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.

Interpretation biases in the processing of ambiguous affective information are assumed to play an important role in the onset and maintenance of emotional disorders. Reports of low reliability for experimental measures of cognitive biases have called into question previous findings on the association of these measures with markers of mental health and demonstrated the need to systematically evaluate measurement reliability for measures of cognitive biases. We evaluated reliability and correlations with self-report measures of mental health for interpretation bias scores derived from the Ambiguous Cue Task (ACT), an experimental paradigm for the assessment of approach-avoidance behavior towards ambiguous affective stimuli. For a non-clinical sample, the measurement of an interpretation bias with the ACT showed high internal consistency (r = .91 - .96, N = 354) and acceptable 2-week test-retest correlations (r = .61 - .65, n = 109). Correlations between the ACT interpretation bias scores and mental health-related self-report measures of personality and well-being were generally small (r ≤ |.11|) and statistically not significant when correcting for multiple comparisons. These findings suggest that in non-clinical populations, individual differences in the interpretation of ambiguous affective information as assessed with the ACT do not show a clear association with self-report markers of mental health. However, in allowing for a highly reliable measurement of interpretation bias, the ACT provides a valuable tool for studies considering potentially small effect sizes in non-clinical populations by studying bigger samples as well as for work on clinical populations, for which potentially greater effects can be expected.

Due to its reliance on heterogeneous symptomatology, the accurate diagnosis of psychotic disorders remains a challenging task in clinical practice. Precise and early diagnosis of psychotic disorders facilitates early intervention, which has been shown to have substantial benefits for long-term outcomes. Still, the lack of specific biomarkers is an important limitation in early diagnosis and intervention. Exosomes, which act as messengers between cells, including brain cells, contain a vast array of molecules that hold promise for unveiling disorder-specific abnormalities. In this review, we discuss recent evidence highlighting the potential of circulating exosomes and brain-derived exosomes as valuable tools for the identification of accessible, non-invasive, and blood-based biomarkers of psychotic symptomatology and risk. We discuss current limitations in biomarker discovery studies focusing on exosomes. To enhance diagnosis specificity and treatment response, we also provide guidance for future investigations that need to target biomarkers of risk and relapse, as well as consider duration of untreated psychosis, biological sex, and other factors in the multifactorial biosignature of psychosis.

Schizophrenia is a serious mental disorder, and monitoring remission is a widely used measure of effectiveness of the treatment provided. It is very important to identify possible factors correlating with remission. In our substudy of BeSt InTro, a randomized controlled trial of three antipsychotic drugs, 126 patients with ICD-10 diagnoses F20-29 (F23 excluded) were randomized to one of the second-generation antipsychotic drugs amisulpride, aripiprazole or olanzapine. Remission rate was calculated at seven assessment points, with and without using the time criterion of six months included in the consensus remission criteria. Because of drop-out (n = 77), we had data for 49 patients at one-year follow-up. These data were used to calculate the one-year remission rate to 55 % (27/49), without taking into consideration the 6-month time criterion. When we applied the consensus remission criteria with the 6-month time criterion included, the one-year remission rate was calculated for 59 patients: 29 % (17/59). Antipsychotic drug naivety and low negative symptom load at baseline correlated highly with belonging to the remission group. Use of amisulpride was more probable to lead to remission than that of aripiprazole, but it was not more probable than the use of olanzapine (in per-protocol analyses). Negative symptoms showed the largest resistance to treatment. The lack of remission for the majority of the participants in this closely monitored antipsychotic drug trial is alarming and could act as a reminder that novel treatment principles are needed, especially targeted towards the negative symptoms in schizophrenia.

Mental fitness is a construct that goes beyond a simple focus on subjective emotional wellbeing to encompass more broadly our ability to think, feel, and act to achieve what we want in our daily lives. The measurement and monitoring of multiple (often interacting) domains is crucial to gain a holistic and complete insight into an individual's mental fitness. We aimed to demonstrate the capability of a new mobile app to characterise the mental fitness of a general population of Australians and to quantify the interrelationships among different domains of mental fitness. Cross-sectional data were collected from 4901 adults from the general population of Australians engaged in work or education who used a mobile app (Innowell) between September 2021 and November 2022. Individuals completed a baseline questionnaire comprised of 26 questions across seven domains of mental fitness (i.e., physical activity, sleep and circadian rhythms, nutrition, substance use, daily activities, social connection, psychological distress). Network analysis was applied at both a domain-level (e.g., 7 nodes representing each cluster of items) and an individual item-level (i.e., 26 nodes representing all questionnaire items). Only 612 people (12%) were functioning well across all domains. One quarter (n = 1204, 25%) had only one problem domain and most (n = 3085, 63%) had multiple problem domains. The two most problematic domains were physical activity (n = 2631, 54%) and social connection (n = 2151, 44%), followed closely by daily activity (n = 1914, 39%). At the domain-level, the strongest association emerged between psychological distress and daily activity (r = 0.301). Psychological distress was the most central node in the network (as measured by strength and expected influence), followed closely by daily activity, sleep and circadian rhythms and then social connection. The item-level network revealed that the nodes with the highest centrality in the network were: hopelessness, depression, functional impairment, effortfulness, subjective energy, worthlessness, and social connectedness. Social connection, sleep and circadian rhythms, and daily activities may be critical targets for intervention due to their widespread associations in the overall network. While psychological distress was not among the most common problems, its centrality may indicate its importance for indicated prevention and early intervention. We showcase the capability of a new mobile app to monitor mental fitness and identify the interrelationships among multiple domains, which may help people develop more personalised insights and approaches.

