A Community Participation Initiative During COVID-19 Pandemic:A Case Study From India

Background: A community participation initiative of stitching personal protective equipment (PPE), masks, and face shields for healthcare professionals working in the hospital during the COVID-19 pandemic was conducted using a case study design. Methods: The hospital tailoring unit was used to cater to the in-house demand for stitching safety gear kits for healthcare professionals. A transect walk was conducted to survey hospitals for selecting material for stitching the safety gears and to draw up a plan to meet future demand. The psychiatric social worker induced a community participatory initiative using the method of social work of community organization. A flyer was prepared to invite participants with prior experience in tailoring for this initiative. All participants were trained by the master trainers of the tailoring unit. The participants were also interviewed about their views on this initiative in an informal interview. Results: A total of 83 participants, including 26 individuals (8 volunteers and 18 who received an honorarium), 2 boutiques ( n = 12), and 1 government organization, participated in the activity ( n = 45). A total of 1700 complete PPE kits and 13,000 masks were stitched during this period. The participants reported that the benefit of being a part of this initiative was reduced boredom, sense of purpose and satisfaction, and improved mental health due to structured activity. Conclusions: A community participation initiative using the principles of community organization, a method of social work, can help produce desired outputs and improve the well-being of the participants

Schedule of Factors Influencing Adherence (SOFIA) to Psychiatric Treatment in Persons with Schizophrenia: Validity and Pilot Testing

Qualitative research has highlighted the complex interplay of multiple factors that preclude persons with schizophrenia in rural Indian settings for discontinued psychiatric treatment. In this context, this paper aims to establish the face and content validities of an interview schedule titled „Schedule of Factors Influencing Adherence (SOFIA) to Psychiatric Treatment in Persons with Schizophrenia‟ which comprehensively assesses factors for discontinued psychiatric treatment and the feasibility of its administration of the schedule. SOFIA contains 16 factors. This schedule involves three phases of interviewing patients and family members. This was given to twelve experts who used likert scales to rate each items wells as the dimensions of the schedule. Later on, fifteen persons with schizophrenia were interviewed with SOFIA to test the feasibility of administration. The results showed that Fourteen items were rated as either satisfactory (score=4) or very much satisfactory (score=5) by all twelve experts; remaining two were rated as 4 or 5 by 11 experts. Regarding comprehensiveness of the factors, scoring methods and general instructions given to the interviewers, all provided scores > 4; regarding method of interviewing, 11 provided score of > 4; with regard to overall interview schedule, all experts provided scores > 4. Pilot testing revealed that it took 60 minutes to administer SOFIA

Schedule of Factors Influencing Adherence (SOFIA) to Psychiatric Treatment in Persons with Schizophrenia: Validity and Pilot Testing

Qualitative research has highlighted the complexinterplay of multiple factors that preclude persons withschizophrenia in rural Indian settings for discontinuedpsychiatric treatment. In this context, this paper aims toestablish the face and content validities of an interviewschedule titled „Schedule of Factors InfluencingAdherence (SOFIA) to Psychiatric Treatment in Personswith Schizophrenia‟ which comprehensively assessesfactors for discontinued  psychiatric treatment and   thefeasibility of its administration of the schedule. SOFIAcontains 16 factors. This schedule involves three phases of interviewing patients and family members.  This wasgiven to twelve experts who used likert scales to rate eachitems wells as the dimensions of the schedule. Later on,fifteen persons with schizophrenia were interviewed withSOFIA to test the feasibility of administration. The resultsshowed that Fourteen items were rated as eithersatisfactory (score=4) or very much satisfactory (score=5)by all twelve experts; remaining two were rated as 4 or 5by 11 experts. Regarding comprehensiveness of thefactors, scoring methods and general instructions given tothe interviewers, all provided scores > 4; regardingmethod of interviewing, 11 provided score of > 4; withregard to overall interview schedule, all experts providedscores > 4. Pilot testing revealed that it took 60 minutes to administer SOFIA

Effectiveness of Bifrontal ECT in Practice: A Comparison with Bitemporal ECT

Background: Bifrontal (BF) placement of electrodes in electroconvulsive therapy (ECT) has emerged as an alternative option to the conventional bitemporal (BT) and right unilateral electrode placement in view of fewer cognitive adverse effects. However, the results have been contradictory in terms of clinical efficacy. Materials and Methods: We studied the records of all patients referred for ECT between the months of August 2008 and July 2010 (n=1575). One hundred and five of these patients had received BF-ECT. These records were compared with the records of 105 patients who received BT-ECT. For each patient who received BF-ECT, the very next person posted for BT-ECT was taken as the control. All patients received bilateral ECTs at 1.5-times the threshold stimulus dose. The number of ECTs administered, duration of hospital stay after ECT initiation, seizure threshold and failure to achieve adequate seizures were compared. Two raters who achieved good inter-rater reliability assessed the initial severity using the clinical global impression scale and clinical improvement using a Likert scale. Results: The speed of response, as assessed by the number of ECTs received and the duration of hospital stay after ECT initiation was similar in the two groups. In addition, both groups were comparable in terms of clinical improvement scores on the Likert scale. BF-ECT patients also had a significantly higher seizure threshold, which remained significant in spite of controlling for age. This study is chart based, with its inherent limitations. Standard outcome measures were not used. Cognitive adverse effects were not studied. Conclusions: BF-ECT performed similar to BT-ECT with regard to therapeutic efficacy. Given the consistent results of the former, with fewer cognitive side-effects, the findings of the present study support BF-ECT as the first line for electrode application

Parental Consanguinity Among Schizophrenia Patients

Some studies have reported parental consanguinity as a risk factor for schizophrenia. These finding need replication in different socio-cultural settings. Hence we studied inbreeding to examine its effect on susceptibility to schizophrenia. A case-control study was conducted among people living in a rural community at Turuvekere (SZ, n = 120; controls, n = 222). The prevalence of consanguinity was estimated from family history data (‘self report’), followed by DNA analysis using SNPs (n = 384) (‘DNA-based’ rates) in order to add substantial reliability to our data. Self reported parental consanguinity was elevated among the patients (SZ: 10.71%, controls: 7.69%). Tests for normality of the DNA based estimates for coefficients of inbreeding ‘ f ’ showed that ‘ f ‘ was not normally distributed. Mann-Whitney U test showed parental consanguinity rates are significantly elevated among the patients relative to the healthy individuals (p = 0.035). Our data suggest that schizophrenia is associated with higher parental consanguinity. Larger cross-sectional studies are warranted to validate our findings