The Unregulated Psychoactive Compound: ‘Benzo Fury’

Introduction: The ‘legal high’ ‘Benzo Fury’ [1-(benzofuran-5-yl)propan-2-amine (5-APB) and 1-(benzofuran-6-yl)propan-2-amine (6-APB)] is an unregulated psychoactive compound which has similar effects as known controlled drugs like amphetamines and ecstasy (with hallucinogenic and stimulant properties). It is known to pose significant health risks, such as causing anxiety, sinus tachycardia, hypertension, and QT prolongation. Furthermore, it is easily obtained from the internet. Methods: A systematic review based on PubMed and Medline literature was conducted. Deaths involving ‘Benzo Fury’ (implicated in death and/or identified at post mortem toxicology) in the UK from 1997-2012 were identified from the national programme on Substance Abuse Deaths (np-SAD) database. The programme periodically receives information regarding drugrelated deaths in the UK submitted voluntarily by Coroners, the Northern Ireland Statistics and Research Agency, and the Scottish Crime and Drug Enforcement Agency. The general characteristics of these fatalities were analysed. Results: Ten cases were found with ‘Benzo Fury’ identified at post mortem and it was directly implicated in eight of these deaths. In nine cases, ‘Benzo Fury’ was found in combination with other psychoactive substances. All deaths occurred between 2011-12; the median age at death was 24 years; the majority were male (8/10); and where ethnicity was known, all were white. Conclusions: Our findings indicate a need for a Public Health education campaign on the risks of ‘Benzo Fury’ consumption, especially targeting young users and drugs education workers. Further research into the toxicity of ‘Benzo Fury’ and the risks associated with its consumption is also needed.Peer reviewe

Training the trainers: Finding new educational opportunities in the virtual world

The COVID-19 pandemic has disrupted scientific gatherings and conferences, opening up opportunities for virtual learning platforms. Realizing the potential of online academic exchanges, the World Psychiatric Association (WPA) also developed virtual avenues and information systems for capacity building of mental health professionals across the world. Among its first such initiatives, the WPA organized a virtual Train the Trainers workshop, where 123 psychiatrists, psychiatric trainees, and educators from 45 countries participated. The innovative and interactive workshop allowed participants to get to know each other, exchange educational and professional experiences, and ask questions or receive advice from experts. Keynote speakers, including WPA President Prof. Afzal Javed and Prof. Norman Sartorius, stressed upon the importance of finding innovative solutions in psychiatry training and the need to improve teaching and training in the field of psychiatry, especially in the provision of leadership and communication skills. Online training methods can provide easy access to academics and students while reducing the organizational and logistical costs. They have the potential to improve educational equality and allow the voice of the underprivileged scientists to be heard across the globe. The devastating impact on access to mental health services during COVID-19 underscores the urgent need for online training, particularly in countries where the ratio of psychiatrists to patients is inadequate and doctors concentrate more on treatment than on research and education. Virtual educational interventions could prove incredibly useful in the future just as they are being successfully utilized in local and regional contexts during the pandemic

Online digital education for postregistration training of medical doctors: systematic review by the Digital Health Education Collaboration

Background: Globally, online and local area network–based (LAN) digital education (ODE) has grown in popularity. Blended learning is used by ODE along with traditional learning. Studies have shown the increasing potential of these technologies in training medical doctors; however, the evidence for its effectiveness and cost-effectiveness is unclear. Objective: This systematic review evaluated the effectiveness of online and LAN-based ODE in improving practicing medical doctors’ knowledge, skills, attitude, satisfaction (primary outcomes), practice or behavior change, patient outcomes, and cost-effectiveness (secondary outcomes). Methods: We searched seven electronic databased for randomized controlled trials, cluster-randomized trials, and quasi-randomized trials from January 1990 to March 2017. Two review authors independently extracted data and assessed the risk of bias. We have presented the findings narratively. We mainly compared ODE with self-directed/face-to-face learning and blended learning with self-directed/face-to-face learning. Results: A total of 93 studies (N=16,895) were included, of which 76 compared ODE (including blended) and self-directed/face-to-face learning. Overall, the effect of ODE (including blended) on postintervention knowledge, skills, attitude, satisfaction, practice or behavior change, and patient outcomes was inconsistent and ranged mostly from no difference between the groups to higher postintervention score in the intervention group (small to large effect size, very low to low quality evidence). Twenty-one studies reported higher knowledge scores (small to large effect size and very low quality) for the intervention, while 20 studies reported no difference in knowledge between the groups. Seven studies reported higher skill score in the intervention (large effect size and low quality), while 13 studies reported no difference in the skill scores between the groups. One study reported a higher attitude score for the intervention (very low quality), while four studies reported no difference in the attitude score between the groups. Four studies reported higher postintervention physician satisfaction with the intervention (large effect size and low quality), while six studies reported no difference in satisfaction between the groups. Eight studies reported higher postintervention practice or behavior change for the ODE group (small to moderate effect size and low quality), while five studies reported no difference in practice or behavior change between the groups. One study reported higher improvement in patient outcome, while three others reported no difference in patient outcome between the groups. None of the included studies reported any unintended/adverse effects or cost-effectiveness of the interventions. Conclusions: Empiric evidence showed that ODE and blended learning may be equivalent to self-directed/face-to-face learning for training practicing physicians. Few other studies demonstrated that ODE and blended learning may significantly improve learning outcomes compared to self-directed/face-to-face learning. The quality of the evidence in these studies was found to be very low for knowledge. Further high-quality randomized controlled trials are required to confirm these findings

Satisfaction with psychiatric in-patient care as rated by patients at discharge from hospitals in 11 countries

Purpose: There is disregard in the scientific literature for the evaluation of psychiatric in-patient care as rated directly by patients. In this context, we aimed to explore satisfaction of people treated in mental health in-patient facilities. The project was a part of the Young Psychiatrist Program by the Association for the Improvement of Mental Health Programmes. Methods: This is an international multicentre cross-sectional study conducted in 25 hospitals across 11 countries. The research team at each study site approached a consecutive target sample of 30 discharged patients to measure their satisfaction using the five-item study-specific questionnaire. Individual and institution level correlates of ‘low satisfaction’ were examined by comparisons of binary and multivariate associations in multilevel regression models. Results: A final study sample consisted of 673 participants. Total satisfaction scores were highly skewed towards the upper end of the scale, with a median total score of 44 (interquartile range 38–48) out of 50. After taking clustering into account, the only independent correlates of low satisfaction were schizophrenia diagnosis and low psychiatrist to patient ratio. Conclusion: Further studies on patients’ satisfaction should additionally pay attention to treatment expectations formed by the previous experience of treatment, service-related knowledge, stigma and patients’ disempowerment, and power imbalance.</p