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An ethnographic study of pharmacist prescribers' competencies, collaboration, and barriers in hospital settings.
No full textOBJECTIVES: This ethnographic study explores hospital pharmacist prescribing practices in an inpatient multidisciplinary team (MDT) setting. This study aimed to identify the underlying mechanisms, including competencies, facilitators, and inhibitors, related to pharmacist prescribing practices in hospital settings. METHODS: Non-participant observations were conducted over six half-day sessions with three experienced prescribing pharmacists. Data were analysed using framework and thematic analysis. The RPS Competency Framework guided framework analysis, while thematic analysis identified overarching themes related to emotional intelligence and hierarchical dynamics. KEY FINDINGS: Key competencies frequently observed included interpreting patient records and collaborating with MDT members. Facilitators of effective prescribing included strong interdisciplinary collaboration and access to comprehensive patient information. Barriers such as fragmented IT systems, high workloads, and hierarchical constraints affected the pharmacists' ability to efficiently manage and document patient care. Emotional intelligence was identified as a critical skill for managing professional identity within hierarchical structures and handling the emotional toll of systemic inefficiencies. CONCLUSIONS: Pharmacist prescribers significantly enhance patient care through collaboration and proactive engagement in MDTs. However, systemic barriers, particularly IT-related inefficiencies and hierarchical dynamics, limit their full potential. Training in emotional intelligence and improved interdisciplinary support may enhance the effectiveness of prescribing pharmacists. Addressing systemic issues, especially IT infrastructure, could optimize prescribing efficiency and reduce cognitive load
Staff perceptions of the DIALOG tool and its use for early intervention in psychosis services
No full textEarly intervention in psychosis (EIP) services aim to delay or prevent the onset of severe mental health issues, including psychosis, and provide a stepped care approach for people experiencing emerging psychotic symptoms. The DIALOG service user-rated outcome and experience measure is used routinely in EIP services and provides a comprehensive assessment of service users’ quality of life, care needs and treatment satisfaction. This service evaluation explored staff’s perceptions of using DIALOG in one EIP service. Data were collected from 20 staff members (including 12 nurses) via a survey and a focus group. Themes extrapolated from focus group data were feasibility, engagement and facilitation. Findings showed that staff felt confident using DIALOG regardless of the number of years they had worked in the EIP service and that DIALOG supported person-centred conversations with service users. However, there was variability in how frequently DIALOG was administered and some staff regarded it as a tick-box exercise.https://journals.rcni.com/mental-health-practice/evidence-and-practice/staff-perceptions-of-the-dialog-tool-and-its-use-for-early-intervention-in-psychosis-services-mhp.2025.e1740/ab
A systematic review of burnout among nursing students: impact on academic performance, psychological well-being, and strategies for prevention
No full textAims/Background Burnout among nursing students has become a critical issue, negatively impacting their academic performance, psychological well-being, and professional development. This systematic review aims to synthesise literature on nursing student burnout and explore its effects on self-concept, engagement, and psychological health, along with strategies to mitigate burnout. Methods This review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and included studies published between January 2015 and January 2024. Data were extracted from peer-reviewed studies identified in databases including MEDLINE, CINAHL, PsycINFO, and SCOPUS, focusing on burnout among undergraduate and graduate nursing students. Results A total of 28 articles were included in the review. Three major themes emerged: (1) burnout’s negative effect on student self-concept and self-efficacy, (2) the protective role of academic and clinical engagement in preventing burnout, and (3) interventions such as resilience training and mindfulness-based programs that help reduce burnout. Promoting self-concept, fostering engagement, and building resilience were identified as key strategies to alleviate student burnout. Conclusion Burnout in nursing students is linked to poorer academic performance and psychological distress. Early interventions, such as resilience training and mindfulness, should be integrated into nursing programs to help mitigate burnout. Nurse educators and clinical supervisors can play a pivotal role by creating supportive and engaging learning environments that reduce burnout and promote students’ well-being.https://www.magonlinelibrary.com/doi/full/10.12968/hmed.2025.014
