Pathways to professional mental care in the Swiss young adult community: a case-control study.

Treatment success for mental health (MH) problems depends, among others, on the timeliness of help-seeking. Therefore, we studied the effect of symptoms and reasons for help-seeking on the point-of-contact and the most intensive professional treatment in a community sample. Participants were recruited as part of the 'Bern Epidemiological At-Risk' (BEAR) study on 16-40-year-old community persons of the Swiss canton Bern. Of the 2,683 participants, 615 (22.9%) reported at least one instance of help-seeking for MH problems and were selected for the presented analyses. Help-seeking behavior was assessed by a modified version of the 'WHO pathway-to-care questionnaire', from which the outcome 'most intensive MH professional contact' was generated. The effect of symptoms and reasons for help-seeking were analyzed in separate models using path analyses. Most help-seeking persons sought MH professional help (n = 405; 65.9%) with a high number of medical pre-contacts (n = 233; 37.9%). The 'most intensive MH professional contact' was provided after an average of 1.47 contacts. Both models showed negative associations between non-MH professional pre-contacts and the most intensive, likely most adequate MH treatment. In the symptom model, 'substance misuse' and 'central-vegetative problems' increased the general likelihood of MH professional contact. Our findings highlight the importance of the first point-of-contact in pathways to adequate MH care and, when seeking help from non-MH professional, of quick referrals to MH professionals. Awareness campaigns or training of health professionals, such as general practitioners, may support timely contact with MH professionals to improve diagnosis, prognosis, and outcome.

The Process of Sterilizing Tattoo Inks Releases Formaldehyde.

INTRODUCTION: Around 12% of Europeans and 20% of Americans have at least one tattoo. Tattoo inks, the substances used to create tattoos on the body, consist of chemicals that contain formaldehyde, which can be harmful to human health. The amount of formaldehyde present in commercially available tattoo inks and its causes are not well understood. METHODS: We investigated the levels of formaldehyde in tattoo ink products sold in different countries and identified the factors contributing to its production. We also explored methods to reduce formaldehyde generation in tattoo inks. Seven tattoo inks from various brands were tested. RESULTS: Formaldehyde release was predominantly associated with gamma radiation sterilization. Formaldehyde levels were observed to be higher in compositions containing organic components compared to those with inorganic components, irrespective of sterilization method and container type. Glycerin released over seven times more formaldehyde than other components during gamma-ray sterilization. CONCLUSION: The results suggest that the presence of hydroxyl groups in carbon organic compounds in tattoo ink leads to photodegradation during gamma-ray radiation sterilization, resulting in increased concentrations of formaldehyde. Further research is needed to examine the chemical reactions occurring during sterilization processes and identify alternative sterilization methods that minimize formaldehyde formation. Additionally, the development of tattoo inks with reduced formaldehyde content and the establishment of strict quality control measures can help ensure the safety of tattooing practices.

Differences in Minority Stress Experiences, Mental Health, and Relationship Quality Outcomes Among Bisexual, Pansexual, and Queer Women.

The majority of sexual minority women in the United States today identify as bi+. Recent research suggests that "non-traditional" bi+ labels such as pansexual and queer are being adopted more frequently than ever before, making it increasingly important to evaluate whether these women have unique needs. In the current study, we explored differences in minority stress experiences, mental health, and relationship quality outcomes by sexual identity label among women who identify with the most common bi+ labels: bisexual, pansexual, and queer. Participants were 285 bi+ cisgender women in romantic relationships. They completed online measures of minority stress (antibisexual experiences, identity concealment, disconnection from the sexual and gender minority (SGM) community, and internalized stigma), mental health (depression and anxiety), and relationship quality (satisfaction and commitment). Overall, participants reported similar experiences of minority stress and few differences in their mental health outcomes. However, there were differences in antibisexual experiences by sexual identity label, such that pansexual women reported more frequent antibisexual experiences than bisexual and queer women. There were also differences in relationship quality by sexual identity label, such that bisexual women reported higher satisfaction than pansexual women and higher commitment than both pansexual and queer women. Findings suggest that pansexual and queer women may be facing their own unique challenges, even compared to bisexual women. Clinical prevention and intervention efforts can be tailored for these women to include strategies to cope with more frequent exposure to antibisexual experiences, as well as relationship education and skill-building to promote healthy romantic relationships.

Parenting style and child mental health at preschool age: evidence from rural China.

