Mental Health Act

The COVID-19 pandemic posed a grave threat not only to Indigenous people's health and well-being, but also to Indigenous communities and societies. This applies also to the Indigenous peoples of the Arctic, where unintentional effects of public health actions to mitigate the spread of virus may have long-lasting effects on vulnerable communities. This study aim was to identify and describe Sámi perspectives on how the Sámi society in Sweden was specifically affected by the pandemic and associated public health actions during 2020-2021. A mixed-method qualitative case study approach was employed, including a media scoping review and stakeholder interviews. The media scoping review included 93 articles, published online or in print, from January 2020 to 1 September 2021, in Swedish or Norwegian, regarding the pandemic-related impacts on Sámi society in Sweden. The review informed a purposeful selection of 15 stakeholder qualitative interviews. Thematic analysis of the articles and interview transcripts generated five subthemes and two main themes: "weathering the storm" and "stressing Sámi culture and society". These reflect social dynamics which highlight stressors towards, and resilience within, the Sámi society during the pandemic. The results may be useful when evaluating and developing public health crisis response plans concerning or affecting the Sámi society in Sweden.

This study provides the first examination of the frequency, characteristics, and dynamics surrounding daily experiences of OCD-relevant intrusions among non-clinical participants (N = 54, N = 2314) using ecological momentary assessment. It also examines the extent to which self-related constructs-participants' feared-self beliefs and their tendency to conceal aspects of self-relate to such intrusive phenomena. Participants completed a baseline questionnaire before reporting state depressed mood and intrusions up to five times per day (at semi-random intervals) for 14 days. Results suggest that questionnaire measures may result in underreporting of the frequency of intrusions, with most participants (80%) reporting at least one intrusion across the momentary observations, and 20% of observations indicating intrusive phenomena experienced since the previous momentary report. Baseline factors including OCD-related beliefs and feared self were related to the proportion of intrusions experienced, whereas self-concealment was not. Within the moment, state feared-self predicted intrusion-related distress, duration, perceived importance, the urge to act, and the need to control thoughts. The urge to conceal within the moment was significant but negatively related to perceived importance and the urge to act. Overall, this study provides evidence for the relevance of momentary measures of intrusions, and adds to evidence for self-beliefs in the dynamics of the disorder.

Dopaminergic receptor antagonism is a crucial component of all licensed treatments for psychosis, and dopamine dysfunction has been central to pathophysiological models of psychotic symptoms. Some clinical trials, however, indicate that drugs that act through muscarinic receptor agonism can also be effective in treating psychosis, potentially implicating muscarinic abnormalities in the pathophysiology of psychosis. Here, we discuss understanding of the central muscarinic system, and we examine preclinical, behavioural, post-mortem, and neuroimaging evidence for its involvement in psychosis. We then consider how altered muscarinic signalling could contribute to the genesis and maintenance of psychotic symptoms, and we review the clinical evidence for muscarinic agents as treatments. Finally, we discuss future research that could clarify the relationship between the muscarinic system and psychotic symptoms.

With the enforcement of the Cannabis Act on 1 April 2024, Germany has adopted one of the most liberal legal approaches to cannabis on the continent. The German model prioritises a non-profit approach and precludes legal market mechanisms. We believe these are the main drivers for increasing cannabis use and related health problems, based on observations following cannabis legalisation in Canada and many states in the U.S. Although legalising cannabis possession and cultivation may not immediately eliminate the illegal market, it is expected to serve public health goals. Despite the overall positive evaluation of the Cannabis Act in Germany, there are three potential areas of concern: the potential for misuse of the medical system, the normalization of cannabis use, and the influence of the cannabis industry. The German model may herald the beginning of a new generation of European cannabis policies, but concerted efforts will be required to ensure that these policy reforms serve rather than undermine public health goals.

Vasopressin or arginine-vasopressin (AVP) is a neuropeptide molecule known for its antidiuretic effects and serves to regulate plasma osmolality and blood pressure. The existing literature suggests that AVP plays a multifaceted-though less well-known-role in the central nervous system (CNS), particularly in relation to the pathophysiology and treatment of mood disorders. Animal models have demonstrated that AVP is implicated in regulating social cognition, affiliative and prosocial behaviors, and aggression, often in conjunction with oxytocin. In humans, AVP is implicated in mood disorders through its effects on the hypothalamic-pituitary-adrenal (HPA) axis as well as on the serotoninergic and glutamatergic systems. Measuring plasma AVP has yielded interesting but mixed results in mood and stress-related disorders. Recent advances have led to the development of copeptin as a stable and reliable surrogate biomarker for AVP. Another interesting but relatively unexplored issue is the interaction between the osmoregulatory system and mood disorder pathophysiology, given that psychotropic medications often cause dysregulation of AVP receptor expression or signaling that can subsequently lead to clinical syndromes like syndrome of inappropriate diuresis and diabetes insipidus. Finally, pharmaceutical trials of agents that act on V1a and V1b receptor antagonists are still underway. This narrative review summarizes: (1) the neurobiology of the vasopressinergic system in the CNS; (2) the interaction between AVP and the monoaminergic and glutamatergic pathways in the pathophysiology and treatment of mood disorders; (3) the iatrogenic AVP dysregulation caused by psychotropic medications; and (4) the pharmaceutical development of AVP receptor antagonists for the treatment of mood disorders.

Although depression is one of the most common mental health disorders outpacing other diseases and conditions, poor access to care and limited resources leave many untreated. Secure messaging (SM) offers patients an online means to bridge this gap by communicating nonurgent medical questions. We focused on self-care health management behaviors and delved into as the initial act of engagement and as continuous engagement patterns. This study examined whether those with depression might be using SM more than those without depression. Patient portal data were obtained from a large academic medical center's electronic health records spanning 5 years, from January 2018 to December 2022. We organized and analyzed SM and using the linear mixed-effects modeling technique. Our predictors correlated with SM initiations, accounting for 25.1% of variance explained. In parallel, 24.9% of SM exchanges were attributable to these predictors. Overall, our predictors demonstrate stronger associations with SM exchanges. We examined patients with and without depression across 2,629 zip codes over five years. Our findings reveal that the predictors affecting SM initiations and exchanges are multifaceted, with certain predictors enhancing its utilization and others impeding it. SM telehealth service provided support to patients with mental health needs to a greater extent than those without. By increasing access, fostering better communication, and efficiently allocating resources, telehealth services not only encourage patients to begin using SM but also promote sustained interaction through ongoing SM exchanges.

Fibromyalgia (FM) is a chronic pain disorder characterised by widespread pain, fatigue and cognitive symptoms. Acceptance and commitment therapy (ACT) aims to improve psychological flexibility and has been found to be beneficial in treating chronic pain; however, there are few studies evaluating its efficacy in treating FM.

Heparan sulfate (HS) is degraded in lysosome by a series of glycosidases. Before the glycosidases can act, the terminal glucosamine of HS must be acetylated by the integral lysosomal membrane enzyme heparan-α-glucosaminide N-acetyltransferase (HGSNAT). Mutations of HGSNAT cause HS accumulation and consequently mucopolysaccharidosis IIIC, a devastating lysosomal storage disease characterized by progressive neurological deterioration and early death where no treatment is available. HGSNAT catalyzes a unique transmembrane acetylation reaction where the acetyl group of cytosolic acetyl-CoA is transported across the lysosomal membrane and attached to HS in one reaction. However, the reaction mechanism remains elusive. Here we report six cryo-EM structures of HGSNAT along the reaction pathway. These structures reveal a dimer arrangement and a unique structural fold, which enables the elucidation of the reaction mechanism. We find that a central pore within each monomer traverses the membrane and controls access of cytosolic acetyl-CoA to the active site at its luminal mouth where glucosamine binds. A histidine-aspartic acid catalytic dyad catalyzes the transfer reaction via a ternary complex mechanism. Furthermore, the structures allow the mapping of disease-causing variants and reveal their potential impact on the function, thus creating a framework to guide structure-based drug discovery efforts.

A mouse plague occurred in Eastern Australia from spring 2020 to winter 2021, impacting an area of around 180,000 km. It harmed human physical and psychological health, damaged the natural and built environment, and endangered farmed, domestic and native animals. However, the mouse plague was overshadowed by the COVID-19 pandemic, especially as the end of the plague coincided with the arrival and surge of the COVID-19 delta strain in rural New South Wales (NSW). In this article, we systematically overview the multiple impacts of the plague and highlight their complex interactions. Using a One Health framework, we comprehensively review the i) human, ii) animal and iii) environmental impacts including economic dimensions. Given the damage that the mouse plague caused to infrastructure, we consider the environment from two perspectives: the natural and the built environment. This One Health description of the 2020-2021 mouse plague identifies priorities for preparedness, response and recovery at local, regional land levels to inform response and management of future mouse plague events in Australia. It also highlights the need for ongoing collaboration between researchers and practitioners in the human, animal and environmental health sectors.

The COVID-19 pandemic negatively impacted global mental health, with adolescents experiencing disproportionate effects. Limited research has explored the impact of different pandemic restrictions on adolescent mental health, and only a few studies have examined the longer-term impacts of the pandemic on adolescent mental health. These investigations are crucial for informing public health policies, particularly the integration of mental health care in future public health emergencies.

The MR CLEAN-LATE trial provided evidence for the safety and efficacy of endovascular treatment for acute ischaemic stroke within the late window (after 6-24 h) in patients who were preselected based on the presence of collateral flow on CT angiography. We aimed to evaluate clinical outcomes 2 years after randomisation.

