Development of an intervention aimed at increasing awareness and acknowledgement of victimisation and its consequences among people with severe mental illness

Individuals with severe mental illness have a significant risk of (anticipated) discrimination and (criminal) victimisation, which is not structurally and systematically addressed by mental health practitioners. The aim of this study was to develop and pilot an intervention which supports professionals to address victimisation and its consequences, in order to reinforce safe social participation and improve recovery. Following the rehabilitation and positive risk management literature, in addition to current practice, intervention components were developed in two focus groups and four subsequent expert meetings. The intervention was piloted in two outpatient teams before being finalised. The Victoria intervention includes positive risk management, focusing on clients’ narratives and strengths, and awareness of unsafe (home) environments: it comprises four steps: exploring issues with social participation, analysing victimisation experiences, clarifying the context of these experiences, and determining future steps, including victimisation-sensitive rehabilitation planning and optional trauma treatment. Future research should further test this intervention

Barriers and facilitators for treatment-seeking for mental health conditions and substance misuse:Multi-perspective focus group study within the military

Background Globally, millions are exposed to stressors at work that increase their vulnerability to develop mental health conditions and substance misuse (such as soldiers, policemen, doctors). However, these types of professionals especially are expected to be strong and healthy, and this contrast may worsen their treatment gap. Although the treatment gap in the military has been studied before, perspectives of different stakeholders involved have largely been ignored, even though they play an important role. Aims To study the barriers and facilitators for treatment-seeking in the military, from three different perspectives. Method In total, 46 people participated, divided into eight homogeneous focus groups, including three perspectives: soldiers with mental health conditions and substance misuse (n = 20), soldiers without mental health conditions and substance misuse (n = 10) and mental health professionals (n = 16). Sessions were audio-taped and transcribed verbatim. Content analysis was done by applying a general inductive approach using ATLAS.ti-8.4.4 software. Results Five barriers for treatment-seeking were identified: fear of negative career consequences, fear of social rejection, confidentiality concerns, the ‘strong worker’ workplace culture and practical barriers. Three facilitators were identified: social support, accessibility and knowledge, and healthcare within the military. The views of the different stakeholder groups were highly congruent. Conclusions Barriers for treatment-seeking were mostly stigma related (fear of career consequences, fear of social rejection and the ‘strong worker’ workplace culture) and this was widely recognised by all groups. Social support from family, peers, supervisors and professionals were identified as important facilitators. A decrease in the treatment gap for mental health conditions and substance misuse is needed and these findings provide direction for future research and destigmatising interventions

The Hungarian Legislation Concerning Infanticide A Historical Overview and Criminological Background

В статті розглядаються ситуації, які спонукали уповноважених з прав людини при Угорському парламенті створити групу, метою якої є популяризація і розвиток культури прав особистості. Визначаються правові норми професійної діяльності омбудсмена, а також інституту з захисту конституції і прав людини в цілому. Більш детально розглядається результат роботи даної структури, її роль, функції, необхідність захисту культури конституційних прав і їхнього розвитку. Ключові слова: Угорщина, Омбудсменський інститут, культура прав особистості, політичне право, реактивна роль, активна роль, неслухняність громадян, конституційно - правова шкода, легітимність.В статье рассмотрены ситуации, которые побудили уполномоченных в вопросах личных прав человека при Венгерском парламенте, создать группу, цель которой, содействие и развитие культуры прав личности. Здесь вы увидите определения правовых стандартов профессиональной деятельности омбудсмена и института по защите Конституции и прав человека в целом. Более детально рассматриваются вопросы касательно результатов работы данной структуры, ее роли в государстве, функций, потребностей в защите культуры конституционных прав и их развития. Ключевые слова: Венгрия, Омбудсменский институт, культура прав личности, политическое право, реактивная роль, активная роль, непослушность граждан, конституционно-правовой вред, легитимность.In the article reviewed situation, that are prompted the commissioners of personal rights in the Hungarian parliament to create a group for promote and develop the culture of personal rights. Here you see a define of the legal standards of professional activities of the Ombudsman, of the Institute for the Protection of the Constitution and human rights. The more attention paid in questions of the results of this structure, role in the State, functions, needs in the protect the culture of constitutional rights and their development. Key words: Hungary, Ombudsman’s Institution, culture of personal rights, political law, reactive role, proactive role, disobedience of citizens, the constitutional legal injury, and legitimacy

Recovery for all in the community:Position paper on principles and key elements of community-based mental health care