BACKGROUND: Mental health problems among children at preschool age are a common issue across the world. As shown in literature, a caregiver's parenting style can play a critical role in child development. This study aims to examine the associations between a caregiver's parenting style and the mental health problems (or not) of their child when he/she is at preschool age in rural China. METHODS: Participants were children, aged 49 to 65 months, and their primary caregivers. The primary caregivers of the sample children completed the Parenting Styles and Dimensions Questionnaire, Short Version, the Strengths and Difficulties Questionnaire, and a questionnaire that elicited their socio-demographic characteristics. The level of cognitive development of each sample child was assessed using the Wechsler Preschool and Primary Scale of Intelligence, Fourth Edition. Pearson correlation analysis, linear regression analysis, and multivariable regression analysis were used to analyze the data. RESULTS: The prevalence of mental health problems among sample children at preschool age was high (31.6%). If a caregiver practices an authoritative parenting style, it was found to be negatively associated with the mental health problems of their child. In contrast, a caregiver's authoritarian parenting style was positively associated with the mental health problems of their child. Compared to those in a subgroup of primary caregivers that used a combination of low authoritative and low authoritarian parenting style, primary caregivers that used a combination of high authoritarian and low authoritative or a combination of high authoritative and high authoritarian were found to have positive association with child health problems. A number of demographic characteristics were found to be associated with the adoption of different parenting styles. CONCLUSION: Different parenting styles (including authoritative, authoritarian, and combination of authoritative and authoritarian) of the sample caregivers had different associations with the mental health problems of the sample children. Parenting programs that aim to improve the parenting styles (favoring authoritative parenting styles) should be promoted in an effort to improve the status of child mental health in rural China.

Food insecurity versus public health? Social resilience.

The health problems of low-income communities and their relationship to food insecurity are a widespread problem worldwide. Understanding the complex relationship between these two conditions of food insecurity and health outcomes is the focus of this study. In addressing these issues, managing food security and adopting comprehensive strategies that consider the broader public health of the poor and socially vulnerable requires a multi-pronged approach that integrates sustainable food systems, social protection interventions, community engagement, and nutrition-specific interventions. This study is useful for improving our understanding of the relationship between food insecurity and health outcomes, which ultimately contributes to better health and social resilience strategies.

Sociodemographic and environmental characteristics associated with thoughts of death and suicidal ideation in community-dwelling residents of a rural town in Japan: analyses from a perspective of accompanying problems.

OBJECTIVE: Suicide prevention has been focused on primary prevention as a group rather than individuals. However, we aimed to identify sociodemographic and environmental characteristics of individuals with suicidal thoughts among rural residents in Japan. METHODS: In 2015, a cross-sectional home visit survey was conducted in a rural town in Akita Prefecture. A total of 1,844 residents aged ≥ 20 years (response rate, 65%) answered a self-administered questionnaire about suicidal thoughts in the past one month. Multivariate logistic regression analyses were used to investigate sociodemographic and environmental characteristics associated with suicidal thoughts in models with accompanying problems for human relations problems (HRP), health problems (HP), and financial problems (FP), or with no accompanying problems. RESULTS: In total, 218 (men 9.4%, women 13.8%) had suicidal thoughts with accompanying problems for HRP (n = 104), HP (n = 112), and FP (n = 72). The risk characteristics were Kessler Psychological Distress Scale scores ≥ 9 in models with HRP, HP, and FP or with no accompanying problems; being a woman and current smoking with no accompanying problems; absence of a person for help in a model of FP; and absence of family member for help in a model of HRP or with no accompanying problems. The mitigating factor were being optimistic (a domain of resilience skills identified by factor analysis) in models of HRP, HP, and FP or with no accompanying problems; being aged 70-79 and being aged ≥ 80 in a model of HRP. CONCLUSIONS: Suicidal thoughts among rural residents in Japan were associated with multifactorial sociodemographic and environmental characteristics.

Assessment of the association between health problems and cooking fuel type, and barriers towards clean cooking among rural household people in Bangladesh.

