Does a comprehensive service user-led education programme effect more positive attitudes towards recovery and less stigmatising attitudes towards people with lived experience of mental distress in medical students? A comparative cohort study.

Objective: This study sought to investigate the impact of a service user-led anti-stigma and discrimination education programme, encompassing numerous interventions focused on facilitating multiple forms of social contact, the promotion of recovery, and respect for human rights, on medical student attitudes.

Method: A comparison cohort study was used to compare the attitudes of two cohorts of medical students who received this programme as part of their fifth (the fifth-year cohort) or sixth (the sixth-year cohort) year psychological medical education attachment (programme cohorts) with two cohorts of equivalent students who received a standard psychological medical attachment (control cohorts). Attitudes to recovery (using the Recovery Attitudes Questionnaire) and stigma (using the Opening Minds Scale for Healthcare Providers) were measured at the beginning and end of the attachments for each year and compared both within and between the cohorts using Wilcoxon signed-rank or Wilcoxon rank-sum tests.

A comparative analysis of two alternative programmes to counter stigma and discrimination associated with mental illness delivered to medical students.

Objective: To assess and compare attitudes of medical students in response to two service-user-led anti-stigma and discrimination education programmes.

Method: Two programmes, consistent with the key elements of effective contact-based anti-stigma and discrimination education programmes for healthcare providers, were delivered to medical students in their penultimate and final year: a more intensive version of the programme in 2015/2016 and a briefer programme in 2016/2017. Attitudes were assessed using the Recovery Attitudes Questionnaire (RAQ) and the Opening Minds Stigma Scale for Health Care Providers (OMS-HC-20) at the beginning and end of their final year.

Key Ingredients-Target Groups, Methods and Messages, and Evaluation-of Local-Level, Public Interventions to Counter Stigma and Discrimination: A Lived Experience Informed Selective Narrative Literature Review.

A proliferation of recent literature provides substantial direction as to the key ingredients-target groups, messages and methods, and evaluation-of local-level, public interventions to counter stigma and discrimination. This paper provides a selective narrative review of that literature from the perspective or standpoint of anti-stigma experts with lived experience of mental distress, the key findings of which have been synthesised and presented in diagrammatic overviews (infographics). These are intended to guide providers in planning, delivering and evaluating lived experience-directed local-level, public interventions to counter stigma and discrimination in accord with current best practice.

New Zealand's mental health legislation needs reform to avoid discrimination.

New Zealand's Mental Health (Compulsory Assessment and Treatment) Act (the Act) is now over 20 years old. As has occurred historically our conceptualisation of humane treatment of people with mental illness has altered significantly over the period in which the Act has been in force. The emergence of the philosophy of recovery, and its subsequent policy endorsement, has seen a significant shift in mental health service delivery towards a greater emphasis on autonomy.

Modified criteria for the systemic inflammatory response syndrome improves their utility following cardiac surgery.

Background: Debate remains regarding whether the systemic inflammatory response syndrome (SIRS) identifies patients with clinically important inflammation. Defining criteria may be disproportionately sensitive and lack specificity. We investigated the incidence and evolution of SIRS in a homogenous population (following cardiac surgery) over 7 days to establish the relationship between SIRS and outcome, modeling alternative permutations of the criteria to increase their discriminatory power for mortality, length of stay, and organ dysfunction.

Discovering stigma through recovery teaching.

Objective: From the perspective of the tutor, course coordinators and a clinical supervisor, we describe and reflect on our observations of innovative service-user led tutorials on recovery that were delivered to final year medical students as part of their psychiatric module.

Conclusions: Much to our surprise, and in contrast to observations elsewhere during the module, students openly expressed blatant stigmatising attitudes in the tutorials on recovery, particularly after spending time with inpatient services. More specifically, they were pessimistic about the possibility of recovery and they struggled to accept the service user status of the recovery tutor.

Core dimensions of recovery: a psychometric analysis.

Core recovery dimensions lie between the large general factor of recovery and its underlying components. Identifying these could enhance recovery frameworks, practice and research. In contrast to existing conceptually based taxonomies, we sought to empirically identify the core dimensions of recovery through further psychometric analysis of a robust eleven factor (sub-scale) consumer recovery outcome measure, My Voice, My Life.

Recovery constructs and the continued debate that limits consumer recovery.

It is generally agreed that the concept of recovery is the result of two primary influences: longitudinal studies and the work, writing, perspectives, and advocacy of the consumer-survivor movement. To clarify what is actually meant by recovery, investigators have compared and contrasted the constructs being conveyed through each primary influence. This process has resulted in the proposal of two main taxonomies-"recovery from" as opposed to "recovery in" and "recovery as an outcome" as opposed to "recovery as a process.

Recovery of evidence-based practice.

Consumer recovery is now enshrined in the national mental health policy of many countries. If this construct, which stems from the consumer/user/survivor movement, is truly to be the official and formal goal of mental health services, then it must be the yardstick against which evidence-based practice (EBP) is judged. From a consumer-recovery perspective, this paper re-examines aspects of services chosen for study, methodologies, outcomes measures, and standards of evidence associated with EBP, those previously having been identified as deficient and in need of expansion.

Development of a self-assessed consumer recovery outcome measure: my voice, my life.

We report the development of a self-assessed consumer recovery outcome measure by way of a consumer led and focused iterative process, informed by exploratory and confirmatory factor analysis. The process began with a deliberately over-inclusive preliminary measure of 127 items, based on 12 presumptive domains derived from the recovery literature and consumer consultation, being piloted with over 500 mental health consumers. The full 504 participant data set was randomly split into two discrete sets of 300 and 204 to provide one for the initial exploratory factor analysis and another (of independence) for the subsequent confirmatory factor analysis and reliability estimation.

Investigation of endothelial function by pulse contour analysis: a protocol for drug administration and timing of pulse contour assessment.

Aims: Pulse contour analysis (PCA) obtained by finger photoplethysmography produces a digital volume pulse (DVP) including an inflection point in its down-slope. The reflection index (RI: ratio of the inflection point height over the maximal DVP) is responsive to vasodilatation. We aimed to optimize the drug dose and time interval for assessing endothelial function using PCA in healthy volunteers and patients with severe coronary artery disease.