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Article ; Online: The Role of Insulin-Like Growth Factor 1 in Delirium: A Systematic Review and Meta-Analysis.

Adamis, Dimitrios / Eikelenboom, Piet

Dementia and geriatric cognitive disorders

2023 Volume 51, Issue 6, Page(s) 449–459

Abstract: Background: The relationship between delirium and low levels of insulin-like growth factor 1 (IGF-1) is contradictory and uncertain. We hypothesised that low levels of IGF-1 are a predisposing factor for delirium in medical and abdominal surgical ... ...

Abstract	Background: The relationship between delirium and low levels of insulin-like growth factor 1 (IGF-1) is contradictory and uncertain. We hypothesised that low levels of IGF-1 are a predisposing factor for delirium in medical and abdominal surgical cohorts, in contrast to other surgical cohorts. Aims: Systematic review and meta-analysis investigating the association between peripheral levels of IGF-1 and delirium in medical and surgical patients to explore if there are distinct patterns of associations by using subgroup meta-analysis. Methods: PubMed, Scopus, CINAHL, Cochrane, and Embase databases were searched. Inclusion criteria were prospective studies in medical and surgical populations and available data. The following were collected: the setting (surgical/medical), the type (orthopaedic surgery, abdominal, cardiovascular, or medical), the number of participants, mean age, the number of delirious patients, scale/criteria for delirium, IGF-1 levels, and MMSE. Results: Thirteen studies were included and analysed. Low levels of IGF-1 are significantly associated with delirium in abdominal surgical samples and medical samples but not in the other surgical samples. Age, cognition, and the setting (medical vs. surgical) do not have any significant effect on the differences in IGF-1 levels between those with and without delirium. Discussion: Delirium in acute medical and abdominal surgery is triggered by low IGF-1 which may reflect chronic conditions like frailty/cachexia/sarcopenia, while in other surgeries perhaps from an inflammatory process. Conclusions: Low peripheral levels of IGF-1 are a predisposing factor for delirium only in acute medical and abdominal surgery. More studies are needed to confirm and to explore further this finding.
MeSH term(s)	Humans ; Delirium ; Frailty ; Insulin-Like Growth Factor I/analysis ; Insulin-Like Growth Factor I/metabolism ; Prospective Studies
Chemical Substances	Insulin-Like Growth Factor I (67763-96-6) ; IGF1 protein, human
Language	English
Publishing date	2023-01-23
Publishing country	Switzerland
Document type	Systematic Review ; Meta-Analysis
ZDB-ID	1026007-9
ISSN	1421-9824 ; 1013-7424
ISSN (online)	1421-9824
ISSN	1013-7424
DOI	10.1159/000527061
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Article ; Online: Holistic assessment of patients with chronic mental disorders who attend a metabolic clinic in Sligo Town catchment area.

Usman, Memoona / Saleem, Faisal / Adamis, Dimitrios

Irish journal of medical science

2023 Volume 192, Issue 5, Page(s) 2323–2329

Abstract: Background: People with serious mental illness exhibit higher morbidity and mortality rates of chronic diseases than the general population.: Aims: The aim of this study was to establish a dedicated clinic for patients with chronic mental illness to ... ...

Abstract	Background: People with serious mental illness exhibit higher morbidity and mortality rates of chronic diseases than the general population. Aims: The aim of this study was to establish a dedicated clinic for patients with chronic mental illness to monitor physical health and quality of life in accordance with best practice guidelines. Methods: Patients were invited to attend the clinic. The following areas were examined: personal and family history of cardiovascular disease, diet, exercise, and smoking. Mental state examination, waist circumference, BP, pulse, ECG and BMI. Laboratory tests including U + E, LFTs, HbA1c, Lipid profile and other tests as appropriate such as serum lithium. AIMS scale, HoNOS and WHOQOL-BREF scales as additional indicators of global health. Results: A total of 80 patients attended during 3.5 years of clinic. Mean age was 54.9 years (SD: 13.81) at first contact and 45% were females. Mean years in the service was 19.66 (SD: 11.54) and mean number of previous hospital admissions was 4.4 (SD: 5.63). Metabolic syndrome was present in 42% at first assessment. A statistically significant improvement was found for the psychological domain of the WHOQOL-BREF and the HoNOs, particularly at third assessment. (β = 4.64, Wald x Conclusion: The results show a high prevalence of physical health conditions in this cohort, some of which represent a new diagnosis. This implicates better allocation of existing resources for screening and early detection, and potential to run joint clinics with primary care.
MeSH term(s)	Female ; Humans ; Middle Aged ; Male ; Quality of Life/psychology ; Mental Disorders/epidemiology ; Mental Disorders/psychology ; Patients ; Hospitalization ; Chronic Disease
Language	English
Publishing date	2023-02-06
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	390895-1
ISSN	1863-4362 ; 0021-1265
ISSN (online)	1863-4362
ISSN	0021-1265
DOI	10.1007/s11845-023-03284-y
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Article ; Online: Perspectives of psychiatric trainees and examiners on the assessment of communication skills during an online clinical examination: a qualitative study.

