How usable are digital collections for endangered languages? A review

Here, we report on pilot research on the extent to which language collections in digital linguistic archives are discoverable, accessible, and usable for linguistic research. Using a test case of common tasks in phonetic and phonological documentation, we evaluate a small random sample of collections and find substantial, striking problems in all domains. Of the original 20 collections, only six had digitized audio files with associated transcripts (preferably phrase-aligned). That is, only 30% of the collections in our sample were even potentially suitable for any type of phonetic work (regardless of quality of recording). Information about the contents of the collection was usually discoverable, though there was variation in the types of information that could be easily searched for in the collection. Though eventually three collections were aligned, only one collection was successfully force-aligned from the archival materials without substantial intervention. We close with recommendations for archive depositors to facilitate discoverability, accessibility, and functionality of language collections. Consistency and accuracy in file naming practices, data descriptions, and transcription practices is imperative. Providing a collection guide also helps. Including useful search terms about collection contents makes the materials more findable. Researchers need to be aware of the changes to collection structure that may result from archival uploads. Depositors need to consider how their metadata is included in collections and how items in the collection may be matched to each other and to metadata categories. Finally, if our random sample is indicative, linguistic documentation practices for future phonetic work need to change rapidly, if such work from archival collections is to be done in future

Guidance for researchers wanting to link NHS data using non-consent approaches:a thematic analysis of feedback from the Health Research Authority Confidentiality Advisory Group

Introduction: The use of linked data and non-consent methodologies is a rapidly growing area of health research due to the increasing detail, availability and scope of routinely collected electronic health records data. However, gaining the necessary legal and governance approvals to undertake data linkage is a complex process in England. / Objectives: We reflect on our own experience of establishing lawful basis for data linkage through Section 251 approval, with the intention to build a knowledgebase of practical advice for future applicants. / Methods: Thematic analysis was conducted on a corpus of Section 251 feedback reports from the NHS Health Research Authority Confidentiality Advisory Group. / Results: Four themes emerged from the feedback. These were: (a) Patient and Public Involvement, (b)~Establishing Rationale, (c) Data maintenance and contingency, and the need to gain (d) Further Permissions from external authorities prior to full approval. / Conclusions: Securing Section 251 approval poses ethical, practical and governance challenges. However, through a comprehensive, planned approach Section 251 approval is possible, enabling researchers to unlock the potential of linked data for the purposes of health research

The Occupation-Centered Intervention Assessment: Bridging Theory and Practice in Fieldwork Education

Occupational therapy’s identity is grounded in occupation-centered care. However, evidence suggests external factors in the healthcare system burden practitioners’ time and resources, reducing attention directed toward occupation-centered practice and student learning and transfer of theoretically grounded knowledge. The departure from theory-based practice can threaten the identity and viability of the profession. The Occupation-Centered Intervention Assessment (OCIA) was designed for practitioners or students to self-rate the degree to which interventions are occupation-based or occupation-focused, creating an occupation-centered framework. In this pilot explanatory sequential mixed methods study, Level II fieldwork educators and fieldwork students in Alaska completed OCIA training and utilized the tool. A pre- and post-survey identified attitudes toward theory application, feedback, confidence, developing and understanding occupation-centered perspectives, and the OCIA. Additionally, focus group participants discussed using the OCIA during Level II fieldwork and the impact on development, understanding, and communicating using an occupation-centered perspective. Results of the survey revealed preliminary receptivity to the tool as a communication aid and as a theoretical framework for an occupation-centered perspective. The focus group highlighted the “common language” provided by the tool and drew attention to contextual factors influencing the transfer of knowledge and use of the OCIA in practice. Further research is needed to understand the potential of the OCIA as a resource for facilitating student learning with a grounded, occupation-centered perspective

Predictors of Mental Health Review Tribunal (MHRT) outcome in a forensic inpatient population:a prospective cohort study