Corrective squint surgery has a significant psychological impact, affecting both the quality of life and mental health of patients. This study highlights the quantitative and subjective assessment of both the psychological and functional outcomes of squint surgery in adults having horizontal strabismus with no preoperative diplopia using a Quality-Of-Life Adult Strabismus 20 (QOL AS-20) questionnaire.

The subjective experience of coercion may have a more significant impact on clinical outcomes than formal coercive measures. This study aimed to investigate the subjective experience of coercion among patients on admission in Portuguese psychiatric departments by assessing their perceived coercion, procedural justice, and negative pressures during admission. The study also investigated whether this subjective experience of coercion changed with time during admission, and the predictors of this change. Validated instruments, including the McArthur Admission Experience Survey (AES) and the Client Assessment of Treatment Scale, were used to collect information from 208 adults admitted to five public psychiatric inpatient departments in rural and urban regions of Portugal. About a third (32.24%, n = 49) of the sample had a legal involuntary admission status, while more than a third of them perceived their admission to be involuntary (40.13%, n = 61). The subjective experience of coercion was significantly higher among people who perceived their admission to be involuntary compared to people who perceived their admission to be voluntary (Median = 10, IQR = 5.5 vs. Median = 3, IQR = 6; p < 0.001). Satisfaction with their care was significantly inversely correlated with the subjective experience of coercion (p < 0.01). The changes in the subjective experience of coercion at the second assessment were predicted by the perceived admission status rather than the legal admission status, and the initial procedural justice (p < 0.05). The study findings highlight the importance of improving procedural justice in psychiatric admissions, regardless of the legal status of admission.

For almost five decades, the development and implementation of integrated care-the simultaneous combination of primary care with mental health and substance use care-has been a major challenge for the behavioral health care field. Integrated care is exceptionally important because many people with behavioral health conditions also have chronic physical health conditions. Early research findings in the mid-1980s showed that persons with mental illness are likely to develop chronic physical conditions earlier and more severely than other people. These findings precipitated efforts to understand this problem and to develop further appropriate integrated care solutions. Subsequently, the US Surgeon General made care integration a major focus of his landmark 1999 Report on Mental Health, as did the 2008 Mental Health Parity and Addiction Equity Act and the 2010 Patient Protection and Affordable Care Act. However, it was not until 2014, and later, that integrated care actually began to be implemented more broadly. This article reviews these major developmental milestones, examines current activities, and explores likely developments over the next several years. Major current issues include the response to the COVID-19 pandemic, adjusting to its effects on the behavioral health care workforce, and the growing realization that behavioral health care must address the social determinants of life. Likely developments over the next several years will include devising ways to address our workforce crisis, developing effective community interventions, and implementing population health management strategies; implementing the CMS Innovation in Behavioral Health Model; improving reimbursement practices; and exploring the potential of AI for integrated care. Implications for future service organization and training of behavioral health care providers also are discussed. Granted the severity of the current workforce crisis in behavioral health care, urgent efforts are needed to advance the deployment of integrated care in the short-term future.

The number of people with dementia is on the rise in Kenya and across Africa. Although family carers act as the main providers of dementia care in Kenya, there is still a significant knowledge gap regarding why family members care for someone with dementia. This study explores perceived drivers of care for people with dementia in a rural Kenyan context.

Preterm and/or low birthweight (PT/LBW) is predictive of a range of adverse adult outcomes, including lower employment, educational attainment, and mental wellbeing, and higher welfare receipt. Existing studies, however, on PT/LBW and adult psychosocial risks are often limited by low statistical power. Studies also fail to examine potential child or adolescent pathways leading to later adult adversity. Using a life course framework, we examine how adolescent problem behaviors may moderate the association between PT/LBW and a multidimensional measure of life success at age 30 to potentially address these limitations.

