Hospital-in-the-Home experience of first 23 COVID-19 patients at a regional NSW hospital.

Ambulatory care is an important service for patients with the COVID-19 infection especially in a regional area where most of the patients underwent home isolation. Escalation of treatment and timely transition to inpatient care are critical when COVID-19 patients deteriorate. Equally important is ensuring transfer into facility is carried out in a well-planned, safe manner to prevent exposure to health care professionals as well as other inpatients. This study is a summary of our COVID Hospital-in-the-Home (HITH) service and clinical presentation of COVID-19 patients.

Sexual Safety for In-Patient Mental Health Care-The Democratic Diagnosis of Change.

This article discusses a co-produced qualitative understanding aimed at reducing the risk of sexual violence within mental health in-patient settings. It describes the first stages of testing a new approach which democratises organisational change as, people who use mental health services take the lead in partnership working with those who provide services. The article sets out 'TODAYICAN' (and its second-generation iteration, 'TODAYWECAN') as emerging approaches towards change. In particular, the article focusses upon the 'diagnose' component of the approach and reports findings from a mixed methods qualitative methodology. In doing so the article offers a conceptualisation of in-patient sexual safety in a mental health context drawn from the perspectives of people who use or provide in-patient services. The article also outlines where the consensus rests on what needs to change to make sexual safety an 'always event' whilst, critically analysing where the two groups differed in their views.

Transgender, Mental Health, and Older People: An Appreciative Approach Towards Working Together.

It cannot be assumed by healthcare providers that transgender people routinely receive care and treatment that is of the quality and sensitivity that should be expected. In particular there are concerns from within the transgender community that they experience discrimination and disrespect from both individual practitioners and the healthcare system as a whole. This causes an avoidance of contact that is undesirable for both users and providers of healthcare services. Older transgender people are vulnerable to a range of mental health problems and, like all elderly, increasingly to dementia; failure to access specialist services in a timely manner may result in unnecessary distress and potentially to crisis. This paper reports on the use of an appreciative inquiry approach towards identifying the opportunities for one health board in North Wales to work more closely with older members of the transgender community it serves.

Neural correlates of self-deception and impression-management.

Self-deception and impression-management comprise two types of deceptive, but generally socially acceptable behaviours, which are common in everyday life as well as being present in a number of psychiatric disorders. We sought to establish and dissociate the 'normal' brain substrates of self-deception and impression-management. Twenty healthy participants underwent fMRI scanning at 3T whilst completing the 'Balanced Inventory of Desirable Responding' test under two conditions: 'fake good', giving the most desirable impression possible and 'fake bad' giving an undesirable impression. Impression-management scores were more malleable to manipulation via 'faking' than self-deception scores. Response times to self-deception questions and 'fake bad' instructions were significantly longer than to impression-management questions and 'fake good' instructions respectively. Self-deception and impression-management manipulation and 'faking bad' were associated with activation of medial prefrontal cortex (mPFC) and left ventrolateral prefrontal cortex (vlPFC). Impression-management manipulation was additionally associated with activation of left dorsolateral prefrontal cortex and left posterior middle temporal gyrus. 'Faking bad' was additionally associated with activation of right vlPFC, left temporo-parietal junction and right cerebellum. There were no supra-threshold activations associated with 'faking good'. Our neuroimaging data suggest that manipulating self-deception and impression-management and more specifically 'faking bad' engages a common network comprising mPFC and left vlPFC. Shorter response times and lack of dissociable neural activations suggests that 'faking good', particularly when it comes to impression-management, may be our most practiced 'default' mode.

If brain scans really detected deception, who would volunteer to be scanned?

Recent neuroimaging studies investigating the neural correlates of deception among healthy people, have raised the possibility that such methods may eventually be applied during legal proceedings. Were this so, who would volunteer to be scanned? We report a "natural experiment" casting some light upon this question. Following broadcast of a television series describing our team's investigative neuroimaging of deception in 2007, we received unsolicited (public) correspondence for 12 months. Using a customized template to examine this material, three independent assessors unanimously rated 30 of an initial 56 communications as unequivocally constituting requests for a "scan" (to demonstrate their author's "innocence"). Compared with the rest, these index communications were more likely to originate from incarcerated males, who were also more likely to engage in further correspondence. Hence, in conclusion, if neuroimaging were to become an acceptable means of demonstrating innocence then incarcerated males may well constitute those volunteering for such investigation.

Effect of pretesting on intentions and behaviour: a pedometer and walking intervention.

This study addressed the influence of pedometers and a pretest on walking intentions and behaviour. Using a Solomon four-group design, 63 female university students were randomly assigned to one of four conditions: pedometer and pretest (n = 16), pedometer and no pretest (n = 16), no pedometer and pretest (n = 15), no pedometer and no pretest (n = 16). The pretest conditions included questions on walking, intentions to walk 12,500 steps per day, and self-efficacy for walking 12,500 steps per day. In the pedometer conditions a Yamax Digi-Walker SW-650 pedometer was worn for one week. All participants completed posttest questions. While significant pretest x pedometer interactions would have indicated the presence of pretest sensitisation, no such interactions were observed for either intention or self-reported walking. Wearing pedometers reduced intentions for future walking and coping self-efficacy. However, after controlling for pretest self-reported walking, pedometer use resulted in more self-reported walking. We conclude that wearing a pedometer increased self-reported walking behaviour but that a pretest did not differentially influence walking intentions, behaviour, or self-efficacy.