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Objectives: To examine if the COVID-19 pandemic is associated with a differential effect over a 2-year time period in relation to its psychological and social impact on patients with established anxiety disorders. Methods: Semi-structured interviews were conducted with 21 individuals attending the Galway-Roscommon Mental Health Services in Ireland with an ICD-10 diagnosis of an anxiety disorder. Interviews occurred at three time-points over a 2-year period to determine the impact of the COVID-19 pandemic and associated restrictions on anxiety and depressive symptoms, social and occupational functioning, and quality of life. Results: No statistical difference in symptomatology was noted between the three time-points in relation to anxiety symptoms as measured utilising psychometric rating scales (Beck Anxiety Inventory (BAI), Hamilton Anxiety Rating Scale (HARS) or Likert Scale measures). The greatest impact of COVID-19 at all time-points related to social functioning and quality of life. Significant variability was noted for individual participants. Qualitative analysis noted a tentative optimism for the future in the setting of vaccination and societal re-opening. Fear of re-emerging anxiety symptoms with the removal of societal restrictions was noted. Conclusions: No significant overall change in symptomatology or functioning over time was noted for individuals with pre-existing anxiety disorders, however variability was demonstrated, with some individuals describing ongoing anxiety, social isolation and concern for their future. A strong theme of hope for the future and less concern regarding the COVID-19 pandemic was evident; however tailored supports including the utilisation of tele-psychiatry is suggested, particularly for those experiencing increased anxiety with the removal of societal restrictions.

Objectives: To examine and compare rates and methods of self-harm presenting to a tertiary referral hospital during an 18-month period since the onset of the COVID-19 pandemic with a similar period immediately prior to the pandemic onset. Methods: Data from an anonymized database compared rates of self-harm presentations and methods employed between 1st March 2020 and 31st August 2021 to a similar time-frame prior to the onset of the COVID-19 pandemic. Results: A 9.1% increase in presentations with self-harm was noted since the onset of the COVID-19 pandemic. Periods of more stringent restrictions were associated with higher levels of self-harm (daily rate of 2.10 v 0.77). A higher lethality of attempt was demonstrated post-COVID-19 onset (χ2 = 15.38, p < 0.001). Fewer individuals presenting with self-harm were diagnosed with an adjustment disorder since the onset of the COVID-19 pandemic (n = 84, 11.1%, v. n = 112, 16.2%, χ2 = 7.898, p = 0.005), with no other differences pertaining to psychiatric diagnosis noted. More patients actively engaged with mental health services (MHS) presented with self-harm (n = 239 (31.7%) v. n = 137, (19.8%), χ2 = 40.798, p ≤ 0.001) since the onset of the COVID-19 pandemic. Conclusions: Despite an initial reduction, an increase in rates of self-harm has occurred since the onset of the COVID-19 pandemic with higher rates evident during periods of higher government mandated restrictions. An increase in active patients of MHS presenting with self-harm potentially relates to reduced availability of supports and particularly group activities. The recommencement of group therapeutic interventions for individuals attending MHS in particular is warranted.

Objectives: In Ireland, regularly reviewed Individual Care Plans (ICPs) for inpatients at all acute psychiatric inpatient units are a requirement of the Mental Health Act 2001. In this study, we comprehensively evaluated and compared opinions of key stakeholders in relation to the ICP as a care delivery tool. Methods: We employed a descriptive survey design. Questionnaires were distributed to 123 stakeholders (patients and mental health professionals (MHPs)) to evaluate and compare opinions regarding the impact of the ICP in relation to healthcare delivery and health outcomes, and regarding the structure and frequency of use of the ICP. Results: Ninety-eight stakeholders (80%) completed study questionnaires. Stakeholders (patients (58%) and MHPs (85%)) reported that the ICP assisted in healthcare delivery. However, different attitudes between groups were noted in relation to whether the ICP contributed towards healthcare outcomes, with 64% of patients, but only 41% of MHPs reporting that the ICP positively contributed to mental healthcare outcomes. Some free-text comments described patient dissatisfaction with the role of the ICP for healthcare delivery, and MHP dissatisfaction that the ICP was time-consuming and did not significantly enhance standard patient care. Conclusion: Whilst the implementation of the ICP is generally viewed positively by both patients and MHPs, considerable dissatisfaction by MHPs was also noted with certain aspects of how the ICP was delivered in practice. Practical adjustments to the implementation of ICP in order to build more positive stakeholder experiences appear warranted and worthy of further research.