BACKGROUND: In low- and middle-income countries, households mainly use solid fuels like wood, charcoal, dung, agricultural residues, and coal for cooking. This poses significant public health concerns due to the emission of harmful particles and gases. To address these issues and support Sustainable Development Goals (SDGs), adopting cleaner cooking fuels like electricity and gas are acknowledged as a viable solution. However, access to these cleaner fuels is limited, especially in rural areas. METHODS: This study conducted a face-to-face survey with 1240 individuals in rural Bangladesh to explore the link between health issues and cooking fuel type, as well as barriers to transitioning to clean cooking. Using a convenient sampling technique across four divisions/regions, the survey gathered socio-demographic and health data, along with information on clean cooking barriers through a semi-structured questionnaire. Binary and multivariable logistic regression analyses were then employed to identify significant associations between cooking fuel type and health problems. RESULTS: The study revealed that a majority of participants (73.3%) relied on solid fuel for cooking. The use of solid fuel was significantly correlated with factors such as lower education levels, reduced family income, location of residence, and the experience of health issues such as cough, chest pressure while breathing, eye discomfort, diabetes, asthma, and allergies. Economic challenges emerged as the foremost obstacle to the adoption of clean cooking, accompanied by other contributing factors. CONCLUSION: The use of solid fuel in rural Bangladeshi households poses substantial health risks, correlating with respiratory, eye, cardiovascular, and metabolic issues. Lower education and income levels, along with specific residential locations, were associated with higher solid fuel usage. Economic challenges emerged as the primary obstacle to adopting clean cooking practices. These findings emphasize the need for implementing strategies to promote clean cooking, address barriers, and contribute to achieving Sustainable Development Goal targets for health and sustainable energy access in Bangladesh.

Dealing with the challenges of the pandemic - results of a population-based survey during the second year of the COVID-19 pandemic contrasting benefits and burden.

BACKGROUND: The pandemic and the associated consequences have been ongoing stressors with severe impacts on the population and particularly on families. Research focusing on groups dealing well with the challenges of the pandemic is scarce. Here, we aimed to identify groups being well-adjusted during the pandemic and associated predictors. METHODS: A representative sample of the German population (N = 2,515, 51.6% women, 50.09 years), and a subsample of persons with children or adolescents under the age of 18 (N = 453, 60.3% women, 40.08 years) was assessed from July to October 2021. As huge differences in coping with the pandemic are seen, cluster analysis was performed. RESULTS: Persons in the "well-adjusted cluster" were characterized by higher quality of life, better coping with the pandemic and lower burden of the pandemic. The family subsample well-adjusted cluster was characterized by lower pandemic-associated burden, lower parental stress compared to before the pandemic and a better relationship with the child. Fewer mental health symptoms and less pandemic-associated negative impact on career predicted membership of the well-adjusted cluster in both samples. An interaction between mental health symptoms and the negative impact of COVID-19 on the career was found. CONCLUSIONS: Our results underscore the importance of mental health and work-related factors for coping with the pandemic.

Evaluation of the Teaching Recovery Techniques intervention among newcomer students in Swedish schools: a randomised controlled trial turned into a feasibility study.

BACKGROUND: During recent years, Europe has faced the arrival of migrants whereof a considerable group of youth present mental health problems, such as symptoms of post-traumatic stress disorder (PTSD). Schools offer a safe environment for mental health interventions to these groups, yet there is limited research on the impact of school-based interventions addressing mental health problems in newcomer youths, especially in the Swedish context. This cluster randomized controlled trial (RCT) aimed to explore the effectiveness of the Teaching Recovery Techniques (TRT) intervention among newcomer students with PTSD symptoms in Swedish secondary schools. METHODS: Nine schools were randomly assigned to TRT or a wait list control group prior to the baseline assessment. Follow-up data were collected immediately following the intervention and three months post-intervention. In total, 531 students were approached, of which 61 gave consent and were eligible to be included in the study: 55 in TRT and 6 in the control condition. Given the low number of participants in the control condition, we merely analyzed students who had received TRT. RESULTS: We report on feasibility of recruitment, data collection, intervention delivery and intervention effectiveness. In terms of intervention effectiveness, within subjects ANOVAs revealed significant reductions in PTSD symptoms and general mental health problems from baseline to the three months-follow-up (p < 0.001). CONCLUSIONS: Our results indicate that TRT is a promising school-based intervention for newcomer students with PTSD symptoms. For a successful implementation of TRT in the school context, schools need to be engaged and the implementation should be managed by a local coordinator. TRIAL REGISTRATION: ISRCTN, ISRCTN48178969, Retrospectively registered 20/12/2019.

Health care needs, experiences, and satisfaction after terrorism: a longitudinal study of parents of survivors of the Utøya attack.

