An examination of the factors that influence the publication or non-publication of mental health nursing research presented at national or international nursing conferences

Mental health nurses are required to be able to identify and access the current evidence surrounding a particular topic and evaluate and decide upon the best care approach to people with mental health problems. This is aided by specific guidance on how to facilitate access to and deliver the best quality evidence-based care. This is most commonly acquired by accessing evidence through hand searching publications or through electronic sources (databases, web search engines or internet publications). However, evidence indicates that only a small proportion of mental health nursing research is published and that many nurses carry out research that is not published. Although, it is difficult to judge the quality of unpublished research the likelihood is that a number of high quality mental health nursing research projects are not published and are therefore not available to be evaluated as part of the evidence base of care. There has been relatively little examination of the reasons underpinning publication of nursing research. This project examined the factors that influence the publication or non-publication of mental health nursing research presented at national or international nursing conferences in the UK

Section 5(4) of the Mental Health Act 1983: a review of local policy and guidance in England and Wales

Purpose – The purpose of this study is to review policy or guidance on the implementation of Section 5(4) written by NHS mental health trusts in England and health boards in Wales. Design/methodology/approach - A Freedom of Information request was submitted to all trusts in England (n = 57) and health boards in Wales (n = 7) asking them to provide a copy of any policy or guidance on the implementation of Section 5(4). Documents were analysed using content analysis. Specific attention was given to any deviations from the national Mental Health Act Codes of Practice. Findings - Forty-one (67.2%) organisations had a policy on the implementation of Section 5(4). There was a high level of consistency between local guidance and the Mental Health Act Codes of Practice. There were however; different interpretations of the guidance and errors that could lead to misuse of the section. Some policies contained useful guidance that could be adopted by future versions of the national Codes of Practice. Research implications - The research has demonstrated the value of examining the relationship between national and local guidance. Further research should be undertaken on the frequency and reasons for any reuse of the section. Practical implications - Greater attention should be given to considering the necessity of local policy, given the existence of national Codes of Practice. Originality - This is the only research examining the policy framework for the implementation of Section 5(4). Keywords: Best practice, in-patient, Mental Health Act, Nurses’ holding power, Policy, Section 5(4). Paper type: Researc

Leave for informally admitted patients: a review of written guidance produced by mental health services in England and Wales

Purpose (limit 100 words) To report on the use and content of written guidance produced by mental health services in England and Wales describing hospital leave for informally admitted patients. Design/methodology/approach (limit 100 words) Guidance on leave was requested from NHS mental health trusts in England and health boards in Wales (n = 61) using a Freedom of Information submission. Data were analysed using content analysis. Findings (limit 100 words) Thirty-two organisations had a leave policy for informal patients. Policies varied considerably in content and quality. The content of policies was not supported by research evidence. Organisations appeared to have developed their policies by either adapting or copying the guidance on section 17 leave outlined in the Mental Health Act Codes of Practice for England and Wales (DH, 2016; WG, 2016). Definitions of important terms, for example leave and hospital premises, were either absent or poorly defined. Finally, some organisations appeared to be operating pseudo-legal coercive contracts to prevent informal patients leaving hospital wards. Research limitations/implications (limit 100 words) Research should be undertaken to explore the impact of local policies on the informal patient’s right to life and liberty. Practical implications (limit 100 words) All NHS organisations need to develop an evidence-based policy to facilitate the informal patient’s right to take leave. A set of national standards, that organisations are required to comply with, would help to standardise the content of leave policies. Originality/value (limit 100 words) This is the first study to examine the use and content of local policies describing how informal patients can take leave from hospital

The implementation of Section 5(4) of the Mental Health Act 1983.

Section 5(4) (nurse's holding power) of the Mental Health Act 1983 empowers mental health nurses to legally prevent an informal in-patient from leaving hospital for up to six hours. The section may be applied for the patient's health or safety or the protection of others. Since its introduction in September 1983 there have been 34,000 applications of the section, an average of 1460 per annum. The application of Section 5(4) is likely to: lead to further detention under the Act; have implications for the practice of nurses; and affect the care received by patients in the aftermath of its use. However, the literature review revealed a paucity of research on the subject. The existing research has focused on three main areas: nurses' opinions of their holding power; their knowledge of Section 5(4); and trends associated with the implementation of the section. However, no attempts have been made to examine the events before, during and after the implementation of Section 5(4). This qualitative study sought to address this deficit by examining why and how Section 5(4) was implemented from the perspective of the nurses and patients involved in the process.A collective case study approach was utilised to generate data from one mental health NHS Trust over a period of one year. Data were generated from three sources: archival (statistical) records on 803 applications of the section; documentary accounts of the detention process, for example nursing notes; and interviews with 30 nurses and four patients. Within- and cross-case narrative analysis was undertaken on the data set. The method of narrative analysis employed was developed specifically for this study.The analysis produced a six-part typology of nurses' stories that explained why Section 5(4) was implemented. The six types were: 'health, safety or protection'; Tack of knowledge'; 'catalyst'; 'medical inaction'; 'self-protection'; and 'last resort'. The analysis also constructed a collective story of nurses' experiences that identified the key stages in the detention process. Stories were also constructed from patients' experiences of being detained. These stories generated in-depth accounts of patients' admission to hospital, the events leading up to their detention, the implementation of Section 5(4), and the aftermath of their experiences.The implications of the study's findings are considered for education, policy, practice and research and focus on four main areas: informal admission to hospital; information giving; reasons for implementing Section 5(4); and the consequences of the detention for both nurses and patients

Perceptions, attitudes and cultural understandings of mental health in Nigeria: a scoping review of published literature