Introduction and aims: Objective structured clinical examinations (OSCEs) play a pivotal role in medical education assessment. The Advanced Clinical Skills (ACS) OSCE examines clinical skills in psychiatry, general practice, obstetrics and gynaecology and paediatrics. This study examined if the 2020 ACS OSCE for fourth year medical students attending the National University of Ireland, Galway, was associated with any significant result differences compared to the equivalent 2019 OSCE. Additionally, we assessed students’ satisfaction and explored any organisational difficulties in conducting a face-to-face OSCE during the COVID-19 pandemic. Materials and methods: This study compared anonymised data between the 2019 and 2020 ACS OSCEs and analysed anonymised student feedback pertaining to the modified 2020 OSCE. Results: The mean total ACS OSCE result achieved in 2020 was statistically higher compared to the 2019 OSCE [62.95% (SD = 6.21) v. 59.35% (SD = 5.54), t = 6.092, p < 0.01], with higher marks noted in psychiatry (p = 0.001), paediatrics (p = 0.001) and general practice (p < 0.001) with more students attaining honours grades (χ2 = 27.257, df = 3, p < 0.001). No difference in failure rates were found. Students reported feeling safe performing the 2020 OSCE (89.2%), but some expressed face-mask wearing impeded their communication skills (47.8%). Conclusion: This study demonstrates that conducting a face-to-face OSCE during the pandemic is feasible and associated with positive student feedback. Exam validity has been demonstrated as there was no difference in the overall pass rate.

Studies seeking predictors of outcomes after involuntary admission, including quality of life (QoL), are limited and results inconsistent. We aimed to describe QoL 3 months after involuntary psychiatric admission and to investigate associated factors. One hundred and fifty-three involuntarily admitted inpatients were assessed for a range of sociodemographic and clinical variables. Structured scales included the Brief Psychiatric Rating Scale (BPRS), the MacArthur Admission Experience Survey, the Heinrichs Quality of Life Scale and the World Health Organisation Quality of Life Brief Assessment (WHOQOL-BREF, n = 124). The mean total score on the Heinrichs QoL scale at 3 months was 69.3 (SD = 24.1). Predictors of higher 3 month QoL after involuntary admission in a multiple regression model (adjusted R

ObjectivesTo describe similarities and differences in mental health legislation between five jurisdictions: the Republic of Ireland, England and Wales, Scotland, Ontario (Canada), and Victoria (Australia).MethodsAn in-depth examination was undertaken focussing on the process of involuntary admission, review of Admission Orders and the legal processes in relation to treatment in the absence of patient consent in each of the five jurisdictions of interest.ResultsAll jurisdictions permit the detention of a patient if they have a mental disorder although the definition of mental disorder varies between jurisdictions. Several additional differences exist between the five jurisdictions, including the duration of admission prior to independent review of involuntary detention and the role of supported decision making.ConclusionsAcross the five jurisdictions examined, largely similar procedures for admission, detention and treatment of involuntary patients are employed, reflecting adherence with international standards and incorporation of human rights-based principles. Differences exist in relation to the criteria to define mental disorder, the occurrence of automatic review hearings in a timely fashion after a patient is involuntarily admitted and the role for supported decision making under mental health legislation.