Backgroud:Service providers throughout Europe have identified the need to define how high-quality community-based mental health care looks to organize their own services and to inform governments, commissioners and funders. In 2016, representatives of mental health care service providers, networks, umbrella organizations and knowledge institutes in Europe came together to establish the European Community Mental Health Services Provider (EUCOMS) Network. This network developed a shared vision on the principles and key elements of community mental health care in different contexts. The result is a comprehensive consensus paper, of which this position paper is an outline. With this paper the network wants to contribute to the discussion on how to improve structures in mental healthcare, and to narrow the gap between evidence, policy and practice in Europe.Main text:The development of the consensus paper started with an expert workshop in April 2016. An assigned writing group representing the workshop participants built upon the outcomes of this meeting and developed the consensus paper with the input from 100 European counterparts through two additional work groups, and two structured feedback rounds via email. High quality community-based mental health care: 1) protects human rights; 2) has a public health focus; 3) supports service users in their recovery journey; 4) makes use of effective interventions based on evidence and client goals; 5) promotes a wide network of support in the community and; 6) makes use of peer expertise in service design and delivery. Each principle is illustrated with good practices from European service providers that are members of the EUCOMS Network.Conclusions:Discussion among EUCOMS network members resulted in a blueprint for a regional model of integrated mental health care based upon six principles.</p

Facilitating Recovery of Daily Functioning in People With a Severe Mental Illness Who Need Longer-Term Intensive Psychiatric Services:Results From a Cluster Randomized Controlled Trial on Cognitive Adaptation Training Delivered by Nurses

Background: Feasible and effective interventions to improve daily functioning in people with a severe mental illness (SMI), such as schizophrenia, in need of longer-term rehabilitation are scarce. Aims: We assessed the effectiveness of Cognitive Adaptation Training (CAT), a compensatory intervention to improve daily functioning, modified into a nursing intervention. Method: In this cluster randomized controlled trial, 12 nursing teams were randomized to CAT in addition to treatment as usual (CAT; n = 42) or TAU (n = 47). Daily functioning (primary outcome) was assessed every 3 months for 1 year. Additional follow-up assessments were performed for the CAT group in the second year. Secondary outcomes were assessed every 6 months. Data were analyzed using multilevel modeling. Results: CAT participants improved significantly on daily functioning, executive functioning, and visual attention after 12 months compared to TAU. Improvements were maintained after 24 months. Improved executive functioning was related to improved daily functioning. Other secondary outcomes (quality of life, empowerment, negative symptoms) showed no significant effects. Conclusions: As a nursing intervention, CAT leads to maintained improvements in daily functioning, and may improve executive functioning and visual attention in people with SMI in need of longer-term intensive psychiatric care. Given the paucity of evidence-based interventions in this population, CAT can become a valuable addition to recovery-oriented care

UP's: A cohort study on recovery in psychotic disorder patients : Design protocol

Recovery is a multidimensional concept, including symptomatic, functional, social, as well as personal recovery. The present study aims at exploring psychosocial and biological determinants of personal recovery, and disentangling time-dependent relationships between personal recovery and the other domains of recovery in a sample of people with a psychotic disorder. A cohort study is conducted with a 10-year follow-up. Personal recovery is assessed using the Recovering Quality of Life Questionnaire (ReQoL) and the Individual Recovery Outcomes Counter (I.ROC). Other domains of recovery are assessed by the Positive and Negative Symptom Scale Remission (PANSS-R), the BRIEF-A and the Social Role Participation Questionnaire—Short version (SRPQ) to assess symptomatic, functional and societal recovery, respectively. In addition, multiple biological, psychological, and social determinants are assessed. This study aims to assess the course of personal recovery, and to find determinants and time-dependent relationships with symptomatic, functional and societal recovery in people with a psychotic disorder. Strengths of the study are the large number of participants, long duration of follow-up, multiple assessments over time, extending beyond the treatment trajectory, and the use of a broad range of biological, psychological, and social determinants

Belemmerende en bevorderende factoren voor hulp zoeken bij psychische klachten of verslaving:Focusgroepstudie vanuit meerdere perspectieven binnen de Nederlandse krijgsmacht

