AUDIT ON THE QUALITY OF HANDOVERS OF A PSYCHIATRIC LIAISON TEAM IN THE UK: A SHORT REPORT

Background: The importance of handovers has been recognised and proven in clinical practice. In liaison psychiatry, this is particularly important due to the high turnover of patients seen, the shift work pattern and the number of member staff engaging in this process. An Audit on the Quality of Handovers was carried out within a Psychiatric Liaison team of a General hospital in UK with an intention to review and improve this. Method: Handovers were evaluated against the gold standard of the SBAR tool (Situation/Background/Assessment/Recommendations) over a period of 4 weeks. Handovers were assessed by 2 members of staff (a Consultant & a Specialty doctor). Data was analysed using Microsoft Excel. Results: Results showed that the team’s handover practice is mostly "Good" but there was also an amount of "Poor" under "Situation & Background", mostly presented by mid-grade doctors & trainees. Nurses scored higher than medics on overall rating, nearly 50%.This could be attributed to the fact that handovers form an essential & integral part of Nurse’s training & culture. Also mid-grade (staff grade) doctors have had a significant amount of "excellent" scoring that other groups didn\u27t have, mostly on the Assessment & Recommendations domains, which can be attributed to the fact that importance is stressed more on the assessment & treatment module by the doctors. Conclusion: The multi-disciplinary composition of the liaison psychiatry team has a positive impact on the patient care. This audit has revealed overall good communication amongst the members of the team, nevertheless one that needs some improvement, particularly amongst the doctors. Doctors tend to focus on the remedial (assessment & treatment) module rather than the holistic approach. SBAR remains an effective & handy tool to improve the handover quality. A re-audit will be carried out in 6months time to assess the improvements observed following the implementation of this new tool

FACTITIOUS HYPOGLYCAEMIA: A CASE REPORT AND LITERATURE REVIEW

Background: Factitious hypoglycaemia is a form of factitious disorder imposed on self with high morbidity and mortality. It is therefore important to be aware of the key demographic and contextual risk factors for factitious hypoglycaemia, as well the investigations and management options available for suspected cases. Subjects and methods: In this article we describe a case report and literature review of factitious hypoglycaemia. The search was conducted using the PubMed database and identified 23 case reports of 31 patients aged 18 or over with insulin-induced factitious hypoglycaemia. Results: The average age of these patients was 33.7 (±13.5) years, the female: male ratio was 4.3:1, 38% had medical occupations or past medical training, 53% had diabetes mellitus, and 41% had a positive psychiatric history. Misdiagnoses were common and often resulted in inappropriate treatment. Very few cases discussed psychiatric management. Conclusions: Factitious hypoglycaemia is more commonly reported in middle-aged females, in a medical profession, with a past medical history of diabetes mellitus and psychiatric illness. However, it may affect a variety of patients and the absence of these features should not discourage a diagnosis. C-peptide levels and insulin assays can help identify factitious hypoglycaemia over other causes of hypoglycaemia, and management should include a greater focus on psychiatric treatment

Study protocol for an adaptive, multi-arm, multi-stage (MAMS) randomised controlled trial of brief remotely delivered psychosocial interventions for people with serious mental health problems who have experienced a recent suicidal crisis: Remote Approaches to Psychosocial Intervention Delivery (RAPID)