Multicultural Implementation-experiences of peer support workers in MH Services : qualitative findings of UPSIDES innovative intervention-an international multi-site project
Get PDFOpen Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.PURPOSE: Mental health peer support is growing as an essential recovery-oriented occupation that can help alleviate the burden of mental health (MH) conditions. Despite its international growth, there is lack of cross-cultural knowledge about peer support workers' (PSW) implementation experiences. This study explored PSWs' implementation experiences of Using Peer Support In Developing Empowering Mental Health Services (UPSIDES) innovative intervention-a multi-country project designed to empower and scale-up peer support in low-, middle- and high-income countries (LMIC & HIC). METHOD: Nine focus groups totaling 38 PSWs were conducted at six study sites: Ulm and Hamburg (Germany), Kampala (Uganda), Dar es Salaam (Tanzania), Be'er Sheva (Israel), and Pune (India). Transcripts were analyzed using qualitative analysis and MAXQDA software. RESULTS: Four domains were identified: (i) PSWs' experiences of recovery; (ii) PSWs' experiences of vocational development; (iii) PSWs' experiences with staff and work-role in MH systems;and (iv) PSWs' strive to influence broader circles. In low-and-middle-income countries specifically, PSWs experienced gains for illness management, access to care, employability and financial standing. They also engaged in active interactions with stakeholders in the community (e.g., relatives, police, etc.) promoting social-educative and anti-stigma influences. In high-income countries, experiences related to self-disclosure and peer-vocational development issues. Across sites PSWs' expressed challenges and needs related to lack of role clarity, relations with MH staff and integration into services. CONCLUSIONS: The findings reveal the potential of mental health peer support workers (MH PSWs) to aid in mental health recovery and systemic change. However, implementation experiences vary across cultures, highlighting the need to further develop the PSW role and integrate it into mental health systems across different sites. Trial Registration: ISRCTN26008944.https://link.springer.com/article/10.1007/s10926-025-10320-
A Qualitative evaluation exploring co-production of falls management in care homes
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cited.
© 2025 The Author(s). Health Expectations published by John Wiley & Sons Ltd.ABSTRACT Background Co-production approaches are increasingly used in research but are rarely evaluated in care home settings. This study explored factors influencing key principles of co-production in a series of workshops around falls management in care homes. Methods Stakeholders (care home residents and relatives, care home staff, and health and social care staff) participating in co-production workshops as part of a research study were invited to take part in this qualitative evaluation. The workshops were developing a model to implement falls training in care homes as part of a systemic action research study. Non-participant observations of workshops explored stakeholder interactions. Stakeholders participated in reflection meetings about their experiences of co-production. Framework analysis mapped key themes to the National Institute for Health and Care Research's (NIHR) principles of co-production. Results Nine themes were identified. Sharing power was affected by two themes: opportunities to challenge dominant voices, resulting from the influence of the research team and separate stakeholder groups, and integrating a disjointed system. Including all perspectives and skills was influenced by two themes: involvement of key stakeholders and a flexible approach. Respecting and valuing knowledge was impacted by two themes: respecting and utilising expertise and experience, and confidence. Two themes relating to reciprocity were identified: benefits and potential harms. One theme related to building and maintaining relationships: team dynamics. Conclusions Co-production in this context is complex and affected by multiple factors. Separate stakeholder groups, a flexible approach and recognising different experiences and expertise facilitated co-production in line with its key principles. Potential reputational risks, confidence levels and limited involvement of residents, relatives and care home staff in a variety of roles were identified as barriers. Future studies in care homes should consider organisational power dynamics and create safe spaces, providing opportunities for inclusive participation. Patient and Public Contribution A collaborator group, including a patient and public involvement and engagement (PPIE) advisor and health and social care professionals, contributed to the research methods, presentation of findings and authorship. Care home residents informed the design of the co-production workshops.https://onlinelibrary.wiley.com/doi/abs/10.1111/hex.7050
