A population health approach to workplace mental health: rationale, implementation and engagement.

Objectives: To describe a population health-based program to support employee and dependent mental health and learn from engagement trends. Methods: Retrospective analysis of a program utilizing an assessment of mental health risk. For scoring "at risk," a Care Concierge is offered to connect users with resources. Results: Participation was offered to 56,442 employees and dependents. Eight thousand seven hundred thirty-one completed the assessment (15%). Of those, 4,644 (53%) scored moderate or higher. A total of 418 (9%) engaged the Care Concierge. Factors that negatively influenced the decision to engage care included bodily pain, financial concerns. Positive influences were younger age, high stress, anxiety, PTSD and low social support. Conclusion: Proactive assessment plus access to a Care Concierge facilitates mental healthcare utilization. Several factors influence likelihood to engage in care. A better understanding of these factors may allow for more targeted outreach and improved engagement.

Food restriction during development delays puberty but does not affect adult seasonal reproductive responses to food availability in Siberian hamsters (Phodopus sungorus).

Seasonally breeding animals respond to environmental cues to determine optimal conditions for reproduction. Siberian hamsters (Phodopus sungorus) primarily rely on photoperiod as a predictive cue of future energy availability. When raised in long-day photoperiods (>14 h light), supplemental cues such as food availability typically do not trigger the seasonal reproductive response of gonadal regression, which curtails reproduction in unsuitable environments. We investigated whether recognition of food availability as a cue could be altered by a nutritional challenge during development. Specifically, we predicted that hamsters receiving restricted food during development would be sensitized to food restriction (FR) as adults and undergo gonadal regression in response. Male and female hamsters were given either ad libitum (AL) food or FR from weaning until d60. The FR treatment predictably limited growth and delayed puberty in both sexes. For 5 weeks after d60, all hamsters received an AL diet to allow FR hamsters to gain mass equal to AL hamsters. Then, adult hamsters of both juvenile groups received either AL or FR for 6 weeks. Juvenile FR had lasting impacts on adult male body mass and food intake. Adult FR females exhibited decreased estrous cycling and uterine horn mass indiscriminately of juvenile food treatment, but there was little effect on male reproductive measurements. Overall, we observed a delay in puberty in response to postweaning FR, but this delay appeared not to affect seasonal reproductive responses in the long term. These findings increase our understanding of seasonal reproductive responses in a relevant environmental context.

Workplace Mental Health: Application of a Population Health Approach of Proactive Screening to Identify Risk and Engage in Care.

OBJECTIVE: To evaluate a proactive, voluntary screening program designed to identify employees with emerging mental health risk and engage them in care. METHODS: Risk was proactively identified through online screening of 344 participants. At-risk participants were offered a mental health care concierge to provide support, develop a care plan, and connect to care. RESULTS: Risk for common mental health conditions was identified in 244 (71%) participants, of whom 66 (27%) connected with a care concierge. Compared with participants who did not connect to a care concierge, those who did were more likely to report a financial crisis (68.2% vs 50.8%) and less likely to report verbal abuse (9.1% vs 19.6%) and difficulty meeting daily needs (12.1% vs 25.1%). CONCLUSION: Implementation of this screening program identified employees at risk for mental health conditions and facilitated connection to care.

Contrasting responses to salinity and future ocean acidification in arctic populations of the amphipod Gammarus setosus.

Climate change is leading to alterations in salinity and carbonate chemistry in arctic/sub-arctic marine ecosystems. We examined three nominal populations of the circumpolar arctic/subarctic amphipod, Gammarus setosus, along a salinity gradient in the Kongsfjorden-Krossfjorden area of Svalbard. Field and laboratory experiments assessed physiological (haemolymph osmolality and gill Na+/K+-ATPase activity, NKA) and energetic responses (metabolic rates, MO2, and Cellular Energy Allocation, CEA). In the field, all populations had similar osmregulatory capacities and MO2, but lower-salinity populations had lower CEA. Reduced salinity (S = 23) and elevated pCO2 (~1000 µatm) in the laboratory for one month increased gill NKA activities and reduced CEA in all populations, but increased MO2 in the higher-salinity population. Elevated pCO2 did not interact with salinity and had no effect on NKA activities or CEA, but reduced MO2 in all populations. Reduced CEA in lower-rather than higher-salinity populations may have longer term effects on other energy demanding processes (growth and reproduction).

Endotoxin rapidly desensitizes the gonads to kisspeptin-induced luteinizing hormone release in male Siberian hamsters (Phodopus sungorus).

