5 results
Understanding and Overcoming COVID-19 Vaccine Hesitancy & Anti-Vaccine Beliefs Within the High Secure Forensic Services
- Karla Giles, Anju Soni, Marc Head, William Gewanter, Christina Kalovidouri, Tomasz Tyszuk-smith
-
- Journal:
- BJPsych Open / Volume 8 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 20 June 2022, p. S133
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Aims
This is a cross-sectional service evaluation study of the vaccination programme within the high secure setting of Broadmoor hospital with a view of improving the quality of it's delivery. We aimed to establish patients views about COVID-19 vaccinations particularly if there are any themes as to why the patients choose/did not choose to receive the vaccine. This information will be used to help us understand how to overcome vaccine hesitancy and anti-vaccine beliefs.
MethodsPatients across Eight wards were asked to participate in the study. 56 patients agreed to be administered the following semi-structured questionnaire by the doctors.
1. Have you had a COVID-19 vaccine?
2. Do you think there any advantages to taking a COVID-19 vaccine? Yes/No. If you think there are any advantages, please write these
3. Do you have any fears or worries about the COVID-19 vaccine? Yes/No. If you do have any fears or worries, please write these.
Results14 patients had no vaccination, 2 had one, 38 had two or more.
34 patients said there were advantages, 13 said no advantages and 9 did not know. The themes of the advantages were established: Protects you from bad infection and symptoms (48), stops you from passing it on to others (3), blank (13), others (13) which included “Important to follow government guidelines, proven through history to work, it was offered, I'm more concerned with hepatitis, The doctor would have my best interests.”
30 patients stated that they did have fears and 26 did not. Common themes established were; side effects (17), Not tested correctly/given too quickly (5), Blood clots (2), positive comments (2), blank (22), others (10), which included, “Interaction with medications, more fear about face masks, injecting humanity with something could kill them, infertile generation, Control the public, don't like injections and alter the DNA genome.” The common side effects of concern were “painful arm, fever and headache.”
Conclusion68% of patients had 2 or more vaccinations across the 8 wards studied. The commonest advantages cited by 86% of patients was to protect themselves from serious illness. The commonest fears or worries were of side-effects that result from the vaccine, although 46% patients had no worries and 39% gave no explanation for fears or worries. The fears and worries appeared mainly related to vaccine hesitancy rather than fixed generalised anti- vaccine views.
A study of the reasons for prescribing and misuse of gabapentinoids in prison including their co-prescription with opioids and antidepressants
- Anju Soni, Pamela Walters
-
- Journal:
- BJPsych Open / Volume 7 / Issue S1 / June 2021
- Published online by Cambridge University Press:
- 18 June 2021, pp. S291-S292
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Aims
Electronic medical case files of male prisoners in a category B prison in London was studied to establish a prevalence during an 8-month period of the use of and the reasons for prescribing gabapentinoids in prison.
In addition, the prevalence of co-prescription of gabapentinoids with opioids and antidepressants was also assessed in light of the increased risk of respiratory depression resulting in death when these drugs are used in combination.
MethodA retrospective, SystmOne electronic case-file based survey was undertaken searching by SNOMED CT supplemented by examination of free text, in a category B prison for males (Capacity 1500 prisoners; Average turnover of prisoners up to 6000 per year), including to establish practice standards related to the prescription of Gabapentinoids in the prison and determine the compliance with these.
ResultIn total, 109 cases were identified of prisoners having been prescribed gabapentinoids, pregabalin in 66 cases (61 per cent) and gabapentin in 43 cases (39 per cent). In 36 cases (33 per cent) prescriptions were for unlicensed indications. This in fact represented 50 per cent of the cases where the indications were documented. Half of the cases were co-prescribed gabapentinoids with an opioid substitute and 17% with antidepressants. Only in 22% of the cases there was documentation of discussion with the prisoner about the potential risks of co-prescribing with these medications. In 14 cases (13 per cent), prescribed gabapentinoids were diverted to other prisoners.
ConclusionFor those prescribed gabapentinoids in prison, the indications for such use especially if off label should be reviewed and their use minimised where relevant.
The initiation of gabapentinoids in prison should be avoided.
For patients who are also receiving antidepressants and opioid substitutes or are abusing opiates, consideration should be given as to whether it is safe to continue on gabapentinoids, given the risks of misuse and death.
Issues raised by this study are likely to apply to other prisons, secure forensic psychiatric facilities and indeed community mental health and primary care as well.
From 1 April 2019, gabapentinoids have been classed as Class C controlled drugs in the UK.
Qualitative study: learning from recovery: what do people who have recovered from alcohol dependence have to teach those who are still struggling?
- Anju Soni, Ian Treasaden
-
- Journal:
- BJPsych Open / Volume 7 / Issue S1 / June 2021
- Published online by Cambridge University Press:
- 18 June 2021, p. S292
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Aims
The aim is to tap into user experience in the UK and to analyse what lessons can be learnt from those who have recovered from alcohol dependence to help those who are struggling including to inform the delivery of alcohol services.
MethodThe study was conducted in London, UK. 20 males in the age group 30–45 years were recruited. 10 of these participants had recovered from alcohol dependence and the other 10 were in treatment for alcohol dependency and diagnosed as dependent according to ICD-10 or DSM 5 criteria. In the former group, each participant had at least 2 years of complete sobriety. A semi structured questionnaire was developed and used to interview all the subjects.
Males 30-45 years were eligible as alcohol dependence is more common in this age group and purposive sampling drove the selection (i.e. if early analysis suggests the importance of a particular factor, subjects likely not to show that factor would be sampled for comparison).
