Lincolnshire Partnership NHS Foundation Trust

a:2:{s:4:"lang";s:2:"en";s:7:"content";s:1545:"<h3>Introduction</h3> Multiple sclerosis (MS) exhibits familial clustering, with increased susceptibility among first-degree relatives. Recent advancements in diagnostic criteria and the availability of disease-modifying therapies have opened avenues for potential screening programs. However, understanding the perspectives of people with MS (pwMS) on screening their relatives is crucial for determining the feasibility and acceptability of such initiatives. <h3>Aims</h3> To explore attitudes of pwMS towards screening of their first-degree biological relatives. <h3>Methods</h3> Semi-structured interviews were conducted with 31 pwMS conveniently sampled when attending clinic. Field notes were taken throughout the interviews and data was analysed using framework analysis. <h3>Results</h3> 77.4% of participants were positive about screening. Key themes within positive responders included reduced uncertainty and options for earlier treatment. Themes from PwMS with negative attitudes highlighted a lack of genetic risks awareness and concerns about increased mental health burden. Participants were more positive when acknowledging their treatment efficacy. <h3>Conclusion</h3> This study overall provides evidence supporting screening for MS. However, concerns about the potential negative psychological impact of screening require further investigation. Future research should focus on eliciting the perspectives of first-degree relatives regarding potential screening programs. ishodge03{at}gmail.com ";}

Restraints in mental health in-patient settings can negatively affect recovery. This study aimed to examine the prevalence and associated factors of restraint use. A retrospective cohort study was conducted in a rural NHS mental health trust in the UK, covering all adult in-patients from July 2020 to July 2021. The prevalence of restraint was 34%. Factors associated with restraint included age 18-25 or ≥65 years, female gender, disability, long-term sickness benefits, detention under the Mental Health Act, frequent admissions and a diagnosis of depressive or severe mental illness. Statistically significant associations were found for age ≥65 years (odds ratio 3.920), Section 2 detention (odds ratio 5.72), more than ten previous admissions (odds ratio 5.672) and depressive disorders (odds ratio 3.478). Restraint use remains common and is linked to identifiable risk factors. These findings support the need for targeted interventions to reduce restraint, particularly for high-risk patient groups.

Intimate partner violence has a significant impact on people as individuals, as families, and as communities. The ripple effects extend beyond the immediate victims, straining healthcare systems, stifling economic productivity, and hindering social progress. The study aims to present the spatial distribution of intimate partner violence prevalence, identify socio-demographic and contextual predictors, and establish associations with public health indicators. This is a secondary data analysis, using a nationally representative demographic and health survey (DHS) conducted in Nigeria. A two-stage stratified random sampling was employed in the standard DHS survey and 10,678 women of childbearing age were randomly selected for the intimate partner violence module. A Research Proforma of the selected variables from DHS was used to extract the data required for the study. Descriptive and inferential analyses were carried out on the data using Microsoft Excel dashboards, spatial map and random-intercept logistic regression. The study found the prevalence of intimate partner violence across the country to be 33.9%. Region and place of residence had significant association with intimate partner violence (p < 0.05). The multivariate analysis identified ethnicity difference of couple (OR = 1.23, 95% CI: 1.03-1.48), age (OR = 1.02, 95% CI: 1.01-1.03), sex of household head (OR = 2.19, 95% CI: 1.22-3.94), jealousy (OR = 1.67, 95%, CI: 1.50-1.86), family history of intimate partner violence (OR = 2.79, 95% CI: 2.29-3.40), and alcohol consumption (OR = 3.01, 95% CI 2.54-3.58) among other factors as the socio-demographic and contextual factors influencing intimate partner violence. Intimate partner violence also had a significant association with mental health, physical health, and sexual health. The spatial analysis done on the prevalence of intimate partner violence found a variation in the occurrence of intimate partner violence across the States of the country, while the probability of intimate partner violence obtained from the model ranges from 0.24 to 0.85. The study identified communities in Nigeria with higher probability of intimate partner violence (IPV). These communities should be priortised for targeted intervention, also it is recommended that laws on IPV should be strengthened at national and regional levels.

