagy
- Vadaskert Child and Adolescent Psychiatric Hospital, Vadaskert, Hungary
| | | | | | - Evren Tufan
- Abant Izzet Baysal University Medical Faculty, Bolu, Turkey
| | - Fatima Youssef
- Dubai Department of Medical Education, Dubai, United Arab Emirates
| | | | - Dennis Ougrin
- King's College London, Child and Adolescent Psychiatry, London, UK
| |
Collapse
|
21
|
McDonnell T, Conlon C, McNicholas F, Barrett E, Barrett M, Cummins F, Hensey C, McAuliffe E, Nicholson E. Paediatric hospital admissions for psychiatric and psychosocial reasons during the first year of the COVID-19 pandemic. Int Rev Psychiatry 2022; 34:128-139. [PMID: 35699100 DOI: 10.1080/09540261.2022.2061840] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Increases in youth psychiatric presentations to out-patient and emergency department settings during COVID-19 have been reported. This study, using data from five hospitals in Ireland, examines changes in the number and type of paediatric admissions during COVID-19 (March 2020 - February 2021) compared to the previous two years. ICD-10 classification was used to establish admissions with mental, behavioural, neuro-developmental disorders and psychosocial reasons (MBN-PS). Overall hospital admissions fell by 25.3%, while MBN-PS fell by only 2.6%, mostly during an initial lockdown. Admissions for MBN-PS increased in July-August (9.2%), increased further in September-December (28.3%), returning to pre-COVID-19 levels in January-February 2021. Significant increases were observed among youths with anorexia nervosa (47.8%), other eating disorders (42.9%), and admissions for anxiety (29.6%), with these effects relating to females only. Although admissions for self-harm increased (3%) and rates of ASD admissions reduced (17%), these were not statistically significant. The disproportionate increase in admissions for MBN-PS compared to medical admissions suggests an adverse effect of COVID-19 on youth mental health, for females in particular, and supports previous reports of a pandemic specific increase in eating psychopathology. Combined community and acute service delivery and capacity planning are urgently needed given the prior underfunding of services pre-pandemic.
Collapse
Affiliation(s)
- T McDonnell
- UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems, School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland
| | - C Conlon
- UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems, School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland
| | - F McNicholas
- Children's Health Ireland at Crumlin, Dublin, Ireland.,UCD Child and Adolescent Psychiatry, University College Dublin, Belfield, Ireland.,Lucena Clinic, Rathgar, Ireland
| | - E Barrett
- UCD Child and Adolescent Psychiatry, University College Dublin, Belfield, Ireland.,Children's Health Ireland at Temple Street, Dublin, Ireland
| | - M Barrett
- Children's Health Ireland at Crumlin, Dublin, Ireland.,Women's and Children's Health, School of Medicine, University College Dublin, Dublin, Ireland.,National Children's Research Centre, Dublin, Ireland
| | - F Cummins
- ALERT, REDSPOT, Emergency Department, Limerick University Hospital, Limerick, Ireland
| | - C Hensey
- Children's Health Ireland at Temple Street, Dublin, Ireland
| | - E McAuliffe
- UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems, School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland
| | - E Nicholson
- UCD Centre for Interdisciplinary Research, Education and Innovation in Health Systems, School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin, Ireland.,School of Psychology, Dublin City University, Dublin, Ireland
| |
Collapse
|
22
|
Ougrin D, Wong BHC, Vaezinejad M, Plener PL, Mehdi T, Romaniuk L, Barrett E, Hussain H, Lloyd A, Tolmac J, Rao M, Chakrabarti S, Carucci S, Moghraby OS, Elvins R, Rozali F, Skouta E, McNicholas F, Kuruppuaracchi N, Stevanovic D, Nagy P, Davico C, Mirza H, Tufan E, Youssef F, Meadowcroft B, Landau S. Pandemic-related emergency psychiatric presentations for self-harm of children and adolescents in 10 countries (PREP-kids): a retrospective international cohort study. Eur Child Adolesc Psychiatry 2022; 31:1-13. [PMID: 33677628 PMCID: PMC7937052 DOI: 10.1007/s00787-021-01741-6] [Citation(s) in RCA: 60] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 02/08/2021] [Indexed: 12/11/2022]
Abstract
To examine the differences in hospital emergency psychiatric presentations for self-harm of children and adolescents during the covid-19 lockdown in March and April 2020 compared with the same period in 2019. Retrospective cohort study. We used electronic patient records from 23 hospital emergency departments in ten countries grouped into 14 areas. We examined data on 2073 acute hospital presentations by 1795 unique children and adolescents through age 18. We examined the total number of emergency psychiatric hospital presentations and the proportion of children and adolescents presenting with severe self-harm as our two main outcome measures. In addition, we examined sociodemographic and clinical characteristics and clinical management variables for those presenting with self-harm. To compare the number of hospital presentations between 2020 and 2019 a negative binomial model was used. For other variables, individual participant data (IPD) meta-analyses were carried out. Emergency psychiatric hospital presentations decreased from 1239 in 2019 to 834 in 2020, incident rate ratio 0.67, 95% CI 0.62-0.73; p < 0.001. The proportion of children and adolescents presenting with self-harm increased from 50% in 2019 to 57% in 2020, odds ratio 1.33, 1.07-1.64; p = 0.009 but there was no difference in the proportion presenting with severe self-harm. Within the subpopulation presenting with self-harm the proportion of children and adolescents presenting with emotional disorders increased from 58 to 66%, odds ratio 1.58, 1.06-2.36; p = 0.025. The proportion of children and adolescents admitted to an observation ward also decreased from 13 to 9% in 2020, odds ratio 0.52, 0.28-0.96; p = 0.036. Service planners should consider that, during a lockdown, there are likely to be fewer emergency psychiatric presentations. Many children and adolescents with psychiatric emergencies might not receive any service. A focus on developing intensive community care services with outreach capabilities should be prioritised.
Collapse
Affiliation(s)
- Dennis Ougrin
- Child and Adolescent Psychiatry, Kings College London, London, UK
| | | | | | - Paul L. Plener
- Medical University of Vienna, Vienna, Austria ,Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Ulm, Germany
| | - Tauseef Mehdi
- Berkshire Healthcare NHS Foundation Trust, Bracknell, Bracknell Forest, UK
| | - Liana Romaniuk
- The University of Edinburgh Centre for Clinical Brain Sciences, Edinburgh, UK
| | | | - Haseena Hussain
- Hertfordshire Partnership University NHS Foundation Trust, Child and Adolescent Mental Health Services, Hatfield, Hertfordshire UK
| | - Alexandra Lloyd
- Hertfordshire Partnership University NHS Foundation Trust, Child and Adolescent Mental Health Services, Hatfield, Hertfordshire UK
| | - Jovanka Tolmac
- Central and North West London NHS Foundation Trust, London, UK
| | - Manish Rao
- South London and Maudsley Mental Health NHS Trust, London, UK
| | | | - Sara Carucci
- Università Degli Studi Di Cagliari Facoltà Di Medicina E Chirurgia Monserrato, Sardegna, Italy
| | | | - Rachel Elvins
- Manchester University NHS Foundation Trust, Greater Manchester, UK
| | | | | | | | | | - Dejan Stevanovic
- Clinic for Neurology and Psychiatry for Children and Youth, Belgrade, Serbia
| | - Peter Nagy
- Bethesda Children’s Hospital, Budapest, Hungary ,Vadaskert Child and Adolescent Psychiatric Hospital, Vadaskert, Hungary
| | | | | | - Evren Tufan
- Abant Izzet Baysal University Medical Faculty, Bolu, Turkey
| | - Fatima Youssef
- Dubai Department of Medical Education, Dubai, United Arab Emirates
| | | | | |
Collapse
|
23
|
O'Flynn A, Murphy J, Barrett E. Psychological benefits for volunteers at the Watersports Inclusion Games. Ir J Med Sci 2021; 191:2247-2252. [PMID: 34725789 DOI: 10.1007/s11845-021-02834-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 10/21/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND We wished to pilot a survey of volunteers at the annual Watersports Inclusion Games regarding benefits and barriers to participation. We collaborated with community partners regarding the impact of the event, which invites individuals across physical, sensory, intellectual and learning ability spectrums and those experiencing barriers accessing mainstream sport to participate in watersports. AIMS The project aimed to assess the survey data in the context of current knowledge about volunteers in watersports inclusion. METHODS Literature review was completed using keywords in databases and grey literature. An anonymous survey of participants gathered basic data using industry-standard encrypted techniques and opt-in methodology, including qualitative and quantitative aspects. Data was quantitatively analysed using Excel and SPSS, and free text was analysed to explore themes using Braun and Clarke (2006). RESULTS This pilot data demonstrates the role, demographics, motivations and benefits for the 2019 volunteer cohort. Seventy-nine of 208 volunteers responded. We describe demographics of the cohort and explore psychological benefits of volunteering at the event. Of 78 responses, 94% (n = 73) gained confidence, and 95% (n = 74) felt more engaged with the watersports community. Of 79 responses, 95% (n = 75) gained skills, and 96% (n = 76) learned more about inclusion by volunteering. CONCLUSIONS Our plot data supports previous evidence of the value of volunteerism in inclusive watersports, for the event and for volunteers. It is the first article on inclusive watersports volunteers in Ireland we are aware of, and the largest cohort of inclusive watersports volunteers surveyed internationally.