Mental and neuropsychological disorders make up approximately 14% of the total health burden globally, with 80% of the affected living in low- and middle-income countries (LMICs) of whom 90% cannot access mental health services. The main objective of the TREAT INTERACT study is to adapt, implement, and evaluate the impact of a novel, intersectoral approach to prevent, identify, refer, and treat mental health problems in children through a user centred task-sharing implementation of the TREAT INTERACT intervention, inspired by the World Health Organization (WHO) Mental Health Gap Action Programme Intervention Guide (mhGAP-IG) for primary school staff in Mbale, Uganda. Health care personell will be trained in the mhGAP-IG.

More than 50% of people who die by suicide have not been in contact with formal mental health services. The rate of people who fly 'under the radar' of mental health services is higher among men than women, indicating a need to improve engagement strategies targeted towards men who experience suicidal thoughts and/or behaviours. In Australia, a range of mental health support services exist, designed specifically for men, yet, a substantial proportion of men do not use these services. The aim of this study is to evaluate whether a brief online video-based messaging intervention is an effective approach for encouraging men with suicidal thoughts and/or behaviours to engage with existing support services.

Some recent publications have used the term "vagal-adrenal axis" to account for mechanisms involved in the regulation of inflammation by electroacupuncture. This concept proposes that efferent parasympathetic nerve fibers in the vagus directly innervate the adrenal glands to influence catecholamine secretion. Here, we discuss evidence for anatomical and functional links between the vagi and adrenal glands that may be relevant in the context of inflammation and its neural control by factors, including acupuncture. First, we find that evidence for any direct vagal parasympathetic efferent innervation of the adrenal glands is weak and likely artifactual. Second, we find good evidence that vagal afferent fibers directly innervate the adrenal gland, although their function is uncertain. Third, we highlight a wealth of evidence for indirect pathways, whereby vagal afferent signals act via the central nervous system to modify adrenal-dependent anti-inflammatory responses. Vagal afferents, not efferents, are thus the likely key to these phenomena.

Incidences of sexual violence have increased over the past few years. The negative impacts of sexual violence on adolescents are social isolation, low self-esteem, and disrupting the developmental stages of adolescents, and can even cause the risk of suicide. Nurses as providers of comprehensive nursing care have a role in reviewing various aspects to reduce the impact of sexual violence on adolescents. The purpose of this study is to explore methods of nursing intervention for reducing the symptoms of post-traumatic stress disorder among adolescents who are victims of sexual violence. The design used in this study is scoping review. Article were searched from CINAHL, PubMed, and Scopus databases. The inclusion criteria for articles in this study were full text, randomized control trial or quasi-experimental research design, English language, samples is adolescents (10-19 years based on WHO) who are victims of sexual violence, and the publication period of the last 10 years (2013-2022). We found 12 articles which discussed about nursing interventions in reducing PTSD symptoms in adolescents who are victims of sexual violence. Range of the samples is 40-405 adolescents. Several articles from developed countries. There are three nursing intervention methods that can be carried out, namely improve skill interventions, relaxation interventions, and cognitive behavior therapy. Nurses act as educators, facilitators and counselors so that victims can recover from their traumatic experiences. Providing nursing interventions to adolescents who are victims of sexual violence needs to pay attention to all aspects that affect the physical and psychological condition of the victim.

Anorexia nervosa (AN) has the highest mortality rate of any psychiatric disease, yet available pharmacological treatments are largely ineffective due, in part, to an inadequate understanding of the neurobiological drivers that underpin the condition. The recent resurgence of research into the clinical applications of psychedelic medicine for a range of mental disorders has highlighted the potential for classical psychedelics, including psilocybin, to alleviate symptoms of AN that relate to serotonergic signaling and cognitive inflexibility. Clinical trials using psychedelics in treatment-resistant depression have shown promising outcomes, although these studies are unable to circumvent some methodological biases. The first clinical trial to use psilocybin in patients with AN commenced in 2019, necessitating a better understanding of the neurobiological mechanisms through which psychedelics act. Animal models are beneficial in this respect, allowing for detailed scrutiny of brain function and behavior and the potential to study pharmacology without the confounds of expectancy and bias that are impossible to control for in patient populations. We argue that studies investigating the neurobiological effects of psychedelics in animal models, including the activity-based anorexia (ABA) rodent model, are particularly important to inform clinical applications, including the subpopulations of patients that may benefit most from psychedelic medicine. Appeared originally in 2020; 14:43.