Usman, Memoona / Adamis, Dimitrios / McCarthy, Geraldine

Irish journal of psychological medicine

2023 , Page(s) 1–7

Abstract: Background: Effective doctor-patient communication is a core competency for healthcare professionals. With the pivot to online clinical education and assessment due to the COVID-19 pandemic, there was a need to explore the views of psychiatric trainees ... ...

Abstract	Background: Effective doctor-patient communication is a core competency for healthcare professionals. With the pivot to online clinical education and assessment due to the COVID-19 pandemic, there was a need to explore the views of psychiatric trainees and examiners on assessment of communication skills during online high stakes postgraduate examinations. Methods: The study was designed as descriptive qualitative research. All candidates and examiners of the September and November 2020 sitting of online Basic Specialist Training exam (a clinical Objective Structured Clinical Examination exam completed in the first 4 years of psychiatry training) were invited to participate. The respondents were interviewed by Zoom which was transcribed verbatim. Data were analyzed by NVivo20 pro and various themes and subthemes were drawn using Braun and Clarke thematic analysis. Results: A total of seven candidates and seven examiners were interviewed with an average duration of 30 minutes and 25 minutes, respectively. Four main themes emerged: Communication, Screen optimization, Continuation postpandemic and Overall experience. All candidates preferred to continue an online format post pandemic for practical reasons e.g., avoiding travel and overnight stay, while all examiners preferred to go back to in-person Objective Structured Clinical Examination. However, continuation of online Clinical Formulation and Management Examination was agreed by both groups. Conclusion: The participants were largely satisfied with the online examination but did not consider it equal to face-to-face for picking up nonverbal cues. Overall minimal technical issues were reported. These findings may be helpful to modify current psychiatry membership examinations or similar assessments in other countries and specialties.
Language	English
Publishing date	2023-06-15
Publishing country	England
Document type	Journal Article
ZDB-ID	227751-7
ISSN	2051-6967 ; 0790-9667
ISSN (online)	2051-6967
ISSN	0790-9667
DOI	10.1017/ipm.2023.19
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Article ; Online: COVID-19-related occupational stress in staff in an acute paediatric teaching hospital in Ireland.

Murray, Johanna / Adamis, Dimitrios / McNicholas, Fiona

BMJ paediatrics open

2022 Volume 6, Issue 1

Abstract: Background: The COVID-19 pandemic has resulted in major strains for healthcare staff.: Objectives: This study aims to assess prevalence of occupational burnout (BO) during COVID-19 in staff working in an acute paediatric hospital setting.: ... ...

