Investigation of the prevalence and factors influencing tobacco and alcohol use among adolescents in Nigeria: A systematic literature review.

The increase in tobacco and alcohol prevalence among Nigerian teenagers necessitates the need to understand the factors influencing use. The aim of this systematic literature review was to synthesis evidence from studies on tobacco and alcohol use among Nigerian adolescents and young adults in order to determine factors influencing tobacco and alcohol use. Six databases MEDLINE, Embase, CINAHL, PsycINFO, PubMed, ScienceDirect, and Google Scholar were used to search for peer-reviewed articles reporting the prevalence and predictors of tobacco and alcohol use among adolescents/youths published between 2010 and 2022. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guided this review. From our search, twelve articles from the 6 geopolitical zones within Nigeria were included. The high prevalence of tobacco and alcohol use among Nigerian adolescents necessitates the need to understand the factors influencing use. A high prevalence rate was recorded among the male gender. Gender, age, and curiosity appear to place adolescents at extra risk for tobacco and alcohol use. Lack of parental monitoring, peer influence, low socio-economic status, low education level, stressful life events, advertisements, availability, and accessibility are factors identified to influence adolescents' alcohol and tobacco use. Alcohol and tobacco use remains a major public health issue as it continues to contribute largely to the growing occurence of diseases globally. Our review showed that adolescents' alcohol and tobacco use behaviour is triggered by various factors on the personal, interpersonal, organisational, community, and policy levels, and these factors are understood to predict or protect against alcohol and tobacco use.

A systematic review of interventions aiming to improve newly-qualified doctors' wellbeing in the United Kingdom.

BACKGROUND: Newly-qualified doctors in the United Kingdom experience a great deal of stress and have poor wellbeing when compared to more senior counterparts. A number of interventions have been put in place to boost healthcare professionals' wellbeing, but little is known about interventions aimed to improve the wellbeing of newly-qualified doctors in the United Kingdom. This study aims to systematically review current evidence of interventions which improved the wellbeing of newly-qualified junior doctors in the United Kingdom. METHODS: Five key electronic databases were searched. Subsequently, reference scanning and citation search was performed. Studies were included if they were conducted from the commencement of the Foundation Programme in 2004, until 2019. In addition, studies had to be performed on junior doctors: working in the United Kingdom and within their first five years post-qualification and have a quantitative outcome. Studies which did not meet these criteria were excluded. Quality was assessed using the modified Newcastle-Ottawa scale. Bias was not formally assessed using a standardised tool. RESULTS: Seven papers met the inclusion criteria and identified three main types of interventions: mentorship, mindfulness and clinical preparation interventions. The majority of included studies reported a positive result from the performed intervention, suggesting these to be beneficial in improving junior doctor wellbeing, and thereby reducing anxiety and stress levels. However, most of the studies used small sample sizes. CONCLUSIONS: This review reveals that there is dearth of evidence on the effectiveness of intervention to improve the wellbeing of newly-qualified doctors in the United Kingdom. Most of the identified interventions focused on relieving stress and anxiety inherent within newly-qualified doctors' training programmes. However, wellbeing interventions need to take into cognisance all the factors which impact on wellbeing, particularly job-related factors. We recommend that future researchers implement large-scale holistic interventions using appropriate research methods. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019127341.

The influence of the COVID-19 pandemic and the first UK lockdown on older age presentations to a regional psychiatric liaison service: A retrospective observational study.

Background: Loneliness and social isolation may have increased during the coronavirus disease 2019 (COVID-19) pandemic, possibly increasing mental health problems. However, due to fears of contracting COVID-19, patients may not have presented to hospitals. Aims: We assessed the impact of the COVID-19 pandemic measures and lockdown on elderly (≥65 years) presentations to a psychiatric liasion service. Settings and Design: A UK regional liasion psychiatry service. Materials and Methods: Mixed methods methodologies were used to assess data between 01/01/20 and 31/08/20, which were compared to data from the same time period in 2019. Statistical and thematic analyses were conducted to understand drivers of presentations. Statistical Analysis: Nonparametric testing and analysis of variance (ANOVA). Results: Presentations to liaison psychiatry reduced by 13% for 01-08/2020 compared to 01-08/2019, with a 42% reduction during lockdown. Average weekly presentations significantly decreased during the main lockdown months only (April 2019 vs. 2020: 213.0 [12.3] vs. 110.3 [22.9] [adjusted P = 0.006], May 2019 vs. 2020: 209.5 [14.6] vs. 148.8 [12.3] [adjusted P = 0.006]). There was only a trend toward reduced elderly presentations from January to August 2020 and during lockdown. Lockdown pressures did not drive significantly more new elderly presentations. However, we still found a highly significant difference in the distribution of causal factors for the elderly presentations affected by the pressures of lockdown compared to those who were not. Conclusions: A trend toward reduced elderly presentations during lockdown and the pandemic was found. Thematic analysis supported by further statistical analysis of the drivers of elderly presentations showed that the pressures of lockdown clearly affected older age liaison psychiatry presentations.