It is increasingly clear that unconscious information impairs the performance of the corresponding action when the instruction to act is delayed. However, whether this impairment occurs at the response level or at the perceptual level remains controversial. This study used fMRI and a computational model with a pre-post design to address this elusive issue. The fMRI results showed that when the unconscious information containing strong stimulus-response associations was irrelevant to subsequent stimuli, the precuneus in the parietal lobe, which is thought to be involved in sensorimotor processing, was activated. In contrast, when the unconscious information was relevant to subsequent stimuli, regardless of the strength of the stimulus-response associations, some regions in the occipital and temporal cortices, which are thought to be involved in visual perceptual processing, were activated. In addition, the percent signal change in the regions of interest associated with motor inhibition was modulated by compatibility in the irrelevant but not in the relevant stimuli conditions. Modeling of behavioral data further supported that the irrelevant and relevant stimuli conditions involved fundamentally different mechanisms. Our finding reconciles the debate about the mechanism by which unconscious information impairs action performance and has important implications for understanding of unconscious cognition.

Active outdoor play is important for children's health and development, and playgrounds provide good places for play. However, the importance of playground use for health and well-being is unclear. Our scoping review aims to create an overview of all research on playground use and health benefits for children.

G protein-coupled receptors (GPCRs) are the largest group of membrane receptors in the central nervous system and one of the key proteins for signal transduction between cells. Currently, many drugs available on the market act via GPCRs and these receptors remain attractive targets for the treatment of brain disorders, including alcohol use disorder (AUD). Here, we describe the most recent literature, with a primary focus on the past 5 years, on GPCR targets with the potential for reducing behaviours associated with excessive alcohol intake. Specifically, we focus on preclinical evidence of compounds with attractive pharmacological profiles and potential for future clinical investigation for the treatment of AUD.

Encouraging engagement in rewarding or pleasant activities is one of the most important treatment goals for depression. Mental imagery exercises have been shown to increase the motivation for planned behaviour in the lab but it is unclear whether this is also the case in daily life. Therefore, we aimed to investigate the effect of mental imagery exercises on motivation and behaviour in daily life. Participants with depressive symptoms (N = 59) were randomly assigned to a group receiving mental imagery (MI) exercises or a control group receiving relaxation (RE) exercises via study phones. We employed an experience sampling design with 10 assessments per day for 10 days (three days baseline, four days with two exercises per day and three days post-intervention). Data was analysed using t-tests and multilevel linear regression analyses. As predicted, MI exercises enhanced motivation and reward anticipation during the intervention phase compared to RE. However, MI did not enhance active behaviour or strengthen the temporal association from reward anticipation (t-1) to active behaviour (t). Mental imagery exercises can act as a motivational amplifier but its effects on behaviour and real-life reward processes remain to be elucidated.

Antisocial behavior in childhood and adolescence is associated with poor family and peer relationships, and a higher risk of mental and physical health problems in adulthood, as well as criminality. Emotions play a central role in children's moral development, but most research has focused on negative emotions (e.g., shame and guilt), in relation to childhood antisocial behavior. Research in adult populations indicates that positive emotions experienced in anticipation of, during, and after antisocial acts may play an important role in the development and maintenance of antisocial behavior. Consequently, this systematic review aimed to investigate the relationship between positive emotion and antisocial behavior in children and adolescents. A systematic search in five databases was conducted, yielding 52 studies that used different methodological approaches, samples, designs and methods to examine this association. Results provide support for a positive relationship between positive emotion and antisocial behavior across community, forensic and clinical samples. This link appeared to be stronger for younger children, boys, and for children high in social dominance, callous-unemotional or sensation-seeking traits. Results suggested that positive affect may act in concert with negative emotion, cognitive, personality and motivational processes, as well as peer influences to determine the initiation and maintenance of antisocial behavior. This review presents directions for future research and discusses the implications of findings for prevention and intervention programs for youth with antisocial behavior.

This Aotearoa New Zealand-based study addresses a gap in literature focusing on individual experiences of racism among adolescents and young adults and its links to health.

Consent is an essential part of healthcare practice, allowing patients to make autonomous decisions. However, this changes when a patient has mental incapacity or is unable to make decisions for themselves for a duration of time. This month's Policy column looks at some of the key principles of the Mental Capacity Act 2005, and how this can be applied in community nursing practice.

In light of clinical trials and disease-modifying therapies, an early identification of patients at-risk of developing Alzheimer's disease (AD) is crucial. Blood-based biomarkers have shown promising results regarding the in vivo detection of the earliest neuropathological changes in AD. Herein, we investigated the ability of plasma p-tau181 to act as a prescreening marker for amyloid positivity in a heterogeneous memory clinic-based cohort.