Abstract Background Previous studies have investigated factors associated with outcome at Mental Health Review Tribunals (MHRTs) in forensic psychiatric patients; however, dynamic variables such as treatment compliance and substance misuse have scarcely been examined, particularly in UK samples. We aimed to determine whether dynamic factors related to behaviour, cooperation with treatment, and activities on the ward were prospectively associated with outcome at MHRT. Methods At baseline, demographic, clinical, behavioural, and treatment-related factors were ascertained via electronic medical records and census forms completed by the patient\u2019s clinical team. Data on MHRTs (i.e., number attended, responsible clinician\u2019s recommendation, and outcome) were collected at a 2-year follow-up. Logistic regression analyses were performed to determine factors associated with outcome among those who attended a MHRT within the follow-up period. Of the 135 forensic inpatients examined at baseline, 79 patients (59%) attended a MHRT during the 2-year follow-up period and therefore comprised the study sample. Of these 79 patients included in the current study, 28 (35%) were subsequently discharged. Results In univariable analyses, unescorted community leave, responsible clinician\u2019s recommendation of discharge, and restricted Mental Health Act section were associated with a greater likelihood of discharge at MHRT; whilst inpatient aggression, a recent episode of acute illness, higher total score on the Historical Clinical Risk \u2013 20 (HCR-20), higher HCR-20 clinical and risk scores, and agitated behaviour were negatively associated with discharge ( p \u2009<\u20090.05). In multivariable analyses, HCR-20 clinical scale scores and physical violence independently predicted outcome at tribunal after controlling for other dynamic variables. Conclusion By identifying dynamic factors associated with discharge at tribunal, the results have important implications for forensic psychiatric patients and their clinical teams. Our findings suggest that by reducing levels of agitated behaviour, verbal aggression, and physical violence on the ward, achieving unescorted community leave, and targeting specific items on the HCR-20 risk assessment tool, patients may be able to improve their changes of discharge at a MHRT

Cohort profile: Working age adults accessing secondary mental healthcare services in South London (UK) and benefits – A data linkage of electronic mental healthcare records and benefits data

Objectives To present an overview of a cohort of working age adults accessing secondary mental healthcare services and benefits related to unemployment, sickness, disability, or income support and describe the different benefit types received across diagnostic and sociodemographic groups. Methods Using a novel data linkage containing electronic secondary mental health care records from the South London and Maudsley (SLaM) NHS Foundation Trust and benefits data from the Department for Work and Pensions (DWP), we present descriptive statistics on a cohort of working age adults. The data window covers the period January 2007-June 2020. Results We identified n=150,348 patients of working age (18-65 years), who had attended SLaM secondary mental health care services, 78.3% of which had received a benefit relating to unemployment, sickness, disability, or income support. Of this group, 68% had a recorded primary psychiatric diagnosis. We found that a much higher percentage of those with a primary psychiatric diagnosis received more than one benefit (69.4%) compared to those who had not received a primary psychiatric diagnosis (30.6%). Conclusions We showed types of benefits received among working age adults accessing secondary mental health care services. This cohort will be further examined to explore trajectories of mental health care and benefit receipt and provide evidence that will help to inform both DWP policies and mental health care delivery

Clinical Neuroimaging Findings in Catatonia: Neuroradiological Reports of MRI Scans of Psychiatric Inpatients With and Without Catatonia

OBJECTIVE: Catatonia is a debilitating psychomotor disorder. Previous neuroimaging studies have used small samples with inconsistent results. The authors aimed to describe the structural neuroradiological abnormalities in clinical magnetic resonance imaging (MRI) brain scans of patients with catatonia, comparing them with scans of psychiatric inpatients without catatonia. They report the largest study of catatonia neuroimaging to date. METHODS: In this retrospective case-control study, neuroradiological reports of psychiatric inpatients who had undergone MRI brain scans for clinical reasons were examined. Abnormalities were classified by lateralization, localization, and pathology. The primary analysis was prediction of catatonia by presence of an abnormal MRI scan, adjusted for age, sex, Black race-ethnicity, and psychiatric diagnosis. RESULTS: Scan reports from 79 patients with catatonia and 711 other psychiatric inpatients were obtained. Mean age was 36.4 (SD=17.3) for the cases and 44.5 (SD=19.9) for the comparison group. Radiological abnormalities were reported in 27 of 79 cases (34.2%) and in 338 of 711 in the comparison group (47.5%) (odds ratio [OR]=0.57, 95% confidence interval [CI]=0.35, 0.93; adjusted OR=1.11, 95% CI=0.58, 2.14). Among the cases, most abnormal scans had bilateral abnormalities (N=23, 29.1%) and involved the forebrain (N=25, 31.6%) and atrophy (N=17, 21.5%). CONCLUSIONS: Patients with catatonia were commonly reported to have brain MRI abnormalities, which largely consisted of diffuse cerebral atrophy rather than focal lesions. No evidence was found that these abnormalities were more common than in other psychiatric inpatients undergoing neuroimaging, after adjustment for demographic variables. Study limitations included a heterogeneous control group and selection bias in requesting scans

