Why don’t students seek help? Barriers to seeking professional help by students with mental health issues

Psihički poremećaji zahvaćaju značajan dio studentske populacije, no adekvatnu stručnu pomoć traži samo manji broj pojedinaca. Ovaj problem veoma je slabo istražen u Republici Hrvatskoj i ovo je istraživanje prvo toga tipa. Cilj je bio istražiti razloge zbog kojih studenti ne traže stručnu pomoć kada imaju psihičke smetnje. Istraživanje se sastojalo od dva dijela: kvalitativnog predistraživanja s dvije fokusne grupe i kvantitativnog istraživanja putem online upitnika na uzorku od N=645 studenata, od čega 76 % studentica i 24 % studenata u dobi od 18 do 27 godina. Rezultati pokazuju kako 32,8 % studenata ima klinički indikativne psihičke smetnje, od kojih je samo 23,6 % potražilo pomoć. Studenti kao glavne barijere koje su ih spriječile u traženju stručne pomoći ističu uvjerenje da njihovi problemi nisu dovoljno ozbiljni, oslanjanje na same sebe u rješavanju problema, nedostatak povjerenja u učinkovitost psiholoških tretmana te nepoznavanje mjesta na kojima mogu potražiti besplatnu stručnu pomoć. Osobe muškog spola i osobe sklonije samostigmatizirajućim uvjerenjima iskazale su manje pozitivne stavove prema traženju stručne pomoći, dok povezanost između psihopatoloških teškoća i stavova prema traženju pomoći nije pronađena. Dobivena saznanja mogu se praktično primijeniti putem predočavanja razmjera ovog problema stručnoj i drugoj zainteresiranoj javnosti, kao i kreiranja odgovarajućih intervencija.Even though mental health issues affect a great number of students, only a small number of them receive adequate professional help. This issue has not been sufficiently researched in Croatia, and this paper is the first to assess the matter. The goal was to examine the reasons that prevent students in Zagreb from seeking the professional help they need. The research consisted of two parts: a qualitative pilot study with two focus groups and a quantitative online study (n=645), with 76 % female and 24 % male students, aged from 18 to 27. The results show that 32.8 % of the students were clinically indicative of mental health issues, but only 23.6 % of them sought professional help. Students report that the main barriers which prevented them from seeking professional help were the following: the belief that their problems are not serious enough, the dependence on themselves to solve problems, the lack of confidence in the effectiveness of psychological treatments and the lack of knowledge about the places where they can seek free psychological help. The male students and those who were more prone to self-stigmatization had less positive attitudes towards seeking professional help. Additionally, no relationship was found between mental health issues and attitudes towards seeking help. The findings of this study could be applied by raising awareness of among all relevant stakeholders regarding this widespread problem, as well as by creating apt interventions

Substance use and self-poisoning in schizophrenia: 11-year findings from a national clinical survey of suicide in mental health patients in the UK

Suicide is the leading cause of unnatural death among people with schizophrenia. Substance use is a highly prevalent comorbid feature of schizophrenia and a modifiable risk factor for suicide. However, no studies have examined changes in the frequency of substance use or self-poisoning in those who died by suicide over time. Knowing this could support more tailored approaches to reducing specific risk factors and access to means in those with schizophrenia who are at risk of suicide. We conducted an 11-year observational study on a clinical survey of people with schizophrenia in the UK who died by suicide within 12 months of contact with mental health services between 2010 and 2020 (n = 2718). Overall, alcohol, cannabis and stimulants were the most frequently reported substances. The odds of lifetime use significantly increased over time for cannabis, stimulants, heroin, and benzodiazepines. There were differences in socio-demographic, behavioural and clinical factors between those with recent and historical alcohol and drug use before death. Deaths by hanging, jumping and self-poisoning were the most common suicide methods. Though deaths by hanging significantly increased over time, deaths by self-poisoning significantly decreased, especially by means of psychotropic medication and opioids. To improve risk management, clinical efforts should focus on identifying and treating people with schizophrenia using specific substances. Nationwide initiatives for improving safety in prescribing could be contributing to reduced risks of suicide via self-poisoning in this group

Study Protocol on Cognitive Performance in Bulgaria, Croatia, and the Netherlands: The Normacog Brief Battery

The Normacog Brief Battery (NBB) provides a comprehensive overview of an individual’s cognitive functioning within a short amount of time. It was originally developed for the Spanish population in Spain. However, there is a considerable need for brief batteries in clinical neuropsychological assessment, especially in eastern European countries. Cultural background and other individual characteristics—such as age, level of education, and sex—are shown to influence both cognition and patients’ performance on neuropsychological tests. Therefore, it is important to develop understanding of how and why culture impacts on cognitive testing and determine which sociodemographic variables affect cognitive performance. The current study aims to translate, adapt, and standardize the NBB in Bulgaria, Croatia, and the Netherlands, and to analyze the effect of sex, age, and education level on cognitive performance between these three countries. This brief battery assesses eleven cognitive domains, including those most currently relevant in cognition such as premorbid intelligence, attention, executive function, processing speed, and memory. The translation and adaptation of the battery for different cultures will be done using the back-translation process. After exclusion criteria, the current study will include a total sample of three hundred participants (≥18 years old). The samples of 100 participants per country will be balanced through the consideration of their age and level of education. Effects of the sociodemographic variables (age, level of education, and sex) on cognitive performance are expected. Furthermore, this relationship is expected to differ across countries. A multivariate hierarchical linear regression will be used and exploratory analysis will be carried out to investigate further effects. The results will be particularly valuable for future research and assessment in cognitive performance. The growing demand for accurate and fast neuropsychological assessment shows the importance of creating a universal brief assessment tool for wider cross-cultural application