The Golgi compartment performs a number of crucial roles in the cell. However, the exact molecular mechanisms underlying these actions are not fully defined. Pathogenic mutations in genes encoding Golgi proteins may serve as an important source for expanding our knowledge. For instance, mutations in the gene encoding Transmembrane protein 165 (TMEM165) were discovered as a cause of a new type of congenital disorder of glycosylation (CDG). Comprehensive studies of TMEM165 in different model systems, including mammals, yeast, and fish uncovered the new realm of Mn homeostasis regulation. TMEM165 was shown to act as a Ca/Mn:H antiporter in medial- and trans-Golgi network, pumping the metal ions into the Golgi lumen and protons outside. Disruption of TMEM165 antiporter activity results in defects in N- and O-glycosylation of proteins and glycosylation of lipids. An impaired glycosylation of TMEM165-CDG arises from lack of Mn within the Golgi. Nevertheless, Mn insufficiency in the Golgi is compensated by the activity of the ATPase SERCA2. TMEM165 turnover has also been found to be regulated by Mn cytosolic concentration. Besides causing CDG, recent investigations have demonstrated the functional involvement of TMEM165 in several other pathologies including cancer and mental health disorders. This systematic review summarizes the available information on TMEM165 molecular structure, cellular function, and its roles in health and disease.

During the Covid-19 pandemic Germany experienced its first increase in the proportion of heavy cannabis users since 1995. With the expected nationwide decriminalization of cannabis before 2025, we investigate the potential causes for that increase. Data were from the 2021 European Web Survey on Drugs (EWSD) including 762 12-month marijuana users from Germany (72.9% male, mean age = 29.5 years). Both heavy and regular cannabis consumers reported an increase in marijuana consumption during the pandemic, with infrequent users reporting a decrease. Using multinomial logistic regression, we found younger individuals (OR = 0.95 [95% CI = 0.92, 0.98]) and those not pursuing or completing higher education (OR = 1.86 [1.23, 2.81]) had increased use. Additionally, using cannabis to self-medicate (OR = 2.79 [1.56, 4.99]) and purchasing marijuana (OR = 2.26 [1.35, 3.77]) was associated with increased use. We found, relative to infrequent users, both regular (OR = 4.00 [2.39, 6.72]) and notably heavy users (OR = 31.17 [12.10, 80.32]) were more likely to use cannabis to self-medicate. Both regular (OR = 4.09 [2.47, 6.77]) and especially heavy users (OR = 13.53 [6.74, 27.16]) were also more likely to purchase marijuana. Heavy users were also more likely to be past 30-day tobacco users (OR = 5.92 [2.81, 12.45]). We identified the self-reported motivation of using cannabis to self-medicate as well as act of purchasing marijuana as having the strongest relation to being a heavy user and increasing marijuana use during the Covid-19 pandemic.

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.

Violence is a major public health problem globally, with the highest rates in low- and middle-income countries (LMICs) in the Americas and southern Africa. Parenting programmes in high-income countries can diminish risk for violence, by reducing risk factors such as child aggression and harsh parenting, and increasing protective factors such as child cognitive development and school readiness. However, there is critical need to identify low-cost programmes with replicable benefits that work in real-world LMICs contexts. A three-arm, randomised, single-blind trial evaluated effects of two low-cost, group-based parenting programmes recommended for LMICs (ACT: Raising Safe Kids; DBS: dialogic book-sharing) on child aggression (primary outcome), child development, parenting, maltreatment, and stress. Participants were 369 children with medium-high levels of aggression (mean age 3.1 years at baseline) in poor households. Interventions were implemented in city health and education services in southern Brazil. Maternal reports, filmed observations, child tasks, and hair cortisol were assessed at baseline, 1-month post-intervention, and 8-month follow-up. Intention-to-treat analyses compared each of ACT and DBS with a control group. Three hundred sixty-eight (99.7%) participants completed follow-up assessments 8 months after the interventions. There was no effect of ACT (standardised mean difference, SMD 0.11, 95% CI - 0.05, 0.27) or DBS (SMD 0.05, 95% CI - 0.11, 0.21) on the primary outcome of child aggression. ACT reduced harsh parenting behaviour post-intervention (SMD - 0.23; 95% CI - 0.46, - 0.01), but not at follow-up. DBS improved book-sharing practices at both time points (e.g., maternal sensitivity at follow-up SMD 0.33; 95% CI 0.08, 0.57). There were no benefits of either programme for other parenting, child development, or stress outcomes. Two parenting programmes in Brazil had small effects on parenting practices but did not reduce child aggression or several other important risk/protective factors for violence. Effective early interventions that reduce violence in real-world LMIC settings are highly desirable but may be challenging to achieve.

