Development of digital mental health in Ireland

This paper provides an overview of the development and current status of digital mental health in Ireland. It will present the results of the work carried out on this topic as part of Interreg Europe's eMEN project. This charts the trajectory of digital mental health developments in Ireland across three phases: pre-, mid-, and post-COVID-19 pandemic. Before the pandemic hit, the field of digital mental health was gradually growing through a combination of bottom-up and top-down activities. The pandemic triggered a rapid shift to the online provision of mental health services, which often involved remote consultations via video platforms. As we come out of the pandemic, the focus has shifted to consolidating these pandemic-driven changes, as well as continuing to build on existing initiatives. This article outlines the key elements of each phase, as well discussing certain key issues that should be factored into healthcare policies and provision.These include quality assurance frameworks designed to cover a range of digital mental health applications, as well as new ontological frameworks to characterize the emerging ecosystem of technology-based care in the post-pandemic "new normal”. Copyright © 2023 John Libbey Eurotext. Téléchargé;Ce document présente un aperçu de l'évolution et du statut actuel de la santé mentale numérique en Irlande. Il présente les résultats du travail effectué par les auteurs dans le cadre du projet Interreg eMEN. Il décrit la trajectoire d'évolution de la santé mentale numérique en Irlande selon trois phases: avant, pendant et après la pandémie de Covid-19. Avant la pandémie, la santé mentale numérique évoluait progressivement grâce à une combinaison d'activités ascendantes et descendantes. La période de pandémie a déclenché une évolution rapide vers la fourniture en ligne de services de santé mentale, notamment les consultations à distance via des plateformes vidéo. Au sortir de la pandémie, l'accent est mis sur la consolidation des changements induits par la pandémie, ainsi que sur la poursuite du développement des initiatives déjà lancées auparavant. Cet article présente les éléments clés de chaque phase et examine certaines questions essentielles à prendre en compte dans les politiques et l'offre de soins. Il s'agit notamment des cadres d'assurance qualité destinés à couvrir les applications de santé mentale numérique, ainsi que de nouveaux cadres ontologiques pour caractériser l'écosystème émergent des soins basés sur la technologie dans la « nouvelle normalité» post-pandémique. Copyright © 2023 John Libbey Eurotext. Téléchargé;Este documento ofrece una panorámica de la evolución y el estado actual de la salud mental digital en Irlanda. Presenta los resultados del trabajo de los autores sobre este tema como parte del proyecto Interreg eMEN. Describe la trayectoria de evolución de la salud mental digital en Irlanda según tres fases: antes, durante y después de la pandemia de la COVID-19. Antes de la pandemia, la salud mental digital evolucionaba gradualmente mediante una combinación de actividades ascendentes y descendentes. El periodo pandémico desencadenó una rápida evolución hacia la prestación en línea de servicios de salud mental, en particular las consultas a distancia a través de plataformas de vídeo. Después de la pandemia, la atención se ha centrado en consolidar los cambios provocados por la pandemia, así como en seguir desarrollando las iniciativas ya puestas en marcha anteriormente. Este artículo presenta los elementos claves de cada fase y examina algunas de las cuestiones fundamentales que deben tenerse en cuenta en las políticas y la prestación de asistencia. Entre ellas se incluyen en primer lugar los marcos de garantía de calidad con el fin de cubrir las aplicaciones digitales de salud mental, así como los nuevos marcos ontológicos para caracterizar el ecosistema emergente de atención basada en la tecnología en la "nueva normalidad” pospandémica. Copyright © 2023 John Lib ey Eurotext. Téléchargé

Applying the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents to Misophonia: A Case Example

Misophonia is a condition in which individuals suffer a wide range of intense emotions in response to sound triggers. Emotions such as anxiety, irritability, and disgust may lead individuals to engage in avoidance behaviors to escape or suppress sound triggers. Transdiagnostic treatment may serve as a practical intervention for misophonia as it addresses a broad scope of emotions and physiological sensations. This paper presents the first reported case example of misophonia treated with a transdiagnostic treatment protocol, the Unified Protocol for Emotional Disorders in Adolescents (UP-A). In this case, the UP-A was efficacious in treating a client with autism spectrum disorder, comorbid misophonia and anxiety symptoms. The client evidenced reliable change in misophonia and related problems. Future research should investigate the efficacy of the UP-A in a larger sample of youth with misophonia, as well as assess mechanisms of change in transdiagnostic treatment of this disorder in youth.Copyright © 2022 Society of Clinical Child & Adolescent Psychology.