Many first-time mothers (primiparous) within UK National Health Service (NHS) settings require an obstetric intervention to deliver their babies safely. While the antepartum period allows time for conversations about consent for planned interventions, such as elective caesarean section, current practice is that, in emergencies, consent is addressed in the moments before the intervention takes place. This paper explores whether there are limitations on the validity of consent offered in time-pressured and emotionally charged circumstances, specifically concerning emergency obstetric interventions. Using the legal framework of the Mental Capacity Act, (2015) and (2023), we argue that while women have the capacity to consent during labour, their autonomy is best supported by providing more information about instrumental delivery (ID) during the antepartum period. This conclusion is supported by some national guidelines, including those developed by the Royal College of Obstetricians and Gynaecologists, but not all. Further, we examine the extent to which these principles are upheld in modern-day practice. Data suggest there is relatively little antepartum information provision regarding ID within NHS settings, and that primiparous women do not report a thorough understanding of ID before labour. Based on these results, and bearing in mind the pressures under which NHS obstetric services currently operate, we recommend further research into patient and clinician perceptions of the consent process for ID. Pending these results, we discuss possible modes of information delivery in future practice.

Glymphatic dysfunction has been correlated with cognitive decline, with a higher choroid plexus volume (CPV) being linked to a slower glymphatic clearance rate. Nevertheless, the interplay between CPV, glymphatic function, and cognitive impairment in white matter hyperintensities (WMHs) has not yet been investigated. In this study, we performed neuropsychological assessment, T1-weighted three-dimensional (3D-T1) images, and diffusion tensor imaging (DTI) in a cohort of 206 WMHs subjects and 43 healthy controls (HCs) to further explore the relationship. The DTI analysis along the perivascular space (DTI-ALPS) index, as a measure of glymphatic function, was calculated based on DTI. Severe WMHs performed significantly worse in information processing speed (IPS) than other three groups, as well as in executive function than HCs and mild WMHs. Additionally, severe WMHs demonstrated lower DTI-ALPS index and higher CPV than HCs and mild WMHs. Moderate WMHs displayed higher CPV than HCs and mild WMHs. Mini-Mental State Examination, IPS, and executive function correlated negatively with CPV but positively with DTI-ALPS index in WMHs patients. Glymphatic function partially mediated the association between CPV and IPS, indicating a potential mechanism for WMHs-related cognitive impairment. CPV may act as a valuable prognostic marker and glymphatic system as a promising therapeutic target for WMHs-related cognitive impairment.

The prevalence of major depressive disorder (MDD) is on the rise globally, and the use of antidepressant medications for its treatment does not usually result in full remission. However, the combination of physical exercise and psychotherapy for the treatment of MDD increase the rate of full remission among patients. This three-armed, parallel-group, double-blinded randomised controlled trial (RCT) aims to assess and compare the effects between the combination of exergame and acceptance and commitment therapy (e-ACT) programme, ACT only and treatment-as-usual (TAU) control groups on the severity of depression and anxiety symptoms, the degree of experiential avoidance and quality of life (QoL) and the serum levels of depression biomarkers (such as brain-derived neurotrophic factor, C-reactive protein and vascular endothelial growth factor) among patients with MDD across three time points.

This systematic review investigated the practices that support and hinder the recovery and healing of communities and the environments within which they live, following climate-related environmental disasters. Although the literature focused on recovery is dominated by interventions aimed at the individual and their mental health, a thematic analysis of thirty-six studies established a range of practices that enhance collective recovery and healing. Four narratives were identified from the findings highlighting key practices: (1) collective and community-led recovery; (2) recognising the criticality of context, place, and identity; (3) adopting a holistic conception of well-being and Country-centred practices; and (4) decolonising and Indigenising the literature. This study details recommendations for research and practice. First Nations' knowledges and healing practices need to be recognised and harnessed in climate-related environmental disaster recovery. Community-led interventions harness local knowledge, networks, and expertise, which improves the dissemination of resources and enables recovery efforts to be tailored to the specific needs of communities.

Social rhythm dysregulation has been identified as a determining factor in bipolar disorder (BD) relapses. It directly impacts individuals' quality of life (QoL). This study aims to present preliminary data on the efficacy of an e-health psychoeducational intervention for BD for improving clinical outcomes. This study used an open-label, crossover, randomized controlled trial design. The inclusion criteria consisted of a BD diagnosis, affiliation with the Consultation Psychiatry and Psychosomatic Center at the University Hospital in Cagliari, Italy, age over 18, and the obtaining of informed consent. Anxiety and depressive symptoms, QoL, and social and biological rhythms were measured using standardized instruments validated in Italian. A total of 36 individuals were included in the experimental group (EG) and 18 in the control group (CG). The final sample consisted of 25 in the EG and 14 in the CG. A statistically significant improvement in QoL was found in the EG post-treatment ( = 0.011). Significant correlations were found between QoL and the dysregulation of biorhythms in the EG at T0 ( = 0.0048) and T1 ( = 0.0014). This study shows that, during extreme distress, an e-health group psychoeducation intervention for people with BD could significantly improve the perception of QoL. The results must be confirmed by studies conducted with larger-sized samples.

Results from randomized clinical trials of psilocybin in depressive disorders highlight the therapeutic potential of serotonergic psychedelic compounds in mental health disorders. The synthetic 5-hydroxytryptamine 2A receptor agonist 4-hydroxy-,-diisopropyltryptamine (4-OH-DiPT) is structurally similar to psilocin but is reported to have a shorter duration (2-3 h) of psychedelic effects, suggesting the potential for psilocybin-like therapeutic activity with reduced clinical resource burden. Here, we describe the preclinical and translational characterization of RE104, a 4-OH-DiPT prodrug comprising a glutarate moiety designed to cleave rapidly in situ and thus provide reasonable bioavailability of the active drug. Plasma concentration of 4-HO-DiPT over time in PK experiments in rats was correlated with head-twitch intensity. The half-life of 4-OH-DiPT was 40 min after subcutaneous administration of RE104 in rats. In a forced swim test, a single dose of RE104 (1 mg/kg) significantly reduced mean immobility time at 1 week compared with vehicle ( < 0.001), confirming translational antidepressant potential. Taken together, these data with RE104 show that the glutarate ester can act as an efficient prodrug strategy for 4-HO-DiPT, a unique short-duration psychedelic with potential in depressive disorders.

The authors examined whether use of a co-responder program reduced the likelihood of an involuntary commitment examination as the disposition of a police encounter with youths experiencing a mental health crisis and 1 year after the initial incident.

In healthcare and related fields, there is often a gap between research and practice. Scholars have developed frameworks to support dissemination and implementation of best practices, such as the Interactive Systems Framework for Dissemination and Implementation, which shows how scientific innovations are conveyed to practitioners through tools, training, and technical assistance (TA). Underpinning those aspects of the model are evaluation and continuous quality improvement (CQI). However, a recent meta-analysis suggests that the approaches to and outcomes from CQI in healthcare vary considerably, and that more evaluative work is needed. Therefore, this paper describes an assessment of CQI processes within the Substance Abuse and Mental Health Services Administration's (SAMHSA) Technology Transfer Center (TTC) Network, a large TA/TTC system in the United States comprised of 39 distinct centers. We conducted key informant interviews ( = 71 representing 28 centers in the Network) and three surveys (100% center response rates) focused on CQI, time/effort allocation, and Government Performance and Results Act (GPRA) measures. We used data from each of these study components to provide a robust picture of CQI within a TA/TTC system, identifying Network-specific concepts, concerns about conflation of the GPRA data with CQI, and principles that might be studied more generally.

The National Framework for Inclusion Health identified the need for collaborative action between the NHS and third sector health to improve access and outcomes for Inclusion Health groups. Clinical psychology trainee placements in homelessness settings could be a valuable pathway to improving access to psychological support for people experiencing homelessness and the provision of clinical services, which is key to developing the workforce and a catalyst for the future recruitment of clinical psychologists in the third sector.

As a part of the VA's interprofessional fellowship in psychosocial rehabilitation, the authors developed an 8-week spirituality group manual, ACTing Spiritually, which incorporates principles of acceptance and commitment therapy (ACT) into a spirituality group protocol. The group, administered weekly as possible for 28 weeks on an inpatient psychiatric unit at a veterans affairs (VA) medical center in West Haven, CT, aimed to incorporate veterans' spirituality into their mental health treatment through concepts of acceptance, values, mindfulness, and committed action. ACTing Spiritually ran in tandem with a basic ACT group and the two groups had comparable average group sizes, suggesting interest in ACTing Spiritually similarly compares to interest in a basic ACT group in this context. In addition, development of the group yielded several qualitative findings, including a discussion of the similarities and differences between ACT and spiritual care, clinical gains for chaplains conducting the group, and clinical tensions that arose through the process of integration. The study provided preliminary evidence of the potential feasibility and acceptability of ACTing Spiritually. Next steps should include a formal evaluation of its potential efficacy.

This chapter of the New York City Panel on Climate Change 4 (NPCC4) report provides an overview of energy trends in New York City and the State of New York, as well as accompanying challenges and barriers to the energy transition-with implications for human health and wellbeing. The link between energy trends and their impact on health and wellbeing is brought to the fore by the concept of "energy insecurity," an important addition to the NPCC4 assessment.