The traditional sequential clinical approach to medical assessment is to take a history, examine the patient, create a differential diagnosis, consider some investigations, confirm the diagnosis and then commence management, see figure 1A.

The FPOP inpatient workstream was first developed in 2013 following recognition of a growing need in the area. In 2019 the long-term plan came out detailing how care should be delivered across the patient journey, and this was then followed by the Acute Inpatient Standards and Culture of Care in 2023 and 2024 respectively. It was agreed that a renewed focus on older adult inpatient care was needed and the workstream reformed. Three areas of work have been identified and will be the foci for the workstream over the next year.

Diabetes mellitus, which is a case of impaired metabolism related to insulin production or resistance occurs. Serum uric acid levels elevating to some extent were related to diabetes and metabolic syndrome. Hyperuricemia is a serious health risk that may underlie metabolic disorders, such as type 2 diabetes and metabolic syndrome. Objective: To investigate the correlation of uric acid and triglyceride variables with glycemic control in patients with Type 2 Diabetes Mellitus (T2DM). Methods: A Comparative cross-sectional study was conducted on 167 patients categorized into non-diabetic (n=59), diabetic with good glycemic control (n=41), and diabetic with poor glycemic control (n=62) groups. Sociodemographic data and serum variables were recorded. Statistical analysis was performed using SPSS version 26.0, employing one-way ANOVA and Pearson correlation tests. Results: Patients with poor glycemic control exhibited significantly higher fasting blood sugar levels and triglyceride glucose index compared to non-diabetic and well-controlled diabetic individuals. However, there were no significant differences in serum uric acid levels and UHR among the study groups. A positive correlation was observed between the triglyceride glucose index and HbA1c, highlighting the association between intermittent blood glucose rises and worse glycemic outcomes. Conclusion: The triglyceride glucose index revealed the potential to be an inexpensive indicator to evaluate blood sugar levels and should be taken into consideration together with the other generally used indicators like HbA1c to strengthen diabetes management.

BackgroundTelehealth usage has been promoted in all settings but has been identified as a panacea to issues of access and equity in the rural context. However, uptake and widespread integration of telehealth across all parts of the health system has been slow, with a myriad of barriers documented, including in rural settings. The crisis of the COVID-19 pandemic, saw barriers rapidly overturned with the unprecedented and exponential rise in telehealth usage. The uniqueness of the crisis forced telehealth adoption, but as the urgency stabilises, pandemic learnings must be captured, utilised, and built upon in a post-pandemic world. The aim of this study was to document staff experiences and perceptions of delivering rural psychological therapies via telehealth during the pandemic and to capture learnings for future rural telehealth delivery.MethodsAn online cross-sectional survey that explored mental health professional’s experiences, use, and perceptions of telehealth before and after pandemic-enforced changes to service delivery.ResultsSixty-two respondents completed the questionnaire (response rate 68%). Both the delivery of telehealth via telephone and online video conferencing significantly increased during the pandemic (66% vs 98%, p < .001 for telephone and 10% vs 89%, p < 0.001 for online video). Respondents indicated that client’s access to services and attendance had improved with telehealth use but their attention and focus during sessions and non-verbal communication had been negatively affected. The challenges for older adults, people with learning and sensory disabilities, and residents in remote areas with poorer mobile/internet connectivity were identified. Despite these challenges, none of the respondents indicated a preference to return to fully face-to-face service delivery with most (86%) preferring to deliver psychological therapies fully or mostly via telehealth.ConclusionsThis study addresses three major gaps in knowledge: the experience of delivering local telehealth solutions to address rural mental health needs, the provision of strong rural-specific telehealth recommendations, and the dearth of rural research emanating from the United Kingdom. As the world settles into a living with COVID-19 era, the uniqueness of the rural telehealth context may be forgotten as urban myopia continues to dominate telehealth policy and uptake. It is critical that rural resourcing and digital connectivity are addressed.