ObjectivesOur principle objective was to examine the personal and professional impact of service user (SU) suicide on mental health professionals (MHPs). We also wished to explore putative demographic or clinical factors relating to SUs or MPHs that could influence the impact of SU suicide for MHPs and explore factors MHPs report as helpful in reducing distress following SU suicide.MethodsA mixed-method questionnaire with quantitative and thematic analysis was utilised.ResultsQuantitative data indicated SU suicide was associated with personal and professional distress with sadness (79.5%), shock (74.5%) and surprise (68.7%) particularly evident with these phenomena lasting less than a year for more than 90% of MHPs. MHPs also reported guilt, reduced self-confidence and a fear of negative publicity. Thematic analysis indicated that some MHPs had greater expertise when addressing SU suicidal ideation and in supporting colleagues after experiencing a SU suicide. Only 17.7% of MHPs were offered formal support following SU suicide.ConclusionSU suicide impacts MHPs personally and professionally in both a positive and negative fashion. A culture and clear pathway of formal support for MHPs to ascertain the most appropriate individualised support dependent on the distress they experience following SU suicide would be optimal.

Aims To ascertain epilepsy prevalence in Irish psychiatric inpatient units and compliance with care planning guidelines. Methods Case records were reviewed in seven psychiatric inpatient units. Results The prevalence of epilepsy across seven psychiatric inpatient units (n=9/267) was three times that of general population estimates. Minimal data was recorded pertaining to seizure type (n=1,11.1%), triggers (n=2,22.2%), clinical investigations relating to epilepsy (n=2,22%) and no epilepsy risk assessments were recorded (n=0,0%). Conclusions The introduction of appropriate care plans is needed to optimise physical and mental wellbeing of those with epilepsy in psychiatric units.

Aims and methodWe aimed to evaluate clinical note documentation of valproate prescribing and establish the level of knowledge among women of child-bearing potential regarding valproate-associated adverse effects, including teratogenesis, in a regional Irish mental health service.ResultsOf the 42 women prescribed sodium valproate, 21.4% (n = 9) had some documentation in relation to associated risks and 33.3% (n = 14) described an awareness of these risks from consultation with their treating mental health team. On clinical interview, 9.5% (n = 4) of individuals with clear documentation of the risks of teratogenesis described no such awareness. Augmentation with lithium was associated with greater awareness of the teratogenic risks of valproate (P = 0.011).Clinical implicationsA clear description of the teratogenic risks of valproate and potential management strategies, including advice regarding contraception and supplementation with folic acid, should be clearly documented and provided repeatedly and in context to all women of child-bearing age who are prescribed valproate.Declaration of interestNone.

Purpose – The purpose of this paper is to determine the drivers of economic financial success of US cow-calf operations. Design/methodology/approach – This research uses a system of equations (DuPont analysis) in conjunction with 2008 farm-level data from the US Department of Agriculture's Agricultural Resource Management Survey to evaluate the factors driving cow-calf profitability, namely net profit margins, asset turnover ratio, and asset-to-equity ratio. Findings – The study finds that the main drivers of return on equity are region, number of harvested acres on the farm, diversification of the farm, operator off-farm work, spousal off-farm work, and adoption of technologies. Of these factors, those for which producers can make short-term adjustments include off-farm work decisions and adoption of technologies. Longer-term adjustments can be made for farm diversification. Originality/value – To the authors’ knowledge, no existing research has used farm-level data across US production regions to examine the factors affecting returns to equity of US cow-calf operations. These research results may be used to identify strategies producers can use to improve their farm's economic viability, areas where extension services can assist farmers in making better financial decisions and economic factors that are likely to lead to structural changes in the beef industry.

Many factors shape the global network of bilateral trade including fundamental forces of supply and demand factors and government policies. This study uses the generalised gravity framework to distinguish among the different drivers that either deter or aid partner trade in land-intensive agriculture and labour-intensive clothing. The dataset used in the analysis includes bilateral trade among 70 countries in 1995, 2000 and 2005. Collectively, the 70 countries account for 85% of the world’s trade in agriculture and 96% of its GDP. Empirical results lend support to the Heckscher–Ohlin explanation of trade, namely that relative factor endowments motivate cross-border trade. Results also show that tariffs are not always binding and bilateral free-trade agreements more often divert rather than create trade.