BACKGROUND: There is scarce knowledge on the health care follow-up of parents of terror attack survivors. This study focused on the mothers and fathers of survivors and examined (1) their perceived health care needs relative to their psychological reactions, physical health problems (unmet health care needs), and adaptation to work; (2) whether sociodemographic characteristics, health problems and social support were associated with unmet health care needs; and (3) how unmet health care needs, sociodemographic characteristics, and experiences with health services associated with overall dissatisfaction during the health care follow-up. METHODS: Interview and questionnaire data from three waves of the Utøya parent study were analyzed (n = 364). Chi-square tests and t- tests were used to compare unmet physical and psychological health care needs, sociodemographic factors and post-terror attack health reported by mothers and fathers. Logistic regression analyses were used to examine whether sociodemographic characteristics, unmet health care needs, and health care experiences were associated with overall dissatisfaction among mothers and fathers of the survivors during the health care follow-up. RESULTS: Among the mothers, 43% reported unmet health care needs for psychological reactions, while 25% reported unmet health care needs for physical problems. Among the fathers, 36% reported unmet health care needs for psychological reactions, and 15% reported unmet health care needs for physical problems. Approximately 1 in 5 mothers and 1 in 10 fathers reported "very high/high" needs for adaptation to work. Poorer self-perceived health, higher levels of posttraumatic stress and anxiety/depression symptoms, and lower levels of social support were significantly associated with reported unmet psychological and physical health care needs in both mothers and fathers. Parents with unmet health care needs reported significantly lower satisfaction with the help services received compared to parents whose health care needs were met. Low accessibility of help services and not having enough time to talk and interact with health care practitioners were associated with overall dissatisfaction with the help received. CONCLUSIONS: Our findings highlight that parents of terror-exposed adolescents are at risk of having unmet psychological and physical health care needs and thus need to be included in proactive outreach and health care follow-up programs in the aftermath of a terror attack.

Overlooked by the obstetric gaze - how women with persistent health problems due to severe perineal trauma experience encounters with healthcare services: a qualitative study.

BACKGROUND: During the first year postpartum, about 25 per cent of Swedish women with severe perineal trauma (SPT), i.e., a third- or fourth-degree perineal laceration at childbirth, are unsatisfied with their healthcare contacts. Further, there is a lack of research on the more long-term experiences of healthcare encounters among women with persistent SPT-related health problems. This study explores how women with self-reported persistent SPT-related health problems experience their contact with healthcare services 18 months to five years after childbirth when the SPT occurred. METHODS: In this descriptive qualitative study, a purposive sample of twelve women with self-reported persistent health problems after SPT were individually interviewed from November 2020 - February 2022. The data was analysed using inductive qualitative content analysis. RESULTS: Our results showed a paradoxical situation for women with persistent health problems due to SPT. They struggled with their traumatised body, but healthcare professionals rejected their health problems as postpartum normalities. This paradox highlighted the women's difficulties in accessing postpartum healthcare, rehabilitation, and sick leave, which left them with neglected healthcare needs, diminished emotional well-being, and loss of financial and social status. Our results indicated that these health problems did not diminish over time. Consequently, the women had to search relentlessly for a 'key person' in healthcare who acknowledged their persistent problems as legitimate to access needed care, rehabilitation, and sick leave, thus feeling empowered. CONCLUSIONS: Our study revealed that women with persistent SPT-related health problems experienced complex health challenges. Additionally, their needs for medical care, rehabilitation, and sick leave were largely neglected. Thus, the study highlights an inequitable provision of SPT-related healthcare services in Sweden, including regional disparities in access to care. Hence, the authors suggest that Swedish national guidelines for SPT-related care need to be developed and implemented, applying a woman-centered approach, to ensure equitable, effective, and accessible healthcare.

Secular trends in mental health problems among young people in Norway: a review and meta-analysis.

There is a growing concern that the mental health of recent generations of youth is deteriorating, yet the etiology of these secular changes is not fully understood. We aimed to review the evidence on trends in mental health problems among young people in Norway. Seven large-scale repeated cross-sectional studies were included in this study, comprising 35 cross-sectional data collections between 1992 and 2019, with a total sample of 776,606 young people. Our study found a clear increase in mental health problems among young females in Norway over the past few decades, while the trends were less marked for males. The proportion of individuals scoring above the problematic symptom score threshold increased on average by 11.2% (range 2.2% to 21.9%) for females and 5.2% (range - 0.9% to 11.1%) for males, based on data from the individual studies. The results from a meta-regression analysis showed that across all surveys, mean symptom scores increased by 17% (95% CI 12 to 21%) among females and 5% (95% CI 1 to 9%) among males from 1992 to 2019. Overall, mental health problems have increased continually since the early 1990s among young people, especially among young females. The cause of these secular changes remains unknown but likely reflect the interplay of several factors at the individual and societal level.Protocol registration: Open science framework, November 8, 2021 ( https://osf.io/g7w3v ).