Collapse
Affiliation(s)
- Aela O'Flynn
- School of Medicine, University College Dublin, Belfield, Dublin 4, Ireland.
| | | | - Elizabeth Barrett
- Child and Adolescent Psychiatry, School of Medicine, University College Dublin, Belfield, Dublin 4, Ireland.,Child and Adolescent Liaison Psychiatry, Children's University Hospital, Temple St, Dublin 1, Ireland
| |
Collapse
|
24
|
Vertullo L, Barrett E, Quinonez C, Sidhu N, Casas M. Trends in repeat general anaesthesia for treatment of dental caries at a children's hospital in Toronto, Canada: a 10-year retrospective investigation. Eur Arch Paediatr Dent 2021; 22:1087-1093. [PMID: 34626351 DOI: 10.1007/s40368-021-00667-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 09/22/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Treatment of early childhood caries (ECC) under general anaesthesia (GA) was the most common day surgical procedure performed for preschool children in Canada. Evidence with regard to the rate of repeat GA for dental care for Canadian Children is limited. AIM To determine the rate of repeat dental caries treatment performed under GA over a 10-year period and to assess the relationship between the frequency of repeat dental treatment under GA and medical comorbidities. DESIGN This was a retrospective assessment of the dental records of 973 children who required repeat dental treatment under GA over a 10-year period. The rate of repeat dental treatment under GA was calculated. A Chi-square analysis was performed to determine associations between medical comorbidities and the frequency of repeat dental treatment under GA. RESULTS The rate of repeat dental treatment under GA over a 10-year period was 10.8%. The yearly repeat rate and simple moving 5-year rate of repeat dental treatment under GA increased. Having a medical comorbidity was not associated with repeat dental treatment under GA. CONCLUSIONS The rate of repeat dental treatment under GA was consistent with the rates reported in the dental literature and increased over the 10-year period.
Collapse
Affiliation(s)
- L Vertullo
- Faculty of Dentistry, University of Toronto, 124 Edward Street, Toronto, M5G 1G6, Canada.
| | - E Barrett
- Paediatric Dentistry, Department of Dentistry, The Hospital for Sick Children, 555 University Avenue, Toronto, M5G 1X8, Canada
| | - C Quinonez
- Graduate Program in Dental Public Health, The University of Toronto, Faculty of Dentistry, 124 Edward Street, Toronto, M5G 1G6, Canada
| | - N Sidhu
- Department of Dentistry, The Hospital for Sick Children, 555 University Avenue, Toronto, M5G 1X8, Canada
| | - M Casas
- Department of Dentistry, The Hospital for Sick Children, 555 University Avenue, Toronto, M5G 1X8, Canada
| |
Collapse
|
25
|
Salgado A, Murphy J, Barrett E. The Benefits Experience by Families Participating in the Watersports Inclusion Games. Ir Med J 2021; 114:436. [PMID: 35969219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Aims The Watersports Inclusion Games (Inclusion Games) is a free event for children and families with disability to participate in water-based activities. Family participation in physical activity can improve mental health and confidence in children with disability. This study aims to gain an insight into the benefits and barriers of participation, perceived by parents and carers. Methods After an initial literature review, an online pre-event and post-event survey was constructed via SurveyMonkey. Both surveys were circulated three times to attendees. Statistical and thematic analysis was carried out to compare changes in responses both before and after the event. Results 49% of participants were primarily hoping to experience a new sport in a controlled environment and meet others with similar challenges. The surveys also highlighted an increase in reported family bonding [P=0.14] due to the event. A thematic analysis revealed event organisation and planning is vital for effective participation of children with disability. Conclusion Creating an equal opportunity for young people with disabilities and their families to partake in watersports led to increased confidence and a higher likelihood of future participation. Effective organisation and extra help were key enabling factors facilitating these benefits.
Collapse
Affiliation(s)
- A Salgado
- UCD School of Child and Adolescent Psychiatry, School of Medicine, University College Dublin, Belfield, Dublin 4
| | | | - E Barrett
- Child and Adolescent Liaison Psychiatry, Children's University Hospital, Temple Street, Dublin 1
| |
Collapse
|
26
|
Punjabi A, Barrett E, Cheng A, Mulla A, Walls G, Johnston D, McAleese J, Moore K, Hicks J, Blyth K, Denholm M, Magee L, Gilligan D, Silverman S, Qureshi M, Clinch H, Hatton M, Philipps L, Brown S, O'Brien M, McDonald F, Faivre-Finn C, Hiley C, Evison M. Neutrophil-Lymphocyte Ratio and Absolute Lymphocyte Count as Prognostic Markers in Patients Treated with Curative-intent Radiotherapy for Non-small Cell Lung Cancer. Clin Oncol (R Coll Radiol) 2021; 33:e331-e338. [PMID: 33863615 DOI: 10.1016/j.clon.2021.03.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 02/27/2021] [Accepted: 03/24/2021] [Indexed: 12/21/2022]
Abstract
AIMS The neutrophil-lymphocyte ratio (NLR) and the absolute lymphocyte count (ALC) have been proposed as prognostic markers in non-small cell lung cancer (NSCLC). The objective of this study was to examine the association of NLR/ALC before and after curative-intent radiotherapy for NSCLC on disease recurrence and overall survival. MATERIALS AND METHODS A retrospective study of consecutive patients who underwent curative-intent radiotherapy for NSCLC across nine sites in the UK from 1 October 2014 to 1 October 2016. A multivariate analysis was carried out to assess the ability of pre-treatment NLR/ALC, post-treatment NLR/ALC and change in NLR/ALC, adjusted for confounding factors using the Cox proportional hazards model, to predict disease recurrence and overall survival within 2 years of treatment. RESULTS In total, 425 patients were identified with complete blood parameter values. None of the NLR/ALC parameters were independent predictors of disease recurrence. Higher pre-NLR, post-NLR and change in NLR plus lower post-ALC were all independent predictors of worse survival. Receiver operator curve analysis found a pre-NLR > 2.5 (odds ratio 1.71, 95% confidence interval 1.06-2.79, P < 0.05), a post-NLR > 5.5 (odds ratio 2.36, 95% confidence interval 1.49-3.76, P < 0.001), a change in NLR >3.6 (odds ratio 2.41, 95% confidence interval 1.5-3.91, P < 0.001) and a post-ALC < 0.8 (odds ratio 2.86, 95% confidence interval 1.76-4.69, P < 0.001) optimally predicted poor overall survival on both univariate and multivariate analysis when adjusted for confounding factors. Median overall survival for the high-versus low-risk groups were: pre-NLR 770 versus 1009 days (P = 0.34), post-NLR 596 versus 1287 days (P ≤ 0.001), change in NLR 553 versus 1214 days (P ≤ 0.001) and post-ALC 594 versus 1287 days (P ≤ 0.001). CONCLUSION NLR and ALC, surrogate markers for systemic inflammation, have prognostic value in NSCLC patients treated with curative-intent radiotherapy. These simple and readily available parameters may have a future role in risk stratification post-treatment to inform the intensity of surveillance protocols.
Collapse
Affiliation(s)
- A Punjabi
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - E Barrett
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - A Cheng
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - A Mulla
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - G Walls
- Queen's University Belfast, Belfast, UK
| | - D Johnston
- Northern Ireland Cancer Centre, Belfast, UK
| | - J McAleese
- Northern Ireland Cancer Centre, Belfast, UK
| | - K Moore
- NHS Greater Glasgow & Clyde, Glasgow, UK
| | - J Hicks
- NHS Greater Glasgow & Clyde, Glasgow, UK
| | - K Blyth
- NHS Greater Glasgow & Clyde, Glasgow, UK
| | - M Denholm
- Cambridge University Hospitals NHS Trust, Cambridge, UK
| | - L Magee
- Cambridge University Hospitals NHS Trust, Cambridge, UK
| | - D Gilligan
- Cambridge University Hospitals NHS Trust, Cambridge, UK
| | - S Silverman
- University College London Hospital, London, UK
| | - M Qureshi
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - H Clinch
- The University of Sheffield Medical School, Sheffield, UK
| | - M Hatton
- Weston Park Hospital, Sheffield, UK
| | | | - S Brown
- The University of Manchester, Manchester, UK
| | | | | | - C Faivre-Finn
- The University of Manchester, Manchester, UK; The Christie NHS Foundation Trust, Manchester, UK
| | - C Hiley
- CRUK Lung Cancer Centre of Excellence, UCL Cancer Institute, London, UK
| | - M Evison
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK.