Mental health is a public health challenge with lack of understanding, great institutional neglect and widespread stigma in Nigeria. There is also a dearth of secondary review studies exploring knowledge, perceptions, and attitudes towards persons with mental health disorders in Nigeria. The aim of this scoping review was to explore the knowledge, perceptions, and attitudes of Nigerians towards mental health issues. Sixty-four articles were identified as meeting the eligibility criteria. The most common determinants of mental health disorders as perceived by Nigerians were supernatural causes such as possession of evil spirits, sorcery, witchcraft, and divine punishment. In addition, a significant number of articles attributed the cause to drug or alcohol misuse. Social distancing and avoidance were expressed in all papers that looked at attitudes towards people with mental disorders. The research showed that Nigerians held supernatural belief as the cause of mental disorders and religion is a significant cultural aspect for Nigerians. Therefore, collaboration with religious and traditional institutions could help improve knowledge and awareness. Further qualitative studies are needed to explore the lived experiences of Nigerians particularly, in the northern regions of the country

A pilot study exploring the experiences of mental health among internal migrants in Nigeria

Purpose: This article identified and explored factors that impact on the mental health of internal migrants in Nigeria. Design: A pilot qualitative phenomenological study with four participants from the Federal Capital Territory and Lagos states in Nigeria. Semi-structured interviews were undertaken using the application known as Zoom© from August to September 2019. Interviews were analysed using the six steps of thematic analyse described by Braun and Clarke (2006). Findings: Five themes emerged from this study; ‘purpose of migration’, ‘experience of migration’, ‘coping strategies’, ‘knowledge of mental health’, and ‘impact of internal migration on mental health’. In summary, the participants described the reasons or migrating as work, marriage, and wanting a better life. They described having accommodation issues, difficulties finding a job after migration and also experienced challenges of building new friendships. Participants also explained that religion and perseverance helped them cope after relocating. Practical implications: The pilot study concludes that the stress of internal migration combined with socio-economic challenges and lack of social support can result in a lack of ability to settle in a new culture (ethnic group) which may likely result in poor mental health. Originality: This article contributes to existing knowledge of mental health in Nigeria, a sensitive topic that is rarely discussed in the country, by studying an under-researched group (internal migrants)

Membrane properties specialize mammalian inner hair cells for frequency or intensity encoding

The auditory pathway faithfully encodes and relays auditory information to the brain with remarkable speed and precision. The inner hair cells (IHCs) are the primary sensory receptors adapted for rapid auditory signaling, but they are not thought to be intrinsically tuned to encode particular sound frequencies. Here I found that under experimental conditions mimicking those in vivo, mammalian IHCs are intrinsically specialized. Low-frequency gerbil IHCs (~0.3 kHz) have significantly more depolarized resting membrane potentials, faster kinetics, and shorter membrane time constants than high-frequency cells (~30 kHz). The faster kinetics of low-frequency IHCs allow them to follow the phasic component of sound (frequency-following), which is not required for high-frequency cells that are instead optimally configured to encode sustained, graded responses (intensity-following). The intrinsic membrane filtering of IHCs ensures accurate encoding of the phasic or sustained components of the cell’s in vivo receptor potential, crucial for sound localization and ultimately survival

A tectorin-based matrix and planar-cell-polarity genes are required for normal collagen-fibril orientation in the developing tectorial membrane

The tectorial membrane is an extracellular structure of the cochlea. It develops on the surface of an epithelium and contains collagen fibrils embedded in a tectorin-based matrix. The collagen fibrils are oriented radially with an apically-directed slant - a feature considered critical for hearing. To determine how this pattern is generated, collagen-fibril formation was examined in mice lacking a tectorin-based matrix, epithelial cilia, or the planar-cell-polarity genes Vangl2 and Ptk7. In wild-type mice, collagen-fibril bundles appear within a tectorin-based matrix at E15.5 and, as fibril-number rapidly increases, become co-aligned and correctly oriented. Epithelial-width measurements and data from Kif3acKO mice suggest, respectively, radial stretch and cilia play little, if any, role in determining normal collagen-fibril orientation, but evidence from tectorin-knockout mice indicates confinement is important. PRICKLE2 distribution reveals the planar-cell-polarity axis in the underlying epithelium is organised along the length of the cochlea and, in mice in which this polarity is disrupted, the apically-directed collagen offset is no longer observed. These results highlight the importance of the tectorin-based matrix and epithelial signals for precise collagen organisation in the tectorial membran

Localization of the Cochlear Amplifier in Living Sensitive Ears

BACKGROUND: To detect soft sounds, the mammalian cochlea increases its sensitivity by amplifying incoming sounds up to one thousand times. Although the cochlear amplifier is thought to be a local cellular process at an area basal to the response peak on the spiral basilar membrane, its location has not been demonstrated experimentally. METHODOLOGY AND PRINCIPAL FINDINGS: Using a sensitive laser interferometer to measure sub-nanometer vibrations at two locations along the basilar membrane in sensitive gerbil cochleae, here we show that the cochlea can boost soft sound-induced vibrations as much as 50 dB/mm at an area proximal to the response peak on the basilar membrane. The observed amplification works maximally at low sound levels and at frequencies immediately below the peak-response frequency of the measured apical location. The amplification decreases more than 65 dB/mm as sound levels increases. CONCLUSIONS AND SIGNIFICANCE: We conclude that the cochlea amplifier resides at a small longitudinal region basal to the response peak in the sensitive cochlea. These data provides critical information for advancing our knowledge on cochlear mechanisms responsible for the remarkable hearing sensitivity, frequency selectivity and dynamic range