Determinants of workload-related clinician stress levels in general hospital consultation liaison psychiatry services during the COVID-19 pandemic in England and Ireland. Short report.

OBJECTIVE: To explore workload-related stress levels experienced by consultation liaison psychiatry (CLP) staff in England and Ireland, and factors relevant to such a burden, during the COVID-19 pandemic. METHODS: Data were obtained for England and Ireland from a European survey among CLP services in general hospitals spread via CLP networks (11th June - 3rd October 2021). The heads of respective CLP services in general hospitals responded on behalf of each service, on 100 CLP hospital staff in total. DEPENDENT VARIABLE: workload-related stress levels in CLP services due to COVID-19 (0-10 point scale). INDEPENDENT VARIABLES: hospital size, CLP service size, degree of hospital involvement in COVID-19-related care, and the number of support options available to hospital staff. Spearman's rho correlation analyses were performed. RESULTS: There was a significant association between the hospital's involvement in COVID-19-related care and workload-related stress levels as reported by CLP staff: r(22) = 0.41, p = 0.045, R2 = 0.17. There were no significant associations between workload-related stress levels and other variables including staff support (p = 0.74). CONCLUSION: Our findings suggest that perceived workload-related stress levels of CLP staff during the COVID-19 pandemic can be an indicator of COVID-19 involvement of the hospitals. Staff support seemed not to alleviate work stress in the context of the pandemic. Healthcare policies should improve working conditions for CLP hospital staff that play an essential role from a population health perspective. Rigorous measures may be needed to ensure mental healthcare provision remains tenable and sustainable in the long term.

COVID-19-related consultation-liaison (CL) mental health services in general hospitals: A perspective from Europe and beyond.

OBJECTIVE: The COVID-19 pandemic posed new challenges for integrated health care worldwide. Our study aimed to describe newly implemented structures and procedures of psychosocial consultation and liaison (CL) services in Europe and beyond, and to highlight emerging needs for co-operation. METHODS: Cross-sectional online survey from June to October 2021, using a self-developed 25-item questionnaire in four language versions (English, French, Italian, German). Dissemination was via national professional societies, working groups, and heads of CL services. RESULTS: Of the participating 259 CL services from Europe, Iran, and parts of Canada, 222 reported COVID-19 related psychosocial care (COVID-psyCare) in their hospital. Among these, 86.5% indicated that specific COVID-psyCare co-operation structures had been established. 50.8% provided specific COVID-psyCare for patients, 38.2% for relatives, and 77.0% for staff. Over half of the time resources were invested for patients. About a quarter of the time was used for staff, and these interventions, typically associated with the liaison function of CL services, were reported as most useful. Concerning emerging needs, 58.1% of the CL services providing COVID-psyCare expressed wishes for mutual information exchange and support, and 64.0% suggested specific changes or improvements that they considered essential for the future. CONCLUSION: Over 80% of participating CL services established specific structures to provide COVID-psyCare for patients, their relatives, or staff. Mostly, resources were committed to patient care and specific interventions were largely implemented for staff support. Future development of COVID-psyCare warrants intensified intra- and inter-institutional exchange and co-operation.

Modulation of ion channels in clinical psychopharmacology: adults and younger people.

This review focuses on the use of Na(+), Ca(2+) and Cl(-) channel modulators in psychiatric disease. Drugs that modulate ion channels have been used in psychiatry for more than a century, and in this review we critically evaluate clinical research that reports the therapeutic effects of drugs acting on GABA(A), voltage-gated Na(+) and voltage-gated Ca(2+) channels in pediatric and adult patients. As in other fields, the evidence underpinning the use of medicines in younger people is far less robust than for adults. In addition, we discuss some current developments and highlight clinical disorders in which current molecules could be further tested. Notable success stories, such as benzodiazepines (in sleep and anxiety disorders) and antiepileptics (in bipolar disorder), have been the result of serendipitous discoveries or refinements of serendipitous discoveries, as in all other major treatments in psychiatry. Genomic, high-throughput screening and molecular pharmacology discoveries may, however, guide further developments in the future. This could include increased research in promising targets that have been perceived as commercially risky, such as selective α-subunit GABA(A) receptors.

Efecto de la celulosa oxigenada regenerada en la prevención de la peritonitis experimental / The oxygen regenerated cellulose effectiveness in the prevention of experimental peritonitis

Con el objeto de determinar su efectividad en la prevención de peritonitis por dehiscencia de anastomosis viscerales, se evaluaron los efectos de COR aplicada experimentalmente a orificios en estómago y colon de ratas. Se utilizaron 90 ratas divididas en 6 grupos de 14 animales. Grupos 1 y 4, gastrotomía y cecostomía no ocluidas, respectivamente. Grupos 2y 5, gastrostomía y cecostomía ocluidas con gasa. Grupos 3 y 6, gastrostomía y cecostomía con COR. Se estudiaron la sobrevida en 30 días y la bacteriología del exudado peritoneal y de abscesos y/o granulomas. En los grupos 1 y 4 la mortalidad fue de 40 y 100%y los cultivos fueron positivos en el 100%de los que murieron por peritonitis difusa. En los grupos 2 y 5 fue del 27 y 47%; los animales que no murieron presentaron granulomas abscedados rodeando la gasa y cultivos positivos. En los grupos 3 y 6 la mortalidad fue de 0 y 7%, con cultivos negativos. Comparando los grupos con gastrostomía, no existieron diferencias estadísticas significativas entre control y gasa, pero sí entre control-gasa vs. COR (p < 0,005). En los grupos con cecostomía hubo diferencias estadísticamente significativas entre control vs. gasa y control-gasa vs. COR (p<0,01). Se destaca la mayor efectividad de COR en la prevención de peritonitis experimental en ratas

Efecto de la celulosa oxigenada regenerada en la prevención de la peritonitis experimental / The oxygen regenerated cellulose effectiveness in the prevention of experimental peritonitis

Con el objeto de determinar su efectividad en la prevención de peritonitis por dehiscencia de anastomosis viscerales, se evaluaron los efectos de COR aplicada experimentalmente a orificios en estómago y colon de ratas. Se utilizaron 90 ratas divididas en 6 grupos de 14 animales. Grupos 1 y 4, gastrotomía y cecostomía no ocluidas, respectivamente. Grupos 2y 5, gastrostomía y cecostomía ocluidas con gasa. Grupos 3 y 6, gastrostomía y cecostomía con COR. Se estudiaron la sobrevida en 30 días y la bacteriología del exudado peritoneal y de abscesos y/o granulomas. En los grupos 1 y 4 la mortalidad fue de 40 y 100%y los cultivos fueron positivos en el 100%de los que murieron por peritonitis difusa. En los grupos 2 y 5 fue del 27 y 47%; los animales que no murieron presentaron granulomas abscedados rodeando la gasa y cultivos positivos. En los grupos 3 y 6 la mortalidad fue de 0 y 7%, con cultivos negativos. Comparando los grupos con gastrostomía, no existieron diferencias estadísticas significativas entre control y gasa, pero sí entre control-gasa vs. COR (p < 0,005). En los grupos con cecostomía hubo diferencias estadísticamente significativas entre control vs. gasa y control-gasa vs. COR (p<0,01). Se destaca la mayor efectividad de COR en la prevención de peritonitis experimental en ratas