| |
Collapse
|
27
|
Hiley C, Punjabi A, Barrett E, Cheng A, Mulla A, Walls G, Johnston D, McAleese J, Moore K, Hicks J, Blyth K, Denholm M, Magee L, Gilligan D, Silverman S, Qureshi M, Clinch H, Hatton M, Philips L, Brown S, O’Brien M, Macdonald F, Faivre-Finn C, Evison M. PH-0274 NLR & ALC as prognostic markers in patients treated with curative intent radiotherapy for NSCLC. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07289-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
28
|
McLoughlin C, Casey S, Feeney A, Weir D, Abdalla AA, Barrett E. Burnout, Work Satisfaction, and Well-being Among Non-consultant Psychiatrists in Ireland. Acad Psychiatry 2021; 45:322-328. [PMID: 33420699 PMCID: PMC7794076 DOI: 10.1007/s40596-020-01366-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 10/28/2020] [Indexed: 06/02/2023]
Abstract
OBJECTIVE The aim of this study was to explore the areas of psychological well-being, satisfaction at work, and burnout among non-consultant psychiatrists in Ireland, and to assess for potential contributory factors. METHODS The College of Psychiatrists of Ireland distributed the survey online to 100 non-consultant psychiatry doctors working in Ireland. The survey contained questions relating to demographic and work-related variables, the Abbreviated-Maslach Burnout Inventory (a-MBI), Basic Needs Satisfaction at Work (BNSW) scale, and WHO-5 Well-being Index. Descriptive statistics were used by the authors to summarize the data and univariate associations were explored between baseline data and subscales. RESULTS Sixty-nine percent of our sample completed the survey. Thirty-six percent of the sample met the criteria for burnout, with lack of supervision the only variable significantly associated with this. Lack of regular supervision was associated with lower scores across all work satisfaction domains of the BNSW scale. The WHO-5 Well-being Index identified that 30% of respondents scored low in personal well-being, indicating that this proportion screened positive for depression, based on international diagnostic criteria. Lack of regular supervision was found to be significantly associated with low psychological well-being. CONCLUSION This study indicates that lack of supervision is significantly associated with burnout, lower satisfaction at work, and poorer psychological well-being. Close evaluation of these areas is important to identify vulnerable individuals and areas of training which can be improved upon, which may lead to relevant measures being implemented for the benefit of psychiatrists, patients, and the wider society.
Collapse
Affiliation(s)
| | - Sarah Casey
- Temple St University Hospital, Dublin, Ireland
| | - Anna Feeney
- St Patricks University Hospital, Dublin, Ireland
| | - David Weir
- Cavan Monaghan Mental Health Services, Monaghan, Ireland
| | | | | |
Collapse
|
29
|
Davenport M, Okhiria R, Barrett E, Highton L. 767 Magnetic Resonance Imaging in the Assessment of Patients with Breast Cancer Undergoing Neoadjuvant Chemotherapy: Evaluation of the Prognostic Value of Mid-Chemotherapy and Post-Chemotherapy Scans. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
Magnetic Resonance Imaging (MRI) is used to assess the response to Neoadjuvant Chemotherapy (NAC) when used in patients with breast cancer.
Method
This retrospective observational study compared patterns of tumour response at mid-chemotherapy and post-chemotherapy MRIs to histological outcomes. 118 cases of breast cancer, from a local database, were included.
Results
There was a significant association between complete pathological response in resected breast tissue and complete radiological response on both mid-chemotherapy MRI (p = 0.007) and post-chemotherapy MRI (p < 0.001). In patients who had both scans,100% of those with complete response at mid-chemotherapy scan maintained this response pattern. In those who had both scans, complete response at the mid-chemotherapy scan had a PPV for complete pathological response in resected breast tissue of 92% compared to 64% in those with complete response that was not achieved until the post-chemotherapy scan. There was a trend towards an association between early complete radiological response and complete pathological response (p = 0.124).
Conclusions
Both scans have significant prognostic value. A mid-chemotherapy scan may have superior prognostic value when complete response is achieved, though larger studies are needed to determine the significance. 100% maintenance of complete radiological response after the mid-chemotherapy scan highlights the possibility that some post-chemotherapy scan could be avoided.
Collapse
Affiliation(s)
- M Davenport
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - R Okhiria
- University of Manchester, Manchester, United Kingdom
| | - E Barrett
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - L Highton
- Manchester University NHS Foundation Trust, Manchester, United Kingdom
| |
Collapse
|
30
|
Mclaughlin R, O'Reilly D, Ronayne C, Barrett E, Kalachand R, De Frein A, Macanovic B, Connolly R, Power D, Bambury R, Reilly S, Collins D. 152P Analysis of patient access to breast cancer drugs in the USA and Europe with a focus on the UK and Ireland. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.03.166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
31
|
O’Flynn A, Murphy J, Barrett E. The watersports inclusion games - what are the benefits for volunteers? Eur Psychiatry 2021. [PMCID: PMC9475715 DOI: 10.1192/j.eurpsy.2021.1235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction The Watersports Inclusion Games is an annual event organised by Irish Sailing and partners that provides an opportunity for individuals of all abilities across the physical, sensory, intellectual and learning spectrums and those experiencing barriers accessing mainstream sport to partake in a range of watersports. 79 volunteers from the 2019 cohort responded to a pilot survey to assess the benefits for volunteers at the event. Objectives This project aims to assess this data in the context of current knowledge about the benefits for volunteers in inclusive sport. Methods Literature review used the PEO keyword framework in medical and psychological databases, as well as grey literature. Data was collected using SurveyMonkey, quantitative data was analysed using Survey Monkey and SPSS, and qualitative themes were analysed using SurveyMonkey and Excel. Results Only one article exploring the benefits for volunteers in inclusive watersports was identified during literature review. This pilot survey analysis is the first on this topic in Ireland, and the largest sample of volunteers in inclusive watersport that we are aware of internationally. Thematic analysis finds that volunteers at this event are primarily motivated by altruistic motives, while the benefits they perceive include both personal enjoyment and growth, and seeing the enjoyment of other participants. Conclusions This project demonstrates that inclusive watersports can have many benefits for volunteers. The findings of this study can contribute to the evidence base on the benefits of inclusive sport for all those involved, while also identifying an opportunity for further study on volunteerism in inclusive sport, particularly adaptive watersports. Conflict of interest Ms O’Flynn reports a scholarship from the Health Research Board for this project, Dr Barrett has nothing to disclose, Ms Murphy reports to be the Inclusion Games Office, and thus responsible for the organisation of the Watersports Inclusion Games.
Collapse
|
32
|
Doherty AM, Colleran GC, Durcan L, Irvine AD, Barrett E. A pilot study of burnout and long covid in senior specialist doctors. Ir J Med Sci 2021; 191:133-137. [PMID: 33713306 PMCID: PMC7955691 DOI: 10.1007/s11845-021-02594-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 03/07/2021] [Indexed: 11/30/2022]
Abstract
Background Covid-19 has placed unprecedented demand on healthcare systems and on healthcare professionals. There have been concerns about the risk of distress, moral injury and burnout among healthcare professionals, especially doctors. Aim To assess the effect of the ongoing Covid-19 pandemic on Irish doctors by investigating the incidence of burnout and long covid among senior medical staff in Ireland. Methods This is a cross-sectional pilot study of the prevalence of burnout and long covid among senior physicians. A survey was sent by email to members of the Irish Hospital Consultant’s Association. The survey included measures of mental and physical health and the 2-item Maslach Burnout Scale (MBS-2). The study explored the experience of delivering health care in the context of a pandemic and experience of the long covid syndrome. Results A total of 114 responses were received. Three-quarters 77% (N = 88) screened positive for burnout on the MBS, with mean score of 5.6 (SD3.3), nearly double the cut-off for burnout. Nearly two-thirds (64%, n = 72) reported that Covid-19 has had an adverse effect on their mental health. One-quarter reported that they or colleagues had experience of ‘long-covid’ secondary to the virus. Conclusion More comprehensive evaluation of the effect of the pandemic on front-line staff is needed to identify the extent of the problem and the factors which contribute to it. This will inform measures to mitigate these effects.
Collapse
Affiliation(s)
- Anne M Doherty
- School of Medicine, University College Dublin, Dublin, Ireland. .,Mater Misericordiae University Hospital, Dublin, Ireland.
