The future of mental health nursing: are we barking up the wrong tree?

This commentary has been prompted by a degree of disquiet among the UK mental health nursing community in response to the Shape of Caring Review on the future of nurse education in England (Willis 2015). Proposals for the structure of nurse education have been interpreted as emphasizing generic at the expense of field-specific (e.g. mental health) education, with much specialist training beyond the scope of pre-registration courses (Lintern 2014, Middleton 2015). Specifically, there is a suggestion that student nurses will not enter their specialized field until completing two years of more generalist learning; reminiscent of the previous Project 2000 approach, criticized for supposed inadequate preparation of mental health students because general adult nursing dominated curriculum and teaching (UKCC 1999)

Understanding the experience of initiating community-based physical activity and social support by people with serious mental illness: a systematic review using a meta-ethnographic approach

Background People with long-term serious mental illness live with severe and debilitating symptoms that can negatively influence their health and quality of life, leading to outcomes such as premature mortality, morbidity and obesity. An interplay of social, behavioural, biological and psychological factors is likely to contribute to their poor physical health. Participating in regular physical activity could bring symptomatic improvements, weight loss benefits, enhanced wellbeing and when undertaken in a community-based group setting can yield additional, important social support benefits. Yet poor uptake of physical activity by people with serious mental illness is a problem. This review will systematically search, appraise and synthesise the existing evidence that has explored the experience of community-based physical activity initiation and key features of social support within these contexts by adults with schizophrenia, bipolar affective disorder, major depressive disorder or psychosis using the meta-ethnography approach. This new understanding may be key in designing more acceptable and effective community-based group PA programmes that meet patients’ need and expectations. Methods This will be a systematic review of qualitative studies using the meta-ethnography approach. The following databases will be searched: ASSIA, CINAHL, Cochrane Central Register of Controlled Trials, EMBASE, Health Technology Assessment Database, MEDLINE, PsycINFO, Sociological Abstracts, SPORTDiscus and Web of Science. Grey literature will also be sought. Eligible studies will use qualitative methodology; involve adults (≥18 years) with schizophrenia, bipolar affective disorder, major depressive disorder or psychosis; will report community-based group physical activity; and capture the experience of physical activity initiation and key features of social support from the perspective of the participant. Study selection and assessment of quality will be performed by two reviewers. Data will be extracted by one reviewer, tabled, and checked for accuracy by the second reviewer. The meta-ethnography approach by Noblit and Hare [1] will be used to synthesise the data. Discussion This systematic review is expected to provide new insights into the experience of community-based group physical activity initiation for adults who have a serious mental illness to inform person-centred improvements to the management of serious mental illness through physical activity. Registration The protocol has been registered on the International Prospective Register of Systematic Reviews (PROSPERO) on 22/03/2017; http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42017059948 (registration number CRD42017059948). Keywords Serious mental illness - Physical activity - Community - Social support - Exercise - Sport - Adults - Patient experience - Qualitative research - Meta-ethnography - Systematic revie

IMPACT OF COVID-19 ON ECT PRACTICE IN QATAR

There is paucity of Electroconvulsive therapy (ECT) utilization surveys from the Arabian Gulf region and none available from Qatar. There is no literature available on impact of Coronavirus Disease 2019 (COVID-19) pandemic on ECT provision. ECT is a lifesaving treatment in psychiatric practice requiring anesthetic support and there were concerns that redeployment of anesthetists due to COVID-19 pandemic might have comparatively bigger impact on the provision of ECT. These concerns stem from the fact that psychiatric patients often get discriminated against in health care systems; largely due to stigma and the belief among healthcare providers that psychiatric illness is somehow not as serious as other types of medical or surgical illness. In this brief report we present pre-COVID ECT utilization from Qatar. We also report findings on ECT utilization during COVID-19 and compare changes with other elective and non-elective surgeries. ECT provision was down by 40% during March to August 2020 in our setting. The decline in ECT provision was comparable to other elective and non-elective surgeries

