6 research outputs found

    Implicit bias in referrals to relational psychological therapies: review and recommendations for mental health services

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    Data availability statement: The dataset supporting this study is publicly available on Brunel University's Figshare repository. It can be accessed at the following link: https://doi.org/10.17633/rd.brunel.27332307.v2.Introduction: Timely and appropriate psychological treatment is an essential element required to address the growing burden of mental health issues, which has significant implications for individuals, society, and healthcare systems. However, research indicates that implicit biases among mental health professionals may influence referral decisions, potentially leading to disparities in access to relational psychological therapies. This study investigates bias in referral practices within mental health services, identifying key themes in referral procedures and proposing recommendations to mitigate bias and promote equitable access. Methods: A systematic review of literature published between 2002 and 2022 was conducted, focusing on biases, referral practices, and relational psychological therapies. The search strategy involved full-text screening of studies meeting inclusion criteria, specifically those examining professional and organizational implicit bias in mental health referrals. Thematic synthesis was employed to analyze and categorize bias within these domains, providing a structured framework for understanding its impact on referral decision making processes. Results: The search yielded 2,964 relevant papers, of which 77 underwent full-text screening. Ultimately, eight studies met the inclusion criteria and were incorporated into the review. The analysis revealed that bias development mechanisms in referral decisions occurred across five key domains: resource allocation, organizational procedures, clinical roles, decision-making, and referral preferences. These domains highlight organizational and practitioner-level factors contributing to disparities in access to psychological therapies. Discussion: Findings suggest that implicit biases within referral processes can limit equitable access to psychological therapies, particularly relational therapies that emphasize therapeutic alliance and patient-centered care. This study provides recommendations to address these biases, including standardized referral guidelines, enhanced professional training on implicit bias, and improved oversight mechanisms within mental health services.The author(s) declare financial support was received for the research, authorship, and/or publication of this article. CNWL NHS Foundation Trust provided a grant to Brunel University of London

    TRPV1 regulates excitatory innervation of OLM neurons in the hippocampus

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    TRPV1 is an ion channel activated by heat and pungent agents including capsaicin, and has been extensively studied in nociception of sensory neurons. However, the location and function of TRPV1 in the hippocampus is debated. We found that TRPV1 is expressed in oriens-lacunosum-moleculare (OLM) interneurons in the hippocampus, and promotes excitatory innervation. TRPV1 knockout mice have reduced glutamatergic innervation of OLM neurons. When activated by capsaicin, TRPV1 recruits more glutamatergic, but not GABAergic, terminals to OLM neurons in vitro. When TRPV1 is blocked, glutamatergic input to OLM neurons is dramatically reduced. Heterologous expression of TRPV1 also increases excitatory innervation. Moreover, TRPV1 knockouts have reduced Schaffer collateral LTP, which is rescued by activating OLM neurons with nicotine-via α2β2-containing nicotinic receptors-to bypass innervation defects. Our results reveal a synaptogenic function of TRPV1 in a specific interneuron population in the hippocampus, where it is important for gating hippocampal plasticity.peerReviewe

    The role of double-strand break repair - insights from human genetics

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    The efficient repair of DNA double-strand breaks is crucial in safeguarding the genomic integrity of organisms. Responses to double-strand breaks include complex signal-transduction, cell-cycle-checkpoint and repair pathways. Defects in these pathways lead to several human disorders with pleiotropic clinical features. Dissection of the molecular basis that underlies the diverse clinical features is enhancing our understanding of the damage-response mechanisms and their role in development, and might ultimately facilitate treatment
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