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Abstract Background Given the high prevalence and burden associated with depression and anxiety disorders and the existence of treatment barriers, there is a clear need for brief, inexpensive and effective interventions such as passive psychoeducational interventions. There are no published meta-analyses of the effectiveness of passive psychoeducation in reducing symptoms of depression, anxiety or psychological distress. Methods Cochrane, PsycInfo and PubMed databases were searched in September 2008. Additional materials were obtained from reference lists. Papers describing passive psychoeducational interventions for depression, anxiety and psychological distress were included if the research design was a randomized controlled trial and incorporated an attention placebo, no intervention or waitlist comparison group. Results In total, 9010 abstracts were identified. Of these, five papers which described four research studies targeting passive psychoeducation for depression and psychological distress met the inclusion criteria. The pooled standardized-effect size (four studies, four comparisons) for reduced symptoms of depression and psychological distress at post-intervention was d = 0.20 (95% confidence interval: 0.01-0.40; Z = 2.04; P = 0.04; the number needed to treat: 9). Heterogeneity was not significant among the studies (I2 = 32.77, Q:4.46; P = 0.22). Conclusions Although it is commonly believed that psychoeducation interventions are ineffective, this meta-analysis revealed that brief passive psychoeducational interventions for depression and psychological distress can reduce symptoms. Brief passive psychoeducation interventions are easy to implement, can be applied immediately and are not expensive. They may offer a first-step intervention for those experiencing psychological distress or depression and might serve as an initial intervention in primary care or community models. The findings suggest that the quality of psychoeducation may be important.

Background: Given the high prevalence and burden associated with depression and anxiety disorders and the existence of treatment barriers, there is a clear need for brief, inexpensive and effective interventions such as passive psychoeducational interventions. There are no published meta-analyses of the effectiveness of passive psychoeducation in reducing symptoms of depression, anxiety or psychological distress.Methods: Cochrane, PsycInfo and PubMed databases were searched in September 2008. Additional materials were obtained from reference lists. Papers describing passive psychoeducational interventions for depression, anxiety and psychological distress were included if the research design was a randomized controlled trial and incorporated an attention placebo, no intervention or waitlist comparison group.Results: In total, 9010 abstracts were identified. Of these, five papers which described four research studies targeting passive psychoeducation for depression and psychological distress met the inclusion criteria. The pooled standardized-effect size (four studies, four comparisons) for reduced symptoms of depression and psychological distress at post-intervention was d = 0.20 (95% confidence interval: 0.01-0.40; Z = 2.04; P = 0.04; the number needed to treat: 9). Heterogeneity was not significant among the studies (I2 = 32.77, Q:4.46; P = 0.22).Conclusions: Although it is commonly believed that psychoeducation interventions are ineffective, this meta-analysis revealed that brief passive psychoeducational interventions for depression and psychological distress can reduce symptoms. Brief passive psychoeducation interventions are easy to implement, can be applied immediately and are not expensive. They may offer a first-step intervention for those experiencing psychological distress or depression and might serve as an initial intervention in primary care or community models. The findings suggest that the quality of psychoeducation may be important. [ABSTRACT FROM AUTHOR]

Background: Globally, detections of carbapenemase-producing Enterobacterales (CPE) colonisations and infections are increasing. The spread of these highly resistant bacteria poses a serious threat to public health. However, understanding of CPE transmission and evidence on effectiveness of control measures is severely lacking. This paper provides evidence to inform effective admission screening protocols, which could be important in controlling nosocomial CPE transmission., Methods: CPE transmission within an English hospital setting was simulated with a data-driven individual-based mathematical model. This model was used to evaluate the ability of the 2016 England CPE screening recommendations, and of potential alternative protocols, to identify patients with CPE-colonisation on admission (including those colonised during previous stays or from elsewhere). The model included nosocomial transmission from colonised and infected patients, as well as environmental contamination. Model parameters were estimated using primary data where possible, including estimation of transmission using detailed epidemiological data within a Bayesian framework. Separate models were parameterised to represent hospitals in English areas with low and high CPE risk (based on prevalence)., Results: The proportion of truly colonised admissions which met the 2016 screening criteria was 43% in low-prevalence and 54% in high-prevalence areas respectively. Selection of CPE carriers for screening was improved in low-prevalence areas by adding readmission as a screening criterion, which doubled how many colonised admissions were selected. A minority of CPE carriers were confirmed as CPE positive during their hospital stay (10 and 14% in low- and high-prevalence areas); switching to a faster screening test pathway with a single-swab test (rather than three swab regimen) increased the overall positive predictive value with negligible reduction in negative predictive value., Conclusions: Using a novel within-hospital CPE transmission model, this study assesses CPE admission screening protocols, across the range of CPE prevalence observed in England. It identifies protocol changes-adding readmissions to screening criteria and a single-swab test pathway-which could detect similar numbers of CPE carriers (or twice as many in low CPE prevalence areas), but faster, and hence with lower demand on pre-emptive infection-control resources. Study findings can inform interventions to control this emerging threat, although further work is required to understand within-hospital transmission sources., (© 2023. Crown.)

Background: To combat the spread of antimicrobial resistance (AMR), hospitals are advised to screen high-risk patients for carriage of antibiotic-resistant bacteria on admission. This often includes patients previously admitted to hospitals with a high AMR prevalence. However, the ability of such a strategy to identify introductions (and hence prevent onward transmission) is unclear, as it depends on AMR prevalence in each hospital, the number of patients moving between hospitals, and the number of hospitals considered 'high risk'., Methods: We tracked patient movements using data from the National Health Service of England Hospital Episode Statistics and estimated differences in regional AMR prevalences using, as an exemplar, data collected through the national reference laboratory service of Public Health England on carbapenemase-producing Enterobacteriaceae (CPE) from 2008 to 2014. Combining these datasets, we calculated expected CPE introductions into hospitals from across the hospital network to assess the effectiveness of admission screening based on defining high-prevalence hospitals as high risk., Results: Based on numbers of exchanged patients, the English hospital network can be divided into 14 referral regions. England saw a sharp increase in numbers of CPE isolates referred to the national reference laboratory over 7 years, from 26 isolates in 2008 to 1649 in 2014. Large regional differences in numbers of confirmed CPE isolates overlapped with regional structuring of patient movements between hospitals. However, despite these large differences in prevalence between regions, we estimated that hospitals received only a small proportion (1.8%) of CPE-colonised patients from hospitals outside their own region, which decreased over time., Conclusions: In contrast to the focus on import screening based on assigning a few hospitals as 'high risk', patient transfers between hospitals with small AMR problems in the same region often pose a larger absolute threat than patient transfers from hospitals in other regions with large problems, even if the prevalence in other regions is orders of magnitude higher. Because the difference in numbers of exchanged patients, between and within regions, was mostly larger than the difference in CPE prevalence, it would be more effective for hospitals to focus on their own populations or region to inform control efforts rather than focussing on problems elsewhere.