Search

Objectives: Higher education students experience elevated levels of suicidal ideation, but often face barriers in accessing support. The Mental Imagery for Suicidality in Students Trial (MISST; ISRCTN13621293; NCT05296538) tested the feasibility and acceptability of a six‐session imagery‐based approach called Broad‐Minded Affective Coping (BMAC). This qualitative evaluation explored the experiences of MISST participants and staff. Design: A qualitative study using one‐to‐one qualitative interviews with participants and staff recruited from MISST. Reflexive thematic analysis was used to explore trial participant and staff experiences to inform a future definitive trial. Methods: Student participants (n = 16), research assistants (n = 4) and the trial therapist (n = 1) were interviewed and transcripts analysed using reflexive thematic analysis. Results: Four key themes were identified. The first theme highlights the value and challenges for students in talking about suicide. The ways in which communication and rapport can be built to facilitate this conversation are explored in theme 2. Theme 3 explains how working with the BMAC therapist increased participants' awareness of their current mood, drew their attention to positive moments in their lives and helped them to actively recall these moments to interrupt negative cycles of rumination and suicidal ideation. The extent to which the BMAC is 'fit for purpose' is outlined in theme 4, generating specific recommendations for future intervention development. Conclusions: The BMAC offers a positive, time‐limited, structured intervention that is well suited to meet the needs of higher education students experiencing suicidal ideation. Further research is needed to test the effectiveness on mental health and suicide‐related outcomes. [ABSTRACT FROM AUTHOR]

Background: Seventy‐five per cent of UK suicides are completed by men, and associated masculinity beliefs are well researched. The self‐regulatory executive functioning (S‐REF) model of distress is governed by metacognitive beliefs about mental processes, such as worry and rumination. Little is known about metacognition in male suicidality and how these processes interact with masculinity beliefs, suicidal ideation and behaviour. Aims: To identify which aspects of the S‐REF model were present in a sample of men experiencing suicidality, and to consider how these processes interact with masculinity beliefs, suicidal ideation and behaviour. Method: Fifteen men experiencing suicidal ideation or behaviour were recruited from a home‐based treatment team. Semi‐structured interviews and self‐report measures were administered to identify metacognitive processes and masculinity beliefs. Interviews were analysed using the framework approach. Results: The S‐REF model was identified across three super‐ordinate themes; 'the cognitive attentional syndrome (CAS) and maladaptive coping', 'metacognitive beliefs about worry, uncontrollability and danger' and 'consequences'. Thirteen sub‐ordinate themes included processes such as 'worry' and 'rumination', metacognitive beliefs such as 'worrying helps me avoid problems' and 'worry is dangerous for me' and emotional consequences such as 'overwhelm', 'emasculation' and 'escape'. Conclusion: Perseverative thinking and erroneous metacognitive beliefs were associated with reduced functioning, which was incompatible with masculinity beliefs about leadership and strength, and suicide was considered as re‐establishing control. Further research into metacognitive processes in male suicidality would enhance theoretical understanding. [ABSTRACT FROM AUTHOR]

Aim: To harmonize two ascertainment and severity rating instruments commonly used for the clinical high risk syndrome for psychosis (CHR‐P): the Structured Interview for Psychosis‐risk Syndromes (SIPS) and the Comprehensive Assessment of At‐Risk Mental States (CAARMS). Methods: The initial workshop is described in the companion report from Addington et al. After the workshop, lead experts for each instrument continued harmonizing attenuated positive symptoms and criteria for psychosis and CHR‐P through an intensive series of joint videoconferences. Results: Full harmonization was achieved for attenuated positive symptom ratings and psychosis criteria, and modest harmonization for CHR‐P criteria. The semi‐structured interview, named Positive SYmptoms and Diagnostic Criteria for the CAARMS Harmonized with the SIPS (PSYCHS), generates CHR‐P criteria and severity scores for both CAARMS and SIPS. Conclusions: Using the PSYCHS for CHR‐P ascertainment, conversion determination, and attenuated positive symptom severity rating will help in comparing findings across studies and in meta‐analyses. [ABSTRACT FROM AUTHOR]