Background People with serious mental health problems (SMHP) are more likely to be admitted to psychiatric hospital following contact with crisis services. Admissions can have significant personal costs, be traumatic and are the most expensive form of mental health care. There is an urgent need for treatments to reduce suicidal thoughts and behaviours and reduce avoidable psychiatric admissions.Methods A multi-stage, multi-arm (MAMS) randomised controlled trial (RCT) with four arms conducted over two stages to determine the clinical and cost effectiveness of three psychosocial treatments, compared to treatment as usual (TAU), for people with SMHP who have had recent suicidal crisis. Primary outcome is any psychiatric hospital admissions over a 6-month period. We will assess the impact on suicidal thoughts and behaviour, hope, recovery, anxiety and depression. The remote treatments delivered over 3 months are structured peer support (PREVAIL); a safety planning approach (SAFETEL) delivered by assistant psychologists; and a CBT-based suicide prevention app accessed via a smartphone (BrighterSide). Recruitment is at five UK sites. Stage 1 includes an internal pilot with a priori progression criteria. In stage 1, the randomisation ratio was 1:1:1:2 in favour of TAU. This has been amended to 2:2:3 in favour of TAU following an unplanned change to remove the BrighterSide arm following the release of efficacy data from an independent RCT. Randomisation is via an independent remote web-based randomisation system using randomly permuted blocks, stratified by site. An interim analysis will be performed using data from the first 385 participants from PREVAIL, SAFETEL and TAU with outcome data at 6 months. If one arm is dropped for lack of benefit in stage 2, the allocation ratio of future participants will be 1:1. The expected total sample size is 1064 participants (1118 inclusive of BrighterSide participants).Discussion There is a need for evidence-based interventions to reduce psychiatric admissions, via reduction of suicidality. Our focus on remote delivery of established brief psychosocial interventions, utilisation of different modalities of delivery that can provide sustainable and scalable solutions, which are also suitable for a pandemic or national crisis context, will significantly advance treatment options.Trial registration ISRCTN33079589. Registered on June 20, 2022

AUDIT ON THE QUALITY OF HANDOVERS OF A PSYCHIATRIC LIAISON TEAM IN THE UK: A SHORT REPORT

Background: The importance of handovers has been recognised and proven in clinical practice. In liaison psychiatry, this is particularly important due to the high turnover of patients seen, the shift work pattern and the number of member staff engaging in this process. An Audit on the Quality of Handovers was carried out within a Psychiatric Liaison team of a General hospital in UK with an intention to review and improve this. Method: Handovers were evaluated against the gold standard of the SBAR tool (Situation/Background/Assessment/Recommendations) over a period of 4 weeks. Handovers were assessed by 2 members of staff (a Consultant & a Specialty doctor). Data was analysed using Microsoft Excel. Results: Results showed that the team’s handover practice is mostly "Good" but there was also an amount of "Poor" under "Situation & Background", mostly presented by mid-grade doctors & trainees. Nurses scored higher than medics on overall rating, nearly 50%.This could be attributed to the fact that handovers form an essential & integral part of Nurse’s training & culture. Also mid-grade (staff grade) doctors have had a significant amount of "excellent" scoring that other groups didn\u27t have, mostly on the Assessment & Recommendations domains, which can be attributed to the fact that importance is stressed more on the assessment & treatment module by the doctors. Conclusion: The multi-disciplinary composition of the liaison psychiatry team has a positive impact on the patient care. This audit has revealed overall good communication amongst the members of the team, nevertheless one that needs some improvement, particularly amongst the doctors. Doctors tend to focus on the remedial (assessment & treatment) module rather than the holistic approach. SBAR remains an effective & handy tool to improve the handover quality. A re-audit will be carried out in 6months time to assess the improvements observed following the implementation of this new tool