Abstract	Background: The COVID-19 pandemic has resulted in major strains for healthcare staff. Objectives: This study aims to assess prevalence of occupational burnout (BO) during COVID-19 in staff working in an acute paediatric hospital setting. Participants: One hundred and thirty-three staff, out of 1900 eligible staff (9.6% response rate), completed an online or paper and pencil survey. Methods: The Copenhagen Burnout Inventory was used as the main outcome measure. Additional questions examined the impact of COVID-19 and restrictions on work setting and personal health. Results: The majority of respondents reported moderate or higher levels of BO for personal (n=93; 70%) and work domains (n=83; 62%). Rates of patient-related BO were lower (n=18; 13%). Higher rates of BO were found in staff with self-rated COVID-19 adverse effects on physical (n=50, 38%) and mental health (n=88, 66%) (F (2, 13.019)=16.019, p<0.001). The majority of staff had no stress reduction training at any stage in their career, either professional (60%), on the job (62%) or postpandemic (59%) work. Although most (82%) were aware of occupational health supports, few (30%) reported an intention to access these if needed; 65% (n=86) of the respondents seriously considered changing jobs in the last 6-12 months. Conclusion: High level of occupational stress among hospital staff during COVID-19, in the absence of stress reduction training is a risk factor for BO. Interventions, acceptable to the employee, are urgently needed given the likelihood of additional work demands as COVID-19 continues.
MeSH term(s)	Burnout, Professional/epidemiology ; COVID-19/epidemiology ; Child ; Hospitals, Pediatric ; Hospitals, Teaching ; Humans ; Ireland ; Job Satisfaction ; Occupational Stress/epidemiology ; Pandemics
Language	English
Publishing date	2022-09-02
Publishing country	England
Document type	Journal Article
ISSN	2399-9772
ISSN (online)	2399-9772
DOI	10.1136/bmjpo-2021-001308
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Article ; Online: Comment on: "Psychological distress among outpatient physicians in private practice linked to COVID-19 and related mental health during the second lockdown".

McNicholas, Fiona / O'Donnell, Shane / Hayden, John / Quigley, Etain / Adamis, Dimitrios / Gavin, Blanaid

Journal of psychiatric research

2023 Volume 165, Page(s) 14–15

MeSH term(s)	Humans ; COVID-19 ; Mental Health ; Outpatients ; Communicable Disease Control ; Private Practice ; Psychological Distress
Language	English
Publishing date	2023-07-08
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	3148-3
ISSN	1879-1379 ; 0022-3956
ISSN (online)	1879-1379
ISSN	0022-3956
DOI	10.1016/j.jpsychires.2023.07.010
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Article ; Online: Author's reply.

Macdonald, Alastair / Adamis, Dimitrios / Craig, Tom / Murray, Robin

The British journal of psychiatry : the journal of mental science

2020 Volume 217, Issue 1, Page(s) 399

Language	English
Publishing date	2020-06-27
Publishing country	England
Document type	Letter ; Comment
ZDB-ID	218103-4
ISSN	1472-1465 ; 0007-1250
ISSN (online)	1472-1465
ISSN	0007-1250
DOI	10.1192/bjp.2020.26
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Article: Work-related experiences of consultant psychiatrists during the COVID-19 response: qualitative analysis.

O'Donnell, Shane / Quigley, Etain / Hayden, John / Adamis, Dimitrios / Gavin, Blánaid / McNicholas, Fiona

BJPsych open

2023 Volume 9, Issue 2, Page(s) e49

Abstract: Background: Research has begun to draw attention to the challenges mental health professionals faced in delivering services during the COVID-19 pandemic response. However, few studies have examined the specific experiences of consultant psychiatrists.!## ...

Abstract	Background: Research has begun to draw attention to the challenges mental health professionals faced in delivering services during the COVID-19 pandemic response. However, few studies have examined the specific experiences of consultant psychiatrists. Aims: To examine the work-related experiences and psychosocial needs of consultant psychiatrists situated in the Republic of Ireland arising from the COVID-19 response. Method: We interviewed 18 consultant psychiatrists and analysed data using inductive thematic analysis. Results: Work-related experience of participants was characterised by increased workload associated with assumption of guardianship of physical and mental health of vulnerable patients. Unintended consequences of public health restrictions increased case complexity, limited availability of alternative supports and hindered the practice of psychiatry, including inhibiting peer support systems for psychiatrists. Participants perceived available psychological supports as generally unsuitable for their needs given their specialty. Long-standing under-resourcing, mistrust in management and high levels of burnout exacerbated the psychological burden of the COVID-19 response. Conclusions: The challenges of leading mental health services were evident in the increased complexity involved in caring for vulnerable patients during the pandemic, contributing to uncertainty, loss of control and moral distress among participants. These dynamics worked synergistically with pre-existing system-level failures, eroding capacity to mount an effective response. The longer-term psychological well-being of consultant psychiatrists - as well as the pandemic preparedness of healthcare systems - is contingent on implementation of policies addressing long-standing under-investment in the services vulnerable populations rely on, not least community mental health services.
Language	English
Publishing date	2023-03-06
Publishing country	England
Document type	Journal Article
ZDB-ID	2829557-2
ISSN	2056-4724
ISSN	2056-4724
DOI	10.1192/bjo.2023.11
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Article: Burnout in mental health services in Ireland during the COVID-19 pandemic.