This chapter of the New York City Panel on Climate Change 4 (NPCC4) report considers climate health risks, vulnerabilities, and resilience strategies in New York City's unique urban context. It updates evidence since the last health assessment in 2015 as part of NPCC2 and addresses climate health risks and vulnerabilities that have emerged as especially salient to NYC since 2015. Climate health risks from heat and flooding are emphasized. In addition, other climate-sensitive exposures harmful to human health are considered, including outdoor and indoor air pollution, including aeroallergens; insect vectors of human illness; waterborne infectious and chemical contaminants; and compounding of climate health risks with other public health emergencies, such as the COVID-19 pandemic. Evidence-informed strategies for reducing future climate risks to health are considered.

Mental health recovery takes place in a social and material world. However, socio-material contexts have often been absent from recovery studies. The present study was conducted in Norway, a Scandinavian welfare country. We interviewed people at meeting places who had experiences as service users, focusing on their experiences of becoming well, and analyzed their recovery stories using an assemblage framework. Our analysis identified four constitutive dimensions that promote mental health recovery: an atmosphere of togetherness, doings as more than the act, personal development, and integration in society. We discuss how these dimensions might be seen as social, relational, and material forces that create important micropolitics that challenge the individualistic professionalization of the recovery concept.

Child justice systems are specialized jurisdictions set up for the purpose of providing justice related services to children. In an effort to resolve many of the systemic injustices expereinced by justice involved children, Kenya recently legislated the Children Act 2022. This new law is viewed as a paradigm shift from previous children acts as it incorporates constitutional provisions, UN conventions, minimum rules and other international protocols that Kenya is a state party to. The Act seeks to transform the child justice system into a jurisdiction which is more amenable to prioritising the mental wellbeing of children. The current study sought to examine the practices applied by state child justice agencies and whether these were therapeutic or non- therapeutic. This would clarify areas where the Act may need to be amended or reviewed to further its own goals. The findings revealed that the most non-therapeutic procedures centred on the courtroom such as the formal court environment and children facing perpetrators in court as well as limited access to mental health services. Therapeutic practices included ensuring children access treatment, use of child friendly interviewing techniques and testifying in camera. These may guide justice actors as to how they apply the Children Act 2022 within their own contexts whilst developing rules and standards that embody the principles of therapeutic jurisprudence.

Transgender and non-binary (TNB) individuals are at greater risk of mental health concerns relative to their cisgender peers due to experiences of minority stress. Thus, it is critically important to identify factors that may be protective and buffer the effects of minority stress. This study examined whether romantic relationship involvement and quality buffered effects of TNB minority stress on depressive symptoms and suicidal ideation.

Loneliness has been identified as an important public health issue, peaking during adolescence. Previous research has suggested that social interaction is a key factor in loneliness, and positive social interaction can act as a protective factor against loneliness. However, it is unclear whether there are differing impacts of in-person and online social interaction on adolescents' loneliness and mental health. Ecological Momentary Assessment (EMA) designs are ideally suited for better understanding these associations.

Difficulties in reasoning about others' mental states (i.e., mentalising/Theory of Mind) are highly prevalent among disorders featuring dopamine dysfunctions (e.g., Parkinson's disease) and significantly affect individuals' quality of life. However, due to multiple confounding factors inherent to existing patient studies, currently little is known about whether these sociocognitive symptoms originate from aberrant dopamine signalling or from psychosocial changes unrelated to dopamine. The present study, therefore, investigated the role of dopamine in modulating mentalising in a sample of healthy volunteers. We used a double-blind, placebo-controlled procedure to test the effect of the D2/D3 antagonist haloperidol on mental state attribution, using an adaptation of the Heider and Simmel (1944) animations task. On 2 separate days, once after receiving 2.5 mg haloperidol and once after receiving placebo, 33 healthy adult participants viewed and labelled short videos of 2 triangles depicting mental state (involving mentalistic interaction wherein 1 triangle intends to cause or act upon a particular mental state in the other, e.g., surprising) and non-mental state (involving reciprocal interaction without the intention to cause/act upon the other triangle's mental state, e.g., following) interactions. Using Bayesian mixed effects models, we observed that haloperidol decreased accuracy in labelling both mental and non-mental state animations. Our secondary analyses suggest that dopamine modulates inference from mental and non-mental state animations via independent mechanisms, pointing towards 2 putative pathways underlying the dopaminergic modulation of mental state attribution: action representation and a shared mechanism supporting mentalising and emotion recognition. We conclude that dopaminergic pathways impact Theory of Mind, at least indirectly. Our results have implications for the neurochemical basis of sociocognitive difficulties in patients with dopamine dysfunctions and generate new hypotheses about the specific dopamine-mediated mechanisms underlying social cognition.

People make countless decisions every day. We explored the self-regulatory function of decisions and assumed that the very act of making a decision in everyday life enhances people's mood. We expected that this decision-related mood change would be more pronounced for intuitive decisions than for analytical ones. The ease of making a decision and the feeling of rightness were expected to mediate the effect of intuitive (vs. analytical) decisions on participants' mood. In a preregistered experimental experience sampling study, participants from the general population were asked to report when they were about to make an everyday decision over the course of 14 days ( = 256 participants, 6,779 decisions). For each decision, participants were randomly instructed to decide either based on their intuition or based on careful analysis. We assessed several variables before and immediately after the decision. Participants also reported retrospectively on their choices in voluntary follow-up assessments. Making a decision per se immediately enhanced participants' mood. This mood enhancement was stronger for intuitive compared to analytic decisions and persisted until follow-up. Ease of decision, but not feeling of rightness, mediated this effect. Intuitive decisions compared to analytic decisions were more likely to be implemented and led to greater satisfaction and pleasantness of the chosen option. Having more options for a particular decision led to generally higher mood improvement and satisfaction. This is the first empirical demonstration showing that using one's gut has beneficial effects in everyday life. Study limitations and implications for theory and practice are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Involuntary psychiatric hospitalisation occurs under different legal premises. According to German law, detention under the Mental Health Act (MHA) is possible in cases of imminent danger of self-harm or harm to others, while detention according to the legal guardianship legislation (LGL) serves to prevent self-harm if there is considerable but not necessarily imminent danger. This study aims to compare clinical, sociodemographic and environmental socioeconomic differences and similarities between patients hospitalised under either the MHA or LGL.

The 1960s and 1970s saw the overt "politicization" of the American Psychological Association as an organization. Politics in this context carried a dual meaning referring to both political lobbying to promote the interests of psychology as a health profession and grassroots political action to advance social justice causes. In the years between the passage of the Community Mental Health Act (1963) and the Vail Conference on levels and patterns of professional training in psychology (1973), these two forms of politics were intertwined. The first significant political mobilization of professional psychologists in the postwar era occurred over the staffing of community mental health centers in the mid-1960s. These creations of the Great Society social welfare programs provided a platform for pursuing bold experiments in structural interventions to improve the lives and mental health of minoritized Americans and came to serve as hubs for the Black psychology movement of the early 1970s. This alternative model for the profession received careful consideration at the Vail Conference. However, a different relationship between politics and the profession crystalized by 1980. The politics of professionalism in psychology took the form lobby on behalf of practitioners working independent practices to receive reimbursement from third-party health insurance providers. This shift in the political economy of mental health has obscured this earlier, communitarian moment in American psychology. The racial economy of psychology's professionalization was structural, but not inevitable. It resulted from a series of historical choices. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Poor social connection is considered a risk factor for dementia. Since socializing behaviors may cluster together or act compensatorily, we aimed to investigate social connection patterns and their association with dementia, for men and women separately.

Poor asthma control may adversely affect mental health. Our study investigates the correlation between inadequate asthma control, exhaled nitric oxide (FENO) levels, and anxiety and depression among pediatric asthma patients with COVID-19.

To determine whether a brief educational intervention for Junior Medical Officers (JMOs), using teaching methods aimed at achieving higher outcomes on Bloom's Taxonomy, significantly improved participant confidence and knowledge in decision making about restrictive care.

Increasing numbers of healthcare data breaches highlight the need for structured organisational responses to protect patients, trainees and psychiatrists against identity theft and blackmail. Evidence-based guidance that is informed by the COVID-19 pandemic response includes: timely and reliable information tailored to users' safety, encouragement to take protective action, and access to practical and psychological support. For healthcare organisations which have suffered a data breach, insurance essentially improves access to funded cyber security responses, risk communication and public relations. Patients, trainees and psychiatrists need specific advice on protective measures. Healthcare data security legislative reform is urgently needed.

The difficulties in accessing Child and Adolescent Mental Health Services (CAMHS) and the lack of out-of-hours and crises services have resulted in Ireland's national police force, An Garda Síochána (GS), becoming increasingly involved as first responders to children and young people (CYP) who are experiencing potential mental health crises.