Temporal trends in primary care-recorded self-harm during and beyond the first year of the COVID-19 pandemic: Time series analysis of electronic healthcare records for 2.8 million patients in the Greater Manchester Care Record

Summary: Background: Surveillance of temporal trends in clinically treated self-harm is an important component of suicide prevention in the dynamic context of COVID-19. There is little evidence beyond the initial months following the onset of the pandemic, despite national and regional restrictions persisting to mid-2021. Methods: Descriptive time series analysis utilizing de-identified, primary care health records of 2.8 million patients from the Greater Manchester Care Record. Frequencies of self-harm episodes between 1st January 2019 and 31st May 2021 were examined, including stratification by sex, age group, ethnicity, and index of multiple deprivation quintile. Findings: There were 33,444 episodes of self-harm by 13,148 individuals recorded during the study period. Frequency ratios of incident and all episodes of self-harm were 0.59 (95% CI 0.51 to 0.69) and 0.69 (CI 0.63 to 0.75) respectively in April 2020 compared to February 2020. Between August 2020 and May 2021 frequency ratios were 0.92 (CI 0.88 to 0.96) for incident episodes and 0.86 (CI 0.84 to 0.88) for all episodes compared to the same months in 2019. Reductions were largest among men and people living in the most deprived neighbourhoods, while an increase in all-episode self-harm was observed for adolescents aged 10–17. Interpretation: Reductions in primary care-recorded self-harm persisted to May 2021, though they were less marked than in April 2020 during the first national lockdown. The observed reductions could represent longer term reluctance to seek help from health services. Our findings have implications for the ability for services to offer recommended care for patients who have harmed themselves

Registered report: How open do you want your science? An international investigation into knowledge and attitudes of psychology students.

The use of Open Science practices is often proposed as a way to improve research practice, especially in psychology. Open Science can increase transparency and therefore reduce questionable research practices, making research more accessible to students, scholars, policy makers, and the public. However, little is known about how widespread Open Science practices are taught and how students are educated about these practices. In addition, it remains unknown how informing students about Open Science actually impacts their understanding and adoption of such practices. This registered report proposes the validation of a questionnaire. The aim is to survey how much psychology students know about Open Science and to assess whether knowledge of and exposure to Open Science in general-be it through university curricula or social media-influences attitudes towards the concept and intentions to implement relevant practices

Suicide after leaving the UK Armed Forces 1996–2018: A cohort study

There are comparatively few international studies investigating suicide in military veterans and no recent UK–wide studies. This is important because the wider context of being a UK Armed Forces (UKAF) veteran has changed in recent years following a period of intensive operations. We aimed to investigate the rate, timing, and risk factors for suicide in personnel who left the UKAF over a 23–year period. Methods and findings: We carried out a retrospective cohort study of suicide in personnel who left the regular UKAF between 1996 and 2018 linking national databases of discharged personnel and suicide deaths, using survival analysis to examine the risk of suicide in veterans compared to the general population and conditional logistic regression to investigate factors most strongly associated with suicide after discharge. The 458,058 individuals who left the UKAF accumulated over 5,852,100 person years at risk, with a median length of follow–up of 13 years, were mostly male (91%), and had a median age of 26 years at discharge. 1,086 (0.2%) died by suicide. The overall rate of suicide in veterans was slightly lower than the general population (standardised mortality ratio, SMR [95% confidence interval, CI] 94 [88 to 99]). However, suicide risk was 2 to 3 times higher in male and female veterans aged under 25 years than in the same age groups in the general population (age–specific mortality ratios ranging from 160 to 409). Male veterans aged 35 years and older were at reduced risk of suicide (age–specific mortality ratios 47 to 80). Male sex, Army service, discharge between the ages of 16 and 34 years, being untrained on discharge, and length of service under 10 years were associated with higher suicide risk. Factors associated with reduced risk included being married, a higher rank, and deployment on combat operations. The rate of contact with specialist NHS mental health services (273/1,086, 25%) was lowest in the youngest age groups (10% for 16– to 19–year–olds; 23% for 20– to 24–year–olds). Study limitations include the fact that information on veterans was obtained from administrative databases and the role of pre–service vulnerabilities and other factors that may have influenced later suicide risk could not be explored. In addition, information on contact with support services was only available for veterans in contact with specialist NHS mental health services and not for those in contact with other health and social care services. Conclusions: In this study, we found suicide risk in personnel leaving the UKAF was not high but there are important differences according to age, with higher risk in young men and women. We found a number of factors which elevated the risk of suicide but deployment was associated with lower risk. The focus should be on improving and maintaining access to mental health care and social support for young service leavers, as well as implementing general suicide prevention measures for all veterans regardless of age.Acknowledgements: We would like to thank Defence Statistics Health, the Armed Forces Team within NHS England, and staff at the National Confidential Inquiry into Suicide and Safety in Mental Health (NCISH) for their help and advice on the study. We thank Dan Stears, Fiona Naylor, and Liz Monaghan (members of Mutual Support for Mental Health Research (MS4MH-R), the patient and public involvement, and engagement group at the Centre for Mental Health and Safety, University of Manchester) and Tom Fox, Jo Brettell, and Wayne Palmer for their advisory roles in the study design. We would also like to thank the HQIP for the provision of data from the Mental Health Clinical Outcome Review Programme (MH-CORP) as delivered by the National Confidential Inquiry into Suicide and Safety in Mental Health.Funders: NHS England; Grant(s): 700030303; Ministry of Defence; funder-id: http://dx.doi.org/10.13039/501100006083; Grant(s): 70003030