Multiple forces operate throughout the global economy and influence the direction, composition, and volume of agri-food trade. The fundamental determinants that impede and foster bilateral trade in two food types, namely staple commodities and manufactured products, are identified using generalized gravity equations. Empirical evidence verified the importance of relative resource endowments and similarities in the structure of partner demand. Other socio-geo-political factors were also found to influence food trade, including the ability of governments to control corruption and curtail disequilibrium in financial markets.

Price transmission is a critically important issue that affects market enlargement and the unification of Canadian–U.S. agriculture. This study adopts alternative frameworks to examine the nature of cross-border integration in selected meat and livestock markets. The aim is to determine the extent to which selected meat and livestock markets transmit price signals across the international border using time-series data through 2001. Typically, price-based studies examining market integration across countries ignore important spatial and temporal factors affecting commodity price relationships such as adjustments lags, changes in the value of national currencies, and policy-induced trade barriers. Here, we account for such factors in our two model specifications. The first model is based upon the law-of-one price (LOP) framework and focuses on spatial efficiency. The second analytical framework is the vector autoregressive (VAR) model that highlights the dynamic notion of market connectedness. The LOP analysis permits us to formally test the existence of perfect market integration and complete market segmentation. The VAR analysis enables us to gauge price-shock transference. Empirical evidence is generated confirming that the two national markets for whole chicken are segmented, a not unsurprising finding given that poultry is a supply managed sector in Canada. The Canadian–U.S. hog- and pork-product markets were found to be more integrated than the Canadian–U.S. steer- and beef-product markets. Evidence is also provided showing that the Canadian–U.S. exchange rate inhibits cross-border integration in these commodity markets. La transmission des prix est un sujet extremement important qui gene l'expansion des marches et l'unification de l'agriculture du Canada et des Etats-Unis. Dans la presente etude, nous avons utilise divers cadres d'analyse pour examiner la nature de l'integration transfrontaliere de marches selectionnes de la viande et des bestiaux. L'objectif consistait a determiner l'etendue avec laquelle des marches selectionnes de la viande et des bestiaux transmettent des signaux de prix au-dela des frontieres en utilisant des donnees de series chronologiques jusqu'en 2001. Generalement, les etudes de prix qui examinent l'integration des marches entre les pays font abstraction de facteurs spatiaux et temporels importants touchant le rapport des prix des produits de base tels que le decalage dans les rajustements, la variation du cours des devises nationales et les obstacles au commerce induits par les politiques. Dans le present article, nous avons tenu compte de ces facteurs dans les specifications de deux modeles. Le premier est modele fonde sur la loi du prix unique qui met l'accent sur l'efficacite spatiale. Le deuxieme est un modele d'autoregression vectorielle (VAR) qui met en evidence la notion dynamique de la connexite des marches. Le modele fonde sur la loi du prix unique nous a permis de verifier l'existence de l'integration parfaite et de la segmentation totale des marches. Le modele d'autoregression vectorielle nous a permis d'evaluer le transfert d'un choc de prix. L'evidence empirique a confirme que les deux marches nationaux du poulet entier etaient segmentes, un resultat qui n'est pas sans surprise compte tenu que l'elevage du poulet au Canada est un secteur soumis a la gestion de l'offre. Nous avons trouve que les marches canado-americains des porcs et de la viande porcine etaient plus integres que les marches canado-americains des bovins et de la viande bovine. L'evidence empirique a egalement montre que le taux de change entravait l'integration transfrontaliere de ces marches de produits de base.