Grounded analysis was the qualitative analysis method of choice and constant comparison was used, i.e., data were collected and analysed concurrently.
ResultThe main “families” that arose grouped around relationships in both the recovered alcoholics (RA) and continued alcoholics (CA). A successful shift required a change in the relationship to self, from feeling empty or critical towards acceptance and this shift was facilitated by being accepted and respected by others.
Relationship as motivator to stop drinking
24% people had the insight to self-refer to voluntary organisations such as AA but 76% did so because of fear of losing either their relationship or their job.
Although 80% of recovered alcoholics had been ambivalent about coming off alcohol, the shift happened when they had a nurturing relationship elsewhere such as a key worker at the Alcoholics Anonymous.
Insight and Perception
Awareness of alcohol as an obstacle rather than a solution was key for change to occur. Although 75% people with insight into their difficulties were more successful in maintaining sobriety, insight alone without action was insufficient. Moreover, action was possible without insight. Fear of death alone was a sufficient motivator.
ConclusionDifference between support systems
As a result of comparing those patients with alcohol dependence who responded well to treatment compared to those who were very recalcitrant to treatment important characteristics of an effective service have been identified. It was clear that the quality of services offered to those with alcohol dependence who attended A&E departments could be improved by offering more time for the initial assessments and adopting a more individualistic approach for each patient.
Training sessions to the A&E staff about the differences required in management between those with alcohol dependence who are motivated to abstain compared to those who will only be able to reduce consumption should be offered rather than mere blanket exhortations to abstain from alcohol consumption. The importance of behavioural avoidance of situations where alcohol is excessively consumed is more helpful in terms of eventual outcome.
The A&E staff should be encouraged to employ individuals from Alcoholics Anonymous in their department as early involvement with AA improves engagement and outcome can greatly improve engagement with treatment programs subsequently and lead to significantly better outcomes.
Establishing prevalence of diagnosis of personality disorder across high secure forensic services using the ICD 10 and ICD 11 classification
- Anju Soni, Samrat Sengupta, Ian Treasaden
-
- Journal:
- BJPsych Open / Volume 7 / Issue S1 / June 2021
- Published online by Cambridge University Press:
- 18 June 2021, p. S291
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Aims
There has been an increasing recognition of the lack of clinical validity of different types of ICD10 personality disorder.
The prevalence was established among patients in a high secure hospital in England of those with either a primary or secondary diagnosis of personality disorder and its recorded type according to ICD10 and then ICD11.
The new ICD11 classification increased the validity of diagnosis of personality disorder as well as its severity.
BackgroundICD 11 has proposed the dropping of the classification of personality disorder based on particular types of personality disorder and instead adopting a diathesis model based on 2 dimensions: presence of personality disorder and three levels of severity (Mild, Moderate and Severe) and the option of specifying one or more prominent trait domain qualifiers (Negative Affectivity, Detachment, Disinhibition, Dissociality, and Anankastia) and also specify a Borderline Pattern qualifier.
MethodThe electronic medical records were used to establish the presence and type of personality disorder using the criteria of ICD10 and ICD11.
The researchers assured reliability by rating some vignettes using the Schedule for Personality Assessment from Notes and Documents (SPAN-DOC) before rating actual cases.
ResultFrom a total population of 208 patients, 64(30.8%) were classified as having either a primary or secondary diagnosis of personality disorder according to the ICD 10.
30 (47%) had dissocial personality disorder (DSPD), 19(30%) emotionally unstable personality disorder (EUPD) and 8(13%) paranoid personality disorder. 20 (31%) had a comorbid diagnosis of mental illness and about a tenth had diagnoses of multiple personality disorders. These types of personality disorder diagnosed by the researchers using ICD 10 did not always match the types of personality disorder diagnosed by clinicians at the hospital.
All patients met the criteria of personality disorder under ICD 11 but the number with a borderline specifier was greater than those with an ICD10 diagnosis of EUPD. Using the trait domain qualifiers in ICD 11, patients with ICD 10 diagnoses of EUPD or DSPD showed dissociation and disinhibition, with those with a DSPD showing low and those with EUPD high negative affectivity.
ConclusionThe results confirm that while psychiatrists in a high secure hospital reliably diagnose the presence of a personality disorder, they are much less able to make an accurate diagnosis as to the actual type of personality disorder. The new ICD 11 classification will increase the clinical validity of the diagnosis of personality disorder and its severity.
Light Scattering from Pulsed Laser Deposited BaBi4Ti4O15 Thin Films
- R.K. Soni, Anju Dixit, R. S. Katiyar, A. Pignolet, K.M. Satyalakshmi, D. Hesse
-
- Journal:
- MRS Online Proceedings Library Archive / Volume 623 / 2000
- Published online by Cambridge University Press:
- 10 February 2011, 167
- Print publication:
- 2000
-
- Article
- Export citation
-
Light scattering investigations are carried out on BaBi4Ti4O15 (BBiT) which is a member of the Bi-layer structure ferroelectric oxide with n = 4. The BBiT thin films, thickness ∼ 300 nm, were grown on epitaxial conducting LaNiO3 electrodes on epitaxial buffer layers on (100) silicon by pulsed laser deposition. Micro-Raman measurements performed on these films reveal a sharp low-frequency mode at 51 cm−1 along with broad highfrequeficy modes corresponding to other lattice vibrations including TiO6 octahedra. No temperature dependence of the low frequency mode is seen while a weak dependence of the broad high frequency vibrations are observed in the mixed oriented regions. Raman polarization carried out at room temperature indicates that the prominent modes have Alg and Eg symmetries in the BaBi4Ti4O15 thin films.