ADHD remote technology and ADHD transition : predicting and preventing negative outcomes (ART-transition) - an adolescent prospective cohort study protocol
Get PDF© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use,
sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and
the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this
article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included
in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will
need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.Late adolescence is a highly challenging and potentially critical period for young people with attention deficit hyperactivity disorder (ADHD). Many of the conditions that frequently co-occur with ADHD, such as depression, often first emerge in adolescence. Major life transitions, such as moving out of the parental home, lead to multiple new demands and changes in available support networks, further increasing the vulnerability. Additionally, UK data show that most young people with ADHD do not successfully transfer to adult services and thus do not receive appropriate interventions at a time when they may need them most. The lack of well-defined targets for holistic interventions limits opportunities for intervention. Our project on ADHD transition - ADHD Remote Technology and ADHD Transition: predicting and preventing negative outcomes (ART-transition) - uses remote measurement technology (RMT), which offers the potential to obtain ongoing, long-term, real-world data. We aim to identify the nature and timing of real-world changes in the transition to adulthood and what predicts such changes. We will further use these timeframes and intervention targets to co-design, with young people with ADHD, a prototype for an ADHD transition interactive smartphone app.https://link.springer.com/article/10.1186/s12888-025-07546-
Cellular and extracellular MicroRNA dysregulation in LRRK2-Linked Parkinson’s disease
Get PDFOpen Access This article is licensed under a Creative Commons Attri bution 4.0 International License, which permits use, sharing, adapta tion, distribution and reproduction in any medium or format, as long
as you give appropriate credit to the original author(s) and the source,
provide a link to the Creative Commons licence, and indicate if changes
were made. The images or other third party material in this article are
included in the article’s Creative Commons licence, unless indicated
otherwise in a credit line to the material. If material is not included in
the article’s Creative Commons licence and your intended use is not
permitted by statutory regulation or exceeds the permitted use, you will
need to obtain permission directly from the copyright holder. To view a
copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.Cell-free microRNAs in body fluids have emerged as promising biomarker candidates in neurodegenerative diseases. While several studies have identified dysregulated miRNAs in sporadic Parkinson’s disease, it remains unclear whether distinguishable alterations of cell-free miRNAs occur in genetic forms of the disease, such as those associated with the LRRK2 G2019S mutation. In this proof-of-concept study, we used a human induced pluripotent stem cell-derived dopaminergic neuron model to investigate whether the LRRK2 G2019S mutation induces detectable changes in the intra- and extracellular miRNAome, and whether miRNA signatures identified in vitro can be validated in patient-derived cerebrospinal fluid. We differentiated dopaminergic neurons from induced pluripotent stem cells carrying the LRRK2 G2019S mutation and an isogenic gene-corrected control. Extracellular vesicles were isolated from the culture medium and used as a source of cell-free miRNA. Next, small RNA libraries were generated and analyzed. Differentially expressed microRNAs were validated in an independent batch using RT-qPCR. We further quantified candidate microRNAs in cerebrospinal fluid samples from five LRRK2 G2019S patients and matching healthy controls. The patient cohort included the fibroblast donor from whom the stem cells were originally derived. We successfully isolated extracellular vesicles from induced pluripotent stem cell-derived human dopaminergic neurons. We identified a distinct set of differentially expressed miRNAs in cellular and cell-free RNA, among which let-7g-5p and miR-21-5p were consistently upregulated and validated across independent replicates. These alterations were reflected in the cerebrospinal fluid of the original donor and partially reproduced in additional LRRK2 patients, supporting the concept of patient-specific signatures. A strong correlation between intra- and extracellular miRNA expression was observed. Our findings demonstrate that induced pluripotent stem cell-derived dopaminergic neurons can serve as a model to identify individualized, cell-free microRNA signatures associated with the LRRK2 G2019S mutation. The dysregulated miRNAs detected in vitro were mirrored in patient cerebrospinal fluid, supporting their potential as accessible molecular readouts. These results lay the groundwork for personalized biomarker strategies in genetic forms of Parkinson’s disease and warrant further validation in larger patient cohorts.https://link.springer.com/article/10.1007/s12035-025-05379-