Activation of the immune system induces rapid reductions in hypothalamic-pituitary-gonadal (HPG) axis activity, which in turn decreases secretion of sex steroids. This response is likely adaptive for survival by temporarily inhibiting reproduction to conserve energy; however, the physiological mechanisms controlling this response remain unclear. The neuropeptide kisspeptin is a candidate to mediate the decrease in sex hormones seen during sickness through its key regulation of the HPG axis. In this study, the effects of acute immune activation on the response to kisspeptin were assessed in male Siberian hamsters (Phodopus sungorus). Specifically, an immune response was induced in animals by a single treatment of lipopolysaccharide (LPS), and reproductive hormone concentrations were determined in response to subsequent injections of exogenous kisspeptin. Saline-treated controls showed a robust increase in circulating testosterone in response to kisspeptin; however, this response was blocked in LPS-treated animals. Circulating luteinizing hormone (LH) levels were elevated in response to kisspeptin in both LPS- and saline-treated groups and, thus, were unaffected by LPS treatment, suggesting gonad-level inhibition of testosterone release despite central HPG activation. In addition, blockade of glucocorticoid receptors by mifepristone did not attenuate the LPS-induced inhibition of testosterone release, suggesting that circulating glucocorticoids do not mediate this phenomenon. Collectively, these findings reveal that acute endotoxin exposure rapidly renders the gonads less sensitive to HPG stimulation, thus effectively inhibiting sex hormone release. More broadly, these results shed light on the effects of immune activation on the HPG axis and help elucidate the mechanisms controlling energy allocation and reproduction.

Effects of exogenous leptin on seasonal reproductive responses to interacting environmental cues in female Siberian hamsters.

Animals living in temperate climates respond to environmental cues that signal current and future resource availability to ensure that energy resources are available to support reproduction. Siberian hamsters (Phodopus sungorus) undergo robust gonadal regression in short, winter-like photoperiods as well as in response to mild food restriction in intermediate photoperiods. The goal of the present study was to investigate whether leptin is a relevant metabolic signal in regulating gonadal regression in response to diminishing food availability. Adult female hamsters housed in short-day (winter-like) or intermediate (fall-like) photoperiods received either ad libitum access to food or mild food restriction (90% of ad libitum intake) and were treated with either leptin or a vehicle for five weeks in order to determine the ability of leptin to inhibit gonadal regression. At the end of five weeks, vehicle-treated hamsters showed physiological signs associated with ongoing gonadal regression, such as decreases in body mass and food intake, cessation of estrous cycling, and small decreases in reproductive tissue mass. Leptin did not modify changes in body mass, food intake, hormone concentration, or tissue mass, but showed a tendency to support estrous cycling, particularly in response to food restriction in the intermediate photoperiod treatment. Overall, leptin appears to play a minor role in coordinating reproductive responses to multiple environmental cues, at least in the early stages of gonadal regression.

Food as a supplementary cue triggers seasonal changes in aggression, but not reproduction, in Siberian hamsters.

Animals living in temperate regions prepare for harsh winter conditions by responding to environmental cues that signal resource availability (e.g., food, day length). Siberian hamsters (Phodopus sungorus) breed in long, summer-like days (LD, >14h light), i.e., photoperiods, and undergo robust gonadal regression and become more aggressive when exposed to short, winter-like photoperiods that signal impending limited resources (SD, <10h light). When hamsters are reared within an intermediate photoperiod (ID, 13.5h light), they are reproductively active, but undergo gonadal regression in response to mild food restriction (FR) over 6-12weeks. We hypothesized that short-term (1-2weeks) FR in an ID photoperiod would provide a signal of impending limited resources and initiate the seasonal increase in aggression typical of SD photoperiods, as well as alter reproductive behaviors in advance of gonadal regression. To test this, we housed male and female hamsters in LD or ID photoperiods, with ad libitum (AL) access to food or a 90%-AL ration. We tested aggressive behavior after one week and reproductive behavior after two weeks, and subsequently monitored females for pregnancy and litter production. Both sexes displayed increased aggression in the ID-FR treatment. Untreated male intruders were less likely to ejaculate when paired with ID females during reproductive encounters. ID-FR males were undergoing gonadal regression after two weeks, but were more likely to have ejaculated. Female pregnancy and litter characteristics were unaltered by treatment: females were equally likely to achieve pregnancy and produce comparable litters across treatment groups. Collectively, we demonstrate that a signal of diminishing resources in an ID photoperiod is sufficient to trigger seasonal aggression, but that hamsters are reproductively resilient to inhibitory environmental cues in the short term. Broadly, our findings provide an important context for exploring seasonal changes in behavior and physiology from an ultimate perspective.