The socio-relational focus of youth peer support workers (YPSWs) poses a challenge when YPSWs are embedded in medical oriented contexts common to child and adolescent mental health services (CAMHS); as it requires YPSWs to find a balance between being a peer on one hand, and adhering to professional boundaries and medical standards set out by CAMHS on the other. To create a suitable position for YPSWs in CAMHS, this study investigated the unique socio-relational contributions YPSWs can make to CAMHS in addition to clinicians, and identified how these contributions can be embedded within CAMHS. This study reports on 37 semi-structured interviews conducted in the Netherlands with youth (n = 10), YPSWs (n = 10), and clinicians (n = 17). Overall, the unique socio-relational contributions YPSWs can make include: their ability to build authentic trusting relationships with youth by providing empowerment, promoting autonomy, valuing stillness in recovery, reducing isolation, recognizing strengths, and navigating life inside and outside of (residential) mental healthcare and beyond classification. Moreover, prerequisites to safeguard the integration of YPSWs and these socio-relational contributions were also identified, including YPSWs achieving stability in recovery, recent lived experiences with mental health challenges, and organizational support in terms of suitable treatment climate, resources to enhance flexibility of YPSWs, and shared goals regarding youth peer support work. Overall, YPSWs view youth holistically and foster a connection with youth based on youthfulness and recent lived experience. Involving YPSWs is an important step forward to drive positive transformation in CAMHS.

Canada legalized recreational cannabis in 2018, and one of the primary objectives of the Cannabis Act was to protect youth by reducing their access to cannabis and providing public education. Canada has the highest prevalence of cannabis use worldwide, particularly among youth and young adults under the age of 25. Cannabis use is linked with many adverse effects for youth and young adults including psychosis, anxiety, depression, respiratory distress, cannabinoid hyperemesis syndrome, and impaired cognitive performance. Despite the high prevalence of cannabis use and the evolution of policies in Canada and globally, significant knowledge and research gaps remain regarding youth and young adult cannabis use. The aim of this scoping review is to map the extent, nature, and range of evidence available on youth and young adult cannabis use in Canada since its legalization, in order to strengthen policies, services, treatments, training, and public education strategies.

The demand for healthcare services during the COVID-19 pandemic was excessive for less-resourced settings, with intensive care units (ICUs) taking the heaviest toll.

A cross-sectoral partnership was formed in 2021 in support of the recommendations in an audit on access to state-funded mental health services. In this first paper, we aimed to describe the demographic and service utilisation of adults with a mental health diagnosis in the Western Australian state-funded health system from 2005 to 2021. Inpatient, emergency department, specialised (ambulatory) community mental health service, and death records were linked in individuals aged ≥ 18 years with a mental health diagnosis in Western Australia. Altogether, 392,238 individuals with at least one mental health service contact between 1st January 2005 and 31st December 2021 were included for analysis. Females, Aboriginal and/or Torres Strait Islander people, and those who lived outside major cities or in the most disadvantaged areas were more likely to access state-funded mental health services. While the number of individuals who accessed community mental health services increased over time (from 28,769 in 2005 to 50,690 in 2021), the percentage increase relative to 2005 was notably greater for emergency department attendances (127% for emergency department; 76% for community; and 63% for inpatient). Conditions that contributed to the increase for emergency department were mainly alcohol disorder, reaction to severe stress and adjustment disorders, and anxiety disorders. Sex differences were observed between conditions. The pattern of access increased for emergency department and the community plus emergency department combination. This study confirmed that the patterns of access of state-funded mental health services have changed markedly over time and the potential drivers underlying these changes warrant further investigation.

Health inequalities are rooted in inequality in vital resources for health, including financial resources, a supportive informal network, a stable living situation, work or daytime activities or education and literacy. About 25% of Dutch citizens experience deprivation of such resources. Social policy consists of crucial instruments for improving resources in those groups but can also have adverse effects and lead to additional burdens. This project aims to contribute to the reduction of health inequalities through (1) a better understanding of how social policy interventions can contribute to reducing health inequality through the redistribution of burdens and resources and (2) developing anticipatory governance strategies to implement those insights, contributing to a change in social policy systems.

The global trend of advanced aging comes at the cost of amplified onset of age-related diseases. Dementia is a common multifactorial age-related neurodegenerative disorder, which manifests with progressive declines in cognitive functioning and ability to perform activities of daily living. As polices discourage institutionalized care, family members act as primary caregivers and endure increased vulnerability to physical and mental health problems secondary to care-related changes in life routine and relationships. Targeting clinically significant distress at earlier stages through valid brief measures may promote caregivers' wellbeing and dementia care continuity/quality. This study aimed to determine the optimal cutoff score of the Depression Anxiety Stress Scale 8-items (DASS-8) in a convenience sample of 571 European caregivers (Mean age = 53 ± 12 years, Italian = 74.4%, Swiss = 25.6%) through three methods. K-means clustering classified the sample into high- and low-distress clusters based on DASS-8 score of 19. Receiver operator curve (ROC) analysis using 48 and 7 cutoffs of the Zarit Burden Interview (ZBI) and the Three-Item University of California, Los Angeles, Loneliness Scale-version 3 (UCLALS3), revealed two DASS-8 cutoffs (12.5 and 14.5, area under the curve (AUC) = 0.85 and 0.92, p values < .001, 95% CI 0.82-0.88 and 0.89 to 0.94, sensitivity = 0.81 and 0.78, specificity = 0.76 and 0.89, Youden index = 0.57 and 0.67, respectively). Decision modeling produced two DASS-8 cutoffs (9.5 and 14.5) for predicting low and high caregiving burden and loneliness, respectively. According to the median of all DASS-8 cutoffs (14.5) the prevalence of mental distress was 50.8%. Distress correlated with key mental problems such as burnout and loneliness-in path analysis, DASS-8 scores were predicted by the ZBI, UCLALS3, care dependency, and receiving help with care, especially among older, female, and spouse caregivers. Further diagnostic workup should follow to confirm psycho-pathogenicity among caregivers with DASS-8 scores above 14.5. Investigations of the DASS-8 in other countries/populations may confirm the validity of this cutoff score.

SCN2A gene-related early-infantile developmental and epileptic encephalopathy (EI-DEE) is a rare and severe disorder that manifests in early infancy. SCN2A mutations affecting the fast inactivation gating mechanism can result in altered voltage dependence and incomplete inactivation of the encoded neuronal Nav1.2 channel and lead to abnormal neuronal excitability. In this study, we evaluated clinical data of seven missense Nav1.2 variants associated with DEE and performed molecular dynamics simulations, patch-clamp electrophysiology, and dynamic clamp real-time neuronal modelling to elucidate the molecular and neuron-scale phenotypic consequences of the mutations. The N1662D mutation almost completely prevented fast inactivation without affecting activation. The comparison of wild-type and N1662D channel structures suggested that the ambifunctional hydrogen bond formation between residues N1662 and Q1494 is essential for fast inactivation. Fast inactivation could also be prevented with engineered Q1494A or Q1494L Nav1.2 channel variants, whereas Q1494E or Q1494 K variants resulted in incomplete inactivation and persistent current. Molecular dynamics simulations revealed a reduced affinity of the hydrophobic IFM-motif to its receptor site with N1662D and Q1494L variants relative to wild-type. These results demonstrate that the interactions between N1662 and Q1494 underpin the stability and the orientation of the inactivation gate and are essential for the development of fast inactivation. Six DEE-associated Nav1.2 variants, with mutations mapped to channel segments known to be implicated in fast inactivation were also evaluated. Remarkably, the L1657P variant also prevented fast inactivation and produced biophysical characteristics that were similar to those of N1662D, whereas the M1501 V, M1501T, F1651C, P1658S, and A1659 V variants resulted in biophysical properties that were consistent with gain-of-function and enhanced action potential firing of hybrid neurons in dynamic action potential clamp experiments. Paradoxically, low densities of N1662D or L1657P currents potentiated action potential firing, whereas increased densities resulted in sustained depolarization. Our results provide novel structural insights into the molecular mechanism of Nav1.2 channel fast inactivation and inform treatment strategies for SCN2A-related EI-DEE. The contribution of non-inactivating Nav1.2 channels to neuronal excitability may constitute a distinct cellular mechanism in the pathogenesis of SCN2A-related DEE.

To evaluate the effectiveness of integrated models of mental healthcare in enhancing clinical outcomes, quality of life, satisfaction with care and health service delivery outcomes in young people aged 12-25 years. A secondary objective was to identify common components of integrated mental health interventions.

The aim of this study was to determine the association between neighbourhood socioeconomic disadvantage and teaching staff's risk of workplace violence and whether workplace psychosocial resources can act as effect modifiers.

Cystic fibrosis transmembrane conductance regulator (CFTR) modulator elexacaftor/tezacaftor/ivacaftor (ETI) significantly improves lung function but its effect on mental health and sleep remains poorly understood. We report on mental health, sleep, and respiratory health outcomes of adolescents with CF commenced on ETI therapy, and monitored the prevalence of neuropsychiatric issues through the coronavirus disease 2019 pandemic.

The ketogenic diet (KD) has been highly developed in the past for the treatment of epileptic pathological states in children and adults. Recently, the current re-emergence in its popularity mainly focuses on the therapy of cardiometabolic diseases. The KD can also have anti-inflammatory and neuroprotective activities which may be applied to the prevention and/or co-treatment of a diverse range of psychiatric disorders.

Previous reviews of online self-help have not exclusively focussed on universally delivered Acceptance and Commitment Therapy (ACT). This systematic review aimed to evaluate the effectiveness of universal online self-help ACT interventions for young people. Relevant databases were searched for studies examining ACT interventions that were delivered universally, online and as self-help (guided and unguided) to young people aged 10 to 25-years-old. Eleven studies met inclusion criteria. These were assessed for quality and findings summarised using a narrative synthesis. Outcomes on mental health, well-being and ACT processes were reviewed, and results across studies were mixed. Most studies found significant improvements in mental health and well-being outcomes following the ACT intervention; however less than half found improvements in ACT process measures. Subgroups, such as those with elevated mental health symptoms, had better outcomes. There were no changes in measures of psychological inflexibility. However, methodological issues limited the interpretation of findings. Heterogeneity between studies and methodological issues made it difficult for this review to draw conclusions regarding the effectiveness of universal online self-help ACT interventions for young people. Future research with consistent approaches is needed across these types of interventions to improve methodological rigour to determine whether these interventions are effective.

