Re-negotiating Ideologies of Bilingualism on the Margins of Education

This article reports on an ethnographic study carried out in three interrelated sites: two contrasting secondary schools and a Youth-Club (the principal focus of this article), in an area of southwest Wales. This article highlights the incongruence between the language at home and the language of the school and posits that the relationship between language use at school and in the wider community needs to be problematised and questioned far more than has been done thus far. This study questions whether school-based ideologies and school-based practices are re-negotiated or contested on the margins of education and whether this re-negotiation and contestation plays an important role in whether a young person chooses to use Welsh or English outside of school. It will be argued that recreational spaces, even though loosely connected to schools as institutions, function as more open spaces where institutional ideologies are actively reworked and renegotiated, either through choosing to use English or by mixing and blending different aspects of linguistic resources, or by re-negotiating and questioning which version of Welshness is more valuable, ‘the removed and authentic’ (as seen at the Welsh school) or the ‘new and hybrid’ as seen at the Youth-Club

Comparison of attitudes to media representation of mental illness between journalists and mental health professionals in Russia with German-speaking countries of Switzerland, Germany, and Austria

Background: The media are an important source of information on mental health. They are often implicit in reinforcing negative stereotypes of people with mental health problems. There are no studies in German-speaking countries or Russia on media attitudes to mental health and mental health professionals’ (MHP) attitudes to the media. Aims: This study explored journalists and MHPs attitudes to mental health media reporting in the German speaking countries of Switzerland, Germany, and Austria and in Russia. Methods: A cross-sectional online internet survey, of ten Likert scale statements to ascertain perceptions of stigma, role, and training needs following the STROBE guidance was conducted among journalists and MHPs via their professional organizations. A non-discriminatory exponential snowballing technique leading to non-probability sampling was used. Descriptive statistics, Kruskal-Wallis, and a post hoc Dunn’s multiple comparisons test using Bonferroni adjustment were used to analyze data. Results: A total of 106 German-speaking and 78 Russian journalists, 109 German-speaking, and 82 Russian MHPs fully answered the survey. Journalists felt the media were more balanced about mental health than MHPs, and MHPs were wary of engagement with the media. Small minorities of journalists had engaged with mental health training, similarly few MHPs had engaged with media training, but both groups were interested in doing so in the future. Significant differences between German and Russian speaking respondents were found on a range of issues (e.g. stigmatization, image about psychotherapy, the media/MHPs, and their own role in engaging with the media/MHPs). Russians were more likely to know specialized (media/mental health awareness) training compared to German-speaking MHPs and journalists. Conclusion: There are potential opportunities to engage journalists and MHPs in training about each other’s worlds and reducing stigma toward mental illness through engaging MHPs with the media. </jats:sec

Identifying co-morbidities and risk in people with epilepsy: The Maltese experience

Background: People with epilepsy are at increased risk of multiple co-morbidities that may influence risk of adverse outcomes including impact on quality of life and premature mortality. These risk factors include potentially modifiable clinical characteristics associated with sudden unexpected death in epilepsy (SUDEP). For services to tackle risk, the clinical complexity of the target epilepsy population needs to be defined. While this has been comprehensively studied in large, economically developed countries little knowledge of these issues exist in small economically developed countries, like Malta (population: 500,000). Methods: This was a single centre study focused exclusively on patients attending Gozo General Hospital (GGH) Malta. STROBE guidance for reporting cross sectional studies was used to design and report the study. This was a retrospective review of standard care and SUDEP and seizure risks provided to all adults (over 18 years) with epilepsy attending GGH (2018–2021). Results: The review identified 68 people and 92% were compliant with their anti-seizure medication. A fifth (21%) had an intellectual disability. Despite only one patient having a psychotic illness, 19% were on antipsychotic medication. Only 18% of patients had a specific epilepsy care plan, 6% nocturnal surveillance and none had received advice on SUDEP. Discussion: Patient outcomes may be improved with increasing rates of personalized epilepsy care plans, appropriate nocturnal surveillance and reducing the prescription of antipsychotic medication as it is associated with greater risk of mortality. Issues such as stigma and shame appear to play a significant role in small communities and their access to care

The failure of suicide prevention in primary care: family and GP perspectives - a qualitative study