We developed a single-equation decomposed negative binomial regression model (NBRM) of the U.S. farm sector to simultaneously evaluate structural changes in the U.S. agricultural sector and the strength of several economic forces that influenced the changes in farm structure during the 1960–96 period. We found all these forces reinforced economic incentives to increase the size and decrease the number of small farms. Only agricultural programs and machinery prices countered these forces. Nous avons elabore un modele de regression binomiale negative (NBRM) decomposeaequation unique pour le secteur agricole des Etats-Unis afin d'evaluer simultanement les changements structurels de ce secteur ainsi que la puissance de plusieurs forces economiques qui ont influence les changements de structure des exploitations agricoles au cours de la periode 1960–96. Nous avons conclu que toutes ces forces ont renforce les stimulants economiques en faveur d'une augmentation de la taille des exploitations et d'une diminution du nombre de petites exploitations. Seuls les programmes agricoles et le prix de la machinerie ont contrecarre ces forces.

In this article, we estimate the growth and relative levels of agricultural productivity for the forty-eight contiguous states for the period 1960-99. For the full 1960-99 period, every state exhibits a positive and generally substantial average annual rate of TFP growth. There is considerable variance however. The median rate of TFP growth was 1.71 % per year, while average growth rates ranged from 0.73% for Oklahoma to 2.59% for Michigan. The wide disparity in growth rates resulted in substantial changes in the rank order of states. For each year, we compute the coeffecient of variation of productivity levels for all forty-eight states. We use these coefficients to show that the range of levels of TFP has narrowed somewhat over time. The fact that some states grew faster than others and yet the cross-section dispersion decreased implies that the states that grew most rapidly were those with lower initial levels of productivity, a finding consistent with technological catch up. Those states that were particularly far behind the technology leaders had the most to gain from the diffusion of technical information and proceeded to grow most rapidly. Finally, we observe a positive and statistically significant relation between productivity growth and growth of the capital-labor ratio, implying embodiment of technology in capital.

USDA uses the concept of “publish-ability” rather than statistical reliability of an estimate for quality validation of USDA estimates, which is solely based on the sample size and the coefficient of variation (CV). We demonstrate conceptually how the reliability of the sample mean can be tested by estimating the upper and lower bounds of the confidence interval for an unknown population mean using the CV. However, the reliability test for the sample mean can be made only under the normality assumption. USDA multiple-way Agricultural Resource Management Survey (ARMS) estimates are used to illustrate the relative measure of precision for sample-based estimators.

This paper states four realities of econometric model building and shows that an econometric model can be causal only if the interpretations given to its coefficients are consistent with these realities. A numerically stable algorithm for estimating such a model subject to equality and inequality constraints on the model parameters is presented. This algorithm is designed in such a way that it can be applied even when the matrix of observations on the model's independent variables and the covariance matrix of the model's errors are deficient in rank.

Recent international financial crises (East Asia in 1997, Russia in 1998, Brazil in 1999) and the speed with which they have spread across countries and regions have called into question the very desirability of financial globalization, that is, the opening of balance of payments' capital accounts in both developed and emerging economies since the mid 1980s.1 Calls for a new, global financial architecture have multiplied, and new and old theoretical arguments for and against controlling capital flows (as well as domestic financial markets, especially banks) have been put forward (IMF, Rodrik, Stiglitz). There is little empirical evidence to support the debate over the potential effects of enhanced financial volatility at the sectoral level, and especially on the agricultural economy. Has international financial volatility actually affected real sectoral performance, and if so how? After briefly reviewing literature in this area, this paper introduces the methodology and preliminary results of an on-going research project that addresses that question with reference to agricultural commodity trade. The purpose of the paper is both to generate productive discussion and to motivate similar research in this

