The impact of the changes to United Kingdom psychiatry training recruitment in 2021

Purpose The purpose of this paper is to review and critically evaluate UK psychiatry national recruitment process for 2021, which was re-structured following the COVID-19 pandemic. Additionally, this paper aims to review the empirical evidence of the selection methodologies in psychiatry recruitment. Design/methodology/approach The UK national psychiatry recruitment process is discussed, with a focus on the changes made to recruitment in 2021. The advantages and disadvantages of different selection methodologies are explored, with an emphasis on evaluating the validity, acceptability and reliability of different recruitment selection methodologies. The potential impact of the changes to psychiatry recruitment are explored. Findings The decision of the National Recruitment Office to remove certain selection methods for recruitment in 2021 may have limited their ability to choose the best candidate for the training place and be fair to the applicant. Overall, there is a lack of research into the validity of the selection methods used in psychiatry recruitment. A framework for outcome criteria relevant to psychiatry recruitment should be developed, which would allow research into selection methods and guide the NRO to examine the evidence base effectively. Originality/value This paper examined the recruitment methods used to choose doctors for psychiatry training in the UK, demonstrating that the empirical evidence base for psychiatry recruitment is limited. This paper can contribute to our understanding of selection methodologies used in psychiatry recruitment and highlights the value of different recruitment approaches for choosing the best psychiatrists of the future.

What is the current state of knowledge and distribution of evidence on established policies and programs to regulate international wildlife trade? A systematic map protocol

Background: The international trade of wildlife (animals and plants) provides critical resources for human communities worldwide and contributes to local, national, and international economies. However, increasing demand presents a significant threat to both species and ecosystems as well as wildlife-centered livelihoods. Concerns regarding illicit trade of wildlife and unsustainable harvest has propelled international wildlife trade regulation to the top of political and conservation agendas. Consequently, a broad range of interventions have been established to regulate the trade and address biodiversity decline. To gain a more comprehensive understanding of the impacts of international wildlife trade interventions, this protocol sets out the parameters for a systematic map which will comprehensively collate and describe the extent and distribution of the evidence base. The resulting map aims to provide insight to guide future research and inform practice. Methods: This systematic map will identify, map, and characterize the available evidence on the impacts of established policies and programs to address international wildlife trade. Specifically, the systematic map will describe: (1) the volume and distribution of studies that have examined impacts of various interventions on conservation, biological, and socioeconomic outcomes; (2) research methodologies that have been used to evaluate impacts; (3) distribution of studies on particular taxa and geographical areas; and (4) identify evidence gaps in need of more research. We will search two publication databases and several organizational and topical websites for relevant published articles and grey literature. In addition, a call for literature will be issued among relevant research networks. The titles, abstracts, and full texts of captured studies will be assessed against inclusion criteria. Double screening will be carried out on a subset of studies to ensure consistency. Relevant information from studies will be extracted using an a priori codebook. The resulting map will consist of descriptive statistics, a heat map in the form of a matrix, and a narrative synthesis describing characteristics of included studies.

A preliminary description of the ecological characteristics of wild waterbird Japanese encephalitis virus hosts in high risk landscapes in India

Wild reservoirs of Japanese encephalitis virus are under-studied globally, which presents critical knowledge gaps for JEV infection ecology despite decades of received wisdom regarding this high-impact mosquito-borne virus. As a result, ardeid birds, generally understood to be the primary reservoirs for JEV, as well as other waterbirds occupying landscapes at high risk for spillover to humans, are frequently ignored by current surveillance mechanisms and infrastructure. This is particularly true in India, which experiences a high annual burden of human outbreaks. Incorporating wild reservoirs into surveillance of human and livestock populations is therefore essential but will first require a data-driven approach to target individual host species. The current study sought to define a preliminary ecological profile of JEV hosts based on 1) species ecological traits, and 2) species presence and abundance adjusted for the biotic constraints of sympatry. Optimal host species tended to be generalists and demonstrate regionally-increasing populations. While ardeid bird species richness, abundance, and relative abundance did demonstrate the strongest and most consistent associations with the distribution of human JEV outbreaks, this study also identified several individual species among two other bird families in these landscapes, the Anatidae and the Rallidae, which also exhibited an optimal host profile and were strongly associated with the distribution of outbreaks. The findings from this work provide the first data-driven evidence base to inform wildlife sampling for the monitoring of JEV circulation in outbreak hotspots in India and thus identify good preliminary targets for the development of One Health wildlife JEV surveillance.