Stress Testing the Fiscal Framework

The part of the UK fiscal framework which determines how UK government funding is allocated across the four home nations has undergone profound change since 2012, given tax and social security devolution. The UK government's post-Brexit plans for regional development funding, state aid, regulation and trade negotiations have led to significant disagreements about the nature of the devolved fiscal and constitutional settlement. And the COVID-19 pandemic provided a major shock to a fiscal system with limited flexibility for the Scottish, Welsh and Northern Irish devolved governments. This paper reviews the changes and challenges faced during these reforms and policy shocks. We find that: tensions about reforms to funding arrangements reflect the inconsistency of principles guiding the reforms;that the UK government's post-Brexit plans do reduce the policy autonomy of the devolved governments, but reflect powers central governments often have in even highly decentralised countries;and that temporary changes to rules and the nature of the COVID-19 pandemic prevented a subnational fiscal crisis, but that more systematic change may make the system more robust to future shocks. This suggests that a review of the principles underpinning the UK's subnational fiscal and economic policies would be highly worthwhile.

DO WOMEN GET WHAT THEY WANT? A SERVICE REVIEW OF ONLINE CONTRACEPTION OFFERED BY AN NHS INTEGRATED SEXUAL HEALTH SERVICE

Introduction Responding to COVID-19 restrictions and increasing demand, we introduced an online contraception service. Patients complete a comprehensive web-questionnaire which is subsequently assessed by a nurse who supplies a suitable method. This service is 'wholly-online' (excludes real-time interactions) however, some patients submit insufficient or ambiguous information and follow-up consultations are required. Aims - to determine the profile of patients using this service, their contraception choices and whether they achieved a wholly-online-service. to determine what factors prevented the wholly-onlineservice and what could be done to improve this. Methods Retrospective notes review of 100 consecutive patients in November 2021, noting: age, contraception requested, had they;watched our online video for chosen method, declared adequate blood pressure, height and weight measurements. Outcomes noted: patients receiving chosen method with a wholly-online-service, if not, what intervention followed (telephone/face-to-face) and reasons. Results Table-1 shows patient profiles. Table-2 shows outcomes of online requests. P89 Table 1 Method of contraception requested via online service P89 Table 2 Outcomes of online request Discussions 'Wholly-online' contraception was achieved in 26% of patients. An extra 6% required a clarification phone call before receiving contraception. An extra 27% attended for biometrics(height, weight, blood-pressure) before receiving contraception. 16% were ineligible, requiring face-to-face consultations for clinical or safeguarding reasons. This suggests - our 'wholly-online' service is meeting a demand, presumably because patients prefer going online in their own time, rather than scheduling an appointment. - a significant appetite for combined-oral-contraception online for those without biometric recordings. We will explore a hybrid service involving online requests and drop-in access for biometrics that could meet this demand, without challenging the capacity of our appointments services (Table Presented).

Adverse events following immunization (AEFI) with COVID-19 vaccines: case series and literature review

There currently exists no formal consensus on advice given to patients who have experienced an adverse event following immunization (AEFI) (WHO definition) following COVID-19 vaccination. The incidence of vaccine-related cutaneous events is only likely to increase with the UK launching subsequent vaccine doses as part of the mass vaccination programme due to concerns about waning immunity. We present a small multicentre case series of 13 patients presenting with cutaneous-only AEFI from February to August 2021. Patients were between the ages of 21 and 83 years, from multiple ethnicities across secondary and tertiary care trusts in the UK and Hong Kong. The case series demonstrated a phenotypic spectrum of cutaneous manifestations not previously categorized in current literature. Along with our literature review, we have been able to surmise that cutaneous AEFI remain exceptionally rare and this should not be used as cautionary evidence against vaccination. On the contrary, better understanding of AEFI would serve to aid clinicians and patients on making informed decisions based on risk- benefit analysis. It is our aim that this pragmatic approach, taking into account multiple variable factors, would serve to aid in recommendations on vaccination as new evidence emerges over time.