IntroductionThe Mental Health Act 2001 provides a legal framework for the involuntary admission and treatment of individuals deemed to have a mental disorder to psychiatric units. The perspectives of people who have been detained are relatively poorly understood.ObjectiveTo develop a theoretical understanding of individual's experiences throughout the trajectory of their detention and to understand the psychological and social processes that individuals use to cope before, during and after detention.MethodsFifty individuals subject to detention across three psychiatric units consented to be interviewed three months after their detention. Using a semi-structured interview people recounted their experiences. Interviews were analysed using the principles underpinning Grounded Theory.ResultsThe theory ‘Preserving Control’ encapsulates individuals’ experiences and consists of three related themes: ‘Losing Control’, ‘Regaining Control’ and ‘Maintaining Control’. ‘Losing Control’ describes individuals’ experiences of losing their autonomy and liberty thought the process of detention and hospitalisation. ‘Regaining Control describes, the strategies individuals used in an attempted to restore their loss of autonomy and control. ‘Maintaining Control’ describes how individuals lived with the consequences of detention and contended with impact on discharge.ConclusionsWhilst a large variation existed in relation to the subjective experience of being detained, the characteristic process that individuals tend to experience related to identifiable phases of preserving control in the face of this loss of autonomy. Findings from this study highlight the importance of more sensitive interactions support and information during and after the detention process.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Agricultural commodity analysts have systematically overpredicted livestock prices during the 1980s by using econometric forecasting models that do not account for changing economic conditions. This article compares the out-of-sample forecast performance of the Swamy—Tinsley stochastic coefficients model with ordinary least squares, Cochrane—Orcutt, and maximum likelihood procedures that estimate red meat and chicken prices. The ability of a stochastic coefficients model to adapt quickly to changing economic conditions helps make it almost uniformly superior to a fixed coefficients model in forecasting the quarterly retail price for beef and chicken. The Cochrane—Orcutt and maximum-likelihood procedures appear to forecast pork prices better.

This article reports tests of aggregation over consumer food products and estimates of aggregate food demand elasticities. Evidence that food demand variables follow unit root processes leads us to build on and simplify existing tests of the Generalized Composite Commodity Theorem. We compute food demand elasticities using a method of cointegration that is shown to apply to a convenient but nonlinear functional form. Estimates are based on consumer reported expenditure data rather than commercial disappearance data. Appropriately specified models of consumer demand are central to market analysis. It has been established that a valid equilibrium for markets characterized by diverse firms or diverse consumer products depends on downward-sloping composite demand curves (Heiner, Braulke, Wohlgenant) or on valid indirect utility functions (Chavas and Cox). Given the large number of consumer food products, food demand and price analysis must be implemented at some level of product aggregation. Improper aggregation can lead to biased estimates of welfare loss associated with public policies, biased estimates of consumer and derived demand elasticities, and misleading tests of market power. Testing for consistent aggregation over food products and estimating aggregate consumer food demand elasticities are the subjects of this article. By far, the most common justification for aggregation has been separable preferences. One reason for its popularity has been the lack of a viable alternative. Tests of the Composite Commodity Theorem (Hicks, Leontief, Lewbel) are always rejected because it restricts relative prices within a group to remain fixed over time. On the other hand, aggregation based on weak separability is often rejected (Diewert and Wales, Eales and Unnevehr).

We propose a technique for computing parameter estimates of dynamic and stochastic programming problems for which boundary conditions must be imposed. We demonstrate the feasibility of the technique by computing and interpreting the estimates of a dynamic food price margin model using secondary economic time series data.

Paige (1979) has produced a reliable computational approach for solving the generalized linear least squares problem. This approach is used here to produce a numerically stable algorithm for computing stochastic coefficients models. This algorithm is well suited to these models because the matrices appearing in them may be singular and the algorithm is made to handle any rank deficiency.

Let A be a finite dimensional algebra over a field F of characteristic zero and let L be a completely reducible Lie algebra of derivations of A. If A is associative, then there exists an L-invariant Wedderburn factor of A. If A is a Lie algebra, there exists an L-invariant Levi factor of A. If A is a solvable Lie algebra, there exists an L-invariant Cartan subalgebra of A. This paper deals with the uniqueness of such L-invariant subalgebras. For the associative case the assumption of characteristic zero can be dropped if we assume that the radical of A is L-invariant.

A simple recursive algorithm is provided for evaluating the noncentral chi-squared distribution function. This algorithm basically reduces the problem to that of evaluating a single central chi-squared distribution function. The algorithm is summarized in a step-by-step form, and a good algorithm for evaluating the central chi-squared distribution function is also given in a step-by-step form.