| | - Gabrielle C Colleran
- Children's Health Ireland, Temple Street, Dublin, Ireland.,National Maternity Hospital, Dublin, Ireland
| | - Laura Durcan
- Beaumont Hospital, Dublin, Ireland.,Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Alan D Irvine
- Children's Health Ireland, Temple Street, Dublin, Ireland.,Children's Health Ireland, Crumlin, Dublin, Ireland
| | - Elizabeth Barrett
- School of Medicine, University College Dublin, Dublin, Ireland.,Children's Health Ireland, Temple Street, Dublin, Ireland.,Clinical Medicine, Trinity College Dublin, Dublin, Ireland
| |
Collapse
|
33
|
Evison M, Barrett E, Cheng A, Mulla A, Walls G, Johnston D, McAleese J, Moore K, Hicks J, Blyth K, Denholm M, Magee L, Gilligan D, Silverman S, Hiley C, Qureshi M, Clinch H, Hatton M, Philipps L, Brown S, O'Brien M, McDonald F, Faivre-Finn C. Predicting the Risk of Disease Recurrence and Death Following Curative-intent Radiotherapy for Non-small Cell Lung Cancer: The Development and Validation of Two Scoring Systems From a Large Multicentre UK Cohort. Clin Oncol (R Coll Radiol) 2021; 33:145-154. [PMID: 32978027 DOI: 10.1016/j.clon.2020.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 07/30/2020] [Accepted: 09/02/2020] [Indexed: 12/26/2022]
Abstract
AIMS There is a paucity of evidence on which to produce recommendations on neither the clinical nor the imaging follow-up of lung cancer patients after curative-intent radiotherapy. In the 2019 National Institute for Health and Care Excellence lung cancer guidelines, further research into risk-stratification models to inform follow-up protocols was recommended. MATERIALS AND METHODS A retrospective study of consecutive patients undergoing curative-intent radiotherapy for non-small cell lung cancer from 1 October 2014 to 1 October 2016 across nine UK trusts was carried out. Twenty-two demographic, clinical and treatment-related variables were collected and multivariable logistic regression was used to develop and validate two risk-stratification models to determine the risk of disease recurrence and death. RESULTS In total, 898 patients were included in the study. The mean age was 72 years, 63% (562/898) had a good performance status (0-1) and 43% (388/898), 15% (134/898) and 42% (376/898) were clinical stage I, II and III, respectively. Thirty-six per cent (322/898) suffered disease recurrence and 41% (369/898) died in the first 2 years after radiotherapy. The ASSENT score (age, performance status, smoking status, staging endobronchial ultrasound, N-stage, T-stage) was developed, which stratifies the risk for disease recurrence within 2 years, with an area under the receiver operating characteristic curve (AUROC) for the total score of 0.712 (0.671-0.753) and 0.72 (0.65-0.789) in the derivation and validation sets, respectively. The STEPS score (sex, performance status, staging endobronchial ultrasound, T-stage, N-stage) was developed, which stratifies the risk of death within 2 years, with an AUROC for the total score of 0.625 (0.581-0.669) and 0.607 (0.53-0.684) in the derivation and validation sets, respectively. CONCLUSIONS These validated risk-stratification models could be used to inform follow-up protocols after curative-intent radiotherapy for lung cancer. The modest performance highlights the need for more advanced risk prediction tools.
Collapse
Affiliation(s)
- M Evison
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK.
| | - E Barrett
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - A Cheng
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - A Mulla
- Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - G Walls
- Northern Ireland Cancer Centre, Belfast, UK
| | - D Johnston
- Cancer Centre Belfast City Hospital, Belfast, UK
| | - J McAleese
- Cancer Centre Belfast City Hospital, Belfast, UK
| | - K Moore
- NHS Greater Glasgow & Clyde, Glasgow, UK
| | - J Hicks
- NHS Greater Glasgow & Clyde, Glasgow, UK
| | - K Blyth
- NHS Greater Glasgow & Clyde, Glasgow, UK
| | - M Denholm
- Cambridge University Hospitals NHS Trust, Cambridge, UK
| | - L Magee
- Cambridge University Hospitals NHS Trust, Cambridge, UK
| | - D Gilligan
- Cambridge University Hospitals NHS Trust, Cambridge, UK
| | - S Silverman
- University College London Hospital, London, UK
| | - C Hiley
- CRUK Lung Cancer Centre of Excellence, UCL Cancer Institute, London, UK
| | | | - H Clinch
- The University of Sheffield Medical School, Sheffield, UK
| | - M Hatton
- Weston Park Hospital, Sheffield, UK
| | | | - S Brown
- The Christie NHS Foundation Trust, Manchester, UK
| | | | | | - C Faivre-Finn
- The Christie NHS Foundation Trust, Manchester, UK; The University of Manchester, Manchester, UK
| |
Collapse
|
34
|
Creese J, Byrne JP, Conway E, Barrett E, Prihodova L, Humphries N. "We All Really Need to just Take a Breath": Composite Narratives of Hospital Doctors' Well-Being during the COVID-19 Pandemic. Int J Environ Res Public Health 2021; 18:2051. [PMID: 33669828 PMCID: PMC7921910 DOI: 10.3390/ijerph18042051] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/05/2021] [Accepted: 02/17/2021] [Indexed: 12/16/2022]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic poses a challenge to the physical and mental well-being of doctors worldwide. Countries around the world introduced severe social restrictions, and significant changes to health service provision in the first wave of the pandemic to suppress the spread of the virus and prioritize healthcare for those who contracted it. This study interviewed 48 hospital doctors who worked in Ireland during the first wave of the pandemic and investigated their conceptualizations of their own well-being during that time (March-May 2020). Doctors were interviewed via Zoom™ or telephone. Interview transcripts were analyzed using structured thematic analysis. Five composite narratives are presented which have been crafted to illustrate themes and experiences emerging from the data. This study found that despite the risks of contracting COVID-19, many doctors saw some improvements to their physical well-being in the first wave of the pandemic. However, most also experienced a decline in their mental well-being due to anxiety, emotional exhaustion, guilt, isolation and poor support. These findings shed light on doctor well-being during COVID-19, and the ways in which they have been affected by the pandemic, both professionally and personally. The paper concludes by highlighting how doctors' work life and well-being can be better supported during and after the COVID-19 pandemic.
Collapse
Affiliation(s)
- Jennifer Creese
- Royal College of Physicians of Ireland, Dublin D02 X266, Ireland; (J.-P.B.); (L.P.); (N.H.)
| | - John-Paul Byrne
- Royal College of Physicians of Ireland, Dublin D02 X266, Ireland; (J.-P.B.); (L.P.); (N.H.)
| | - Edel Conway
- DCU Business School, Dublin City University, Dublin D09 V209, Ireland;
| | - Elizabeth Barrett
- School of Medicine, University College Dublin, Dublin D04 V1W8, Ireland;
- Children’s University Hospital Temple Street, Dublin D01 F772, Ireland
| | - Lucia Prihodova
- Royal College of Physicians of Ireland, Dublin D02 X266, Ireland; (J.-P.B.); (L.P.); (N.H.)
| | - Niamh Humphries
- Royal College of Physicians of Ireland, Dublin D02 X266, Ireland; (J.-P.B.); (L.P.); (N.H.)
| |
Collapse
|
35
|
Barrett E, Richardson SC. Eating Disorders During the COVID-19 Pandemic. Ir Med J 2021; 114:233. [PMID: 37555843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
|
36
|
Doherty AM, Plunkett R, McEvoy K, Kelleher E, Clancy M, Barrett E, Greene E, Cassidy E, Lee W, MacHale S. Consultation-Liaison Psychiatry Services in Ireland: A National Cross-Sectional Study. Front Psychiatry 2021; 12:748224. [PMID: 34912252 PMCID: PMC8666631 DOI: 10.3389/fpsyt.2021.748224] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 11/05/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: This study aimed to describe the provision of consultation-liaison psychiatry (CLP, also known as liaison psychiatry) services in acute hospitals in Ireland, and to measure it against recommended resourcing levels. Methods: This is a survey of all acute hospitals in Ireland with Emergency Departments, via an electronic survey sent by email and followed up by telephone calls for missing data. Data were collected on service configuration, activity, and resourcing. Data were collected from CLP or proxy services at all acute hospitals with an Emergency Department in Ireland (n = 29). This study measured staffing and activity levels where available. Results: None of the services met the minimum criteria set out by either national or international guidance per 500 bed general hospital. Conclusions: CLP is a relatively new specialty in Ireland, but there are clear international guidelines about the staffing levels required to run these services safely and effectively. In Ireland, despite clear national guidance on staffing levels, no services are staffed to the levels suggested as the minimum. It is likely that patients in Ireland's acute hospitals have worse outcomes, and hospitals have unnecessary costs, due to this lack. This is the first study of CLP provision in Ireland and demonstrates the resource constraints under which most services work and the heterogeneity of services nationally.
Collapse
Affiliation(s)
- Anne M Doherty
- University College Dublin, Dublin, Ireland.,Mater Misericordiae University Hospital, Dublin, Ireland
| | | | | | - Eric Kelleher
- Cork University Hospital-CUH, Cork, Ireland.,University College Cork, Cork, Ireland
| | | | - Elizabeth Barrett
- University College Dublin, Dublin, Ireland.,Temple Street Children's University Hospital, Dublin, Ireland
| | | | - Eugene Cassidy
- Cork University Hospital-CUH, Cork, Ireland.,University College Cork, Cork, Ireland
| | - William Lee
- University of Exeter, Exeter, United Kingdom
| | | |
Collapse
|
37
|
O'Flynn A, Barrett E, Murphy J. A brief literature review of the psychological benefits of volunteerism in watersports inclusion. Ir J Med Sci 2020; 190:731-734. [PMID: 33000359 DOI: 10.1007/s11845-020-02393-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 09/24/2020] [Indexed: 11/25/2022]
Abstract
The 2009 National Guidelines on Physical Activity for Ireland assert that 'all people with disabilities should be active'. Events such as the Watersports Inclusion Games invite individuals across the full spectrum of abilities to take part in physical activity in the form of adaptive watersports. This literature review aims to assess the value of inclusive watersport events such as this in the context of what is currently published on the motivation and benefits for volunteers in watersports inclusion. This is the first review that we are aware of on this subject. A literature review was performed using the Population, Exposures and Outcomes framework. Medical and psychological databases, journals and grey literature were searched using keywords, and articles were selected according to their relevance to the question. References from these articles were then hand-searched. The outcomes of this review suggest that, while there are many papers published on the benefits for volunteers in general and in sport, there is a relative paucity of literature on volunteers in inclusive sport, and even less relating to inclusive watersports. This review identifies a powerful opportunity to provide evidence to support the benefits of inclusive watersport for both participants and volunteers. Further research is required on why volunteers become involved in inclusive watersports and the benefits they derive from their involvement.