Yellowstone Volcano Observatory 2021 Annual Report

The Yellowstone Volcano Observatory (YVO) monitors volcanic and hydrothermal activity associated with the Yellowstone magmatic system, carries out research into magmatic processes occurring beneath Yellowstone Caldera, and issues timely warnings and guidance related to potential future geologic hazards (see sidebar on volcanic hazards on p. 2). YVO is a collaborative consortium made up of the U.S. Geological Survey (USGS), Yellowstone National Park, University of Utah, University of Wyoming, Montana State University, UNAVCO, Wyoming State Geological Survey, Montana Bureau of Mines and Geology, and Idaho Geological Survey (see sidebar on YVO on p. 3). The USGS arm of YVO also has the operational responsibility for monitoring volcanic activity in the Intermountain West of the United States, including Arizona, New Mexico, Utah, and Colorado. Despite the decrease in activity compared to the previous 3 years, Steamboat Geyser continued to impress visitors with 20 major water eruptions in 2021. This episodic activity is typical of many geysers in Yellowstone National Park, as demonstrated once again in 2021, when Sawmill Geyser returned to its usual pattern of multiple eruptions per day after about 4.5 years of quiescence. Monitoring measurements indicate background levels of seismicity, deformation, and thermal emissions. The number of located earthquakes (2,773) was the most since 2017, when 3,427 earthquakes were located, but the 2021 value was still not significantly different from the average number of annual located events. GPS measurements indicated no significant deformation at Norris Geyser Basin throughout the year, and Yellowstone Caldera continued to subside at rates of a few centimeters (about 1 inch) per year, as it has since 2015. One noteworthy change in deformation style was detected by satellite radar, which documented about 1 centimeter (0.4 inch) of uplift centered on the north side of the caldera, south of Norris Geyser Basin, between late 2020 and late 2021. The deformation strongly resembles that which occurred during 1996-2004 but is yet too small to be strongly apparent in nearby continuous GPS stations. Heat flux estimates from both satellite imagery and river chemistry indicate no major changes with respect to previous years. The COVID-19 pandemic limited field work in 2021, although critical equipment maintenance and deployments and several scientific studies were still carried out. Temporary deployments of seismometers in Norris and Upper Geyser Basins collected information that will be used to better understand geyser plumbing systems, and a new continuous gas-monitoring station-the first of its kind in Yellowstone National Park-was deployed near Mud Volcano in July. Geologic investigations focused on better understanding the age and history of hydrothermal explosion craters in the Lower Geyser Basin, revising geologic maps in the areas around Mount Everts and the Sour Creek resurgent dome, improving age constraints on post-caldera rhyolite lava flows, and investigating the sources of hydrothermal travertine within Yellowstone Caldera. Additional sedimentary cores were collected from Yellowstone Lake to better constrain the characteristics and extent of lake-bottom hydrothermal activity and triggers for hydrothermal explosions. New research results will be highlighted in future editions of YVO's weekly series of online articles, Yellowstone Caldera Chronicles, which can be accessed at https://www.usgs.gov/volcanoes/yellowstone/caldera-chronicles, as well as in annual reports, monthly updates and videos, and public presentations. © 2021 US Geological Survey. All Rights Reserved.

A behavioral insights approach to recruiting entrepreneurs for an academic study during the COVID-19 pandemic

What should researchers say when recruiting entrepreneurs to participate in their study? Using a sample of entrepreneurs (N = 1,450) who were being asked to participate in an academic research project, we conducted an experiment to determine recruitment message efficacy. Drawing on best practices from the behavioral insights literature, we developed different email message recruitment statements that were randomly assigned across four phases of our experiment. Results indicate that a message grounded in the “descriptive norms” (i.e., social norms) approach resulted in the highest percentage of participants who clicked on the link to participate in our online survey. We discuss the theoretical as well as practical implications of our work. © 2021

Experience of transforming a clinical surgical-anesthetic unit into a COVID-19 critical patient one in a teaching hospital

Introduction: The experience of restructuring a clinical surgical-anesthetic unit into a critical patient unit in charge of surgical-anesthetic personnel is presented during the period from May to July 2020 in the context of a SARS-CoV-2 pandemic. Objectives: Describe the unit’s restructuring process, considering technical aspects, changes in staff functions, clinical outcomes of the patients, quality indicators obtained and the psychological impact on the healthcare team. Matherial and Methods: The strategies implemented by the responsible experts were described (ie: engineering). Clinical data were obtained from an institutional database and electronical medical records. The management of human resources was described using administrative records of the services of anesthesiology, OR and critical patient unit. The psychological impact on the unit staff was evaluated by applying the Maslach questionnaire. The quality of the clinical management of the unit was obtained from the compilation of standardized quality indicators for the critical patient units of the institution. Results: 25 patients were admitted in the unit. The mean age was 62 ± 12 years. About the complications, 52% had pulmonary embolism, 36% had acute kidney injury, and 1 patient died. The prevalence of Burnout Syndrome was 73.6%. The occurrence of adverse events was minimal. Discussion: The transformation of an anesthetic-surgical unit into a COVID critical patient one, demands a complex net of coordinated strategies to allow facing the attention demand with positive clinical results, at the expense of the health care team mental health. © 2021 Sociedad de Anestesiologia de Chile. All rights reserved.