Introduction: Lower limb ischaemia secondary to occlusion of a lower limb artery is a limb‐threatening condition that can be effectively treated by catheter‐directed thrombolysis (CDT). The purpose of this study was to examine treatment outcomes of CDT both at the time of treatment and ongoing patency up to 12 months following treatment. The secondary aim of the study was to investigate the influence of age of occlusion and treatment duration on success and complication rates. Method: A retrospective observational study was performed at a single institution over a 10‐year period from 2010 to 2019. Data for patient demographics, vessel occlusion factors and treatment information were obtained and analysed. Patency data were investigated using Kaplan–Meier analyses. Results: A total of 218 limbs in 159 patients were treated during the study period. The aetiology of vessel occlusion was in situ thrombosis or occluded bypass graft in 74.5%. Technical success was achieved in 55.5% with CDT alone and 84.4% by using CDT in combination with adjunctive endovascular procedures (angioplasty or stenting). The overall probability of patency was 0.65 at 3 months and 0.44 at 12 months. The overall rate of major amputation within 30 days of thrombolysis was 8.2%. Thirty‐day mortality was 6.3% and was secondary to intracranial haemorrhage in three patients. Conclusion: Technical success of CDT was found to be significantly higher when combined with adjunctive endovascular procedures at the time of CDT. Despite an initial moderate technical success, the probability of patency at 12 months was only 44%. The likelihood of bleeding complications and technical and long‐term success remain key considerations when selecting patients for CDT. [ABSTRACT FROM AUTHOR]

Brood parasitism by the brown‐headed cowbird (Molothrus ater) has caused population declines for conservation‐reliant songbird species such as the federally and state endangered subspecies least Bell's vireo (Vireo bellii pusillus). Although cowbird trapping has increased vireo populations, it is costly, and may prevent the development of parasitism‐avoidance behaviors and result in high rates of non‐target species captures. Therefore, wildlife managers have a compelling interest in evaluating multiple means of cowbird control. We conducted a study between 2016 and 2018 on the Santa Clara River (SCR) in Ventura County, California, USA, to test how the removal of cowbird traps would affect cowbird parasitism of the vireo. At our control site, cowbird trapping occurred in spring using modified Australian crow (Corvus spp.) traps. At our treatment site, we stopped this method of trapping and instead used target‐netting of individual cowbirds and a very short duration trap to capture specific individual cowbirds (i.e., contingency trapping). We also tested the impact of shortening the cowbird trapping period on nest parasitism rates, and used point counts to compare cowbird densities between sites. Additionally, we compared the costs of these techniques. A shorter trapping period still resulted in a large number of cowbird captures on the control site (n = 452 captures) with no observed brood parasitism (n = 67 nests). On the treatment site, cowbird parasitism rates varied from 0% to 14% (n = 75 broods). The target‐netting method was not effective for capturing female cowbirds, probably because of their low densities. The short‐term contingency trapping method effectively removed female cowbirds in the vicinity of vulnerable vireo nests. Cowbird traps captured >300 individuals of 9 different non‐target species each year on the control site, whereas target‐netting and contingency trapping resulted in only 8 captures of 4 different non‐target species. Costs of continuous trapping for 2 months versus point counts, nest monitoring, and contingency trapping were $21,100.00 versus $16,996.00, respectively. Based on these findings, we recommend that an adaptive cowbird management program to benefit songbird populations should consider using regular point counts and nest monitoring to provide data on cowbird impacts, in lieu of continued intensive trapping without monitoring. Thresholds for the density of cowbird females and the allowable level of parasitism for host species should also be established to guide an adaptive cowbird management program. Short‐term contingency trapping based on the thresholds should be considered, but restoration of native vegetation, especially in southwestern riparian areas, is also crucial and effective at limiting parasitism, and so should strongly be considered. Lastly, large numbers of non‐target species captures in cowbird traps are probably having consequential impacts to these species, and need to be monitored and minimized. [ABSTRACT FROM AUTHOR]

Objective: Unpaid carers for people with dementia play a crucial role in society. Emerging evidence suggests the COVID-19 pandemic has negatively impacted on carers. This study sought to explore the impact of the COVID-19 pandemic on carers for community-dwelling people with dementia and compare responses with pre-pandemic data.Methods: Data were collected between September 2020 and April 2021 in England and Wales. Carers were identified from the Improving the experience of Dementia and Enhancing Active Life (IDEAL) cohort and data were collected either through the telephone, video conferencing, or an online questionnaire. Responses from 242 carers were compared against benchmark data from the IDEAL cohort collected pre-pandemic. Analyses were conducted for the full sample of carers and spousal/partner carers only.Results: In total 48.8% of carers thought their healthcare needs were negatively affected during the pandemic. Compared with pre-pandemic data carers were more lonely and experienced less life satisfaction. There was little impact on carers' experience of caregiving, although carers felt trapped in their caregiving role. Carers were more optimistic and had higher social contact with relatives. There were changes in the methods carers used for contacting relatives and friends. Most carers coped very or fairly well during the pandemic. There was little difference in the experiences of spousal/partner carers and the full sample.Conclusions: After a long period of providing care under pandemic conditions carers require additional support. This support needs to be focused on alleviating feelings of loneliness and increasing life satisfaction. Services need to consider how to improve access to health care, particularly resuming face-to-face appointments. [ABSTRACT FROM AUTHOR]