Collapse
Affiliation(s)
- Aela O'Flynn
- School of Medicine, University College Dublin, Belfield, Dublin 4, Ireland.
| | - Elizabeth Barrett
- School of Medicine, University College Dublin, Belfield, Dublin 4, Ireland
- Child and Adolescent Liaison Psychiatry, Children's University Hospital, Temple St, Dublin 1, Ireland
| | | |
Collapse
|
38
|
Hayes-Brady C, Barrett E. Narrative Matters: Understanding The Virgin Suicides - myth, memory and the medical gaze. Child Adolesc Ment Health 2020; 25:189-191. [PMID: 32748493 DOI: 10.1111/camh.12413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/07/2020] [Indexed: 10/23/2022]
Abstract
This essay explores representations of adolescent suicide in contemporary culture, arguing that the novel The Virgin Suicides highlights a resistance to the idea of agency and self-reflection in young women that inhibits understanding of mental health issues. The essay argues that the novel presents adolescent suicide as unknowable, using mythic and clinical language to distance the reader from the girls' experience and working to mystify and decontextualise suicide. Tracing patterns of representative language through the novel, the essay shows how the sisters of the title are prevented from speaking and being heard, contributing to their suicides. The essay further argues that this representation underscores the need for adolescents to feel heard in medical contexts and that the inclusion of fiction and popular literature in medical education and training may help provide a frame to explore issues related to adolescent mental health and suicide.
Collapse
Affiliation(s)
- Clare Hayes-Brady
- School of English Drama and Film, University College Dublin, Dublin, Ireland
| | - Elizabeth Barrett
- Temple Street Children's University Hospital, Dublin, Ireland.,Child and Adolescent Psychiatry, University College Dublin, Dublin, Ireland
| |
Collapse
|
39
|
Martiniuk AL, Colbran R, Ramsden R, Edwards M, Barrett E, O'Callaghan E, Bullock R, Lowe EFL, Karlson D, Curnow J, Gotch B, Kramer J, Bagnulo S, Rothnie IP, Hardaker L, Turner N, Wotherspoon A, Russell C. Capability ... what's in a word? Rural Doctors Network of New South Wales Australia is shifting to focus on the capability of rural health professionals. Rural Remote Health 2020; 20:5633. [PMID: 32650644 DOI: 10.22605/rrh5633] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Rural health services, and the workforces that provide those services, are under unprecedented pressure due to insufficient health workforce numbers and distribution of health workforce weighted to urban areas. This creates health service access issues in rural areas, compounding existing health inequalities between rural and urban people. Many approaches to date have aimed to rectify these issues, with moderate success. In this article we present a call to action to pursue a complementary approach: supporting the capability of the rural health workforce. We hypothesise that further exploring what it means to be a 'capable' rural health professional and what processes or conditions support or erode capability may additionally bolster efforts toward strong rural and remote health systems. The Capability Approach is a theory proposed by Amartya Sen, who was awarded the Nobel Memorial Prize in Economic Sciences in 1998 for this work. Although the Capability Approach inspired, for instance, the UN's Human Development Index, it has not been deeply explored in the context of rural health workforce. While still untested, a focus on capability may assist us in taking a broader view, which encompasses functioning and the freedom to pursue different functioning combinations. The feasible freedom and opportunities are paramount to the concept of capability. We posit that competence is static and the responsibility of the practitioner (and their education), but that capability is fluid and multi-dimensional and the responsibility of the practitioner, community and system. Therefore, we hypothesise that a focus on a Capability Approach, which modulates the relation between the contextual factors and outcomes, may provide us with greater understanding and avenues for action when we aim to improve outcomes such as rural health service sustainability. Developing a list of appropriate capabilities and setting strategies to support capability and its more nuanced domains may present unique opportunities for influence, and these may have positive effects on the rural health workforce. Of course it will need to be determined if improving rural primary health professionals' capability has positive impacts upon quality and access to care, and whether supporting capability is sustainable and worthy of investment.
Collapse
Affiliation(s)
| | - Richard Colbran
- NSW Rural Doctors Network (RDN), PO Box 1111, Mascot, NSW 1460, Australia
| | - Robyn Ramsden
- Deakin University, 221 Burwood Highway, Burwood, Victoria 3125, Australia
| | - Mike Edwards
- NSW Rural Doctors Network (RDN), PO Box 1111, Mascot, NSW 1460, Australia
| | - Elizabeth Barrett
- NSW Rural Doctors Network (RDN), PO Box 1111, Mascot, NSW 1460, Australia
| | - Emer O'Callaghan
- NSW Rural Doctors Network (RDN), PO Box 1111, Mascot, NSW 1460, Australia; and Suite 1, 53 Cleary Street, Hamilton, NSW 2303, Australia
| | - Ros Bullock
- NSW Rural Doctors Network (RDN), PO Box 1111, Mascot, NSW 1460, Australia
| | - Estrella F L Lowe
- NSW Rural Doctors Network (RDN), PO Box 1111, Mascot, NSW 1460, Australia; and Suite 1, 53 Cleary Street, Hamilton, NSW 2303, Australia
| | - Dave Karlson
- NSW Rural Doctors Network (RDN), PO Box 1111, Mascot, NSW 1460, Australia; and Suite 1, 53 Cleary Street, Hamilton, NSW 2303, Australia
| | - John Curnow
- NSW Rural Doctors Network (RDN), PO Box 1111, Mascot, NSW 1460, Australia
| | | | - John Kramer
- NSW Rural Doctors Network (RDN), PO Box 1111, Mascot, NSW 1460, Australia; and Beach Street Family Practice, Woolgoolga, NSW 2456, Australia
| | - Sharif Bagnulo
- NSW Rural Doctors Network (RDN), PO Box 1111, Mascot, NSW 1460, Australia
| | - Imogene P Rothnie
- NSW Rural Doctors Network (RDN), PO Box 1111, Mascot, NSW 1460, Australia; and Suite 1, 53 Cleary Street, Hamilton, NSW 2303, Australia
| | - Laura Hardaker
- NSW Rural Doctors Network (RDN), PO Box 1111, Mascot, NSW 1460, Australia
| | - Nicole Turner
- NSW Rural Doctors Network (RDN), PO Box 1111, Mascot, NSW 1460, Australia; and Suite 1, 53 Cleary Street, Hamilton, NSW 2303, Australia
| | - Arna Wotherspoon
- NSW Rural Doctors Network (RDN), PO Box 1111, Mascot, NSW 1460, Australia; and Suite 1, 53 Cleary Street, Hamilton, NSW 2303, Australia
| | - Chris Russell
- NSW Rural Doctors Network (RDN), PO Box 1111, Mascot, NSW 1460, Australia
| |
Collapse
|
40
|
Eyre M, Kaushik A, Barrett E, King MD, Pollak T, Dale RC, Byrne S, Lim M. Catatonic features in children and adolescents with N-methyl-d-aspartate receptor antibody encephalitis. BJPsych Open 2020; 6:e71. [PMID: 38424748 PMCID: PMC7443916 DOI: 10.1192/bjo.2020.55] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 06/09/2020] [Accepted: 06/09/2020] [Indexed: 12/13/2022] Open
Abstract
Catatonia is a psychomotor dysregulation syndrome of diverse aetiology, increasingly recognised as a prominent feature of N-methyl-d-aspartate receptor antibody encephalitis (NMDARE) in adults. No study to date has systematically assessed the prevalence and symptomatology of catatonia in children with NMDARE. We analysed 57 paediatric patients with NMDARE from the literature using the Bush-Francis Catatonia Rating Scale. Catatonia was common (occurring in 86% of patients), manifesting as complex clusters of positive and negative features within individual patients. It was both underrecognised and undertreated. Immunotherapy was the only effective intervention, highlighting the importance of prompt recognition and treatment of the underlying cause of catatonia.