Μελέτη εργαλείων διαχείρισης κοινωνικών δικτύων για χρήση στην πολιτική

Σε αυτή τη διπλωματική εργασία, έγινε έρευνα σχετικά με την επίδραση των κοινωνικών δικτύων στην πολιτική καθώς και τη σημαντικότητα των εργαλείων διαχείρισης κοινωνικών μέσων στην προώθηση μιας πολιτικής καμπάνιας. Αναλύοντας τη φύση των μέσων κοινωνικής δικτύωσης και μελετώντας τις δυνατότητές τους σε ξεχωριστούς τομείς της καθημερινότητάς μας εξετάσαμε την εφαρμογή τους στο πλαίσιο της πολιτικής. Μετά από ενδελεχή μελέτη στην διαδικασία εκπόνησης μιας πολιτικής καμπάνιας τόσο στο παρόν όσο και στο παρελθόν σε παγκόσμιο επίπεδο, καταφέραμε να εντοπίσουμε τον τρόπο σύνδεσης ενός παραδοσιακού θεσμού με τα σύγχρονα μέσα. Αυτή η σύνδεση επιτυγχάνεται με τη διαχείριση των δεδομένων από τα μέσα κοινωνικής δικτύωσης των χρηστών και περιλαμβάνει την παρακολούθηση, την επεξεργασία και την ανάλυση αυτών με απώτερο σκοπό το βέλτιστο χειρισμό της πολιτικής καμπάνιας. Στην εργασία αυτή, εστιάσαμε στα εργαλεία διαχείρισης κοινωνικών δικτύων και εμβαθύναμε στις λειτουργίες, τις ιδιαιτερότητες και την καταλληλόλητά τους σε κάθε περίσταση. Παράλληλα με τα στοιχεία που αντλήθηκαν από τη βιβλιογραφία, διεξήχθη έρευνα μέσω ερωτηματολογίου σε πολιτικούς υποψήφιους, από την οποία παρήχθησαν ωφέλιμα συμπεράσματα για τις πρακτικές που εφαρμόζονται σε πραγματικές συνθήκες καθώς και για το βαθμό αποτελεσματικότητας των μελετηθέντων εργαλείων

The Construction of National Identity through Cybernetic Process: The Example of “K’na” Dance Event in Greek and Turkish Thrace

The research field of this paper is the area of Thrace, a large geopolitical-cultural unit that was divided – due to political reasons – in three subareas distributed among three different countries: Bulgaria, Turkey and Greece. A dance event that used to take place before the border demarcation but is still performed in the Greek and Turkish Thrace is that of “K’na”, a wedding dance event danced by the people of both border areas, despite of the changes in their magical-religious beliefs and the changes brought by socio-economic and cultural development. In particular, the aim of this paper is the study of the “construction” of the national identity of inhabitants both of Greek and Turkish Thrace, as this is manifested through the dance practice within the wedding event of “K’na”, through the lens of sociocybernetics. Data was gathered through ethnographic method as this is applied to the study of dance, while its interpretation was based on sociocybernetics according to Burke’s identity control theory. From the data analysis, it is showed that the “K’na” dance in Greek and Turkish Thrace constructs and reconstructs the national identity of the people who use them as a response to the messages they receive via the communication with “the national others”. In conclusion, the “construction” of the identity results from a continuous procedure of self-regulation and self-control through a cybernetic sequence of steps

Affect and Cognitive Interference: An Examination of Their Effect on Self-Regulated Learning

The present study examined the relationships among affect, self-regulated learning (SRL) strategy use, and course attainment in the didactics of mathematics (teaching mathematics) subject matter domain. The sample consisted of 180 undergraduate students attending a didactics of mathematics course (mean age = 21.1 years) at the School of Early Childhood Education. The participants were asked to respond to the Positive and Negative Affect Schedule (PANAS) and the Cognitive Interference Questionnaire (CIQ). They also completed the Learning Strategies Scales of the MSLQ. Examination grades were used as the measure of course attainment. Pearson correlations and path analysis revealed that negative affect was positively related to cognitive interference, and positive affect influenced positively the use of almost all of the SRL strategies. Elaboration was the only SRL strategy found to predict the didactics of mathematics course attainment. Finally, cognitive interference was found to negatively predict course attainment

Isothermal Recombinase Polymerase Amplification (RPA) of E. coli gDNA in Commercially Fabricated PCB-Based Microfluidic Platforms

Printed circuit board (PCB) technology has been recently proposed as a convenient platform for seamlessly integrating electronics and microfluidics in the same substrate, thus facilitating the introduction of integrated and low-cost microfluidic devices to the market, thanks to the inherent upscaling potential of the PCB industry. Herein, a microfluidic chip, encompassing on PCB both a meandering microchannel and microheaters to accommodate recombinase polymerase amplification (RPA), is designed and commercially fabricated for the first time on PCB. The developed microchip is validated for RPA-based amplification of two E. coli target genes compared to a conventional thermocycler. The RPA performance of the PCB microchip was found to be well-comparable to that of a thermocycler yet with a remarkably lower power consumption (0.6 W). This microchip is intended for seamless integration with biosensors in the same PCB substrate for the development of a point-of-care (POC) molecular diagnostics platform