Guidance for researchers wanting to link NHS data using non-consent approaches: a thematic analysis of feedback from the Health Research Authority Confidentiality Advisory Group

Introduction The use of linked data and non-consent methodologies is a rapidly growing area of health research due to the increasing detail, availability and scope of routinely collected electronic health records data. However, gaining the necessary legal and governance approvals to undertake data linkage is a complex process in England. Objectives We reflect on our own experience of establishing lawful basis for data linkage through Section 251 approval, with the intention to build a knowledgebase of practical advice for future applicants. Methods Thematic analysis was conducted on a corpus of Section 251 feedback reports from the NHS Health Research Authority Confidentiality Advisory Group. Results Four themes emerged from the feedback. These were: (a) Patient and Public Involvement, (b)~Establishing Rationale, (c) Data maintenance and contingency, and the need to gain (d) Further Permissions from external authorities prior to full approval. Conclusions Securing Section 251 approval poses ethical, practical and governance challenges. However, through a comprehensive, planned approach Section 251 approval is possible, enabling researchers to unlock the potential of linked data for the purposes of health research

Prevalence of HIV in mental health service users: a retrospective cohort study.

Objective To examine the prevalence of HIV in a cohort of people who have used secondary mental health services in the UK. Design Retrospective cohort study. Setting Routinely collected clinical data from secondary mental health services in South London, UK available for research through the Clinical Record Interactive Search tool at the National Institute for Health and Care Research Maudsley Biomedical Research Centre were matched with pseudonymised national HIV surveillance data held by the UK Health Security Agency using a deterministic matching algorithm. Participants All adults aged 16+ who presented for the first time to mental health services in the South London and Maudsley (SLaM) National Health Service Trust between 1 January 2007 and 31 December 2018 were included. Primary outcome Point prevalence of HIV. Results There were 181 177 people who had contact with mental health services for the first time between 2007 and 2018 in SLaM. Overall, 2.47% (n=4481) of those had a recorded HIV diagnosis in national HIV surveillance data at any time (before, during or after contact with mental health services), 24.73 people per 1000. HIV point prevalence was highest in people with a diagnosed substance use disorder at 3.77% (n=784). A substantial percentage of the sample did not have a formal mental health diagnosis (27%), but even with those excluded, the point prevalence remained high at 2.31%. Around two-thirds of people had their diagnosis of HIV before contact with mental health services (67%; n=1495). Conclusions The prevalence of HIV in people who have had contact with mental health services was approximately 2.5 times higher than the general population in the same geographical area. Future work should investigate risk factors and disparities in HIV outcomes between those with and without mental health service contact

Using data linkage to electronic patient records to assess the validity of selected mental health diagnoses in English Hospital Episode Statistics (HES)

<div><p>Background</p><p>Administrative data can be used to support research, such as in the UK Biobank. Hospital Episode Statistics (HES) are national data for England that include contain ICD-10 diagnoses for inpatient mental healthcare episodes, but the validity of these diagnoses for research purposes has not been assessed.</p><p>Methods</p><p>250 peoples' HES records were selected based on a HES recorded inpatient stay at the South London and Maudsley NHS Foundation Trust with a diagnosis of schizophrenia, a wider schizophrenia spectrum disorder, bipolar affective disorder or unipolar depression. A gold-standard research diagnosis was made using Clinical Records Interactive Search pseudonymised electronic patient records using, and the OPCRIT+ algorithm.</p><p>Results</p><p>Positive predictive value at the level of lifetime psychiatric disorder was 100%, and at the level of lifetime diagnosis in the four categories of schizophrenia, wider schizophrenia spectrum, bipolar or unipolar depression was 73% (68–79). Agreement varied by diagnosis, with schizophrenia having the highest PPV at 90% (80–96). Each person had an average of five psychiatric HES records. An algorithm that looked at the last recorded psychiatric diagnosis led to greatest overall agreement with the research diagnosis.</p><p>Discussion</p><p>For people who have a HES record from a psychiatric admission with a diagnosis of schizophrenia spectrum disorder, bipolar affective disorder or unipolar depression, HES records appear to be a good indicator of a mental disorder, and can provide a diagnostic category with reasonable certainty. For these diagnoses, HES records can be an effective way of ascertaining psychiatric diagnosis.</p></div