Collapse
Affiliation(s)
- Michael Eyre
- Department of Neurology, Great Ormond Street Hospital for Children, UK
| | - Anya Kaushik
- Department of Child and Adolescent Psychiatry, South London and Maudsley NHS Foundation Trust, UK
| | - Elizabeth Barrett
- St Frances Clinic, Temple Street Children's University Hospital, Ireland; and Department of Child and Adolescent Psychiatry, School of Medicine and Medical Science, University College Dublin, Ireland
| | - Mary D. King
- Department of Pediatric Neurology, Temple Street Children's University Hospital, Ireland; and Academic Centre on Rare Disease, School of Medicine and Medical Science, University College Dublin, Ireland
| | - Thomas Pollak
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Russell C. Dale
- Neuroimmunology Group, Kids Neuroscience Centre, Children's Hospital at Westmead, University of Sydney, Australia
| | - Susan Byrne
- Children's Neurosciences, Evelina London Children's Hospital, UK; and FutureNeuro at Royal College of Surgeons, Ireland
| | - Ming Lim
- Children's Neurosciences, Evelina London Children's Hospital, UK; and Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, UK
| |
Collapse
|
41
|
Barrett E. No Health without Mental Health: Risks and Benefits of School Closures during a Pandemic. Ir Med J 2020; 113:91. [PMID: 32816426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- E Barrett
- UCD Child and Adolescent Psychiatry, University College Dublin, Belfield, Dublin 4
- Child and Adolescent Liaison Psychiatry, Childrens Health Ireland at Temple Street Children's University Hospital, Dublin 1
| |
Collapse
|
42
|
LoPresti K, Camera J, Barrett E, Gosse C, Johnson D, Amirthavasar G, Nashid J, Mbuagbaw M, Vanniyasingam T, Mbuagbaw L. Implementing the patient care collaborative model in three general internal medicine units: a mixed-methods healthcare improvement initiative. BMJ Open Qual 2020; 9:bmjoq-2019-000815. [PMID: 32354754 PMCID: PMC7213873 DOI: 10.1136/bmjoq-2019-000815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 04/01/2020] [Accepted: 04/08/2020] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND As part of the scale-up of the Patient Care Collaborative (PCC) at our institution, we explored staff perceptions and patient outcomes at different levels of model implementation in three general internal medicine units. METHODS We conducted a mixed-methods embedded experimental healthcare improvement initiative. In the qualitative strand, we conducted five focus group discussions. In the quantitative strand, we used hospital administrative data to compare outcomes (falls per 1000, median length of stay in days and resource use measured as resource intensity weights (RIW), before and after the implementation of the PCC, using χ2 tests, Wilcoxon's rank sum tests and interrupted time series analyses. RESULTS Staff showed considerable knowledge and acceptance of the PCC but expressed mixed feelings with regards to patient safety, workload, communication and teamwork. Staff perceptions varied by level of implementation of the PCC. A number of falls (overall) in the full implementation phase were not significantly different from the preimplementation phase (227 per 1000 vs 200 per 1000; p=0.449), but the number of moderate to severe falls dropped (12 vs 2 per 1000); p<0.001). Median length of stay (5 vs 6 days; p<0.001) and resource use were lower (0.1 vs 0.4; p<0.001) in the full implementation phase compared with the preimplementation phase. The trend analyses showed differences across units. CONCLUSIONS The PCC was moderately well adopted. Perceptions of the PCC among staff and patient outcomes are likely linked to the levels of implementation. The PCC resulted in improved safety, shorter hospital stays and lower costs of care.
Collapse
Affiliation(s)
- Kelly LoPresti
- St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | | | | | - Caroline Gosse
- St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | - Donna Johnson
- St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | | | - John Nashid
- St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada
| | | | | | - Lawrence Mbuagbaw
- St Joseph's Healthcare Hamilton, Hamilton, Ontario, Canada .,Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, Ontario, Canada
| |
Collapse
|
43
|
Lorenz RD, Lemmon MT, Maki J, Banfield D, Spiga A, Charalambous C, Barrett E, Herman JA, White BT, Pasco S, Banerdt WB. Scientific Observations With the InSight Solar Arrays: Dust, Clouds, and Eclipses on Mars. Earth Space Sci 2020; 7:e2019EA000992. [PMID: 32715027 PMCID: PMC7375148 DOI: 10.1029/2019ea000992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 03/03/2020] [Accepted: 04/01/2020] [Indexed: 06/11/2023]
Abstract
Records of solar array currents recorded by the InSight lander during its first 200 sols on Mars are presented. In addition to the geometric variation in illumination on seasonal and diurnal timescales, the data are influenced by dust suspended in the atmosphere and deposited on the solar panels. Although no dust devils have been detected by InSight's cameras, brief excursions in solar array currents suggest that at least some of the vortices detected by transient pressure drops are accompanied by dust. A step increase in array output (i.e., a "cleaning event") was observed to be directly associated with the passage of a strong vortex. Some quasiperiodic variations in solar array current are suggestive of dust variations in the planetary boundary layer. Nonzero array outputs before sunrise and after sunset are indicative of scattering in the atmosphere: A notable increase in evening twilight currents is observed associated with noctilucent clouds, likely of water or carbon dioxide ice. Finally, although the observations are intermittent (typically a few hours per sol) and at a modest sample rate (one to two samples per minute), three single-sample light dips are seen associated with Phobos eclipses. These results demonstrate that engineering data from solar arrays provide valuable scientific situational awareness of the Martian environment.
Collapse
Affiliation(s)
| | | | - Justin Maki
- Jet Propulsion LaboratoryCalifornia Institute of TechnologyPasadenaCAUSA
| | - Donald Banfield
- Cornell Center for Astrophysics and Planetary ScienceIthacaNYUSA
| | - Aymeric Spiga
- Laboratoire de Météorologie Dynamique (LMD/IPSL)Sorbonne Université, Centre National de la Recherche Scientifique, École Polytechnique, École Normale SupérieureParisFrance
- Institut Universitaire de FranceParisFrance
| | - Constantinos Charalambous
- Department of Electrical and Electronic EngineeringImperial College, South Kensington CampusLondonUK
| | - Elizabeth Barrett
- Jet Propulsion LaboratoryCalifornia Institute of TechnologyPasadenaCAUSA
| | - Jennifer A. Herman
- Jet Propulsion LaboratoryCalifornia Institute of TechnologyPasadenaCAUSA
| | | | | | - W. Bruce Banerdt
- Jet Propulsion LaboratoryCalifornia Institute of TechnologyPasadenaCAUSA
| |
Collapse
|
44
|
Riese F, Guloksuz S, Roventa C, Fair J, Haravuori H, Rolko T, Flynn D, Giacco D, Banjac V, Jovanovic N, Bayat N, Palumbo C, Rusaka M, Kilic O, Augėnaitė J, Nawka A, Zenger M, Kekin I, Wuyts P, Barrett E, Bausch-Becker N, Mikaliūnas J, del Valle E, Feffer K, Lomax G, Marques J, Jauhar S. Pharmaceutical industry interactions of psychiatric trainees from 20 European countries. Eur Psychiatry 2020; 30:284-90. [DOI: 10.1016/j.eurpsy.2014.09.417] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 09/15/2014] [Accepted: 09/21/2014] [Indexed: 11/30/2022] Open
Abstract
AbstractBackground:Interactions between the pharmaceutical industry (PI) and psychiatrists have been under scrutiny recently, though there is little empirical evidence on the nature of the relationship and its intensity at psychiatry trainee level. We therefore studied the level of PI interactions and the underlying beliefs and attitudes in a large sample of European psychiatric trainees.Methods:One thousand four hundred and forty-four psychiatric trainees in 20 European countries were assessed cross-sectionally, with a 62-item questionnaire.Results:The total number of PI interactions in the preceding two months varied between countries, with least interactions in The Netherlands (M (Mean) = 0.92, SD = 1.44, range = 0–12) and most in Portugal (M = 19.06, SD = 17.44, range = 0–100). Trainees were more likely to believe that PI interactions have no impact on their own prescribing behaviour than that of other physicians (M = 3.30, SD = 1.26 vs. M = 2.39, SD = 1.06 on a 5-point Likert scale: 1 “completely disagree” to 5 “completely agree”). Assigning an educational role to the pharmaceutical industry was associated with more interactions and higher gift value (IRR (incidence rate ratio) = 1.21, 95%CI = 1.12–1.30 and OR = 1.18, 95%CI = 1.02–1.37).Conclusions:There are frequent interactions between European psychiatric trainees and the PI, with significant variation between countries. We identified several factors affecting this interaction, including attribution of an educational role to the PI. Creating alternative educational opportunities and specific training dedicated to PI interactions may therefore help to reduce the impact of the PI on psychiatric training.
Collapse
|
45
|
Barrett E, Jacobs B, Klasen H, Herguner S, Agnafors S, Banjac V, Bezborodovs N, Cini E, Hamann C, Huscsava MM, Kostadinova M, Kramar Y, Maravic VM, McGrath J, Molteni S, Moron-Nozaleda MG, Mudra S, Nikolova G, Vorkas KP, Prata AT, Revet A, Joseph JR, Serbak R, Tomac A, Van den Steene H, Xylouris G, Zielinska A, Hebebrand J. Correction to: The child and adolescent psychiatry: study of training in Europe (CAP‑STATE). Eur Child Adolesc Psychiatry 2020; 29:409-411. [PMID: 31956946 DOI: 10.1007/s00787-020-01473-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The original article has been corrected.