Background and objective Procrastination, which refers to the act of unnecessarily delaying the beginning or completion of an assigned task, is a widespread but often neglected problem among college students. Postponing a task can impair academic performance or lead to stress and poor mental well-being. A knowledge gap exists in understanding the cyclical nature of the relationship between anxiety and procrastination, wherein anxiety leads to procrastination, which in turn exacerbates anxiety. In light of this, we aimed to assess the level of procrastination and anxiety among college students and to correlate the relationship between their procrastination and anxiety status. Methodology A cross-sectional analytical study was conducted among 347 graduate students from various disciplines at a tertiary care hospital in Puducherry, India. A convenient sampling technique was employed to recruit the participants, and data were collected using the validated Procrastination Assessment Scale for Students (PASS) and the Hamilton Anxiety Rating Scale (HAM-A). Results Our findings showed that about 124 (35.7%) participants reported weekly reading assignments as the most frequently procrastinated task, with a mean score of 3.15 ± 1.02, followed by studying for exams and writing term papers. The most commonly reported reason for procrastination was evaluation anxiety, followed by low self-esteem and perfectionism. A significant number of students (157, 45.2%) had mild anxiety, and 58 (16.7%) students were found to have severe anxiety. A Spearman correlation coefficient of 0.26 (95% CI: 0.16 - 0.36) was observed between the overall procrastination score and HAM-A score, which indicated a weak positive correlation and was statistically significant (p<0.05). Similarly, a weak positive correlation was found between task aversiveness, fear of failure, and anxiety levels. Conclusions Procrastination is positively related to anxiety but the relationship is weak. Understanding and addressing the underlying anxiety or stress can be a key to managing procrastination among college students.

Providing physical health and mental health training promotion is necessary for a sustainable change in attitude and lifestyle of diabetic patients. The present study was conducted with the aim of comparing the effect of physical health training and psychological training of the theory of reasoned action (TRA) model on the life quality of patients with type 2 diabetes.

Applying deep brain stimulation (DBS) to several brain regions has been investigated in attempts to treat highly treatment-resistant depression, with variable results. Our initial pilot data suggested that the bed nucleus of the stria terminalis (BNST) could be a promising therapeutic target.

Polycystic ovary syndrome (PCOS) is a prevalent reproductive, endocrine, and metabolic disease that affects 5-18% of women worldwide, with a rising incidence. Hyperandrogenemia and insulin resistance are two key pathophysiological factors that contribute to PCOS, both of which contribute to a variety of health issues such as menstrual irregularities, obesity, dysfunctional glucose and lipid homeostasis, infertility, mental disorders, and cardiovascular and cerebrovascular diseases. Despite ongoing studies, the origin and pathogenesis of PCOS remain elusive; there is also a clinical need for simpler, more effective, longer lasting, and more comprehensive treatments for women with PCOS. The gut-fat axis, a critical regulatory route for metabolism, endocrine function, and immune response, has received considerable interest in recent years in the research of the etiology and treatment of metabolic illnesses such as type 2 diabetes mellitus and non-alcoholic fatty liver disease. The latest research in PCOS has revealed significant alterations in the homogeneity and phylogenetic diversity of the gut microbiota. Animal research using fecal microbiota transplantation has confirmed the importance of gut microbiota in regulating insulin sensitivity and sex hormone balance in PCOS. Furthermore, studies have shown a decrease in the volume and/or activity of brown adipose tissue (BAT) in PCOS patients, a change that alters adipokine release, leading to insulin resistance and hyperandrogenemia, aggravating PCOS progression. Given the function of BAT in increasing energy expenditure and alleviating metabolic parameters, efforts to activate BAT or induce browning of white adipose tissue have emerged as possible treatments for PCOS. Recent research has suggested that the gut microbiota can influence BAT creation and activity via metabolites such as short-chain fatty acids and bile acids, as well as the gut-brain axis. Cold exposure, healthy dieting, metformin, bariatric surgery, glucagon-like peptide 1 receptor agonists and melatonin have all been shown in basic and clinical studies to modulate BAT activity by influencing the gut microbiota, demonstrating significant clinical potential. However, more studies into the regulation mechanisms of the gut-BAT axis are required to produce more effective, comfortable, and safe tailored therapeutics for PCOS.

Health inequality can have a profound impact on a child's life. Maternal mental health challenges can hinder bonding, leading to impaired functioning and poorer child outcomes. To provide extra support for vulnerable pregnant women, the FACAM intervention offers the services of a health nurse or family therapist from pregnancy until the child starts school. This study examined the effects of FACAM intervention on pregnant women in vulnerable positions and their children until the child turned two years old. We randomly assigned 331 pregnant women to either FACAM intervention or care as usual and assessed them at baseline and when the infant was 3-6, 12-13.5, and 24 months old. The primary outcome was maternal sensitivity measured by Coding Interactive Behavior (CIB). Secondary outcomes included the parent-child relationship, child social-emotional development, child developmental progress, parent-child interaction, and child development. Our findings indicate that care-as-usual children were significantly more involved than FACAM children when the child was 4-6 months old (b = -0.25, [-0.42; -0.08] d = -0.42). However, we suspect this result is due to a biased dropout. We did not find any significant differences in any other outcomes. Therefore, the study suggests that the FACAM intervention is not superior to care as usual regarding child development and parent-child interaction outcomes.

Youth of parents who are experiencing psychopathology are more likely to develop emotional concerns, and these mental health symptoms can have a deleterious impact on parents' mental health. However, the relationship between the presentation of specific symptoms in parents and youth is infrequently examined. Symptom network analysis is an analytic approach that is increasingly being used to better understand the relationship of symptoms within and between disorders and can also be used to examine symptom relations within a dyad. The present study used symptom network analysis to examine bidirectional relationships among depressive and anxiety psychopathology in a transdiagnostic sample of treatment-seeking youth and their primary caregiver. Parental anhedonia and child worthlessness exhibited the greatest centrality within the network, suggesting that these may act as risk and maintenance factors for parent-child psychopathology and may be important intervention targets. Findings support the use of symptom network analysis to inform an understanding of the complex relationships among parent and child depressive and anxiety symptoms. Future research should consider the use of network analytic methods to examine the temporal relationships between parent and child psychopathology and to inform joint parent-child interventions for those with internalizing concerns. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Despite high tobacco use prevalence among those with serious mental illnesses, few Assertive Community Treatment (ACT) programs provide tobacco treatment. Understanding the factors associated with the intentions to engage in tobacco treatment from both provider and consumer perspectives is important. The purpose was to examine ACT providers' intention to provide and consumer intention to engage in tobacco treatment.

Mental health nurses (MHNs) experience a range of stressors as part of their work, which can impact their well-being and turnover intention. There is no prior evidence, however, on MHNs' mental health, well-being, resilience, and turnover intention during the COVID-19 pandemic. The aims of this online survey-based cross-sectional study, conducted during the pandemic, were to explore the psychological distress, well-being, emotional intelligence, coping self-efficacy, resilience, posttraumatic growth, sense of workplace belonging, and turnover intention of n = 144 Australian mental health registered and enrolled nurses; and explore relationships between these variables, in particular, psychological distress, well-being, and turnover intention. There was a higher percentage of MHNs with high (27.78%) and very high psychological distress (9.72%) compared to population norms as measured by the K10. Emotional intelligence behaviours were significantly lower than the population mean (GENOS-EI Short). Coping self-efficacy was mid-range (CSES-Short). Resilience was moderate overall (Brief Resilience Scale), and posttraumatic growth was mid-range (Posttraumatic Growth Inventory; PTGI). Sense of workplace belonging was moderate, and turnover intention was low. Higher levels of psychological distress were associated with higher turnover intention, and lower workplace belonging, coping self-efficacy, well-being, resilience, and emotional intelligence behaviours. Despite the levels of psychological distress, nearly half the sample (n = 71) was 'flourishing' in terms of well-being (Mental Health Continuum Short-Form). To help prevent staff distress in the post-pandemic period, organisations need to proactively offer support and professional development to strengthen staff's psychological well-being, emotional intelligence, and resilience skills. These strategies and group clinical supervision may also support lower turnover.

The Patient Protection and Affordable Care Act (ACA) significantly reduced uninsured individuals and improved financial protection; however, escalating costs of cancer treatment has led to substantial out-of-pocket expenses, causing severe financial and mental health distress for individuals with cancer. Mixed evidence on the ACA's ongoing impact highlights the necessity of assessing health-spending changes across income groups for informed policy interventions. In our nationally representative survey evaluating the early- and long-term effects of the ACA on nonelderly adult patients with cancer, we categorized individuals-based income subgroups defined by the ACA for eligibility. We found that ACA implementation increased insurance coverage, which was particularly evident after 2 years of implementation. Early post-ACA (within two years of implementation), there were declines in out-of-pocket spending for the lowest and low-income groups by 26.52% and 38.31%, respectively, persisting long-term only for the lowest-income group. High-income groups experienced continuously increased out-of-pocket and premium spending by 25.39% and 34.28%, respectively, with a notable 122% increase in the risk of high-burden spending. This study provides robust evidence of income-based disparities in financial burden for cancer care, emphasizing the need for health care policies promoting equitable care and addressing spending disparities across income brackets.

