Recovery beyond clinical improvement - Recovery outcomes measured for people with bipolar disorder between 1980 and 2020.

Background: Outcome measurement in bipolar disorder (BD) traditionally focused on clinical improvement without considering other domains. Improvement trajectories in clinical and social-functional domains are different and can simultaneously appear in one while not in other domains. Measuring personal recovery (PR) has become a priority internationally.

Psychological factors in personal and clinical recovery in bipolar disorder.

Background: Research into bipolar disorder (BD) has primarily focused upon clinical recovery (CR), i.e. symptom reduction, and overlooked personally meaningful recovery outcomes emphasized by service users.

An analysis of whether a working-age ward-based liaison psychiatry service requires the input of a liaison psychiatrist.

This article presents a 12-month case series to determine the fraction of ward referrals of adults of working age who needed a liaison psychiatrist in a busy tertiary referral teaching hospital. The service received 344 referrals resulting in 1259 face-to-face contacts. Depression accounted for the most face-to-face contacts.

Predictive accuracy of risk scales following self-harm: multicentre, prospective cohort study.

Scales are widely used in psychiatric assessments following self-harm. Robust evidence for their diagnostic use is lacking.To evaluate the performance of risk scales (Manchester Self-Harm Rule, ReACT Self-Harm Rule, SAD PERSONS scale, Modified SAD PERSONS scale, Barratt Impulsiveness Scale); and patient and clinician estimates of risk in identifying patients who repeat self-harm within 6 months.

Opening the 'black box': liaison psychiatry services and what they actually do.

Aims and method To develop a simple, pragmatic typology to characterise the nature of liaison interventions delivered by a liaison service in a National Health Service setting. We carried out a retrospective electronic case-note review of referrals to a ward-based liaison psychiatry service. Results Three hundred and forty-four patients were referred to the service over a 12-month period.

Is Performance-Based Progress Testing in Psychiatry Feasible?

Objective: The aim of this study was to explore if competency-based progress tests for postgraduate psychiatry are reliable, if they are able to discriminate trainees at different levels of training, and if they are able to demonstrate improvement of trainees' skills from 3 years of data.

Methods: Psychiatry trainees in the North Western Deanery, UK, were invited to participate in the annual progress test. The progress test simulated the Clinical Assessment of Skills and Competencies (CASC) exam, the final postgraduate examination for psychiatry trainees.

Messages from Manchester: pilot randomised controlled trial following self-harm.

Studies of therapeutic contact following self-harm have had mixed results. We carried out a pilot randomised controlled trial comparing an intervention (information leaflet listing sources of help, two telephone calls soon after presentation and a series of letters over 12 months) to usual treatment alone in 66 adults presenting with self-harm to two hospitals. We found that our methodology was feasible, recruitment was challenging and repeat self-harm was more common in those who received the intervention (12-month repetition rate 34.

Workplace-based assessments in psychiatry: evaluation of a whole assessment system.

Objective: Work Place-Based Assessments (WPBAs) were introduced into psychiatry along with the new curriculum in 2005. The Royal College of Psychiatrists decided to pilot several WPBAs to ascertain their suitability.

Method: Eight types of assessments (Case-Based Discussion, Assessment of Clinical Expertise, Mini-Assessed Clinical Encounter, Mini-Peer Assessment Tool, Direct Observations of Procedural Skills, Patient Satisfaction Questionnaires, Case Conference, and Journal Club Presentation) were piloted, either singly or in combination, on 16 sites, with 600 psychiatric trainees.

The enculturation of our nursing graduates.

The transition from undergraduate nursing student to employment as a registered nurse is fraught with difficulties for a neophyte. This qualitative study used interviews and focus groups with graduate nurses from the Flinders University of South Australia in their first year of practice to ascertain their experiences as new graduates. The results reveal an enculturation of graduates not conducive to ongoing learning, consolidation of skills and application to practice.

Should I take my first offer? A graduate nurse survey.

The newly graduated registered nurses' experiences of applying for graduate nurse positions and securing employment in nursing has received little attention in academic nursing literature. This article reports on a survey questionnaire of a cohort of 1995 graduates from the School of Nursing at Flinders University of South Australia. The survey was the first phase of a research project dealing with the transition from education to employment or from university student to registered nurse.

Localization of CAM II kinase-alpha, GAD, GluR2 and GABA(A) receptor subunit mRNAs in the human entorhinal cortex.

The human entorhinal cortex (ERC) is an important relay between neocortical association areas and the hippocampus. Pathology in this area, including disturbances in its unique cytoarchitecture and alterations in neurotransmitter receptor binding, has been implicated in several neuropsychiatric disorders but details of the patterns of gene expression for molecules involved in the major neurotransmitter systems in this cortex have been lacking. We used in situ hybridization histochemistry to localize the mRNAs for several proteins which are involved in excitatory and inhibitory neurotransmission in the human ERC.

From university student to registered nurse: the perennial enigma.

Crucial issues related to the transition from university student to registered nurse are addressed, through a review of the literature. The considerable literature in this area indicates three distinct approaches in examining this question: there are personal and professional deficits which the new graduate must make up, the formal content of the university curriculum is deficient and must be replaced, the socio-political and professional contexts of practice constrains beginning practice. Each of these approaches is examined here in the expectation that uncovering these issues will encourage employers and educators to work together to resolve some of the current conflicts and difficulties inherent in the transition from university student to registered nurse.

Increased density of entorhinal glutamate-immunoreactive vertical fibers in schizophrenia.

Gluatamtergic fibers have been immunocytochemically localized in the entorhinal cortex of postmortem schizophrenic brains. The density of small caliber vertical fibers was higher in schizophrenics than controls, with no significant increase in the number of large caliber fibers. Increased glutamatergic fiber density has been previously reported in the cingulate cortex.

Use of MRI for measuring structures in frozen postmortem brain.

A method was developed for magnetic resonance imaging (MRI) of human autopsy brains stored long-term at -70 degrees C. Scanning brains at temperatures between -70 and -8 degrees C gave minimal MRI signals consistent with protons having limited freedom of movement at low temperature. Raising brain temperature improved the signal such that scanning at -1 degree C generated images with good in-plane resolution, grey/white matter contrast, and fine detail of cortical sulcal/gyral patterns.