Hellesdon Hospital

Hypothyroidism is a chronic health condition which causes physical, cognitive and psychiatric symptoms. The prevalence of hypothyroidism in adults with intellectual disabilities is under researched. Hypothyroidism was examined among 463 patients within an outpatient intellectual disability psychiatric team. Clinic records were utilised for this study, including sociodemographic, psychiatric and physical health diagnoses. Among the 463 patients, 43 (9%) had hypothyroidism. Compared to those without hypothyroidism, the hypothyroid group were significantly older, more likely to be female, and had increased rates of high cholesterol, diabetes, Down's Syndrome and dementia. Rates of hypothyroidism within this cohort of patients with intellectual disabilities were high (9%). The results suggest hypothyroidism in intellectual disability should be the focus of prospective research, in larger, more representative samples. This study indicates a need for increased awareness of, and resources for hypothyroidism in health services.

IntroductionIn dementia care, the integration of innovative interventions is essential to enhancing the wellbeing and quality of life of people with dementia. Among these interventions, the Music Mirror intervention has emerged as a promising tool to provide personalized audio-biographical cues aimed at soothing, motivating, and engaging people with dementia. This study examined the effects of a Music Mirror intervention on the (a) wellbeing, emotions, and behavioral and psychological symptoms of 155 individuals with dementia, (b) perceived burden, relationship quality, and gains of their informal/formal caregivers, and (c) momentary closeness, wellbeing and stress of caregivers.MethodsThis four-year study employed a quasi-experimental waiting-control group design, utilizing before-after measurements in Swiss hospitals, care homes, and domestic homes. For four 6-week intervention phases, Music Mirrors, i.e., brief written resources of acoustic material, associated with practical activities of daily life, were applied at least twice a week by the caregivers during critical moments such as staff handover. Repeated measures' analysis of variance and other tests were used to analyze the data.ResultsIndividuals with dementia had a higher wellbeing after the Music Mirror use across different care situations. While the Music Mirrors were played, individuals with dementia showed more positive than negative emotions at each measurement occasion, but emotion scores did not significantly change over time. After the MM use, caregivers felt better, closer to the person with dementia, and less stressed. Caregivers also reported significant gains at the end of the intervention. However, there were no significant changes in the frequency of the behavioral and psychological symptoms of dementia, care-related burden and relationship quality over time, regardless of the treatment condition.DiscussionBy incorporating personalized audio-biographical cues into their care routines, the wellbeing of people with dementia was improved as well as it had positive momentary effects on their caregivers. The Music Mirror intervention addresses the preferences and needs of people with dementia and helps build bonds between care-recipients and caregivers. Therefore, Music Mirrors can be seen as a highly adaptive and individualized instrument to improve momentary wellbeing of people with dementia in various care situations during daily life.

Morel-Lavallée lesions are traumatic abnormalities characterized by the accumulation of hemolymphatic fluid collection following disruption of subcutaneous fat tissue from the underlying deep fascia. Here, we present the case of a 63-year-old woman with a prepatellar Morel-Lavallée lesion, an unusual location for this pathology initially misdiagnosed as prepatellar bursitis. An MRI was performed allowing the correction of the diagnosis, highlighting the essential role of imaging in confirming the diagnosis and ruling out differentials such as prepatellar bursitis or neoplastic origins. In our case, conservative treatment with compression alone was employed, since surgery is reserved for chronic or complicated cases. Our experience underscores the utility of MRI in accurately delineating the anatomical extent and characteristics of prepatellar Morel-Lavallée effusion (PMLE). This imaging modality serves as a critical tool in guiding appropriate management strategies, ensuring timely and effective treatment for patients presenting with this lesion.

Clinical decision-making is an integral part of the nursing process, as well as a study requirement at Master's level for the advanced professional practice pathway. This article uses Gibbs' reflective cycle as a framework to explore a clinical decision made in practice. Through presentation of a case study of a patient with an adjustment disorder, the authors explore the process of prescribing appropriate treatment in the context of an uncertain evidence base. The authors will examine decision-making and communication theories and consider any biases, as well as ethical, organisational and professional factors that may influence the decision-making process. The individual and organisational steps needed to embed robust decision-making into practice will be discussed.

Anxiety and depression are listed as common side effects for medications licensed for treating ADHD in children and adolescents. This meta-analytic review of randomised controlled trials aimed to explore the effect of medications on symptoms of anxiety and depression in children and adolescents with ADHD. A meta-analytic review of ADHD drug trials in children and adolescents was conducted. Random effects meta-analyses were conducted on anxiety and depression outcomes measured by validated psychological scales or side effect rating scales. Only 11% of eligible trials in this review reported anxiety and/or depression as an outcome or side effect, limiting the conclusions of the meta-analyses. Relative to placebo control, no significant effect of medication was found for symptoms of anxiety or depression in randomised controlled trials of ADHD medication in children and adolescents. This review highlights the systemic lack of mental health outcome reporting in child and adolescent ADHD drug trials. The importance of widespread implementation of standardised measurement of mental health outcomes in future trials is discussed.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00787-022-02004-8.

The aim of this paper was to assess the prevalence of suicide ideation and attempts in Portuguese psychiatry trainees (adult and child and adolescence), and compare the data with the general population and other European countries. A structured and anonymous questionnaire was sent by email to 159 portuguese trainees of adult psychiatry and child and adolescence psychiatry with questions about personal history of suicidal ideation and suicide attempts, as well as family history of suicide attempts and completed suicides. This is part of the BoSS Study (Burnout Syndrome Study) performed in 21 countries worldwide. Data was analysed in SPSS v.19. From the inquired population, 62 trainees (40,3%) partially responded, and 46 (29%) were complete responders - these entered the final analysis. There was a ratio of 2:1 (female:male) and a mean age of 29 years. The suicidal ideation was present in passive form in 44% and in active form in 33%; also, 4.3% of respondents had previous suicide attempts. In first degree relatives, 22% had attempted suicide and 13% completed suicide. The results are worriying and may be associated with some factors to which this population is exposed. It is necessary further research to better understand this phenomenon, its causes and potential modifiers.

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To ascertain the provision and decontamination of uniforms within a cross-section of NHS trusts in the UK and to compare policies regarding their use. A questionnaire was circulated to 170 NHS trust infection control teams in the UK. Eighty-six (51 per cent) responses were received, which represented 101 NHS trusts. Less than half of the trusts (47 per cent) provide adequate numbers of uniforms to allow a clean uniform per shift. Only 26 per cent had adequate on-site staff changing facilities and 65 per cent did not launder uniforms. The majority of nursing staff (91 per cent) were compelled, by a combination of these factors, to launder their uniforms at home. Few were provided with any guidance on how to do this safely. There is an urgent need for minimum standards to be set for the provision of uniforms, laundering and changing facilities, to minimise the potential for spread of healthcare-associated infections.

The European Federation of Psychiatric Trainees (EFPT) is an independent federation of national trainee associations; it represents over 12 000 trainees in 19 member countries across Europe. It is run by an annually elected board, comprising the President, Secretary-General, Treasurer, President elect and past President, and is governed by a written constitution.