Schizophrenia is a leading cause of global disease burden. Current drug treatments are associated with significant side-effects and have limited efficacy for many patients; highlighting the need to develop new approaches that target other aspects of the neurobiology of schizophrenia. Preclinical, in vivo imaging, post-mortem, genetic and pharmacological studies have highlighted the key role of cortical GABA-glutamatergic microcircuits and their projections to subcortical dopaminergic circuits in the pathoetiology of negative, cognitive and psychotic symptoms. Antipsychotics primarily act downstream of the dopaminergic component of this circuit. However, multiple drugs are currently in development that could target other elements of this circuit to treat schizophrenia. These include drugs for GABA or glutamatergic targets, including glycine transporters, d-amino acid oxidase, sodium channels or potassium channels. Other drugs in development are likely to primarily act on pathways that regulate the dopaminergic system such as muscarinic or trace amine receptors or serotonin 2A receptors, whilst phosphodiesterase 10 A inhibitors are being developed to modulate the downstream consequences of dopaminergic dysfunction. Our review considers where new drugs may act on this circuit and their latest clinical trial evidence in terms of indication, efficacy and side-effects. Limitations of the circuit model, including whether there are neurobiologically distinct subgroups of patients, and future directions are also considered. Several drugs based on the mechanisms reviewed have promising clinical data, with the muscarinic agonist KarXT most advanced. If they are approved for clinical use, they have the potential to revolutionise understanding of the pathophysiology and treatment of schizophrenia.

Oligomeric Aβ is considered to play a harmful role in the pathophysiology of Alzheimer's disease (AD). Prolonged exposure to oligomeric Aβ could induce neuronal damage including cellular senescence. Amelioration of Aβ-induced cellular senescence has been considered as a promising strategy for the treatment of AD. Chromofungin, a chromogranin A-derived peptide, has displayed various biological functions in different types of cells and tissues. However, the effects of Chromofungin on oligomeric Aβ-induced cellular senescence have not been previously reported. In the current study, we report a novel function of Chromofungin by showing that treatment with Chromofungin could ameliorate Aβ-induced neurotoxicity in M17 neuronal cells. The Cell Counting Kit-8 (CCK-8) assay and the lactate dehydrogenase (LDH) release experiments revealed that 0.5 and 1 mM are the optimal concentrations of Chromofungin for cell culture in M17 cells. Challenging with oligomeric Aβ (5 μM) for 7 and 14 days led to a significant decrease in telomerase activity, which was rescued by Chromofungin dose-dependently. Additionally, the senescence-associated β-galactosidase (SA-β-gal) staining assay demonstrated that Chromofungin mitigated oligomeric Aβ-induced cellular senescence. Correspondingly, treatment with Chromofungin reversed the gene expression of human telomerase reverse transcriptase (hTERT), telomeric repeat-binding factor 2 (TERF2), and p21 against oligomeric Aβ in M17 neurons. Interestingly, Chromofungin attenuated oligomeric Aβ-induced oxidative stress (OS) in M17 cells by reducing the production of intracellular reactive oxygen species (ROS) but increasing the levels of intracellular superoxide dismutase (SOD). Importantly, the presence of Chromofungin reduced the expression of cyclooxygenase2 (COX-2) as well as the generation of prostaglandin E (PGE). Transduction with Ad-COX-2 impaired the effects of Chromofungin on telomerase activity and the profile of cellular senescence. Our findings suggest that Chromofungin might act as a potential agent for the treatment of AD.

Menopause is a biological process experienced by all people assigned female at birth. A significant number of women experience mental ill health related to the major brain gonadal hormone shifts that occur in their midlife. There is poor understanding and management of the complex mental ill health issues, with the biological brain hormone changes receiving little formal attention. The current treatment advice is to manage this special type of mental ill health in the same way that all mental ill health is managed. This leads to poor outcomes for women and their families. Many women leave the workforce earlier than expected due to menopause-related depression and anxiety, with subsequent loss of salary and superannuation. Others describe being unable to adequately parent or maintain meaningful relationships - all ending in a poor quality of life. We are a large and diverse group of national and international clinicians, lived experience and social community advocates, all working together to innovate the current approaches available for women with menopausal mental ill health. Above all, true innovation is only possible when the woman with lived experience of menopause is front and centre of this debate.

Infertility is a condition characterized by a low fertility rate, which significantly affects the physical and mental health of women of reproductive age. Typically, the treatment duration is prolonged, and the therapeutic outcomes are often unsatisfactory. Professor Cheng-yao He, a renowned expert in traditional Chinese medicine, commonly uses the herb Cnidii Fructus (SCZ) for the treatment of infertility. However, the exact mechanism remains unclear, and there is limited research available on this topic. The active ingredients of SCZ were obtained from the traditional chinese medicine system pharmacology (TCMSP) database and screened for pharmacokinetics (PK), involving absorption, distribution, metabolism, and excretion (ADME). Target prediction was performed by SwissTargetPrediction database, and infertility-related disease targets were searched in GeneCards, TTD, DrugBank, and OMIM database. The protein-protein interaction (PPI) network was constructed using the STRING database (Version 11.5) and analyzed by Cytoscape software (Version 3.9.1). Additionally, the target genes were subjected to biological enrichment analysis in the Metascape database, including gene ontology (GO) and kyoto encyclopedia of genes and genomes (KEGG) enrichment analysis, and the "Disease-Ingredient-pathway-target" network was constructed using Cytoscape software. With the assistance of AutoDockVina, Ligplot, and PyMOL software, a validation of Molecular docking results and a visualization of the results were performed. This study identified 11 retained active ingredients of SCZ, 447 drug targets, 233 of which were related to infertility, and 5393 disease targets. GO enrichment analysis mainly involved 221 biological processes such as cellular response to chemical stress and gland development. KEGG enrichment analysis mainly involved 68 pathways such as thyroid hormone signaling pathway, estrogen signaling pathway, FOXO signaling pathway, and PI3K/Akt signaling pathway. Molecular docking showed that the core active ingredients of SCZ, including Ammidin, Diosmetin, Xanthoxylin N, and Prangenidin, had strong binding abilities with core targets such as MDM2, MTOR, CCND1, EGFR, and AKT1. This study preliminarily demonstrated that SCZ may act on the PI3K/Akt signaling pathway, exerting its therapeutic effects on infertility by improving energy metabolism disorders and endometrial receptivity, inducing primordial follicle activation, regulating oocyte proliferation, differentiation, and apoptosis, and promoting the release of dominant follicles.

The management of offenders with mental disorders has been a significant concern in forensic psychiatry. In Japan, the introduction of the Medical Treatment and Supervision Act in 2005 addressed the issue. However, numerous psychiatric patients at risk of violence still find themselves subject to the administrative involuntary hospitalization (AIH) scheme, which lacks clarity and updated standards.

Acute traumatic stress symptoms may develop in people who have been exposed to a traumatic event. Although they are usually self-limiting in time, some people develop post-traumatic stress disorder (PTSD), a severe and debilitating condition. Pharmacological interventions have been proposed for acute symptoms to act as an indicated prevention measure for PTSD development. As many individuals will spontaneously remit, these interventions should balance efficacy and tolerability.

Abnormalities in auditory processing are believed to play a major role in autism and attention-deficit hyperactivity disorder (ADHD). Both conditions often co-occur in children, causing difficulties in deciding the most promising intervention. Event-related potentials (ERPs) have been investigated and are showing promise to act as potential biomarkers for both conditions. This study investigated mismatch negativity (MMN) using a passive listening task and P3b in an active auditory go/no-go discrimination task. Recordings were available from 103 children (24 females): 35 with ADHD, 27 autistic, 15 autistic children with co-occurring ADHD, and 26 neurotypical (NT) children. The age range considered was between 4 and 17 years, but varied between groups. The results revealed increases in the MMN and P3b amplitudes with age. Older children with ADHD exhibited smaller P3b amplitudes, while younger autistic children showed reduced MMN amplitudes in response to phoneme changes compared to their NT counterparts. Notably, children diagnosed with autism and ADHD did not follow this pattern; instead, they exhibited more similarities to NT children. The reduced amplitudes of phonetically elicited MMN in children with autism and reduced P3b in children with ADHD suggest that the two respective ERPs can act as potential biomarkers for each condition. However, optimisation and standardisation of the testing protocol, as well as longitudinal studies are required in order to translate these findings into clinical practice.

Researchers are required to determine whether a person has capacity to consent to a research study before they are able to participate. The Mental Capacity Act and accompanying Code of Practice for England and Wales provide some guidance on this process, but researchers have identified that it can be difficult to determine capacity to consent when a person has complex cognitive or communication needs. This study aimed to understand the experiences and opinions of researchers who recruit people with dementia to research projects, to inform the future development of training resources.

The overall pandemic created enormous pressure on long-term care workers (LTCWs), making them particularly vulnerable to mental disorders. Despite this, most of the available evidence on professional well-being during COVID-19 has exclusively focused on frontline health care workers.