Rapamycin inhibition of baculovirus recombinant (BVr) ribosomal protein S6 kinase (S6K1) is mediated by an event other than phosphorylation

<p>Abstract</p> <p>Background</p> <p>Ribosomal protein S6 kinase 1(S6K1) is an evolutionary conserved kinase that is activated in response to growth factors and viral stimuli to influence cellular growth and proliferation. This downstream effector of target of rapamycin (TOR) signaling cascade is known to be directly activated by TOR- kinase mediated hydrophobic motif (HM) phosphorylation at Threonine 412 (T412). Selective loss of this phosphorylation by inactivation of TOR kinase or activation/recruitment of a phosphatase has accordingly been implicated in mediating inhibition by rapamycin.</p> <p>Findings</p> <p>We present evidence that baculovirus driven expression of S6K1 in insect cells (Sf9) fails to activate the enzyme and instead renders it modestly active representing 4-6 folds less activity than its fully active mammalian counterpart. Contrary to the contention that viral infection activates TOR signaling pathway, we report that BVr enzyme fails to exhibit putative TOR dependent phosphorylation at the HM and the resultant phosphorylation at the activation loop (AL) of the enzyme, correlating with the level of activity observed. Surprisingly, the BVr enzyme continued to exhibit sensitivity to rapamycin that remained unaffected by mutations compromised for TOR phosphorylation (T412A) or deletions compromised for TOR binding (ΔNH _2-46/ΔCT₁₀₄).</p> <p>Conclusions</p> <p>These data together with the ability of the BVr enzyme to resist inactivation by phosphatases indicate that inhibition by rapamycin is not mediated by any phosphorylation event in general and TOR dependent phosphorylation in particular.</p

Policy and legislation for the treatment of mental health and substance use disorders in Qatar

There is a marked paucity of publications on the policy and legislation of mental health, and substance use disorders in the public domain in Qatar. Qatar National Vision provides a framework for national strategies and the State of Qatar has developed policies and legislation dedicated to mental health and substance use. In doing so, Qatar has adopted international guidance to shape its mental health services and relevant policy and legislation. This article is a narrative description of the evolution of the mental health and substance use policy and legislation in Qatar.Open Access funding provided by the Qatar National Library. OW wrote the initial draft of the manuscript. All the authors read and approved the final manuscript.Scopu

Mental health stigma: The role of dualism, uncertainty, causation and treatability

Public stigma on mental health has been defined as 'the set of negative attitudes and beliefs that motivate individuals to fear, reject, avoid and discriminate against people with mental illness'. Stigma causes immense suffering to people with mental disorders across the globe. According to a recent Human Rights Watch report, people with mental health conditions are still shackled in 60 countries. Nearly nine out of 10 mental health service users in England have experienced discrimination. Stigma can be perpetuated by people in all walks of life, including the family and friends of those with mental disorders, and healthcare professionals, including those working in mental health. The adverse consequences of stigma include shame, self-blame, isolation and discrimination. Examples of discrimination experienced by people with mental health disorders include others avoiding their company, and education, employment and housing opportunities being withheld. Stigma can deter people with mental health problems from seeking help and leads to poor adherence to treatment. People with mental disorders have high rates of physical comorbidity and higher mortality compared with the general population. The reasons for these health disparities are multifactorial, but discrimination and diagnostic overshadowing are believed to contribute. Mental health stigma has many causes including lack of knowledge and inaccurate beliefs, especially regarding the relationship between mental illness and violent behaviour. In this article, we highlight mind-body dualism and an underappreciation of the similarities that can exist between mental and physical disorders as contributory factors to stigma. Negative assumptions about psychiatry include it involving uncertainty, the causation of disorders being poorly understood and conditions having poor treatability. These are misleading generalisations, but more relevant to this article is the fact that these features can be encountered in both psychiatry and general medicine.Scopu