Background: Sleep disturbance is considered a transdiagnostic process due to high comorbidity with mental health difficulties. In particular, sleep disturbances are a feature of mood disorders. To advance transdiagnostic psychological interventions targeting sleep, the Positive and Negative Sleep Appraisal Measure (PANSAM) was developed. The PANSAM is a theory‐driven measure based on an Integrative Cognitive Sleep Model and proposes that positive and negative sleep appraisals for excessively long and short sleep durations play a key role in the development of insomnia, hypersomnia, and reduced need for sleep. This study evaluated clinical validity of this new measure. Methods: Participants were those who met bipolar at risk criteria and bipolar diagnoses (bipolar spectrum group) (N = 22), major depressive disorder (unipolar depression group) (N = 18), and a nonclinical group (N = 22). To compare against previous insomnia and bipolar disorder relevant research, administered measures included the Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS) and the Hypomanic and Positive Predictions Inventory (HAPPI). Results: Analysis of variance (ANOVA) tests revealed that the clinical groups scored significantly higher on the PANSAM. The same was shown for the DBAS and HAPPI. Post hoc analyses showed that the PANSAM scale and subscales had significant correlations with all clinical measures. Effect sizes are reported due to sample size limitations. Conclusion: This study has initially validated the PANSAM with clinical populations and highlighted its applicability to a transdiagnostic approach. [ABSTRACT FROM AUTHOR]

Objectives: The Bipolar at Risk Trial (BART) was a feasibility randomized controlled trial investigating cognitive behavioral therapy (CBT) compared with treatment as usual (TAU) in young people at high risk of developing bipolar disorder (BD). This qualitative study aimed to investigate participants' experiences of trial involvement, and the acceptability of CBT for this population. Design: Participants were those identified as being at risk of bipolar disorder, determined by current symptoms or family history. A purposive sample of twenty‐one participants from both the intervention and TAU arms of the trial was recruited. Methods: Twenty‐one semi‐structured interviews were conducted by service user researchers (13 participants had received therapy and 8 TAU). Interviews were audio recorded with consent from participants and transcribed verbatim. NVivo 11 Pro software was used to conduct an inductive thematic analysis. Results: Super‐ordinate themes were "adaptability and flexibility," "feeling understood and valued," and "relevance of study and intervention" which had two sub‐themes—"value of the trial therapy" and "acceptability of trial processes." Participating in the trial and having therapy enabled participants to feel understood and valued by research assistants (RAs) and therapists. Participants viewed therapy as relevant to their current concerns and valued adaptability and flexibility of RAs and therapists. Conclusions: Findings highlight the importance and value of flexibility, adaptability, and understanding in relationships between participants and trial staff. Findings also indicate that the trial processes and CBT focusing on mood swings are acceptable and relevant to participants from this at risk population. Practitioner points: Young people at risk of bipolar disorder value a flexible approach to assessments and therapy, developing a rapport with research assistants and therapists and opening up to them when they feel comfortable to do so.CBT focusing on coping with mood swings was acceptable to the majority of participants who received it and it was perceived as helpful in ways that were personal to each participant. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study was to describe the epidemiology and clinical features of patients presenting to the ED with suspected and confirmed COVID‐19 during Australia's 'second wave'. Methods: The COVID‐19 ED (COVED) Project is an ongoing prospective cohort study in Australian EDs. This analysis presents data from 12 sites across four Australian states for the period from 1 July to 31 August 2020. All adult patients who met the criteria for 'suspected COVID‐19' and underwent testing for SARS‐CoV‐2 in the ED were eligible for inclusion. Study outcomes included a positive SARS‐CoV‐2 test result, mechanical ventilation and in‐hospital mortality. Results: There were 106 136 presentations to the participating EDs and 12 055 (11.4%; 95% confidence interval [CI] 11.2–11.6) underwent testing for SARS‐CoV‐2. Of these, 255 (2%) patients returned a positive result. Among positive cases, 13 (5%) received mechanical ventilation during their hospital admission compared to 122 (2%) of the SARS‐CoV‐2 negative patients (odds ratio 2.7; 95% CI 1.5–4.9, P = 0.001). Nineteen (7%) SARS‐CoV‐2 positive patients died in hospital compared to 212 (3%) of the SARS‐CoV‐2 negative patients (odds ratio 2.3; 95% CI 1.4–3.7, P = 0.001). Strong clinical predictors of the SARS‐CoV‐2 test result included self‐reported fever, sore throat, bilateral infiltrates on chest X‐ray, and absence of a leucocytosis on first ED blood tests (P < 0.05). Conclusions: In this prospective multi‐site study during Australia's 'second wave', a substantial proportion of ED presentations required SARS‐CoV‐2 testing and isolation. Presence of SARS‐CoV‐2 on nasopharyngeal swab was associated with an increase in the odds of death and mechanical ventilation in hospital. [ABSTRACT FROM AUTHOR]