Towards identifying the characteristics of youth with severe and enduring mental health problems in practice: a qualitative study.

A group of youth with severe and enduring mental health problems (SEMHP) falls between the cracks of the child-and-adolescent psychiatry (CAP) system. An insufficient understanding of these youth's mental health problems results in a failure to accurately identify and provide support to these youth. To gain a deeper understanding, the aim of this study is to explore characteristics of youth with SEMHP in clinical practice based on the experiences of youth and clinicians in CAP. This qualitative study consisted of 20 semi-structured interviews with 10 youth with lived experience and 10 specialized clinicians in CAP. Both a thematic and content analysis was conducted to identify, assess, and report themes associated with youth with SEMHP. Themes were individual characteristics such as trauma, masking, self-destructive behavior, interpersonal distrust as well as environmental and systematic characteristics including parental stressors, social isolation and societal stressors, which go beyond the existing classifications. These characteristics profoundly impact youth's daily functioning across various life domains, creating an interactive process, ultimately leading to elusive mental health problems and overwhelming feelings of hopelessness. The authors recommend proper assessment of characteristics in all life domains affected and their perpetuating effect on SEMHP during diagnostics in CAP. Engaging in a dialogue with youth themselves is crucial due to the nature of youth's characteristics, which frequently transcend traditional classifications and may not be immediately discernible. It also requires an integrated care approach, entailing collaborations between educational institutions and mental healthcare providers, and attention to potential indicators of deficits in the healthcare system and society.

Physical activity and psychopathology: are long-term developmental trajectories of physical activity in children and adolescents associated with trajectories of general mental health problems and of attention-deficit hyperactivity (ADHD) symptoms?

A medium-to-high level of physical activity (PA) may have at least a short-term positive effect on psychopathology in children and adolescents. Hence, the objective of this study was to investigate the long-term effects of PA in non-adult age groups on their general mental health problems and/or ADHD symptoms, using trajectories of concurrent development over a period of 10 years. This study employed data from the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) collected at three time points (baseline, Wave 1, Wave 2, over 10 years) from 17,640 children and adolescents. Using parent-reported data from the Strengths and Difficulties Questionnaire (SDQ), different developmental trajectories of general mental health problems (SDQ-total) and ADHD symptoms (SDQ-H/I) were identified with latent class mixed models (LCMM) statistics. This was also applied to parent- and self-reported data of three levels of PA. The latter was assessed according to WHO recommendations. The joint probability of class membership for SDQ-total as well as ADHD symptoms with PA was calculated to generate the concurrent developmental trajectories between variables. Results showed a 4-class trajectory model for both SDQ-total and ADHD symptoms among boys and girls. The majority of children and adolescents showed "low general difficulties" and "low ADHD symptoms" over the period of 10 years. Three distinct trajectories in boys and four distinct trajectories in girls were found for PA. Most of the participants showed an "increasing-decreasing activity" trajectory. No statistically significant correlations were found between the different SDQ-total or ADHD symptom trajectories and the trajectories of PA in the two genders. Taken together, our findings did not indicate any significant relationship between waxing and waning PA course over 10 years and various classes of mental health problems for children and adolescents. In contrast to our cross-sectional findings, no steady long-term medium/high-level of PA was present, which could (at least partly) explain the non-significant findings.

Longitudinal associations of menstrual characteristics with mental health problems among Chinese girls.

