Cognitive benefits of right-handedness: a meta-analysis.

Hand preference - which is related to cerebral dominance - is thought to be associated with cognitive skills; however, findings on this association are inconsistent and there is no consensus whether left- or right-handers have an advantage in either spatial or verbal abilities. In addition, it is not clear whether an interaction between sex and hand preference exists in relation to these cognitive abilities. As these matters are relevant from a neurodevelopmental perspective we performed a meta-analysis of the available literature. We searched PubMed and Embase, and included 14 studies (359,890 subjects) in the verbal ability meta-analysis and 16 studies (218,351 subjects) in the spatial ability meta-analysis. There was no difference between the full sample of left and right-handers for verbal ability, nor was there a hand preference-by-sex interaction. Subgroup analysis of children showed a small right-hand benefit. Our results further revealed a modest but significant effect favouring right-handedness for overall spatial ability, which was more pronounced when analysis was restricted to studies applying the mental rotation test. We could not identify a specific interaction with sex. Our results indicate that there is a small but significant cognitive advantage of right-handedness on spatial ability. In the verbal domain, this advantage is only significant in children. An interaction effect with sex is not confirmed.

Facilitators and barriers to service user involvement in mental health guidelines: lessons from the Netherlands.

This study is the first in-depth qualitative study of service user involvement in the development of multidisciplinary mental health guidelines in the Netherlands. The study comprised a desk study of guidelines (n = 12) and case studies of service user involvement in five guidelines using document analysis, interviews (n = 24) and observations. The desk study shows that all multidisciplinary mental health guidelines have taken service user perspectives into account to some extent. The five guideline case studies led to the identification of ten main themes. Findings will assist guideline developers in making early, informed decisions on involving service users effectively.

A review of barriers to using psychiatric advance directives in clinical practice.

Despite advocacy and demand for psychiatric advance directives (PADs), uptake and implementation in clinical practice is low. We examine why PAD implementation has been difficult globally by reviewing barriers in existing evidence. The review includes 30 studies, and identified 13 barriers, clustered into system level barriers, health professional level barriers, and service user level barriers. The considerable barriers to uptake and implementation hamper PAD use. We propose several potential strategies for overcoming some of the barriers. In order to realise these strategies, additional research is needed, particularly more field-based and operational research to understand processes and difficulties experienced in clinical practice.

Unpacking the psychiatric advance directive in low-resource settings: an exploratory qualitative study in Tamil Nadu, India.

BACKGROUND: Psychiatric advance directives, a tool to document preferences for care in advance of decisional incapacity, have been shown to benefit persons with mental illness in a number of countries through improving medication adherence, reducing symptoms from escalating in a crisis, accelerating recovery, and enhancing service user autonomy. While concepts such as autonomy are important in a number of high-income country settings, it remains unclear whether tools like psychiatric advance directives are suitable in a different context. The recent introduction of the psychiatric advance directive into draft legislation in India prompts the question as to how feasible psychiatric advance directives are in the Indian context. The aim of this study is to explore the feasibility and utility of PADs in India, with a focus on the need for individual control over decision making and barriers to implementation, by exploring views of its central stakeholders, service users and carers. METHODS: Qualitative semi-structured interviews (n = 51) with clients (n = 39) and carers (n = 12) seeking mental health treatment at outpatient clinics in urban and rural settings provided by a non-profit organisation in Tamil Nadu, India. RESULTS: Clients engaged in a number of forms of decision-making (passive, active, and collaborative) depending on the situation and decision at hand, and had high levels of self-efficacy. Most clients and carers were unfamiliar with PADs, and while some clients felt it is important to have a say in treatment wishes, carers expressed concerns about service user capacity to make decisions. After completing PADs, clients reported an increase in self-efficacy and an increased desire to make decisions. CONCLUSIONS: The introduction of psychiatric advance directives in India appears to be associated with positive outcomes for some service users, however, there is a need to better understand how this tool can be adapted to better suit the care context in India and hold meaning and value for service users to complete.