The aim of this discussion paper is to explore factors and contexts that influence how nurses might conceptualise and assign personhood for people with altered consciousness, cognition and behaviours. While a biomedical framing is founded upon a dichotomy between the body and self, such that the body can be subjected to a medical and objectifying gaze, relational theories of self, multiculturalism and technological advances for life-sustaining interventions present new dilemmas which necessitate discussion about what constitutes personhood. The concept of personhood is dynamic and evolving: where historical constructs of rationality, agency, autonomy and a conscious mind once formed the basis for personhood, these ideas have been challenged to encompass embodied, relational, social and cultural paradigms of selfhood. Themes in this discussion include: the right to personhood, mind-body dualism versus the embodied self; personhood as consciousness, rationality and narratives of self; social relational contexts of personhood and cultural contexts of personhood. Patricia Benner's and Christine Tanner's clinical judgement model is then applied to consider the implications for nursing care that seeks to reflexively incorporate personhood. Nurse clinicians are able to move between conceptions of personhood and act to support the body, as well as presumed autonomy and relational, social and cultural personhood. In doing so, they use analytical, intuitive and narrative reasoning which prioritises autonomous constructions of self. They also incorporate relational and social contexts of the person receiving care within the possibilities of technological advances and constraints of contextual resources.

New antimalarial drug candidates that act via novel mechanisms are urgently needed to combat malaria drug resistance. Here, we describe the multi-omic chemical validation of M1 alanyl metalloaminopeptidase as an attractive drug target using the selective inhibitor, MIPS2673. MIPS2673 demonstrated potent inhibition of recombinant (A-M1) and (A-M1) M1 metalloaminopeptidases, with selectivity over other and human aminopeptidases, and displayed excellent in vitro antimalarial activity with no significant host cytotoxicity. Orthogonal label-free chemoproteomic methods based on thermal stability and limited proteolysis of whole parasite lysates revealed that MIPS2673 solely targets A-M1 in parasites, with limited proteolysis also enabling estimation of the binding site on A-M1 to within ~5 Å of that determined by X-ray crystallography. Finally, functional investigation by untargeted metabolomics demonstrated that MIPS2673 inhibits the key role of A-M1 in haemoglobin digestion. Combined, our unbiased multi-omic target deconvolution methods confirmed the on-target activity of MIPS2673, and validated selective inhibition of M1 alanyl metalloaminopeptidase as a promising antimalarial strategy.

Victoria has new legislation, the Mental Health and Wellbeing Act 2022 (Vic) (MHWA) to govern the care and treatment of people with mental illness that came into effect on 1 September 2023. It takes a human rights approach with a focus on person-centred care. The definition of mental illness encompasses conditions such as dementia even though it is rarely used to manage such conditions. How would the management of dementia and associated conditions change if these conditions were managed under the MHWA? This article uses dementia to examine the differences between the new MHWA, the Medical Treatment Planning and Decisions Act 2016 (Vic) and the Guardianship and Administration Act 2019 (Vic) and how the human rights approach taken by the MHWA might inform future directions in managing dementia.

"Molecular Glues" are defined as small molecules that can either be endogenous or synthetic which promote interactions between proteins at their interface. Allosteric modulators, specifically GPCR allosteric modulators, can promote both the association and the dissociation of a given receptor's transducer but accomplishes this "at a distance" from the interface. However, recent structures of GPCR G protein complexes in the presence of allosteric modulators indicate that some GPCR allosteric modulators can act as "molecular glues" interacting with both the receptor and the transducer at the interface biasing transducer signaling in both a positive and negative manner depending on the transducer. Given these phenomena we discuss the implications for this class of allosteric modulators to be used as molecular tools and for future drug development.

This article critically examines the proposed reforms to Irish mental health law the Mental Health Act 2001 (2001 Act). The article will provide background to the 2001 Act and the lengthy law reform process, which has resulted in the publication of the Heads of Bill that propose significant amendments. The article assesses the suggested reforms, considering Ireland's 2018 ratification of the UN Convention on the Rights of Persons with Disabilities (CRPD), which provides important context to the law reform process. The 2001 Act is the primary piece of legislation regulating mental health services and safeguarding the rights of persons subject to the legislation in Ireland. While passed in 2001, the legislation did not come into effect until 2006. The 2001 Act was seen as bringing Irish mental health law into compliance with international human rights law, in particular the European Convention on Human Rights (ECHR). However, Ireland's ratification of the CRPD has necessitated closer scrutiny of the legislation. This review has culminated in the publication of a Heads of Bill in July 2021 and pre-legislative scrutiny by the responsible parliamentary committee in 2022. The long title of the Heads of Bill explicitly states its goal of safeguarding individual autonomy and underscores its commitment to upholding and advancing the rights of people subject to the legislation. The analysis of the Heads of Bill addresses several key areas. These areas include a background to the long process of review, new guiding principles, the category of persons under the mental health legislation, mental health tribunals, consent to treatment, advance healthcare directives, provisions relating to children and young people, and independent advocacy. Based on this analysis of the Heads of Bill, recommendations are suggested which would strengthen respect for the human rights of persons subject to the legislation.