COVID-19 trajectories among 57 million adults in England: a cohort study using electronic health records

BACKGROUND: Updatable estimates of COVID-19 onset, progression, and trajectories underpin pandemic mitigation efforts. To identify and characterise disease trajectories, we aimed to define and validate ten COVID-19 phenotypes from nationwide linked electronic health records (EHR) using an extensible framework. METHODS: In this cohort study, we used eight linked National Health Service (NHS) datasets for people in England alive on Jan 23, 2020. Data on COVID-19 testing, vaccination, primary and secondary care records, and death registrations were collected until Nov 30, 2021. We defined ten COVID-19 phenotypes reflecting clinically relevant stages of disease severity and encompassing five categories: positive SARS-CoV-2 test, primary care diagnosis, hospital admission, ventilation modality (four phenotypes), and death (three phenotypes). We constructed patient trajectories illustrating transition frequency and duration between phenotypes. Analyses were stratified by pandemic waves and vaccination status. FINDINGS: Among 57 032 174 individuals included in the cohort, 13 990 423 COVID-19 events were identified in 7 244 925 individuals, equating to an infection rate of 12·7% during the study period. Of 7 244 925 individuals, 460 737 (6·4%) were admitted to hospital and 158 020 (2·2%) died. Of 460 737 individuals who were admitted to hospital, 48 847 (10·6%) were admitted to the intensive care unit (ICU), 69 090 (15·0%) received non-invasive ventilation, and 25 928 (5·6%) received invasive ventilation. Among 384 135 patients who were admitted to hospital but did not require ventilation, mortality was higher in wave 1 (23 485 [30·4%] of 77 202 patients) than wave 2 (44 220 [23·1%] of 191 528 patients), but remained unchanged for patients admitted to the ICU. Mortality was highest among patients who received ventilatory support outside of the ICU in wave 1 (2569 [50·7%] of 5063 patients). 15 486 (9·8%) of 158 020 COVID-19-related deaths occurred within 28 days of the first COVID-19 event without a COVID-19 diagnoses on the death certificate. 10 884 (6·9%) of 158 020 deaths were identified exclusively from mortality data with no previous COVID-19 phenotype recorded. We observed longer patient trajectories in wave 2 than wave 1. INTERPRETATION: Our analyses illustrate the wide spectrum of disease trajectories as shown by differences in incidence, survival, and clinical pathways. We have provided a modular analytical framework that can be used to monitor the impact of the pandemic and generate evidence of clinical and policy relevance using multiple EHR sources. FUNDING: British Heart Foundation Data Science Centre, led by Health Data Research UK

Accounting for Construction Contracts

Ugovorom o građenju regulira se odnos između investitora i izvođača gdje se obje strane usuglašavaju i u kojemu se definiraju načini obavljanja određenoga posla. Građevinska djelatnost specifična je po iskazivanju prihoda u obračunskom razdoblju u kojem su obavljeni radovi odnosno usluge te samim time i obračun poreza na dobit koji se krajem svakog razdoblja, u kojem se izdaje račun – privremena situacija, prenosi na krajnjeg korisnika, u ovom slučaju, investitora. Računovodstvo graditeljstva regulirano je MRS i HSFI standardima koji obrađuju problematiku računovodstvenog postupka s prihodima i troškovima. U graditeljstvu se propisima definira što se točno smatra gradnjom, građenjem, rekonstrukcijom, održavanjem ili uklanjanjem građevine, no u svezi s tim postoje mnogobrojne građevinske usluge koje nije moguće sve navesti u poreznim propisima. Stoga je u većini slučajeva potrebno utvrditi radi li se u konkretnom slučaju o građevinskoj usluzi ili o isporuci dobara što je prvenstveno regulirano Zakonom o prostornom uređenju i Zakonom o gradnji, kao i mnogim drugim zakonima vezanim uz graditeljstvo