Cross-sectional studies indicate that menstrual problems are related to poorer mental health; however, longitudinal studies are limited. This longitudinal study aimed to determine whether baseline menstrual characteristics were risk factors for incident and persistent mental health problems. The study was conducted among Chinese adolescent girls. Menstrual characteristics including menarche, menstrual cycle and menstrual pain were assessed at baseline, whereas mental health problems including PTSD, depression, anxiety, ADHD, insomnia, psychotic-like experiences, non-suicidal self-injury, suicide ideation, suicide plan, and suicide attempt were assessed at baseline (n = 1039) and at the 1-year follow-up (n = 946) by self-administered, structured questionnaires. Multiple logistic regressions were performed to examine whether menstrual characteristics were associated with incident (e.g., PTSD at follow-up but not baseline) and persistent (e.g., PTSD at both time points) mental health problems. The results demonstrated that early menarche was related to persistence of psychotic-like experiences; irregular menstruation was associated with higher rates of incident anxiety and insomnia, and persistent depression, anxiety, ADHD, insomnia, non-suicidal self-injury, suicide ideation, and suicide plan; menstrual pain was associated with elevated rates of incident PTSD and depression, and persistent depression, insomnia, psychotic-like experiences, non-suicidal self-injury, suicidal ideation, suicide plan, and suicide attempt. In conclusion, irregular menstruation and menstrual pain specifically contributed to the development of emotional problems and insomnia, and were associated with maintenance of the most mental health problems in early adolescence. The long-term effects of menstrual problems on mental health need further study.

The experiences of familial mental illness stigma among individuals living with mental illnesses.

Persons with mental illnesses may experience stigma from their immediate family members in addition to other forms of stigma. Using semi-structured interviews, we investigated experiences of familial mental illness stigma among 15 people diagnosed with mental illnesses in a mid-sized city in Canada. We identified five themes that speak to participants' experiences of familial mental illness stigma and ways to reduce it. The themes include the following: diagnosis as a 'double-edged sword,' potential familial isolation, familial stigma as societal stigma localized, stories of acceptance, and confronting potential familial mental illness stigma. Participants' narratives indicate that familial mental illness stigma is rooted in the broader social or public stigma, which sees its way into familial relations as well. This stigma takes various forms, including relationship bias or unfair treatment, breakdown in romantic relationships, loss of status, verbal and emotional abuse, exclusion from decision-making, and alienation within their immediate and extended families. Familial mental illness stigma experiences negatively impact participant's psychological well-being and personal empowerment. However, participants also shared ways that family members create supportive environments or actively confront or prevent stigma. Overall, this study has contributed to knowledge on mental illness stigma, particularly familial mental illness stigma from the perspective of participants living with a mental illness in a high-income country. Suggestions for future research include a focus on strategies to prevent ongoing familial mental illness stigma and large-scale studies to explore familial mental illness stigma to understand why families might perpetrate stigma.

A Participatory Evaluation of an Urban Garden Project in Ecuador: Exploring Factors That Impact the Recovery of People With Severe Mental Health Problems.

For the past years, Ecuador has been transitioning away from a hospital-based model of mental healthcare to one that is community-centred. However, challenges associated with hospital-based models endure, notably financial burden faced by those with severe mental health problems (SMHPs) due to labour market discrimination. Employment access for this group is often disregarded in policy planning, despite evidence of its benefits on mental health. Huertomanías, an urban garden initiative in Ecuador founded in 2015, works with individuals with SMHPs, providing work, income, and social inclusion. A case study using a participatory approach was carried out to explore factors that impact the recovery of people with SMHPs. Twelve participants engaged in diverse stages of the research, where several participatory activities were conducted including cognitive mapping, a photovoice project, and interviews. The analysis employed a thematic approach leading to four categories of impact within the urban garden: autonomy (financial and personal), interpersonal relations and relation with the environment, mental health, and family dynamics. A final category of impact was established encompassing external factors (family support and public policy and healthcare services) that influence recovery. Findings suggest that the urban garden promotes autonomy and active participation within society, improves mental health, and transforms family dynamics. Further, this study highlights the importance of community-based mental healthcare (CBMHC), emphasising the need of public policies and healthcare in promoting autonomy through employment and community-centred services. Lastly, the study contributes insights into recovery experiences and CBMHC benefits, informing programme development and similar initiatives in Latin America.

Individual Trajectories of Specialist Substance Use Disorder and Mental Health Treatment Utilization Among Young Adults With Substance Use Problems: A Cohort Study.