IntroductionPoor sleep quality is a major problem in patients with autism spectrum disorder (ASD), and is attributed to low melatonin levels. Melatonin supplementation is recommended; however, its effectiveness varies. β‐Glucans have previously been shown to improve melatonin levels in animal studies. Herein, we examined the effectiveness of Aureobasidium pullulans (Nichi Glucan), a species of black yeast that contains beta‐1,3/1,6‐glucan, in a pilot study of children with ASD.MethodsThirteen children (age, 2.5–13 years) with ASD were recruited for the study. The control group consisted of four patients (Gr. 1), while nine patients were classified into the treatment group (Gr. 2). Gr. 2 received 1 g of Nichi Glucan along with conventional therapy, whereas the Gr. 1 (control) patients received conventional therapy alone for 90 days. Serum melatonin levels and sleep patterns, assessed using a subjective questionnaire, were evaluated before and after treatment.ResultsIn Gr. 2, the average serum melatonin level increased from 238.85 ng/L preintervention to 394.72 ng/L postintervention. Eight of nine participants (88%) in Gr. 2 showed improvements in sleep pattern and quality, while no improvement was observed in the participants in Gr. 1.ConclusionThe consumption of Nichi Glucan for 90 days resulted in visible improvement in sleep quality, sleep pattern, and serum melatonin levels, which was reported for the first time by our study. A larger multicenter study is required to validate our findings.

Autism and autistic traits are risk factors for suicidal behaviour. To explore the prevalence of autism (diagnosed and undiagnosed) in those who died by suicide, and identify risk factors for suicide in this group. Stage 1: 372 coroners' inquest records, covering the period 1 January 2014 to 31 December 2017 from two regions of England, were analysed for evidence that the person who died had diagnosed autism or undiagnosed possible autism (elevated autistic traits), and identified risk markers. Stage 2: 29 follow-up interviews with the next of kin of those who died gathered further evidence of autism and autistic traits using validated autism screening and diagnostic tools. Stage 1: evidence of autism (10.8%) was significantly higher in those who died by suicide than the 1.1% prevalence expected in the UK general alive population (odds ratio (OR) = 11.08, 95% CI 3.92-31.31). Stage 2: 5 (17.2%) of the follow-up sample had evidence of autism identified from the coroners' records in stage 1. We identified evidence of undiagnosed possible autism in an additional 7 (24.1%) individuals, giving a total of 12 (41.4%); significantly higher than expected in the general alive population (1.1%) (OR = 19.76, 95% CI 2.36-165.84). Characteristics of those who died were largely similar regardless of evidence of autism, with groups experiencing a comparably high number of multiple risk markers before they died. Elevated autistic traits are significantly over-represented in those who die by suicide.

Abstract Study objectives: Poor sleep quality is a major problem that patients with autism spectrum disorders (ASD) face, which is attributed to their low melatonin levels. Melatonin supplementation is recommended, but its effectiveness is varied. Beta-glucans have previously been reported to improve melatonin levels in animal studies. Therefore, we examined the effectiveness of Aureobasidium pullulans (Nichi Glucan), a species of black yeast that contains beta-1,3/1,6-glucan, in a pilot study of children with ASD. Methods Thirteen children (age = 2.5 to 13 years) with ASD were recruited into the study. The control group consisted of four patients (Gr. 1), while nine patients were in the treatment group (Gr. 2). Gr. 2 received 1 g of Nichi Glucan along with conventional therapy, whereas Gr. 1 underwent conventional therapy alone for 90 days. The serum melatonin levels and sleep patterns, assessed using a subjective questionnaire, were evaluated before and after treatment. Results In Gr. 2, the average serum melatonin level increased from 238.85 ng/dl pre-intervention to 394.72 ng/dl post-intervention. Eight out of nine subjects (88%) in Gr. 2 group showed and improvement in their sleep pattern and quality, while this improvement was not observed in the control group. Conclusions Our study is the first in the literature to report that consumption of Nichi Glucan for 90 days showed visible improvement in sleep quality, sleep pattern, and serum melatonin levels. A larger multicentre study is warranted to validate our findings.