Unit cohesion is the extent to which military service members feel committed to and supported by their military unit or, conversely, feel overlooked, neglected, and/or alienated. Unit cohesion reflects an important aspect of military social support and can act as a protective factor against mental health challenges, particularly in challenging situations. Theoretical suppositions and emerging evidence suggest that different types of unit support, specifically, and , uniquely matter for service member well-being. (support from leaders in the unit and other higher-ranking positions) may be of universal importance to service members with implications for career progression and personal wellbeing, while (support from fellow unit members and peers) may be of importance under certain circumstances. Informed by the psychometric theory of scale development and validation, the dimensionality of unit cohesion theory, and the need for brief, sound measurement tools, this study first examined the psychometric properties of the Army STARRS four-item Vertical Unit Cohesion Scale in a longitudinal analysis with a large, diverse sample of Soldiers from the Pre/Post Deployment Study component of the Army STARRS dataset ( = 10,116). Then, exploratory analyses were conducted to examine the properties of the Horizontal Unit Cohesion Scale and understand the relationship between vertical and horizontal unit cohesion. Strong evidence for the Vertical Unit Cohesion Scale's psychometric soundness was established regarding factor structure, measurement invariance overtime, and construct validity. Conversely, preliminary evidence suggests that the three-item measure of Horizontal Unit Cohesion should be used with caution. Implications for researchers and military leadership are provided.

Medical confidentiality is the cornerstone for a trustful relationship between patients and the health professionals attending to them. However, when history or clinical findings suggest certain offenses, statutory laws (Children's Act, Older Persons Act, Mental Health Care Act, Sexual Offenses Act) establish a legal obligation for health professionals to report suspected instances of abuse to the police or alternatively, in some cases, to a designated social worker. Given the high rate of domestic violence and abuse in South Africa, health professionals are most likely to encounter such situations. Many clinicians are oblivious of the obligations, exposing themselves to possible liability and their patients to potential additional harm. This article aims to demonstrate the reporting requirements under the respective acts through case scenarios. Finally, the advantages and disadvantages of the existing legal setting are discussed briefly.

As a prodromal stage to major depressive disorder (MDD), subthreshold depression (StD) has a higher prevalence in the population, resulting in a greater healthcare burden. StD individuals' current negative emotion could be moderated by attentional deployment. However, it remains unclear whether attentional deployment training can mitigate subsequent negative emotion in StD individuals.

Climate change is affecting both the frequency and scale of wildfires, as well as the increase in the number of days with Saharan dust intrusions. Traditionally, studies have focused on the extent to which the increase in fine particulate matter (PM) has had an impact on cardio-respiratory diseases, but (apart from PM) not on how the meteorological and pollution conditions in these situations affect other diseases, such as those linked to mental health. This study therefore sought to ascertain how daily mean PM, PM , NO, O concentrations and daily maximum temperature in heat waves influence daily emergency hospital admissions in Spain caused by mental and behavioural disorders, depression and anxiety on days with PM from biomass combustion and/or Saharan dust intrusions, as compared to days without such conditions, across the period 2009-2018. Our results indicate that on days on which there is biomass combustion, PM concentrations have a statistically significant effect on emergency admissions due to mental disorders, probably related with the toxicity of these particles. Yet on days with intrusions of Saharan dust rather than PM, it is the other variables considered in the analysis that are most closely linked to these types of admissions. The results of this study thus point to the need to implement public health prevention plans which take into account the joint effect of various environmental risk factors that act synergistically in given situations.

This contribution highlights novel developments and innovations in psychological psychotherapy for patients with obesity. It underscores the importance of an interdisciplinary approach to treatment, which incorporates not only traditional methods but also contemporary psychotherapeutic modalities such as Acceptance and Commitment Therapy (ACT). Current research suggests that assessing the effectiveness of psychotherapy should not solely rely on changes in weight, but should also consider other outcomes such as subjective quality of life and mental health. Furthermore, the role of telemedicine and blended psychotherapy is emphasized as promising approaches to enhance accessibility and effectiveness of treatment. Through a case study of a 55-year-old woman with obesity and psychiatric comorbidities, the effectiveness of a multimodal psychotherapeutic approach is demonstrated.

