Cognitive Processes during Acute Psychosis: The Role of Heightened Responsibility and Catastrophic Misinterpretations

Background: This study investigated the role of cognitive mechanisms underlying obsessive compulsive and panic disorders in psychosis, and in particular, their possible contributions to acute psychosis. Method: A total of 90 participants were recruited comprising three equal-size groups, including two clinical groups (acute and stable) and one non-clinical matched control group. Symptom severity and distress was assessed using the PSYRATS, and questionnaire measures of anxiety and obsessive beliefs were administered to all participants. Results: Individuals with a diagnosis of psychosis reported significantly higher levels of obsessional beliefs and anxiety sensitivity than the non-clinical group. Furthermore, acutely psychotic patients reported a significantly higher sense of responsibility and catastrophic misinterpretation than the stable psychiatric controls, and than samples of OCD and GAD patients. Conclusions: Results suggest that these anxiety processes are particularly important during acute psychotic episodes, beyond the reported comorbidity. The theoretical and clinical implications of these findings, the limitations of the methodology employed, and suggestions for future research are discussed

The accordian and the deep bowl of spaghetti: Eight researchers' experiences of using IPA as a methodology

Since 1996 Interpretative Phenomenological Analysis (IPA) has grown rapidly and been applied in areas outside its initial “home” of health psychology. However, explorations of its application from a researcher's perspective are scarce. This paper provides reflections on the experiences of eight individual researchers using IPA in diverse disciplinary fields and cultures. The research studies were conducted in the USA, Malaysia, Australia, New Zealand, Ireland and the UK by researchers with backgrounds in business management, consumer behaviour, mental health nursing, nurse education, applied linguistics, clinical psychology, health and education. They variously explored media awareness, employee commitment, disengagement from mental health services, in-vitro fertilisation treatment, student nurses' experience of child protection, second language acquisition in a university context, the male experience of spinal cord injury and academics experience of working in higher education and women’s experiences of body size and health practices. By bringing together intercultural, interdisciplinary experiences of using IPA, the paper discusses perceived strengths and weaknesses of IPA

Delivery suite assessment unit: auditing innovation in maternity triage

yesA Delivery Suite Assessment Unit (DSAU) has been established at a large Northern teaching hospital. This was as a recommendation of ASQUAM (achieving sustainable quality in maternity) to reduce antenatal admissions to delivery suite and provide a more appropriate environment for women attending for antenatal or labour assessment. The DSAU has also provided an effective teaching environment where skills such as effective telephone triage, diagnosis of labour and care of women with pre-labour spontaneous rupture of membranes (SROM) have been developed by junior staff. The first twelve months' audit results indicate that the establishment of the DSAU has been successful in reducing antenatal admissions to delivery suite by increasing the transfers of clients home, rather than to the antenatal wards. This may reflect the confidence of the highly skilled midwives working in this environment and the confidence women feel about their ability to obtain prompt and accurate advice over the telephone

Work-life imbalance: informal care and paid employment

In the United Kingdom informal carers are people who look after relatives or friends who need extra support because of age, physical or learning disability or illness. The majority of informal carers are women and female carers also care for longer hours and for longer durations than men. Thus women and older women in particular, shoulder the burden of informal care. We consider the costs of caring in terms of the impact that these kinds of caring responsibilities have on employment. The research is based on the responses of informal carers to a dedicated questionnaire and in-depth interviews with a smaller sub-sample of carers. Our results indicate that the duration of a caring episode as well as the hours carers commit to caring impact on their employment participation. In addition carers’ employment is affected by financial considerations, the needs of the person they care for, carers’ beliefs about the compatibility of informal care and paid work and employers’ willingness to accommodate carers’ needs. Overall, the research confirms that informal carers continue to face difficulties when they try to combine employment and care in spite of recent policy initiatives designed to help them

"Just a wee boy not cut out for prison" : Policy and reality in children and young people's journeys through justice in Scotland

Youth Justice policy in Scotland, under the ‘Whole System Approach’ (WSA), progressively espouses maximum diversion, minimum intervention and the use of alternatives to custody wherever possible. Yet Scotland still has one of the highest imprisonment rates in Europe. To explore this discrepancy, this qualitative study used individual interviews and focus groups to document the experiences of 14 young males aged 16 and 17 in one Scottish young offenders’ institution on their journeys to custody. Their experiences reveal the significant challenges faced in understanding, navigating, and complying with the justice system, and also indicate that the consistent implementation of WSA is problematic. The disconnection between the intentions of the WSA policy and the practical implementation means that these vulnerable young people are not fully benefiting from the WSA. This paper therefore highlights important gaps between policy, practice and lived experience in youth justice in Scotland

Nursing in an age of multimorbidity.