Optimising service users and carers involvement in nursing and social work pre-registration degrees.

The awareness of the contribution of service users and carers' involvement in nursing and social work pre-registration degree education continues to grow. This study explored ways of optimising its beneficial outcomes to students, service users/carers and academic staff. A phenomenology qualitative approach was employed. The study sample was drawn from service users/carers involved in students' education, and adult nursing and social work degree students and academic staff. A total of 38 participants took part. Semi-structured interviews were used to gather views, which was then thematically analysed. This study identified factors that can optimise the beneficial outcomes of service users and carers' involvement to students, service users/carers and academic staff in Adult nursing and Social work pre-registration degree. The findings of this study support the value of service users' and carers' involvement in undergraduate nursing and social work education and offer strategies which support best practice, and optimise and sustain the efficacy and benefits of this approach in a higher education setting. An understanding of issues related to optimising service user and carer involvement may assist in the development of strategies that continue to make service users and carers' involvement in nursing and social work pre-registration degree effective and meaningful to students, service users/carers and academic staff.

Problems in booking to sit the dental Overseas Registration Examination.

The Overseas Registration Examination (ORE) is a popular examination required by overseas-trained dentists who qualified outside of the United Kingdom (UK), European Union or European Economic Area to join the UK dental workforce. In the last two to three years, booking to attempt this examination, especially the part 2 component, remains a concern raised repeatedly by candidates. This paper describes the philosophies that led to the use of the current booking system and proposes recommendations that will be beneficial both to candidates and to the General Dental Council.

Root causes of deaths by suicide among patients under the care of a mental health trust: thematic analysis.

AIMS AND METHOD: This study explored the root causes of deaths by suicide among patients under the care of a mental health trust. Thematic analysis was carried out to identify themes from the serious incident reports for patients between 1 January 2017 and 31 July 2018. RESULTS: In total, 48 cases were reviewed. Three main themes emerged from this study: patient-, professional- and organisation-related factors. The majority of the deaths were caused by patient-related factors, particularly exacerbation of the patient's mental health condition. CLINICAL IMPLICATIONS: This study provides insight into perceived causes of death by suicide among mental health patients. It is hoped that this will, in turn, influence the manner in which decisions, policies and resource allocation are carried out to further prevent and reduce the incidence of suicide, particularly among mental health patients.

Typology of psychiatric emergency services in the United Kingdom: a narrative literature review.

BACKGROUND: Mental health crisis requiring emergency access to psychiatric service can occur at any time. Psychiatric Emergency Service (PES) is described as one that provides an immediate response to an individual in crisis within the first 24 h. Presently, several types of PESs are available in the United Kingdom (UK) with the aim of providing prompt and effective assessment and management of patients. Therefore, this study aims to provide a detailed narrative literature review of the various types of Psychiatric Emergency Service (PES) currently available in the UK. METHOD: Electronic search of five key databases (MEDLINE, PsychINFO, EMBASE, AMED and PUBMED) was conducted. Studies were included if it described a mental health service in the UK that provides immediate response in mental health crisis within the first 24 h. Excluded studies did not describe a PES, non-English, and were not conducted in UK. RESULTS: Nine types of PESs were found. Amongst the 9 services, more papers described crisis resolution home treatment. Majority of the papers reported services within England than other countries within the UK. CONCLUSION: All types of PESs were described as beneficial, particularly to mental health service users, but not without some shortcomings. There is a need to continue carrying out methodological research that evaluate impact, cost-effectiveness as well as identify methods of optimising the beneficial outcomes of the various types of PESs. This may help inform researchers, policy makers and commissioners, service users and carers, service providers and many more on how to ensure current and future PESs meet the needs as well as aid recovery during crisis.

Prevalence of Mental Disorders, Cognitive Impairment, and Dementia Among Older Adults in Egypt: Protocol for a Systematic Review.