Advanced chronic kidney disease (ACKD) is associated with a high risk of adverse cardiovascular and renal events and has a significant impact on quality of life and life expectancy. Several studies have identified areas for improvement in their management in primary care. Some professional and environmental factors can act as key barriers to appropriate care.

The aim of the study was to explore the clinical significance of school refusal behavior, its negative impact on psychological well-being of children and adolescents and its relationship with the most common psychopathological conditions during childhood and adolescence (e.g. neurodevelopmental disorders, psychiatric disorders). School refusal behavior refers to a distressing condition experienced by children and adolescents that compromise regular school attendance and determine negative consequences on mental health and adaptive functioning. A narrative review of the literature published between January 2019 and March 2023 was conducted. Ten studies (n = 10) were included from a literature search of the electronic databases PubMed, CINAHL, PsycInfo, MedLine, and Cochrane Library. The results indicate that school refusal is highly present in neurodevelopmental disorders such as autism and attention-deficit/hyperactivity disorder due to the presence of behavioral problems and deficits in communication skills. As for psychiatric disorders, school refusal appears to be highly common in anxiety disorders, depressive disorders, and somatic symptoms. We also found that school refusal behavior may be associated with various emotional and behavioral conditions that act as risk factors. Especially, but are not limited to, it may be associated with a diminished self-concept, exposure to cyberbullying, specific affective profiles and excessive technology usage. Our results indicate that school refusal is a condition with many clinical facets. It can be attributed to both vulnerability factors, both temperamental and relational, and to various psychopathological conditions that differ significantly from each other, such as neurodevelopmental disorders and psychiatric disorders. Recognizing these aspects can improve the implementation of patient-tailored therapeutic interventions that are consequently more likely to produce effective outcomes. The therapeutic intervention should facilitate the recognition of cognitive biases regarding school as a threatening environment, while regulating negative emotions associated with school attendance. Additionally, therapeutic intervention programs linked to social skill training and problem-solving training, conducted directly within the school setting, can enhance children's abilities to cope with academic performance and social relationships, ultimately preventing school refusal.

The acts of plastic surgery consist in providing care to patients and pursue a therapeutic purpose. They benefit from VAT exemption in accordance with European legislation. They appear in the Common Classification of Medical Acts as therapeutic acts, whether or not they are covered by health insurance. To assist the plastic surgeon during the consultation in his role as a medico-surgical expert, we propose a global assessment scale for physical disgraces. This scale specifies the importance of disharmony, its etiology, and considers the patient in his entirety, both biologically and psychosocially. All repercussions are analyzed: physiopathological impact, pain, functional impact on daily life activities, pleasure and sexual activities, psychological, social, and professional impact. Each item is independently rated. Depending on the overall score obtained, the therapeutic nature of the act can be confirmed. The proposed scale is a simple tool that easily and seriously supports the therapeutic nature of our acts. It ensures argued expertise, a reliable and indisputable synthesis. We are, above all, doctors, caregivers, contributing to health as defined by the WHO: "a state of complete physical, mental, and social well-being." We alone are able to judge the therapeutic nature of a service, in agreement with our patients.

Relatives of patients with bipolar disorder (BD) often experience emotional burden with stress and depressive symptoms that again increase the likelihood of destabilization and relapses in the patient. The effects of group-based psychoeducation have not been investigated in large-scale real-world settings. We are currently conducting a large-scale real-world randomized controlled parallel group trial (RCT) to test whether group-based psychoeducation for 200 relatives to patients with BD improves mood instability and other critical outcomes in relatives and the corresponding patients with BD.

Metabolic syndrome (Mets) is commonly seen in bipolar disorder (BD). As the key component and early biological index of Mets, insulin resistance (IR) among BD has received more and more attention. However, little is known about the prevalence of IR and its associated factors in drug-naïve patients with (BD), especially among Han Chinese population.

Rehabilitation therapists (RTs) have developed substantial mental health problems since the pandemic. Our study aimed to understand the experience of COVID-19 on occupational therapists and physiotherapists practicing in Canada, how the pandemic may have affected care delivery, and to identify new learnings articulated by RTs. A qualitative descriptive study design guided data collection through one-on-one interviews, dyadic interviews, and focus groups. We recruited active RTs across Canada, advertising on professional practice networks and social media platforms and using snowball sampling. Forty-nine RTs representing seven Canadian provinces participated. The four overarching themes developed using thematic analysis were (1) navigating uncertainty along with ever-changing practices, policies, and attitudes, (2) morphing roles within a constrained system, (3) witnessing patients suffering and experiencing moral distress, and (4) recognizing the personal toll of the pandemic on self and others, as well as lessons learned. Our study demonstrated that many RTs suffered moral distress, poor mental health, and some from challenging financial situations, especially those in the private sector. They also expressed a resilient attitude in response to these stressors. Implications in the future include identifying promising communication strategies that could act as protective factors, addressing workforce constraints and diminishing resources through innovative models of care.

Understanding the health consequences associated with exposure to risk factors is necessary to inform public health policy and practice. To systematically quantify the contributions of risk factor exposures to specific health outcomes, the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 aims to provide comprehensive estimates of exposure levels, relative health risks, and attributable burden of disease for 88 risk factors in 204 countries and territories and 811 subnational locations, from 1990 to 2021.

This paper explores a significant shift in the field of mental health in general and psychotherapy in particular following generative artificial intelligence's new capabilities in processing and generating humanlike language. Following Freud, this lingo-technological development is conceptualized as the "fourth narcissistic blow" that science inflicts on humanity. We argue that this narcissistic blow has a potentially dramatic influence on perceptions of human society, interrelationships, and the self. We should, accordingly, expect dramatic changes in perceptions of the therapeutic act following the emergence of what we term the artificial third in the field of psychotherapy. The introduction of an artificial third marks a critical juncture, prompting us to ask the following important core questions that address two basic elements of critical thinking, namely, transparency and autonomy: (1) What is this new artificial presence in therapy relationships? (2) How does it reshape our perception of ourselves and our interpersonal dynamics? and (3) What remains of the irreplaceable human elements at the core of therapy? Given the ethical implications that arise from these questions, this paper proposes that the artificial third can be a valuable asset when applied with insight and ethical consideration, enhancing but not replacing the human touch in therapy.

Previous studies exploring difficult inpatients have mostly focused on psychiatric inpatients.

There has been recent discussion in Australia and New Zealand concerning the utility of Clinical Practice Guidelines (CPGs) and the role of the Royal Australian and New Zealand College of Psychiatrists (RANZCP) in their development. The College Board therefore established a Steering Group (SG) to oversee an exploration of options and produce recommendations about contemporary approaches to the development of high-quality evidence-based clinical practice guidance for psychiatry. This paper outlines the SG's conclusions and recommendations, as well as the underlying methods and reasoning. In particular, we discuss best practice and recent developments in the synthesis of research evidence. Account has been taken of the opportunities offered by digital technologies, the proliferation of clinical evidence and awareness of the gains to be made by increased inclusion of lived-experience perspectives. It is recommended that the broader concept of best practice resources (BPRs) as now emphasised in so many fields of service is the most appropriate starting point for the College's role in this area especially as the expertise of the College and its fellows lends itself to the development of a range of BPRs. In conclusion, contemporary guidance needs to be tailored to the requirements of the practitioners seeking it, to articulate the real-world needs and experiences of patients, and to be delivered in a contemporary format that is responsive to rapidly emerging evidence. The experience in Australia and New Zealand may have implications elsewhere for the development of CPGs and BPRs more broadly.

Negative childbirth experiences can be related to the onset of perinatal post-traumatic stress symptomatology (P-PTSS), which significantly impacts the mother and the infant. As a response in the face of the discomfort caused by P-PTSS, maladaptive emotion regulation strategies such as brooding can emerge, contributing to the consolidation of post-partum depressive symptoms. Ultimately, both types of symptomatology, P-PTSS and post-partum depression, can act as risk factors for developing mother-child bonding difficulties. Still, this full set of temporal paths has to date remained untested. The present longitudinal study aimed to analyze the risk factors associated with the appearance of P-PTSS after post-partum and to test a path model considering the role of P-PTSS as an indirect predictor of bonding difficulties at eight months of postpartum.

Autism is a neurodevelopmental condition that is increasing in prevalence worldwide. There has been an exponential increase in autism-related research since 2010, when the first Singapore Clinical Practice Guidelines (CPG) on autism was published. Understanding of autism has since evolved to adopt a lifespan approach beyond that of a childhood condition. The aim of this CPG was to provide an updated set of recommendations for children and adolescents to aid clinical practice for professionals.

This study aimed to explore the effect of acceptance and commitment therapy (ACT) on emotion regulation in adolescent patients with nonsuicidal self-injury (NSSI).

The association between work-related moderate-to-vigorous physical activity (MVPA) and higher levels of stress response is recognized, but whether this association is moderated by regular exercise remains unclear. This cross-sectional study investigated whether exercise-based physical activity (PA) associates with lower levels of stress responses moderated by work-related MVPA.

The human gut microbiota has been identified as a potentially important factor influencing the development of COVID-19. It is believed that the disease primarily affects the organism through inflammatory pathways. With the aim of improving early diagnosis and targeted therapy, it is crucial to identify the specific gut microbiota associated with COVID-19 and to gain a deeper understanding of the underlying processes. The present study sought to investigate the potential causal relationship between the gut microbiota and COVID-19, and to determine the extent to which inflammatory proteins act as mediators in this relationship.