BackgroundA changing sociodemographic landscape has seen rising numbers of people with two or more long-term health conditions. Multimorbidity presents numerous challenges for patients and families and those who work in healthcare services. Therefore, the nursing profession needs to understand the issues involved in supporting people with multiple chronic conditions and how to prepare the future workforce to care for them.MethodsA descriptive, exploratory study was used to examine the future of nursing in an age of multimorbidity. An hour-long Twitter chat was organised and run by the Florence Nightingale Foundation Chairs of Clinical Nursing Practice Research to discuss this important area of practice and identify what needs to be done to adequately upskill and prepare the nursing profession to care for individuals with more than one long-term illness. Questions were formulated in advance to provide some structure to the online discussion. Data were collected and analysed from the social media platform using NVivo and an analytics tool called Keyhole. Descriptive statistics were used to describe participants and thematic analysis aided the identification of key themes.ResultsTwenty-four people, from a range of nursing backgrounds and organisations, took part in the social media discussion. Five themes encompassing coping with treatment burden, delivering holistic care, developing an evidence base, stimulating learning and redesigning health services were seen as key to ensuring nurses could care for people with multimorbidity and prevent others from developing chronic health conditions.ConclusionsMultimorbidity is a pressing health issue in today’s society. Changes in nursing research, education and practice are required to help the profession work collaboratively with patients, families and multidisciplinary teams to better manage and prevent chronic illness now and in the future

The Accordion and the Deep Bowl of Spaghetti: Eight Researchers\u27 Experiences of Using IPA as a Methodology

Since 1996 Interpretative Phenomenological Analysis (IPA) has grown rapidly and been applied in areas outside its initial “home” of health psychology. However, explorations of its application from a researcher\u27s perspective are scarce. This paper provides reflections on the experiences of eight individual researchers using IPA in diverse disciplinary fields and cultures. The research studies were conducted in the USA, Malaysia, Australia, New Zealand, Ireland and the UK by researchers with backgrounds in business management, consumer behaviour, mental health nursing, nurse education, applied linguistics, clinical psychology, health and education. They variously explored media awareness, employee commitment, disengagement from mental health services, in-vitro fertilisation treatment, student nurses\u27 experience of child protection, second language acquisition in a university context, the male experience of spinal cord injury and academics experience of working in higher education and women’s experiences of body size and health practices. By bringing together intercultural, interdisciplinary experiences of using IPA, the paper discusses perceived strengths and weaknesses of IPA

The association between community mental health nursing and hospital admissions for people with serious mental illness: a systematic review.

BACKGROUND:Relapse prevention is an important objective in the management of serious mental illness (SMI). While community mental health nurses (CMHN) might be well-placed to support people with SMI in averting relapse, no systematic reviews have examined this association. AIM:To review the evidence from studies reporting an association between CMHN exposure and hospitalisation of persons living with SMI (a proxy for relapse). METHODS:Searches were undertaken in ten bibliographic databases and two clinical trial registries. We included studies of patients with SMI, where CMHN was the exposure, and the outcome was relapse (i.e. readmission to a psychiatric inpatient facility). Quality assessment of included studies was completed using two risk-of-bias measures. RESULTS:Two studies met the inclusion criteria. Studies were rated as being of low-moderate methodological quality. There was insufficient evidence to conclude that community mental health nursing reduced the risk of admission to psychiatric inpatient facilities. CONCLUSIONS:The review found no evidence that CMHN was associated with higher or lower odds of admission to psychiatric inpatient facilities among patients with SMI. The findings of the review point to a need for further research to investigate the impact of CMHN exposure and relapse in people with SMI. SYSTEMATIC REVIEW REGISTRATION:PROSPERO CRD42017058694

Metagenomic and HT-qPCR analysis reveal the microbiome and resistome in pig slurry under storage, composting, and anaerobic digestion

peer-reviewedDirect application of pig slurry to agricultural land, as a means of nutrient recycling, introduces pathogens, antibiotic resistant bacteria, or genes, to the environment. With global environmental sustainability policies mandating a reduction in synthetic fertilisation and a commitment to a circular economy it is imperative to find effective on-farm treatments of slurry that maximises its fertilisation value and minimises risk to health and the environment. We assessed and compared the effect of storage, composting, and anaerobic digestion (AD) on pig slurry microbiome, resistome and nutrient content. Shotgun metagenomic sequencing and HT-qPCR arrays were implemented to understand the dynamics across the treatments. Our results identified that each treatment methods have advantages and disadvantages in removal pollutants or increasing nutrients. The data suggests that storage and composting are optimal for the removal of human pathogens and anaerobic digestion for the reduction in antibiotic resistance (AMR) genes and mobile genetic elements. The nitrogen content is increased in storage and AD, while reduced in composting. Thus, depending on the requirement for increased or reduced nitrogen the optimum treatment varies. Combining the results indicates that composting provides the greatest gain by reducing risk to human health and the environment. Network analysis revealed reducing Proteobacteria and Bacteroidetes while increasing Firmicutes will reduce the AMR content. KEGG analysis identified no significant change in the pathways across all treatments. This novel study provides a data driven decision tree to determine the optimal treatment for best practice to minimise pathogen, AMR and excess or increasing nutrient transfer from slurry to environment