Abstract: When conservation strategies require new, field‐based information, practitioners must find the best ways to rapidly deliver high‐quality survey data. To address this challenge, several rapid‐assessment approaches have been developed since the early 1990s. These typically involve large areas, take many months to complete, and are not appropriate when conservation‐relevant survey data are urgently needed for a specific locale. In contrast, bioblitzes are designed for quick collection of site‐specific survey data. Although bioblitzes are commonly used to achieve educational or public‐engagement goals, conservation practitioners are increasingly using a modified bioblitz approach to generate conservation‐relevant data while simultaneously enhancing research capacity and building working partnerships focused on conservation concerns. We term these modified events expert bioblitzes. Several expert bioblitzes have taken place on lands of conservation concern in Southern California and have involved collaborative efforts of government agencies, nonprofit organizations, botanic gardens, museums, and universities. The results of expert bioblitzes directly informed on‐the‐ground conservation and decision‐making; increased capacity for rapid deployment of expert bioblitzes in the future; and fostered collaboration and communication among taxonomically and institutionally diverse experts. As research and conservation funding becomes increasingly scarce, expert bioblitzes can play an increasingly important role in biodiversity conservation. [ABSTRACT FROM AUTHOR]

Aim: The Metacognitions Questionnaire‐30 (MCQ‐30) has been used to assess metacognitive beliefs in a range of mental health problems. The aim of this study is to assess the validity of the MCQ‐30 in people at risk for psychosis. Methods: One hundred eighty‐five participants meeting criteria for an at risk mental state completed the MCQ‐30 as part of their involvement in a randomized controlled trial. Confirmatory and exploratory factor analyses were conducted to assess factor structure and construct validity. Results: Confirmatory factor analyses confirmed the original five‐factor structure of the MCQ‐30. Examination of principal component analysis and parallel analysis outputs also suggested a five‐factor structure. Correlation analyses including measures of depression, social anxiety, and beliefs about paranoia showed evidence of convergent validity. Discriminant validity was supported using the normalizing subscale of the beliefs about paranoia tool. Conclusions: The MCQ‐30 demonstrated good fit using the original five‐factor model, acceptable to very good internal consistency of items was evident and clinical usefulness in those at risk for psychosis was demonstrated. [ABSTRACT FROM AUTHOR]

Aim There is evidence that psychotic-like phenomena can be detected within the general population and that psychotic experiences lie on a continuum that also spans affective states. We aimed to investigate comparisons of a first-episode psychosis group, an 'at-risk mental state group' and a help-seeking control group with non-patients to explore whether affective states lie on a continuum of psychosis. Method Measures of psychotic-like experiences, social anxiety and depression were administered to 20 patients experiencing first-episode psychosis ( FEP), 113 patients experiencing an 'at-risk' mental state ( ARMS), 28 patients who were help-seeking but not experiencing a FEP or ARMS ( HSC) and 30 non-clinical participants ( NC). Results For distress in relation to psychotic-like experiences, the FEP, ARMS and HSC groups scored significantly higher than the NC group for the perceptual abnormalities and non-bizarre ideas. In terms of severity of psychotic experiences, the FEP scored the highest, followed by the ARMS group, followed by the HSC and NC groups. The clinical groups scored significantly higher for depression than the non-clinical group. Interestingly, only the FEP and the ARMS groups scored significantly higher than non-patients for social anxiety. Conclusions These findings suggest that a psychosis continuum exists; however, this does not suggest that both psychosis and affective symptoms lie on the same continuum, rather it would appear the presence of such affective states that may affect help-seeking behaviour and clinical status. The implications of these findings for clinical practice are discussed. [ABSTRACT FROM AUTHOR]

