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Identification of Cognitive Impairment in Cardiovascular Rehabilitation: A Pilot Cross-Sectional Study
- Qutub Jamali, Suraju Adeyemo, Ahmed Abdelgawad, Sucharitha Narayan, Mirza Najiullah Beg, Salman Karim, Chukwuma Oraegbunam, Kalpesh Solanki
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- Journal:
- BJPsych Open / Volume 9 / Issue S1 / July 2023
- Published online by Cambridge University Press:
- 07 July 2023, pp. S40-S41
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Aims
Cardiac Rehabilitation (CR) is a multidisciplinary intervention for people after an adverse cardiac event to improve their physical, psychological and social functioning. The risk factors of cardiac disease and dementia are similar. This cross sectional study aims to determine whether adding memory assessment to a CR program would improve early detection of cognitive impairment. Therefore, the research question is- “Can adding a memory assessment to the cardiac rehabilitation program improve early detection of cognitive impairment in people with cardiac disease?”.
MethodsStudy ethical approval was granted by Yorkshire & The Humber - Sheffield Research Ethics Committee (reference 20/YH/0146) and the NHS Health Research Authority (project reference 273763). The Lancashire & South Cumbria NHS Foundation Trust accepted the role and responsibilities of study sponsorship. Participants underwent cognitive screening and the data obtained was divided into: - 1- History of memory problems before and after the adverse cardiac event. 2- No memory problems before but presents after. 3- No memory problems before and after.
ResultsDuring the study period, 48 participants who were at the cardiac rehabilitation program expressed their interest to patriciate in the study. Out of 48 participants who expressed their interest in participating in the study, 30 of them did not engage beyond expressing their interest and 18 out of 48 completed the assessment. The studied sample was categorized into three groups according to the relation between the onset of the cognitive decline and the onset of the cardiac condition: those with no history of cognitive decline (22.2%), cognitive decline following the onset of the cardiac condition (27.8 %) and cognitive decline before and after the onset of the cardiac condition (50 %). Comparing the number of the participants in the studied sample who has history of cognitive decline revealed that there was statistically significant difference between the number of participants who have history of cognitive decline and the other group which demonstrated no decline in their cognitive function (p = 0.031). On correlating medications variables with all domains of cognitive functions assessments done by using ACE-III, we found that participants who are taking statins as regular medications had higher mean scores for visuospatial subtest than the other group of participants who are not taking statins and this difference was statistically significant (p = 0.012).
ConclusionThis study indicate that CR could potentially enable early detection of cognitive impairment, which could be either reversible or irreversible. However, a longitudinal study of larger scale is required for proper implementation of cognitive assessment in cardiac rehabilitation.
Perception of Doctors Attending Association of Black Psychiatrists-UK Led CASC Preparatory Course
- Suraju Adeyemo, Olufikunayo Manuwa, Theresa Ugalahi, Nneamaka Asiodu, Sewanu Awhangansi, Babatunde Odebiyi, Nwife Akhator-Eneka, Mojisola Adeniji, Chukwuma Oraegbunam
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- Journal:
- BJPsych Open / Volume 8 / Issue S1 / June 2022
- Published online by Cambridge University Press:
- 20 June 2022, p. S14
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Aims
Within the United Kingdom, there has been differential attainment in academic performance and career progression between International Medical graduates (IMG) and UK medical school graduates. Reasons reported for these differences include; poor relationships with trainers, cultural differences, and inadequate support. To close this differential attainment, effective interventions to support IMGs are indicated. This need for diversity led to the creation of the Association of Black Psychiatrists-UK Tutorial group (The-Tutors). The Tutors is a free online CASC preparatory group that started about 2-years ago and is tailored to meet the specific needs of black doctors sitting the Royal College of Psychiatrists examination. over 100-black Doctors have benefited from the group. This study was conducted to evaluate the experience of these doctors.
MethodsThe sampling frame was the population of doctors who attended The-Tutors before sitting the CASC examination. Data were collected on socio-demographic characteristics, past psychiatry training experiences, and participants' experience toward preparation and passing CASC.
An online questionnaire was completed and this was distributed through social media (closed WhatsApp groups).
Responses were anonymous.
ResultsTotal participants were 33, out of which 20 (60.6%) had passed the CASC examination while 13 (39.4%) are still awaiting results.
The majority (51.5%) of the participants had only international training in Psychiatry, 27.3% had their training in the UK, and 12.1% had both, while 9.1% had no formal-psychiatric training.
Most 21(63.6%) participants indicated that the group was ‘extremely useful’ for CASC preparation.
In terms of comparing experience in this group with other CASC preparatory groups, all the respondents found The Tutors group more helpful; 16(48.5%) indicated that the group was ‘extremely helpful’, 14(42.4%) ‘very helpful’ and 9.1% “moderately helpful”.
Most of the participants (75.8%) indicated that they were “extremely likely” to recommend the group to others.
The majority (>65%) of respondents reported that The-Tutors helped in improving their knowledge, communication skills, confidence approaching the examination, and motivation to study.
Close to half (48.5%) of participants who had passed the CASC examination indicated that The-Tutor was “extremely helpful” toward their success.
ConclusionThis study has shown positive experiences of IMG especially of Black ethnic group attending an all- Black-led CASC preparatory group. This could be an indication that support groups specifically targeted toward the needs of IMG could help lead to an increase in success rates in UK examinations.