Background Although Primary care is crucial for suicide prevention, clinicians tend to report completed suicides in their care as non-preventable. We aimed to examine systemic inadequacies in suicide prevention from the perspectives of bereaved family members and GPs.Methods Qualitative study of 72 relatives or close friends bereaved by suicide and 19 General Practitioners who have experienced the suicide of patients.Results Relatives highlight failures in detecting symptoms and behavioral changes and the inability of GPs to understand the needs of patients and their social contexts. A perceived overreliance on anti-depressant treatment is a major source of criticism by family members. GPs tend to lack confidence in the recognition and management of suicidal patients, and report structural inadequacies in service provision.Conclusions Mental health and primary care services must find innovative and ethical ways to involve families in the decision-making process for patients at risk of suicide

Impact of clerkship in the attitudes toward psychiatry among Portuguese medical students

<p>Abstract</p> <p>Background</p> <p>Given the shortage of human resources and the launching of a new Mental Health Plan, recruitment of psychiatrists is currently a major concern in Portugal, as well as in several other countries. Medical students' attitude toward psychiatry has been pointed as a predictor of recruitment. This study aims to evaluate the medical students' perception of psychiatry before and after a clerkship, and the impact on their intention to pursue psychiatry as a future specialty option.</p> <p>Methods</p> <p>Two self-report questionnaires were administered to all 6^thyear students in a medical school in Lisbon, before and after a 4-weeks full-time psychiatric clerkship, in order to evaluate attitudes toward psychiatry and intention to follow psychiatry in the future. Statistical analysis included Wilcoxon and Chi-square tests.</p> <p>Results</p> <p>153 students (60.8% female) filled in both questionnaires (no dropouts). After the clerkship, there was a significant improvement regarding the overall merits of psychiatry, efficacy, role definition and functioning of psychiatrists, use of legal powers to hospitalize patients and specific medical school factors. There was also a significant increase of students decided or considering the possibility to take a residency in psychiatry.</p> <p>However, perceptions of low prestige and negative pressure from family and peers regarding a future choice of psychiatry remained unchanged in about one-third of the students.</p> <p>Conclusions</p> <p>The results indicate clearly that the clerkship had a favorable overall impact on the student attitude towards psychiatry, as well as in the number of students considering a future career in psychiatry. Attitudes toward psychiatry seems a promising outcome indicator of the clerkship's quality, but further research is needed in order to assess its reliability as a sound predictor of recruitment.</p

Prescribing anti-epileptic drugs for people with epilepsy and intellectual disability

This report addresses the extremely important area of epilepsy in the field of intellectual disability (ID), also known as learning disability. Epilepsy and ID are two conditions that carry stigma and can lead to social isolation. An individual who experiences both these problems faces huge challenges. This report aims to provide epileptologists, psychiatrists, doctors and clinicians working with people with ID and epilepsy an overview of good practice prescribing. Its focus is on using current evidence and applying it to support practical prescribing for people with ID. The document is not a substitute for recognised prescribing guides such as the British National Formulary (BNF). It is not a complete or comprehensive overview of epilepsy management or of epilepsy service provision. The contents of this report need to be considered as guidance, especially where most practitioners struggle when the evidence does not inform the complex clinical challenges. The report is a consensus statement on the application of current evidence used in the general population to people with ID and should be used for the purpose of guiding holistic decision-making in prescribing AEDs. It is important that clinicians keep themselves up to date using the latest information on the subject as part of their continuing professional development, as the subject area covered by this report changes rapidly

‘Defnyddiwch y Gymraeg’: Community sport as a vehicle for encouraging the use of the Welsh language

Despite cultural and statutory changes, including significant investment in Welsh medium education, latest census data show a drop in the percentage of Welsh speakers. Moreover there is a concern that many of those who are able to speak Welsh are not using it – the language is not ‘alive’. The Welsh Language Commissioner has identified sport as a space where Welsh can be used, encouraged and promoted. The aim of this study was to investigate whether community sport clubs can provide a space to encourage the use of Welsh. Using qualitative methods we found that strategies to promote Welsh in sports clubs are potentially divisive. The dominant and ‘operational’ language of many community sport clubs is English. Increasing the use of Welsh in these clubs risks excluding non-Welsh speakers, but ignoring the language denies Welsh speakers the opportunity to participate in Welsh