Adamis, Dimitrios / Minihan, Elisha / Hannan, Noel / Doherty, Anne M / McNicholas, Fiona

BJPsych open

2023 Volume 9, Issue 6, Page(s) e177

Abstract: Background: Burnout is a consequence of chronic occupational stress. Specific work-related factors may contribute to burnout experienced by those working in mental health services (MHS), many of which have increased since the COVID-19 pandemic.: Aims!# ...

Abstract	Background: Burnout is a consequence of chronic occupational stress. Specific work-related factors may contribute to burnout experienced by those working in mental health services (MHS), many of which have increased since the COVID-19 pandemic. Aims: To examine personal, work- and patient-related burnout among MHS staff in Ireland during the COVID-19 pandemic, and explore the impact of work-related conditions on burnout. Method: We conducted a cross-sectional survey of three MHS across Ireland utilising a study-specific questionnaire, the Copenhagen Burnout Inventory and the Effort-Reward Imbalance scale. Results: Of 396 participants, 270 (70.6%) were female. Moderate and high personal burnout was experienced by 244 (64.1%) participants; work-related burnout by 231 (58.5%) participants and patient-related burnout by 83 (21.5%) participants. Risk factors for both personal and work-related burnout were female gender, urban service, time spent outside main responsibilities, overcommitment, high score on the Effort-Reward Imbalance scale and intention to change job. Being younger, with high workload and deterioration of personal mental health during the pandemic was associated with higher personal burnout, whereas a lack of opportunity to talk about work-related stress contributed to work-related burnout. Fewer factors were associated with patient-related burnout, namely overcommitment, working in urban services and poorer physical and mental health during the COVID-19 pandemic. Conclusions: High levels of personal and work-related burnout were found among mental health workers. The weak association with COVID-19-related factors suggest levels of burnout predated the pandemic. This has implications for MHS given the recognised additional work burden created by COVID-19.
Language	English
Publishing date	2023-10-06
Publishing country	England
Document type	Journal Article
ZDB-ID	2829557-2
ISSN	2056-4724
ISSN	2056-4724
DOI	10.1192/bjo.2023.552
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Article ; Online: "We're seen as part of the supply chain of medicines rather than as the professionals that we are": The wellbeing of community pharmacists during the COVID response.

O'Donnell, Shane / Hayden, John / Quigley, Etain / Adamis, Dimitrios / Gavin, Blánaid / McNicholas, Fiona

Research in social & administrative pharmacy : RSAP

2023 Volume 20, Issue 4, Page(s) 389–400

Abstract: Introduction: Challenges facing community pharmacists in delivering and adapting services during the COVID-19 response have been reported. However, few qualitative studies have examined the impact of these experiences on their wellbeing, and what ... ...