The Knowledge Translation (KT) Programme of a pan-Canadian strategic patient-oriented research network focused on brain-based developmental disabilities aimed to mobilize knowledge relevant to the network members. The programme also promotes and studies integrated Knowledge Translation (iKT) approaches involving different interested parties, such as researchers, patient-partners and decision-makers, in all parts of the knowledge creation process.

Inflammatory bowel disease (IBD) often has its onset during late childhood and adolescence, a time of significant change. Young people may be required to transition from a pediatric to an adult IBD service during this time. The transition from pediatric to adult services can be a high-risk period for poor outcomes for emerging adults with IBD. We seek to understand the concerns of patients and carers during this period.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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).

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

To enable greater use of National Institute of Mental Health Research Domain Criteria (RDoC) in real-world settings, we applied large language models (LLMs) to estimate dimensional psychopathology from narrative clinical notes.

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.

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.

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.

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.

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.

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.

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.

Follow-up imaging of gliomas is crucial to look for residual or recurrence and to differentiate them from nontumoral tissue. Positron emission tomography (PET)-magnetic resonance imaging (MRI) is the problem-solving tool in such cases. We investigated the role of dual point contrast (DPC)-enhanced MRI to discriminate tumoral from the nontumoral tissue compared to PET-MRI taken as the gold standard.

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.

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.

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.

Social media has negative effects on adolescent body image and disordered eating behaviors, yet adolescents are unlikely to discontinue engaging with these platforms. Thus, it is important to identify strategies that can reduce the harms of social media on adolescent mental health. This article reviews research on social media and adolescent body image, and discusses strategies to reduce risks associated with social media use. Topics covered include interventions aimed at mitigating social media's negative impacts, the body-positivity movement, and policies regulating adolescents' social media use. Overall, this review highlights specific factors (such as staffing, duration, modality, facilitator training, and cultural sensitivity) to consider when designing and implementing social media interventions targeting adolescents. This review also discusses psychosocial outcomes associated with body positivity on social media. Finally, policy efforts to reduce the negative impact of social media on adolescents' body image and eating behaviors are described. In sum, there is a strong need to conduct further research identifying optimal approaches to reduce the harms of social media for adolescent body image and eating behavior.

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.

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.

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.

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.

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.

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.

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.

A new Mental Health law was recently enacted in Nigeria to replace the Lunacy Ordinance of 1958. The passage of the new law was a major leap from the old. It was received with excitement because the former law was not only outdated but failed to address core issues such as the promotion of mental health and the protection of the rights of the mentally ill. Though the new law adequately makes provisions for these, it has considerable flaws that may hinder implementation. Parts of it lack clarity and other parts are somewhat overzealous in safeguarding the mentally ill, thus potentially defeating its purpose. It appears that certain aspects were not well thought out, or there was no 'looking well' before leaping to legislate. This paper aims to critically review flawed aspects of the new law and make recommendations on the way forward.

Dementia represents a potentially overwhelming health burden, both for the UK and worldwide. Addressing this fast-growing issue is a key priority for the government, health service and the public. Advances in care including the development of efficacious disease-modifying, and eventually curative, treatments can only be achieved through effective dementia research. Specifically, research directly involving participants with dementia is essential to further understanding. However, working with cognitively impaired participants with and without capacity to consent to research presents unique ethical and legal challenges. For clinicians and scientists on the frontline of dementia research, scenarios frequently arise that pose such challenges. A lack of guidance for a consistent approach in navigating these scenarios limits researchers' ability to proceed with confidence. This represents a threat to the rights and wishes of research participants as well as the field at large, as it may lead to studies being unnecessarily terminated or, worse, poor practice. In this article, we take a multiprofessional approach, informed by carer input, to these issues. We review the relevant ethical and legal literature relating to the conduct of non-interventional research studies in patients with dementia. This includes a thorough recap of the Mental Capacity Act (2005), which provides a legal framework in England and Wales for conducting research with participants who lack capacity to consent. We also discuss the important, but sometimes incomplete, role of research ethics committees in guiding researchers. We then present and discuss a series of case vignettes designed to highlight areas of incomplete coverage by existing governance. These vignettes describe theoretical scenarios informed by our own real-word experiences of encountering ethical issues when conducting dementia research. They include scenarios in which participants demonstrate varying degrees of understanding of the research they are involved in and ability to communicate their wishes and feelings. Building on these vignettes, we then provide a checklist for researchers to work through when presented with similar scenarios. This checklist covers the key ethical, legal and practical considerations that we have argued for. Taken together, this article can act as a guide, previously lacking in the literature, for colleagues in the field to enable much needed ethical, legal and effective research.