Clinical prediction rules for cognitive outcomes post-stroke : an updated systematic review and meta-analysis
Get PDF© 2025 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license
(http://creativecommons.org/licenses/by/4.0/).Background: Survivors of stroke are at a higher risk of cognitive syndromes, including dementia and delirium. Timely identification of those at-risk for cognitive syndromes could ensure better clinical management and implementation of risk reduction strategies. This study updates and appraises current evidence on prognostic accuracy of multicomponent risk models for post-stroke cognitive syndromes. Methods In this updated systematic review, we searched multidisciplinary electronic databases between November 2019 and October 2024 for relevant studies. An updated search was conducted on May 30, 2025. Studies were included if they described a multicomponent risk prediction tool developed in a stroke population (aged ≥18 years), free of cognitive impairment/dementia at baseline, with no exclusions on language. All study designs of primary research were eligible provided the study reported a multicomponent model at any point to predict participant cognitive outcomes i.e., incident cognitive impairment, dementia or delirium. Multicomponent refers to having more than one feature in the model e.g. if the study only reported the discriminatory accuracy of a cognitive score this was not eligible. All studies had to report sufficient discriminative performance metrics to assess model performance. Data were extracted from selected studies using a pre-specified proforma. Risk of bias was assessed using the Prediction model Risk of Bias Assessment Tool (PROBAST), certainty of evidence by GRADE, and between-study heterogeneity via I-squared (I2) statistics. Our study was preregistered with PROSPERO (CRD42024601845). Findings From 16,259 articles, 20 new studies contributed 31 models for post-stroke cognitive impairment and/or dementia and six models for post-stroke delirium with most developed in Asia (n = 12). Most models (n = 10) used logistic regression, with some using machine learning methods (n = 5). Development cohorts were small (mean n = 677). The pooled c-statistic for post-stroke cognitive impairment and delirium were 0.81 (95% CI 0.77–0.85, I2 95.7%) and 0.85 (95% CI 0.77–0.93, I2 52.7%), respectively. Three models externally validated (C-statistic: 0.72–0.91); and two models underwent temporal validation (AUC 0.81–0.82). Eight studies included measures of calibration which all demonstrated good calibration. Most studies (n = 17) were deemed to have low risk of bias and applicability concerns but overall certainty of evidence by GRADE was low. Interpretation Development of risk models to predict cognitive syndromes post-stroke has increased. Development cohorts remain small, largely developed in Asia with very few assessing model transportability. Future studies should pool data and utilise the potential of routinely collected large datasets. Stakeholder engagement and cost-effectiveness of risk-stratified interventions are needed prior to clinical implementation.https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(25)00598-X/fulltex
Does mental illness history affect chronic disease management in older adults?
No full textNo abstract availablehttps://academic.oup.com/ageing/article/54/11/afaf329/831740
Online peer support for young onset dementia is a promising resource, but not a panacea : a commentary from the INTERDEM young onset dementia taskforce
Get PDF© 2025 Kafadar, Loseto-Gerritzen, Bakker,
Bartels, Neal, Poos, Ritzen, de Vugt and Talbot.
This is an open-access article distributed
under the terms of the Creative Commons
Attribution License (CC BY). The use,
distribution or reproduction in other forums is
permitted, provided the original author(s) and
the copyright owner(s) are credited and that
the original publication in this journal is cited,
in accordance with accepted academic
practice. No use, distribution or reproduction
is permitted which does not comply with
these terms.No abstract availablehttps://www.frontiersin.org/journals/dementia/articles/10.3389/frdem.2025.172251