Abstract	Introduction: Challenges facing community pharmacists in delivering and adapting services during the COVID-19 response have been reported. However, few qualitative studies have examined the impact of these experiences on their wellbeing, and what supports the profession requires in the future. Aim(s): To examine the work-related experiences and psychosocial needs of community pharmacists situated in the Republic of Ireland arising from the COVID-19 response. Method: 11 pharmacists and 1 representative were interviewed and data analysed through inductive thematic analysis. Results: Work experiences were characterised by increased workload linked to multiple roles pharmacists played during the pandemic. Remaining open, meeting the social and medical needs of patients unable to easily access other primary services exerted its toll on pharmacists while at the same time providing a sense of professional fulfilment. Participants felt contributions made to the community during COVID-19 went largely unrecognised by the wider healthcare structure. This added to a prior sense of professional disenchantment arising from long-standing under-resourcing, lack of clinical autonomy and high administrative burden eroding their sense of purpose and meaning. Informal, peer-support networks were preferred over formal psychological support initiatives. Conclusions: The post-pandemic environment is an opportune time for policy makers to reconsider the role of community pharmacists. Greater clinical autonomy beyond dispensing of medicines, for example, for example, would also serve to enhance the sense of purpose and meaning of pharmacists as healthcare professionals. The longer-term well-being of community pharmacists is contingent on recognition of the value that community pharmacy bring both to the healthcare system and wider society as a whole.
MeSH term(s)	Humans ; Pharmacists ; COVID-19/epidemiology ; Community Pharmacy Services ; Delivery of Health Care ; Qualitative Research ; Professional Role
Language	English
Publishing date	2023-12-31
Publishing country	United States
Document type	Journal Article
ZDB-ID	2192059-X
ISSN	1934-8150 ; 1551-7411
ISSN (online)	1934-8150
ISSN	1551-7411
DOI	10.1016/j.sapharm.2023.12.004
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Article ; Online: Consistent patterns in the inconsistent associations of Insulin-like growth factor 1 (IGF-1), C-Reactive Protein (C-RP) and Interleukin 6 (IL-6) levels with delirium in surgical populations. A systematic review and meta-analysis.

Adamis, Dimitrios / van Gool, Willem A / Eikelenboom, Piet

Archives of gerontology and geriatrics

2021 Volume 97, Page(s) 104518

Abstract: Background: Biomarkers for delirium could increase diagnostic accuracy and may help to identify pathological pathways. Until now study findings concerning cytokine levels have been inconsistent.: Aims: Systematic review and meta-analysis ... ...

Abstract	Background: Biomarkers for delirium could increase diagnostic accuracy and may help to identify pathological pathways. Until now study findings concerning cytokine levels have been inconsistent. Aims: Systematic review and meta-analysis investigating the association between peripheral levels of Insulin-like Growth Factor-1 (IGF-1), C-Reactive Protein (C-RP) and Interleukin-6 (IL-6) and delirium in surgical patients, and to explore if there are distinct/specific patterns that may potentially explain inconsistent results. Methods: PubMed, Scopus, CINAHL, Cochrane, and EMBASE databases were searched. Inclusion criteria were: prospective studies, surgical populations excluding preoperative delirium, available data. The following were collected: type of operation (orthopaedic, abdominal, etc), the timing of operation (acute, elective, both), demographics, number of participants with delirium, time of preoperative blood withdrawal, and preoperative levels of each biomarker. Results: Low levels of IGF-1 (n = 7 studies) are significantly associated with post-operative delirium in abdominal surgical samples. High levels of C-RP (n = 9) are associated with delirium in acute orthopaedic and elective abdominal operations. IL-6 (n = 14) is a significant predictor of post-operative delirium in a variety of surgical conditions (elective or acute). Discussion: A common pattern exists in the otherwise conflicting reported findings. This similarity may reflect different underling mechanisms and predisposing factors like cachexia and catabolic stages. It seems that delirium in abdominal surgery is triggered by IGF-1 disturbances, while in other surgeries by an inflammatory reaction. Conclusions: Despite the contradictory results concerning the association of IGF-1, C-RP and IL-6 with postoperative delirium, the present meta-analysis shows that there are certain patterns. IL-6 seems a consistent predictor for delirium in surgical samples.
MeSH term(s)	C-Reactive Protein/analysis ; Delirium/diagnosis ; Delirium/etiology ; Humans ; Insulin-Like Growth Factor I/analysis ; Interleukin-6/blood ; Prospective Studies
Chemical Substances	IGF1 protein, human ; IL6 protein, human ; Interleukin-6 ; Insulin-Like Growth Factor I (67763-96-6) ; C-Reactive Protein (9007-41-4)
Language	English
Publishing date	2021-09-04
Publishing country	Netherlands
Document type	Journal Article ; Meta-Analysis ; Review ; Systematic Review
ZDB-ID	603162-6
ISSN	1872-6976 ; 0167-4943
ISSN (online)	1872-6976
ISSN	0167-4943
DOI	10.1016/j.archger.2021.104518
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