What Will Happen to This Dog? A Qualitative Analysis of Rehoming Organisations' Pre-adoption Dog Behaviour Screening Policies and Procedures

Rehoming organisations often undertake some type of behaviour evaluation to determine dogs' suitability for rehoming and/or the type of suitable home. Assessments can carry considerable weight in determining dogs' fates. Although evaluation of the validity and reliability of any test is important, a more fundamental consideration is if the nature of the information sought and the weight given to this in organisations' decision making is of more than anecdotal value. Therefore, this study's aim was to conduct a qualitative analysis of organisations' pre-adoption dog behaviour screenings and potential justifications, comparing this with the available scientific evidence. A written enquiry was sent electronically to rehoming organisations in the UK and US from February 2016-July 2017. Of 73 respondents, the majority conducted assessments for all dogs. Using a thematic analysis, nine themes and 71 sub-themes emerged concerning the types of information respondents aim to gather from assessments. The majority of respondents used, at least partially, pass/fail scoring, i.e., certain outcomes would lead to dogs being deemed unadoptable. Forty-one sub-themes and one theme were identified as potentially leading to a dog being deemed unadoptable. The evidence base for these factors was identified from the scientific literature relating to: increased risk for relinquishment, impact on a dog's quality of life, and human safety risk. Evidence supported 10 factors: “aggression towards people”, “aggression towards cats or other animals”, “aggression towards dogs”, “biting or snapping”, “resource guarding”, “activity level or exercise needs”, “destructiveness”, “housetrained”, “fearfulness”, and “knowledge of basic commands and/or general training”. Of those, seven were associated only with relinquishment risk, two (“resource guarding”, “knowledge of basic commands”) with human safety risk, and one (“fearfulness”) with both. Thus, for >85% of characteristics organisations deemed important for dogs' adoptability, scientific evidence to support this is lacking. More research is needed to investigate the value of behaviour assessments, especially concerning the assessment of factors that could pose a public safety risk. However, given the current lack of scientific support for many decisions regarding dogs' rehoming suitability and recognised pressure on resources, it is suggested that organisations should focus on pre-adoption adopter education and post-adoption support.

The Cool Kids as a School-Based Universal Prevention and Early Intervention Program for Anxiety: Results of a Pilot Study

The efficacy of the Cool Kids program has been consistently demonstrated both within Australia and internationally, but limited data are available on the use of Cool Kids as a universal program. The purpose of the study is to evaluate Cool Kids as a universal program for preventing childhood anxiety in the school context. There were 73 Italian children (35 boys and 36 girls, ages 10–13 years) attending the last year of primary school and the first year of middle school who participated in an active intervention based on a school adaptation of the Cool Kids protocol. Results of t-test analyses highlighted a downward trend of anxiety symptoms, especially in total anxiety, somatic anxiety, generalized anxiety, separation anxiety, social anxiety and school phobia at post-treatment assessed by children. Even the score of depression symptoms, measured as a second outcome measure, decreased after the treatment. This study contributes to the evidence base for the Cool Kids program as a universal program for preventing childhood anxiety in the school context. Although these preliminary results show some promise, their replication in future research is necessary given current study limitations.

Protecting against researcher bias in secondary data analysis: challenges and potential solutions

Analysis of secondary data sources (such as cohort studies, survey data, and administrative records) has the potential to provide answers to science and society’s most pressing questions. However, researcher biases can lead to questionable research practices in secondary data analysis, which can distort the evidence base. While pre-registration can help to protect against researcher biases, it presents challenges for secondary data analysis. In this article, we describe these challenges and propose novel solutions and alternative approaches. Proposed solutions include approaches to (1) address bias linked to prior knowledge of the data, (2) enable pre-registration of non-hypothesis-driven research, (3) help ensure that pre-registered analyses will be appropriate for the data, and (4) address difficulties arising from reduced analytic flexibility in pre-registration. For each solution, we provide guidance on implementation for researchers and data guardians. The adoption of these practices can help to protect against researcher bias in secondary data analysis, to improve the robustness of research based on existing data.