BACKGROUND: In Egypt, the population of older adults is rapidly growing. The last census in 2017 indicated that older adults numbered 94.8 million, which is a 2.56% increase from the 2006 census. There is growing evidence that the older population is at greater risk for some forms of mental disorders such as depression, dementia, and many more. OBJECTIVE: This study aims to review the current evidence regarding the prevalence of mental disorders among older adults in Egypt. This will be achieved by estimating the current prevalence of mental disorders and identifying any sociodemographic correlations with mental disorders. METHODS: An electronic search of 5 key databases (MEDLINE, PsycINFO, EMBASE, AMED, and PubMed) from their date of inception was conducted. In addition, scans of reference lists and searches of key journals, citations, and relevant internet resources were conducted. Studies were included if they were published in English, point prevalence studies, conducted with older Egyptians aged ≥60 years, and conducted using a validated diagnostic tool to ascertain mental disorders. Studies that did not meet any of these criteria were excluded. RESULTS: This systematic review started in November 2018. The literature search of the 5 databases revealed 343 papers. After screening titles and abstracts, scanning citations and reference lists, and searching internet sources, a total of 38 full-text articles were accessed, of which 16 studies met the eligibility criteria and were included. We are currently in the process of data extraction and synthesis. CONCLUSIONS: This research will help bring the scale of mental disorders among older adults in Egypt to the forefront. This may help ensure evidence-based initiatives are established and that priority is given to resource allocation for geriatric mental health in Egypt. TRIAL REGISTRATION: PROSPERO International Prospective Register of Systematic Review CRD42018114831; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=114831. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/14637.

A policy pathway to reducing teenage pregnancy in Africa

BACKGROUND: Teenage pregnancy remains an important and complex issue around the world, with reports indicating that Africa has higher rates than other continents. Studies have indicated that social and economic determinants are associated with these higher rates. Therefore this study aims to identify the social and economic influencers of teenage pregnancy which would help develop a best-practice approach to reduce its incidence in Africa. METHODS: Data sets from the World Bank Organisation between 2008 and 2010 specific to 51 Africa countries were obtained to conduct this study, based on availability. Independent t-test, Spearman's correlation and regression analysis were performed. The eight social and economic variables used in this study are: GDP per capita, GINI index, Female Literacy rate, Health expenditure, Unemployed female rate, Gender equality, Contraceptive prevalence and urban population rate. RESULTS: Independent t-test revealed that in countries where teenage pregnancy rate is high, Literacy rate, contraceptive prevalence rate and Healthcare expenditure rate was low. Spearman correlation indicated that female literacy rate, Healthcare expenditure, GDP per capita and Contraceptive prevalence had a significant inverse relationship with teenage pregnancy rate. Logistic regression indicates that Female Literacy rate is the best predictor of teenage pregnancy in Africa. CONCLUSION: Result suggest that a practical approach to reduce teenage pregnancy rate in Africa is to implement strategies and policies aimed at improving female literacy rate, Health care expenditure and the GDP per capita of a country. Additionally, an increase in female literacy rate would concurrently increase Contraceptive prevalence rate...(AU)

A policy pathway to reducing teenage pregnancy in Africa

BACKGROUND: Teenage pregnancy remains an important and complex issue around the world, with reports indicating that Africa has higher rates than other continents. Studies have indicated that social and economic determinants are associated with these higher rates. Therefore this study aims to identify the social and economic influencers of teenage pregnancy which would help develop a best-practice approach to reduce its incidence in Africa. METHODS: Data sets from the World Bank Organisation between 2008 and 2010 specific to 51 Africa countries were obtained to conduct this study, based on availability. Independent t-test, Spearman's correlation and regression analysis were performed. The eight social and economic variables used in this study are: GDP per capita, GINI index, Female Literacy rate, Health expenditure, Unemployed female rate, Gender equality, Contraceptive prevalence and urban population rate. RESULTS: Independent t-test revealed that in countries where teenage pregnancy rate is high, Literacy rate, contraceptive prevalence rate and Healthcare expenditure rate was low. Spearman correlation indicated that female literacy rate, Healthcare expenditure, GDP per capita and Contraceptive prevalence had a significant inverse relationship with teenage pregnancy rate. Logistic regression indicates that Female Literacy rate is the best predictor of teenage pregnancy in Africa. CONCLUSION: Result suggest that a practical approach to reduce teenage pregnancy rate in Africa is to implement strategies and policies aimed at improving female literacy rate, Health care expenditure and the GDP per capita of a country. Additionally, an increase in female literacy rate would concurrently increase Contraceptive prevalence rate...