Achtergrond Wereldwijd worden miljoenen mensen op het werk blootgesteld aan stressvolle factoren die de kans op het ontwikkelen van psychische klachten en/of verslaving (PK/V) verhogen (bijvoorbeeld militairen, politie, artsen). Maar het zijn ook juist deze beroepen waar men geacht wordt sterk en gezond te zijn. Hierdoor is het soms moeilijker om hulp te zoeken voor PK/V. Zo laat Engels onderzoek zien dat 60% van de militairen met PK/V hier geen professionele hulp voor zoekt. Eerder onderzoek naar hulp zoeken voor PK/V richtte zich met name op het perspectief van militairen met PK/V, waarbij andere belangrijke perspectieven niet meegenomen werden. Daarnaast is dit probleem niet eerder onderzocht binnen de Nederlandse krijgsmacht. Doel Het doel van de huidige studie was de belemmerende en bevorderende factoren voor het zoeken van hulp voor PK/V in kaart te brengen binnen de Nederlandse krijgsmacht vanuit verschillende perspectieven. Methode In totaal hebben 46 mensen deelgenomen aan de studie verdeeld over acht focusgroepen, met drie verschillende perspectieven: vier groepen militairen met PK/V (totaal 20 deelnemers), twee groepen militairen zonder PK/V (totaal 10 deelnemers) en twee groepen zorgprofessionals (totaal 16 deelnemers). De focusgroepen zijn opgenomen en letterlijk uitgeschreven. Vervolgens is met behulp van kwalitatieve data-analysesoftware contentanalyse uitgevoerd vanuit een inductieve benadering. Resultaten Er zijn vijf belemmerende factoren voor het zoeken van hulp gevonden: (1) angst voor negatieve carrièregevolgen, (2) angst voor sociale afwijzing, (3) zorgen rond de vertrouwelijkheid, (4) de militaire werkcultuur en (5) praktische barrières. Ook zijn drie bevorderende factoren gevonden: (1) sociale steun, (2) toegankelijkheid zorgverlening en kennis over waar hulp te verkrijgen en (3) militaire zorgverlening. Ondanks dat het onderzoek zich expliciet richtte op verschillende perspectieven kwamen de visies van de deelnemers sterk overeen. Conclusie De meeste belemmerende factoren voor het zoeken van hulp waren gerelateerd aan stigma (angst voor carrièregevolgen, sociale afwijzing en militaire werkcultuur) en dit werd benoemd door alle drie de verschillende perspectieven. Sociale steun vanuit het thuisfront, collega’s, leidinggevende en zorgprofessionals werd gezien als bevorderend voor het zoeken van hulp. De resultaten van de huidige studie geven richting voor zowel toekomstig (interventie)onderzoek als beleid, om ervoor te zorgen dat meer militairen hulp zoeken voor PK/V

Metabolic differences between bronchial epithelium from healthy individuals and patients with asthma and the effect of bronchial thermoplasty

Background: Asthma is a heterogeneous disease with differences in onset, severity, and inflammation. Bronchial epithelial cells (BECs) contribute to asthma pathophysiology. Objective: We determined whether transcriptomes of BECs reflect heterogeneity in inflammation and severity in asthma, and whether this was affected in BECs from patients with severe asthma after their regeneration by bronchial thermoplasty. Methods: RNA sequencing was performed on BECs obtained by bronchoscopy from healthy controls (n = 16), patients with mild asthma (n = 17), patients with moderate asthma (n = 5), and patients with severe asthma (n = 17), as well as on BECs from treated and untreated airways of the latter (also 6 months after bronchial thermoplasty) (n = 23). Lipidome and metabolome analyses were performed on cultured BECs from healthy controls (n = 7); patients with severe asthma (n = 9); and, for comparison, patients with chronic obstructive pulmonary disease (n = 7). Results: Transcriptome analysis of BECs from patients showed a reduced expression of oxidative phosphorylation (OXPHOS) genes, most profoundly in patients with severe asthma but less profoundly and more heterogeneously in patients with mild asthma. Genes related to fatty acid metabolism were significantly upregulated in asthma. Lipidomics revealed enhanced levels of lipid species (phosphatidylcholines, lysophosphatidylcholines. and bis(monoacylglycerol)phosphate), whereas levels of OXPHOS metabolites were reduced in BECs from patients with severe asthma. BECs from patients with mild asthma characterized by hyperresponsive production of mediators implicated in neutrophilic inflammation had decreased expression of OXPHOS genes compared with that in BECs from patients with mild asthma with normoresponsive production. BECs obtained after thermoplasty had significantly increased expression of OXPHOS genes and decreased expression of fatty acid metabolism genes compared with BECs obtained from untreated airways. Conclusion: BECs in patients with asthma are metabolically different from those in healthy individuals. These differences are linked with inflammation and asthma severity, and they can be reversed by bronchial thermoplasty