‘Working relationships’ across difference - a realist review of community engagement with malaria research

Background: Community engagement (CE) is increasingly accepted as a critical aspect of health research, because of its potential to make research more ethical, relevant and well implemented. While CE activities linked to health research have proliferated in Low and Middle Income Countries (LMICs), and are increasingly described in published literature, there is a lack of conceptual clarity around how engagement is understood to ‘work’, and the aims and purposes of engagement are varied and often not made explicit. Ultimately, the evidence base for engagement remains underdeveloped. Methods: To develop explanations for how and why CE with health research contributes to the pattern of outcomes observed in published literature, we conducted a realist review of CE with malaria research – a theory driven approach to evidence synthesis. Results: We found that community engagement relies on the development of provisional ‘working relationships’ across differences, primarily of wealth, power and culture. These relationships are rooted in interactions that are experienced as relatively responsive and respectful, and that bring tangible research related benefits. Contextual factors affecting development of working relationships include the facilitating influence of research organisation commitment to and resources for engagement, and constraining factors linked to the prevailing ‘dominant health research paradigm context’, such as: differences of wealth and power between research centres and local populations and health systems; histories of colonialism and vertical health interventions; and external funding and control of health research. Conclusions: The development of working relationships contributes to greater acceptance and participation in research by local stakeholders, who are particularly interested in research related access to health care and other benefits. At the same time, such relationships may involve an accommodation of some ethically problematic characteristics of the dominant health research paradigm, and thereby reproduce this paradigm rather than challenge it with a different logic of collaborative partnership.

Using Data Integration to Improve Health and Welfare Insights

The Australian Institute of Health and Welfare (AIHW) is a leader in the provision of high-quality health and welfare information. Its work program has built a strong evidence base for better decisions that deliver improved health and welfare outcomes. The evolution of the AIHW’s data integration program has exemplified innovation in identifying and addressing key information gaps, as well as responsiveness to opportunities to develop and capture the data required to inform national priorities. The AIHW conducts data integration in partnership with data custodians and specialists in integration and analysis. A linkage project requiring the integration of Australian government data must be undertaken by an accredited integrating authority. The AIHW has met stringent criteria covering project governance, capability, and data management to gain this accreditation. In this capacity, the AIHW is trusted to integrate Australian government data for high-risk research projects. To date, the AIHW’s integration projects have generated improved research outcomes that have identified vulnerable population groups, improved the understanding of health risk factors, and contributed to the development of targeted interventions. These projects have fostered new insights into dementia, disability, health service use, patient experiences of healthcare, and suicide. Upcoming projects aim to further the understanding of interrelationships between determinants of wellbeing.

Management of psychotropic medications in adults with intellectual disability: a scoping review protocol

Introduction: Psychotropic medications are commonly prescribed among adults with intellectual disability (ID), often in the absence of a psychiatric diagnosis. As such, there is great disparity between the estimated prevalence of mental illness and the rates of psychotropic medication use amongst people with ID. ‘Off-label’ use of these medications may account for much of this discrepancy, in particular their use in the management of challenging behaviour. This has come under scrutiny due to the myriad of side effects and the deficiency of high-quality data supporting their use for this indication. Understanding the causes and justifications for such disparity is essential in discerning the efficacy of current prescription practice. Objective: To explore the existing evidence base regarding the prescription and management of psychotropic medications in adults with ID. The aim will be achieved through identifying the psychotropic medications commonly prescribed, the underlying rationale(s) for their prescription and the evidence available that demonstrates their appropriateness and effectiveness. Additionally, the paper will seek to evaluate the availability of any existing guidance that informs the management of these medications, and the evidence and outcomes of psychotropic medication dose reduction and/or cessation interventions. Inclusion criteria: This review will consider studies that focus on the use of psychotropic medications amongst patients with ID. Methods: Research studies (qualitative, quantitative and mixed design) and Grey Literature (English) will be included. The search will be conducted without time restrictions. Databases will include: Ovid MEDLINE, Embase, CINAHL, JBI Evidence Synthesis, Cochrane Central Register of Controlled Trials, Cochrane Databased of Systematic Reviews, PsycINFO and Scopus. A three-step search strategy will be followed, with results screened by two independent reviewers. Data will be extracted independently by two reviewers using a data extraction tool with results mapped and presented using a narrative form supported by tables and diagrams.

Contextualising Youth Justice Interventions: Making the Case for Realist Synthesis

This article examines the problematic reductionism and decontextualising nature of hegemonic youth justice intervention evaluation and offers a way ahead for a realistic, context-sensitive approach to intervention evaluation in the youth justice field. It opens by considering how the development of risk-based youth justice interventions in England and Wales flowed from and fed into the modernisation and resultant partiality of the ‘evidence-base’, which shaped youth justice practice. It then moves to a critical review of the emergence and continued influence of risk-based interventions and the ‘What Works’ intervention evaluation framework in youth justice. In the closing discussion, this article envisages the potential of taking a realist approach to the evaluation of youth justice interventions to mitigate the limitations of current approaches to intervention selection and the evaluation of their ‘effectiveness’.