Engagement in physical activity (PA) benefits physical and mental health as well as many other areas of society. In Europe however, 1/3 adults do not meet minimum PA recommendations. Social value, and its quantification through social return on investment (SROI) evidence, may be a useful framing to enhance PA promotion. This study aimed to assess the current use of social value framing of PA in European Union (EU) policies.

Intermittent fasting (IF) represents a dietary intervention similar to caloric restriction, characterized by the strategic limitation of food consumption. Among the diverse array of practices for IF, Ramadan IF (RIF), a religious observance in Islam, mandates that healthy adult Muslims abstain from both food and drinks during daylight hours. In sports, researchers have extensively studied IF effects on health, including sleep and physical performance, but its impact on cognitive functions during RIF remains understudied. Therefore, this study was conducted to evaluate the influence of RIF on psychomotor and cognitive performance among young female athletes.

Non-suicidal self-injury (NSSI), which refers to the deliberate act of causing harm to one's own body without the intent to commit suicide, occurs in 20% of youth. Interestingly, approximately 90% of individuals who engage in self-harm report intrusive mental imagery thereof shortly prior to the act of NSSI. Previous research has demonstrated that imagery rescripting (IR) is an effective technique to treat intrusive mental images and associated clinical symptoms, such as emotion dysregulation, in various psychiatric disorders. However, there is no research on IR for adolescents who self-harm. Therefore, the present study aims to investigate the efficacy and feasibility of a two-session short-intervention using IR to reduce NSSI and associated clinical symptoms in adolescents. The intervention was supported by an app-based digital health intervention (DHI).

Violence against women is a global public health issue associated with increased morbidity and mortality. The United Nations defines violence against women as "any act of gender-based violence that results in, or is likely to result in, physical, sexual, or mental harm or suffering to women, including threats of such acts, coercion or arbitrary deprivation of liberty, whether occurring in public or in private life". There is paucity of data on the spatial distribution and predictors of violence against women in sub-Saharan Africa. The objective of this study was to investigate the geographical distribution of attitudes toward wife beating in Ghana, a sub-Saharan African country, utilizing data from the 2014 Ghana Demographic and Health Survey (DHS). Participants from over eleven thousand households were surveyed on topics of demographics and justification of wife beating in at least one of five different scenarios. The identification of geographic clusters of men and women who endorsed wife beating was performed using Ripley K functions. The comparison of the spatial distributions of women and men justifying wife beating were performed using spatial relative risk surfaces. The spatial analysis indicated the presence of clusters in women and men's approval for wife beating compared to those who do not approve of wife beating, with a statistical significance level set at p < 0.01. Major spatial clusters of approval of wife beating were in the Northern region, for both men and women, and in the Upper West region of Ghana for the men participants. This is the first study to explore the geographical distribution of attitudes toward wife beating in Ghana, and revealed evidence of several regional heterogeneous clusters where wife beating was more commonly justified by both men and women. Targeted intervention for reducing the justification of wife beating in Ghana should be focused in these regions.

The prestige theory of evolution states that our memory has an intrinsic bias to memorize information from someone of prestige. However, the evidence for information recall is mainly focused on content bias. Considering that the prestige bias can be advantageous in selecting information in contexts of uncertainty, this study assessed whether, in the scenario of the COVID-19 pandemic, the prestige bias would be favored over other models that do not possess the prestige spirit characteristics. The study was conducted through an online experiment, where participants were subjected to reading fictitious text, followed by a surprise recollection. Data were analyzed using a generalized linear mixed model, Poisson family, and logistic regression. The results showed that prestige is only prioritized in the recall due to the family model and does not present any difference from the other models tested. However, it influenced the recall of specific information, suggesting its role as a factor of cultural attraction. Furthermore, we observed that trust in science-oriented profiles can influence the recall of information during a health crisis. Finally, this study highlights the complexity of the functioning of the human mind and how several factors can act simultaneously in the recall of information.

As the global public health community continues to reflect and recover from the COVID-19 pandemic, noncommunicable diseases (NCDs), and mental health and neurological conditions remains one of the largest unmet gaps in progress towards meeting the Sustainable Development Goals (SDG). People living with these health conditions, particularly among those most marginalized, acutely understand the impact of these failures in global action and investment. Integrating lived experience into the NCD and mental health response can act as an accelerator for action. Through a participatory process to co-create the WHO Framework on Meaningful Engagement on NCDs, and Mental Health and Neurological Conditions, we conducted a mixed methods and semi-structured approach, including informal consultations, focus groups, in-depth interviews, online surveys, and a short film series, that captured the perspectives of 700 individuals from 111 countries, including 386 individuals with lived experience. Working alongside lived experience communities and other relevant stakeholders, we have established and co-created a set of principles, enablers and actions for operationalizing meaningful engagement, related to dignity and respect, power and equity, inclusivity and intersectionality, commitment and transparency, and institutionalization and contextualization. People with lived experience have a right to be equitably included in all levels of policy-setting, design and implementation of programs, and to have a central role in reforming and reorienting the structures and systems intended to address the complex multifactorial challenges that they face. WHO is committed to leveraging its role in global health to further operationalize meaningful engagement within WHO and its Member States.

This study examines the 12-month prevalence rates of intimate partner violence (IPV) victimization, including psychological, physical, and sexual forms, in women and men. It also aims to identify changes in IPV victimization during the COVID-19 pandemic and to explore factors associated with the occurrence of any IPV victimization during this period.

Mitochondria-associated endoplasmic reticulum membranes (MAMs) act as physical membrane contact sites facilitating material exchange and signal transmission between mitochondria and endoplasmic reticulum (ER), thereby regulating processes such as Calipid transport, mitochondrial dynamics, autophagy, ER stress, inflammation, and apoptosis, among other pathological mechanisms. Emerging evidence underscores the pivotal role of MAMs in cardiovascular diseases (CVDs), particularly in aging-related pathologies. Aging significantly influences the structure and function of the heart and the arterial system, possibly due to the accumulation of reactive oxygen species (ROS) resulting from reduced antioxidant capacity and the age-related decline in organelle function, including mitochondria. Therefore, this paper begins by describing the composition, structure, and function of MAMs, followed by an exploration of the degenerative changes in MAMs and the cardiovascular system during aging. Subsequently, it discusses the regulatory pathways and approaches targeting MAMs in aging-related CVDs, to provide novel treatment strategies for managing CVDs in aging populations.

This study explored the understanding of maltreatment from the perspective of various personnel working in roles related to safeguarding and welfare in English professional and semi-professional football.

Despite physical activity (PA) providing specific health benefits during pregnancy and the postpartum period, many women report decreased PA during this time. Provision of PA advice has been found to be lacking amongst midwives due to a range of barriers. This study aimed to evaluate United Kingdom's midwives' current role and knowledge regarding the provision of PA advice to pregnant and postpartum women and identify the barriers and potential solutions.

This study explores the integration of a web-based electronic database technology containing patient-reported outcome measures (PROMs) with electronic health records for refugees with PTSD, emphasizing the systematic inclusion of patient perspectives in clinical decision-making. Our research addresses the notable gap in literature regarding training clinicians for the competent integration of health information technology in healthcare. The training program developed aimed at equipping clinicians, particularly inexperienced with technology, to effectively utilize an electronic PROM system for collecting systematic patient information. Our study is set in the context of the Mental Health Services (MHS) in Denmark, focusing on a specialized clinic for treating trauma-affected refugees. The multidisciplinary team involved in this project reflects a wide range of healthcare professionals. The training program employed a variety of activities over nearly 2 years, adapting to feedback and aiming to engage clinicians in continuous improvement processes. Analyzing qualitative data with thematic analysis we interpreted that the training's extended focus on discussion of the implementation process, with limited hands-on experience, potentially reinforced clinicians' hesitations toward new technology, rather than reducing them. Clinicians prioritized immediate concerns over potential long-term benefits. Despite this, their approach reflects a strong commitment to patient welfare and careful evaluation of new practices. Notably, there were also positive engagements with the technology, highlighting its potential in patient care. This study concludes that the successful integration of technology in clinical settings hinges on its alignment with clinicians' workflows, respect for their professional judgment, and clear benefits to patient care.

Subjective well-being is an essential component of college students' mental health, and the purpose of this study was to investigate the relationship between physical activity and subjective well-being among college students and to examine the mediating role of social support and self-efficacy between the physical activity and subjective well-being.

The Mental Capacity Act 2005 of England and Wales is a ground-breaking piece of legislation with reach into healthcare, social care and legal settings. Professionals have needed to develop skills to assess mental capacity and handle malign influence, but it is unclear how assessments are implemented in real world settings. Our previously reported survey found professionals juggling competing resources in complex systems, often struggling to stay up to date with law.The current follow-up study uses one-to-one interviews of professionals to characterise in detail six areas of uncertainty faced when assessing mental capacity, whilst suggesting ways to make improvements.

COVID-19 disrupted access to bereavement support. The objective of this study was to identify the bereavement supports used by Australians during the COVID-19 pandemic, perceived helpfulness of supports used, prevalence and areas of unmet support need, and characteristics of those with unmet support needs.

To date, concrete recommendations for physical activity in psychiatric treatments are limited. Thus, we evaluated knowledge, barriers and beliefs associated with exercise prescription of mental health professionals (MHP) to people with mental illnesses. We aimed to identify patients' barriers to exercise participation and to work out options addressing these barriers.