OBJECTIVE: The aim of the study was to identify groups of young adults with distinct longitudinal patterns of use of treatment for substance use disorders and mental health (MH) problems and to investigate potential explanatory factors for different patterns of treatment use over time, including sociodemographic factors. METHODS: The sample consisted of 447 young adults aged 16-29 years who entered long-term residential substance use disorder treatment facilities in Norway from 2011 to 2016. In this study, we obtained data collected by the Norwegian Patient Registry and Statistics Norway. These data were linked with the electronic health record data of the substance use disorder treatment facilities from which the participants were recruited. Growth mixture modeling was performed. The identified groups were further compared using analysis of variance or χ2 test. RESULTS: Four groups of participants for total treatment use, substance use disorder treatment use, and MH treatment use were identified. Most participants from the overall sample were classified as members of a group characterized by a low and stable pattern of treatment use over time. A group with a high and stable pattern of treatment use was identified in total and MH treatment use. The proportion of participants with higher levels of substance use disorder treatment use at the end of the study period than at the beginning was larger (35%) than in the case of MH treatment use (14.2%). Younger age was associated with a decreasing pattern of MH treatment use and with an increasing pattern of substance use disorder treatment use over time. There were larger proportions of female participants in groups with a stable high use of MH treatment and in groups with an initially increasing trend of substance use disorder treatment use. Findings revealed that most participants across the identified groups were recipients of welfare benefits, had low educational attainment, and were not working. CONCLUSIONS: Results demonstrated significant variation in trajectories of treatment use among young adults with substance use disorder. Differences in treatment use could indicate differences in symptom severity and complexity. In this study, treatment use was associated with socioeconomic factors, sex, and age. Integrative approaches, including interagency and interdisciplinary collaboration, will often be necessary to sufficiently address the multidimensionality of substance use disorder.

Experiences of managers and staff working in community-based mental health with people ageing with severe mental health problems.

BACKGROUND: Existing research shows that older people with severe mental health problems need different forms of support in daily life and in the community to lead an active and meaningful life. A common form of support for people with severe mental health problems in Sweden is attendance at community-based day centres (DCs). However, knowledge of staff and managers' experiences of how people ageing with severe mental health problems are supported in DCs is scarce. AIM: The aim was to explore DC staff and managers' experiences of how people ageing with severe mental health problems are supported in DCs during the retirement process. METHOD/PROCEDURE: Telephone interviews were conducted with managers in 27 municipalities in southern Sweden. In addition, focus groups were held with personnel from a total of nine different DCs. The material was analysed using content analysis. RESULTS: The results showed that older people who receive support in community-based mental health care were viewed as a neglected group with complex needs, and the informants (managers and staff) had few policies to guide them when providing support. This made the informants desire more knowledge about best practices to support the target group. One theme emerged, Minding the gap between ideal and reality while working with a neglected group with complex needs, with three categories: Reasoning around unmet needs, Navigating in a muddled organisation, and Wishing for an enriched service. CONCLUSION/PRACTICAL APPLICATION: Together with previous research, the results can contribute to increase awareness about an overlooked group at risk of being neglected and the pitfalls that impact the possibility to guide this target group in their recovery journey. Further research focusing on the target group's own experience of their everyday life situations is also needed.

Strategies for mitigation of pesticides from the environment through alternative approaches: A review of recent developments and future prospects.

Chemical-based peticides are having negative impacts on both the healths of human beings and plants as well. The World Health Organisation (WHO), reported that each year, >25 million individuals in poor nations are having acute pesticide poisoning cases along with 20,000 fatal injuries at global level. Normally, only ∼0.1% of the pesticide reaches to the intended targets, and rest amount is expected to come into the food chain/environment for a longer period of time. Therefore, it is crucial to reduce the amounts of pesticides present in the soil. Physical or chemical treatments are either expensive or incapable to do so. Hence, pesticide detoxification can be achieved through bioremediation/biotechnologies, including nano-based methodologies, integrated approaches etc. These are relatively affordable, efficient and environmentally sound methods. Therefore, alternate strategies like as advanced biotechnological tools like as CRISPR Cas system, RNAi and genetic engineering for development of insects and pest resistant plants which are directly involved in the development of disease- and pest-resistant plants and indirectly reduce the use of pesticides. Omics tools and multi omics approaches like metagenomics, genomics, transcriptomics, proteomics, and metabolomics for the efficient functional gene mining and their validation for bioremediation of pesticides also discussed from the literatures. Overall, the review focuses on the most recent advancements in bioremediation methods to lessen the effects of pesticides along with the role of microorganisms in pesticides elimination. Further, pesticide detection is also a big challenge which can be done by using HPLC, GC, SERS, and LSPR ELISA etc. which have also been described in this review.