Background: There is little data available on the prevalence of violence risk factors in people at ultra-high risk of developing psychosis. Aim: The aim of this study was to provide an estimate of the cross-sectional prevalence of violence risk factors in those attending a routine clinical service for people at ultra-high risk of developing psychosis. Methods: The case notes of all 34 clients receiving treatment over a 4-week period were reviewed and all clinicians were interviewed. Information was gathered regarding gender, current violent ideation, history of violence (including convictions), expressions of concern from others, problems with alcohol or substance misuse, jealousy, suspiciousness, irritability, anger and relevant subthreshold psychotic symptoms. Information on protective factors, including treatment engagement, was also gathered. Results: Thirty-eight per cent ( n = 13) had a history of violent behaviour, 79.4% ( n = 27) were thought to be currently experiencing significant levels of suspiciousness and 47.1% ( n = 16) were thought to have problems with anger. Twenty-nine per cent ( n = 10) had previous known convictions for violence. Two-thirds ( n = 8) of those where risk of violence was identified were described as being engaged with treatment. Conclusion: There was a high prevalence of violence risk factors in this small sample. Further research with larger samples and better methodology is urgently required to investigate risk of violence in this group and determine the contribution, if any, of subclinical psychotic symptoms. [ABSTRACT FROM AUTHOR]

Background: Little data is available on the prevalence of suicide risk factors in people at ultra-high risk (UHR) of developing psychosis. Aim: The aim of this study was to provide an estimate of the cross-sectional prevalence of possible suicide risk factors in those attending a routine clinical service for people at UHR of developing psychosis. Methods: For all patients in treatment ( n = 34) over a 4-week period, levels of suicidal ideation and depression upon entry to the service were assessed by auditing intake scores on the Beck Depression Inventory, second edition. Level of engagement with services, social isolation, substance and alcohol misuse, ready access to means, current suicidal ideation, previous suicide attempts, current or previous self-harm, expressions of concern from others, depression, agitation, hopelessness, worthlessness, suspiciousness and fears of mental disintegration were all assessed by case note review and interview with the treating clinician. Results: There was a high prevalence of at least mild suicidal ideation (58.8%, n = 20) and severe depressed mood (47%, n = 16) in this client group at point of entry to the service. Seven people (20.6%) had engaged in serious self-harm (including attempted suicide) during the time they were in contact with the service. Forty-seven per cent ( n = 16) reported at least 27 suicide attempts between them; the mean number of attempts being 1.69 (standard deviation = 1.08). Conclusion: Suicide risk was high in this small sample of people at UHR of developing psychosis. Controlled research with larger samples and better methodology is urgently required to inform legal, ethical and scientific debates surrounding this group. [ABSTRACT FROM AUTHOR]

Researchers studying the misinformation effect tend to present the event in one of two formats: slides or video. Both have their advantages and disadvantages. Videos capture much more information than slides, but slides permit easy counterbalancing of event details. We capitalised on digital technology to create a misinformation event that resolves many of the limitations inherent in earlier formats. Copyright © 2006 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Abstract: Aim: Exercise can improve psychiatric symptoms, neurocognitive functioning and physical health in schizophrenia. However, the effects in early psychosis have not been explored. This study aimed to assess the feasibility of an exercise intervention for early psychosis and to determine if it was associated with changes in physical and mental health. Methods: Thirty‐one patients with first‐episode psychosis (FEP) were recruited from early intervention services to a 10‐week exercise intervention. The intervention group received individualized training programmes, aiming to achieve ≥90 min of moderate‐to‐vigorous activity each week, using exercise programmes tailored to individual preferences and needs. A comparison FEP sample from the same services (n = 7) received treatment as usual. Results: Rates of consent and retention in the exercise group were 94% and 81%, respectively. Participants achieved an average of 107 min of moderate‐to‐vigorous exercise per week. Positive and Negative Syndrome Scale total scores reduced by 13.3 points after 10 weeks of exercise, which was significantly greater than the treatment as usual comparison group (P = 0.010). The greatest differences were observed in negative symptoms, which reduced by 33% in the intervention group (P = 0.013). Significant improvements were also observed in psychosocial functioning and verbal short‐term memory. Increases in cardiovascular fitness and processing speed were positively associated with the amounts of exercise achieved by participants. Conclusion: Individualized exercise training could provide a feasible treatment option for improving symptomatic, neurocognitive and metabolic outcomes in FEP. [ABSTRACT FROM AUTHOR]