Collapse
Affiliation(s)
- Elizabeth Barrett
- Child and Adolescent Psychiatry, University College Dublin, Dublin, Ireland. .,Child and Adolescent Liaison Psychiatry, Children's University Hospital, Temple St., Dublin 1, Ireland.
| | - Brian Jacobs
- Child and Adolescent Psychiatry, South London and Maudsley Hospital, London, UK.,Section of Child and Adolescent Psychiatry, European Union of Medical Specialists (UEMS-CAP), Brussels, Belgium
| | - Henrikje Klasen
- Department of Psychiatry, Leiden University Medical Centre, Leiden, Netherlands
| | - Sabri Herguner
- Child and Adolescent Psychiatry, Private Practice, Ankara, Turkey
| | - Sara Agnafors
- Division of Child and Adolescent Psychiatry, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, 581 85, Linköping, Sweden
| | - Visnja Banjac
- Clinic of Psychiatry, University Clinical Center of the Republic of Srpska, Radoja Domanovica 21, Banjaluka, Bosnia and Herzegovina
| | - Nikita Bezborodovs
- Department of Psychiatry and Narcology, Riga Stradins University, Tvaika iela 2, Riga, 1005, Latvia
| | - Erica Cini
- Child and Adolescent Psychiatrist, East London Foundation Trust, East London Foundation Trust, London, UK
| | - Christoph Hamann
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Forschungsabteilung KJP UPD Bern, Bolligenstrasse 111, Haus A, 3000, Bern 60, Switzerland
| | - Mercedes M Huscsava
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Maya Kostadinova
- Child and Adolescent Psychiatrist, University Hospital "Alexandrovska", Sofia, Bulgaria.,DNCC CAMHS, 44 North Great George's Street, Dublin 1, Ireland
| | - Yuliia Kramar
- TMA ''PSYCHIATRY", Kirilivska str. 103, Kiev, Ukraine
| | - Vanja Mandic Maravic
- Department for Psychotic Disorders, Institute of Mental Health, Belgrade, Serbia
| | - Jane McGrath
- Child and Adolescent Psychiatrist, Linn Dara Child and Adolescent Mental Health Service, Cherry Orchard Hospital, Ballyfermot, Dublin 10, Ireland
| | - Silvia Molteni
- Child Neuropsychiatry Unit, Department of Brain and Behavioral Sciences, University of Pavia, via Mondino 2, 27100, Pavia, Italy
| | - Maria Goretti Moron-Nozaleda
- Department of Psychiatry and Clinical Psychology, Neurodevelopment Outpatient Clinic and Day Hospital for Pre-pubertal Children, Niño Jesús Children's Hospital, Hospital Infantil Universitario Niño Jesús, av/Menéndez Pelayo 65, 28009, Madrid, Spain
| | - Susanne Mudra
- Department of Child and Adolescent Psychiatry, Psychotherapy und Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, W35, 20246, Hamburg, Germany
| | - Gordana Nikolova
- Department of Child and Adolescent Psychiatry, University Clinic of Psychiatry, Belgradska b.b, 1000, Skopje, Macedonia
| | - Kallistheni Pantelidou Vorkas
- Child and Adolescent Psychiatrist, President of Cypriot Society of Child and Adolescent Psychiatry, 77, Kennedy Ave, 1076, Nicosia, Cyprus
| | - Ana Teresa Prata
- Child and Adolescent Psychiatry Specialty, Centro Hospitalar de Lisboa Central, Hospital Dona Estefânia, Rua Jacinta Marto, 1169-045, Lisbon, Portugal
| | - Alexis Revet
- Child and Adolescent Psychiatrist, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Toulouse University Hospital (CHU de Toulouse), UMR1027, INSERM, University of Toulouse III, Toulouse, France
| | - Judeson Royle Joseph
- Child and Adolescent Psyciatric Department, University Hospital of North-Norway, Tromsø, Norway
| | - Reelika Serbak
- Child Psychiatrist, Tallinn Children´s Hospital, Tervise 28, Tallinn, Estonia
| | - Aran Tomac
- Child and Adolescent Psychiatry and in General (Adult) Psychiatry, CAMHS Clare, Unit 6, Quin Rd. Business Pk. Quin Rd., Ennis, Ireland
| | - Helena Van den Steene
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Belgium
| | - Georgios Xylouris
- Child and Adolescent Psychiatrist, General Childrens Hospital "Agia Sophia", Athens, Greece
| | - Anna Zielinska
- Department of Child and Adolescent Psychiatry, Public Pediatric Teaching Clinical Hospital, Medical University of Warsaw, 63A, Żwirki i Wigury Str., 02-091, Warsaw, Poland
| | - Johannes Hebebrand
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Duisburg, Germany
| |
Collapse
|
46
|
Fitzgerald E, Foley D, McNamara R, Barrett E, Boylan C, Butler J, Morgan S, Okafor I. Trends in Mental Health Presentations to a Paediatric Emergency Department. Ir Med J 2020; 113:20. [PMID: 32401083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Aims This study aimed to analyse trends in mental health presentations to the Emergency Department (ED), which anecdotally had increased over the past decade. Methods The ED's electronic 'Symphony' system was used to identify the annual number of presentations categorised as having a mental health complaint from 2006-2017. A detailed analysis was performed on presentations over a one-year period. Results The number of presentations increased from 69 in 2006 to a peak of 432 in 2016 (526% increase). The overall admission rate was 33.3%(n=99), while 52.5%(n=156) of presentations occurred outside of standard working hours. Similar increases were documented by other ED's worldwide, and the WHO estimate that neuropsychiatric disorders will become one of the top five causes of morbidity, mortality and disability among children by 2020. Conclusion With the number of mental health presentations dramatically increasing, carefully designed and integrated strategies are required to pro-actively tackle this growing epidemic.
Collapse
Affiliation(s)
- E Fitzgerald
- Emergency Department, Children's University Hospital, Temple Street, Dublin
| | - D Foley
- Emergency Department, Children's University Hospital, Temple Street, Dublin
| | - R McNamara
- Emergency Department, Children's University Hospital, Temple Street, Dublin
| | - E Barrett
- Department of Psychiatry, Children's University Hospital, Temple Street, Dublin
| | - C Boylan
- Department of Psychiatry, Children's University Hospital, Temple Street, Dublin
| | - J Butler
- Department of Psychiatry, Children's University Hospital, Temple Street, Dublin
| | - S Morgan
- St. Patrick's University Hospital, Dublin
| | - I Okafor
- Emergency Department, Children's University Hospital, Temple Street, Dublin
| |
Collapse
|
47
|
Abstract
UNLABELLED Physician burnout has reached epidemic levels in many countries, contributing to adverse personal, patient and service outcomes. Adverse socioeconomic conditions, such as the economic downturn in the Ireland post 2008, contribute to a situation of increased demand but inadequate resources. Given a recent unprecedented increase in referrals to Irish child and adolescent mental health services (CAMHS), coupled with a fragmented and poorly resourced service, it is important to reflect on consultant child psychiatrists' well-being. OBJECTIVES To report on the level of burnout among consultants working in CAMHS in Ireland using a cross-sectional design. SETTING Community CAMHS in Ireland. PARTICIPANTS An online questionnaire was sent to all consultant child psychiatrists registered with the Irish Medical Council (n=112). Fifty-two consultants replied (46% response rate). PRIMARY OUTCOME MEASURES Questions assessed demographic and occupational details, career satisfaction and perceived management, government and public support. The Copenhagen Burnout Inventory measured personal, work and patient-related burnout. RESULTS The prevalence of moderate or higher levels of work-related and personal burnout was 75% and 72.3%, respectively. Fewer (n=14, 26.9%) experienced patient-related burnout. There was a strong correlation between work burnout and personal (r=0.851, n=52, p<0.001) and patient-related burnout (r=0.476, n=52, p<0.001). Lack of confidence in government commitment to investment in CAMHS (p<0.001) and perceived ineffective management by health authorities (p=0.002) were associated with higher burnout scores. Few consultants (n=11, 21%) felt valued in their job. The majority (n=36, 69%) had seriously considered changing jobs, and this was positively associated with higher burnout (p<0.001). Higher burnout scores were present in those (n=15, 28.8%) who would not retrain in child psychiatry (p=0.002). CONCLUSION The high level of burnout reported by respondents in this study, and ambivalence about child psychiatry as a career choice has huge professional and service implications. Urgent organisational intervention to support consultant psychiatrists' well-being is required.
