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Background: There is limited evidence of the longer-term impact of the COVID-19 pandemic on acute admissions for psychosis in the UK. Aims: We examined the impact of COVID-19 on rates of admissions for first and repeated episode psychosis, and changes in patient profile and seasonal patterns, over a period of 12 months. Method: We conducted a retrospective case note review of all patients admitted with a primary psychosis (F20-29 ICD 10 diagnosis) to an NHS psychiatric inpatient unit. We compared the 12 months pre-COVID-19 period between 1 March 2019 and 28 February 2020, and the 12 months post-COVID-19 period between 1 March 2020 and 28 February 2021. Results: The results showed increase rates of admissions post-COVID-19 in both first and repeated episode psychosis, the patient profile had more females and older age in the repeated episode group, with increased employment rates. Combined group data for both pre- and post-COVID-19 periods showed an increased trend in spring and summer admissions, and even though not statistically significant, more pronounced post-COVID-19. Conclusions: Our findings highlight the effect of the COVID-19 pandemic on acute psychosis admissions over a 12-month period. The results provide evidence for the 'stress-pathogenesis' in the context of genetic vulnerability in psychosis. Preventative strategies in the context of the 'stress-pathogenesis model', improved access to and responsiveness within NHS transformation efforts needs to be adjusted to fit local need and environmental changes. [ABSTRACT FROM AUTHOR]

New Public Governance theory increases citizen participation and expands bureaucrats' roles in the work of government. Citizen participation creates new mechanisms for citizens to influence the policy process. Bureaucrats' expanded roles allow for broader bureaucratic discretion over policy implementation. When citizens' and bureaucrats' views on public management decisions collide, whose views prevail? Do citizen volunteers or bureaucrats have greater influence over public decisions? We answer this question by studying the U.S. Department of Energy's initiative to engage citizens in environmental clean‐up decisions. We assess 10 years of meeting records and administrative decisions using a three‐step, mixed‐method analysis to identify, weigh, and test the influence of citizen participation and bureaucratic discretion. The results indicate that while citizen participation matters, bureaucratic discretion has a more significant influence over administrative decision‐making. The findings expose holes in New Public Governance theory, which has implications for democracy and demands deeper thought into structuring citizen participation. [ABSTRACT FROM AUTHOR]

National and local guidelines focus mainly on clozapine monitoring frequency, and actions based on full blood count results. Prescribing clozapine in the context of COVID‐19‐positive patients brings a complexity of challenge beyond this. In this article the authors put forward an example of a practical clinical guideline in this regard. [ABSTRACT FROM AUTHOR]

Clinical guidelines for mental health disorders produced by the National Institute of Care Excellence (NICE) emphasise a recovery-based approach clinical care with collaborative decision-making. The aim of the study was to explore service user experience of collaborative decision-making and recovery focussed care in relation to a NICE clinical guideline for bipolar disorder four years after publication. Participants with a clinical diagnosis of bipolar disorder were recruited from adult mental health services in four specialist mental health NHS Trusts through health professional or self-referral following advertisement. An online or written survey was designed with service user input to cover 40 NICE recommendations on recovery based or collaborative care. Participants completed the survey anonymously and independent of any health professional involvement. Of 222 participants, 72 (33.5%) reported to a great extent care was delivered in line with a positive recovery message; 55 (25.5%) reported that not much or no care was recovery based. Only four items (10%) on medication or the offer of crisis services were endorsed as collaborative decision-making with a health professional by >70% service users. Most decision-making in relation to the NICE clinical guideline for bipolar disorder was not delivered collaboratively and only some care was recovery focussed. [ABSTRACT FROM AUTHOR]

In this essay, I will attempt to examine and evaluate the 'presence' of Walt Whitman in Maxine Hong Kingston's 1989 novel, Tripmaster Monkey: His Fake Book. The Whitmanian presence is [...]

A number of recent studies have observed that phonetic variability is constrained across speakers, where speakers exhibit limited variation in the signalling of phonological contrasts in spite of overall differences between speakers. This previous work focused predominantly on controlled laboratory speech and on contrasts in English and German, leaving unclear how such speaker variability is structured in spontaneous speech and in phonological contrasts that make substantial use of more than one acoustic cue. This study attempts to both address these empirical gaps and expand the empirical scope of research investigating structured variability by examining how speakers vary in the use of positive voice onset time and voicing during closure in marking the stop voicing contrast in Japanese spontaneous speech. Strong covarying relationships within each cue across speakers are observed, while between-cue relationships across speakers are much weaker, suggesting that structured variability is constrained by the language-specific phonetic implementation of linguistic contrasts. [ABSTRACT FROM AUTHOR]

A college professor reflects on the ethical problems and inadequacies of educational trends and "easy solutions" that sway English instruction from the essentials back to the basics. (RL)