Collapse
Affiliation(s)
- Fiona McNicholas
- School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
- Lucena Clinic, St John of God, Dublin, Ireland
- Our Lady's Hospital for Sick Children, Dublin, Ireland
| | - Sonita Sharma
- School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | - Cliodhna Oconnor
- School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | - Elizabeth Barrett
- School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
- Temple Street University Hospital, Dublin, Ireland
| |
Collapse
|
48
|
Barrett E, Jacobs B, Klasen H, Herguner S, Agnafors S, Banjac V, Bezborodovs N, Cini E, Hamann C, Huscsava MM, Kostadinova M, Kramar Y, Maravic VM, McGrath J, Molteni S, Moron-Nozaleda MG, Mudra S, Nikolova G, Vorkas KP, Prata AT, Revet A, Joseph JR, Serbak R, Tomac A, Van den Steene H, Xylouris G, Zielinska A, Hebebrand J. The child and adolescent psychiatry: study of training in Europe (CAP-STATE). Eur Child Adolesc Psychiatry 2020; 29:11-27. [PMID: 31845068 DOI: 10.1007/s00787-019-01416-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 09/29/2019] [Indexed: 10/25/2022]
Abstract
There is great cultural diversity across Europe. This is reflected in the organisation of child and adolescent mental health (CAMH) services and the training of the respective professionals in different countries in Europe. Patients and their parents will want a high quality, knowledgeable, and skillful service from child and adolescent psychiatrists (CAPs) wherever they see them in Europe. A European comparison of training programs allows all stakeholders in different European countries to assess the diversity and to initiate discussions as to the introduction of improvements within national training programs. Major issues to be addressed in comparing child and adolescent psychiatric training programs across Europe include: (1) formal organisation and content of training programs and the relationship to adult psychiatry and paediatrics; (2) flexibility of training, given different trainee interests and that many trainees will have young families; (3) quality of governance of training systems; (4) access to research; and (5) networking. The Child and Adolescent Psychiatry-Study of Training in Europe (CAP-State) is a survey of training for child and adolescent psychiatrists (CAPs) across European countries. It aims to revisit and extend the survey carried out in 2006 by Karabekiroglu and colleagues. The current article is embedded in a special issue of European Child + Adolescent Psychiatry attempting to for the first time address training in CAP at the European and global levels. Structured information was sought from each of 38 European and neighboring countries (subsequently loosely referred to as Europe) and obtained from 31. The information was provided by a senior trainee or recently qualified specialist and their information was checked and supplemented by information from a senior child and adolescent psychiatry trainer. Results showed that there is a very wide range of provision of training in child and adolescent psychiatry in different countries in Europe. There remains very substantial diversity in training across Europe and in the degree to which it is subject to national oversight and governance. Some possible reasons for this variation are discussed and some recommendations made.
Collapse
Affiliation(s)
- Elizabeth Barrett
- Child and Adolescent Psychiatry, University College Dublin, Dublin, Ireland. .,Child and Adolescent Liaison Psychiatry, Children's University Hospital, Temple St., Dublin 1, Ireland.
| | - Brian Jacobs
- Child and Adolescent Psychiatry, South London and Maudsley Hospital, London, UK.,Section of Child and Adolescent Psychiatry, European Union of Medical Specialists (UEMS-CAP), Brussels, Belgium
| | - Henrikje Klasen
- Department of Psychiatry, Leiden University Medical Centre, Leiden, Netherlands
| | - Sabri Herguner
- Child and Adolescent Psychiatry, Private Practice, Ankara, Turkey
| | - Sara Agnafors
- Division of Child and Adolescent Psychiatry, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, 581 85, Linköping, Sweden
| | - Visnja Banjac
- Clinic of Psychiatry, University Clinical Center of the Republic of Srpska, Radoja Domanovica 21, Banjaluka, Bosnia and Herzegovina
| | - Nikita Bezborodovs
- Department of Psychiatry and Narcology, Riga Stradins University, Tvaika iela 2, Riga, 1005, Latvia
| | - Erica Cini
- Child and Adolescent Psychiatrist, East London Foundation Trust, East London Foundation Trust, London, UK
| | - Christoph Hamann
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Forschungsabteilung KJP UPD Bern, Bolligenstrasse 111, Haus A, 3000, Bern 60, Switzerland
| | - Mercedes M Huscsava
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Maya Kostadinova
- Child and Adolescent Psychiatrist, University Hospital "Alexandrovska", Sofia, Bulgaria.,DNCC CAMHS, 44 North Great George's Street, Dublin 1, Ireland
| | - Yuliia Kramar
- TMA ''PSYCHIATRY", Kirilivska str. 103, Kiev, Ukraine
| | - Vanja Mandic Maravic
- Department for Psychotic Disorders, Institute of Mental Health, Belgrade, Serbia
| | - Jane McGrath
- Child and Adolescent Psychiatrist, Linn Dara Child and Adolescent Mental Health Service, Cherry Orchard Hospital, Ballyfermot, Dublin 10, Ireland
| | - Silvia Molteni
- Child Neuropsychiatry Unit, Department of Brain and Behavioral Sciences, University of Pavia, via Mondino 2, 27100, Pavia, Italy
| | - Maria Goretti Moron-Nozaleda
- Department of Psychiatry and Clinical Psychology, Neurodevelopment Outpatient Clinic and Day Hospital for Pre-pubertal Children, Niño Jesús Children's Hospital, Hospital Infantil Universitario Niño Jesús, av/Menéndez Pelayo 65, 28009, Madrid, Spain
| | - Susanne Mudra
- Department of Child and Adolescent Psychiatry, Psychotherapy und Psychosomatics, University Medical Center Hamburg-Eppendorf, Martinistr. 52, W35, 20246, Hamburg, Germany
| | - Gordana Nikolova
- Department of Child and Adolescent Psychiatry, University Clinic of Psychiatry, Belgradska b.b, 1000, Skopje, Macedonia
| | - Kallistheni Pantelidou Vorkas
- Child and Adolescent Psychiatrist, President of Cypriot Society of Child and Adolescent Psychiatry, 77, Kennedy Ave, 1076, Nicosia, Cyprus
| | - Ana Teresa Prata
- Child and Adolescent Psychiatry Specialty, Centro Hospitalar de Lisboa Central, Hospital Dona Estefânia, Rua Jacinta Marto, 1169-045, Lisbon, Portugal
| | - Alexis Revet
- Child and Adolescent Psychiatrist, Department of Child and Adolescent Psychiatry, Faculty of Medicine, Toulouse University Hospital (CHU de Toulouse), UMR1027, INSERM, University of Toulouse III, Toulouse, France
| | - Judeson Royle Joseph
- Child and Adolescent Psyciatric Department, University Hospital of North-Norway, Tromsø, Norway
| | - Reelika Serbak
- Child Psychiatrist, Tallinn Children´s Hospital, Tervise 28, Tallinn, Estonia
| | - Aran Tomac
- Child and Adolescent Psychiatry and in General (Adult) Psychiatry, CAMHS Clare, Unit 6, Quin Rd. Business Pk. Quin Rd., Ennis, Ireland
| | - Helena Van den Steene
- Collaborative Antwerp Psychiatric Research Institute (CAPRI), University of Antwerp, Universiteitsplein 1, 2610, Wilrijk, Belgium
| | - Georgios Xylouris
- Child and Adolescent Psychiatrist, General Childrens Hospital "Agia Sophia", Athens, Greece
| | - Anna Zielinska
- Department of Child and Adolescent Psychiatry, Public Pediatric Teaching Clinical Hospital, Medical University of Warsaw, 63A, Żwirki i Wigury Str., 02-091, Warsaw, Poland
| | - Johannes Hebebrand
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Duisburg, Germany
| |
Collapse
|
49
|
Van der Graaf P, Francis O, Doe E, Barrett E, O'Rorke M, Docherty G. Structural approaches to knowledge exchange: comparing practices across five centres of excellence in public health. J Public Health (Oxf) 2019. [PMID: 29538725 DOI: 10.1093/pubmed/fdx150] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background In 2008, five UKCRC Public Health Research Centres of Excellence were created to develop a coordinated approach to policy and practice engagement and knowledge exchange. The five Centres have developed their own models and practices for achieving these aims, which have not been compared in detail to date. Methods We applied an extended version of Saner's model for the interface between science and policy to compare five case studies of knowledge exchanges, one from each centre. We compared these practices on three dimensions within our model (focus, function and type/scale) to identify barriers and facilitators for knowledge exchange. Results The case studies shared commonalities in their range of activities (type) but illustrated different ways of linking these activities (function). The Centres' approaches ranged from structural to more organic, and varied in the extent that they engaged internal audiences (focus). Each centre addressed policymakers at different geographical levels and scale. Conclusions This article emphasizes the importance of linking a range of activities that engage policymakers at different levels, intensities and points in their decision-making processes to build relationships. Developing a structural approach to knowledge exchange activities in different contexts presents challenges of resource, implementation and evaluation.
Collapse
Affiliation(s)
- P Van der Graaf
- Fuse, the Centre for Translational Research in Public Health, Teesside University, Middlesbrough TS13BA,UK
| | - O Francis
- Centre for Diet and Activity Research, University of Cambridge, Cambridge CB2 0QQ, UK
| | - E Doe
- Development and Evaluation of Complex Interventions for Public Health Improvement, Cardiff University, Cardiff CF10 3BD,UK
| | - E Barrett
- Centre of Excellence for Public Health in Northern Ireland, Queen's University, Belfast BT7 1NN,UK
| | - M O'Rorke
- Centre of Excellence for Public Health in Northern Ireland, Queen's University, Belfast BT7 1NN,UK
| | - G Docherty
- UK Centre for Tobacco & Alcohol Studies, University of Nottingham, Nottingham NG5 1PB,UK
| |
Collapse
|
50
|
Sidhu N, Wang Y, Barrett E, Casas M. Prevalence and presentation patterns of enamel hypomineralisation (MIH and HSPM) among paediatric hospital dental patients in Toronto, Canada: a cross-sectional study. Eur Arch Paediatr Dent 2019; 21:263-270. [DOI: 10.1007/s40368-019-00477-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 09/09/2019] [Indexed: 10/25/2022]
|