Exploring spatio-temporal patterns in mental health related emergency department use from children and adolescents.

To understand the spatio-temporal patterns and associated risk factors with the frequency, we analyze records of mental health related emergency department (MHED) visits from youth. The data are extracted for the period 2002--2011 from the population-based, provincial health administrative data systems of Alberta, Canada. Guided by a descriptive analysis, we conduct generalized linear regression analyses of the counts of MHED visits from various health areas. Seasonal effects are examined via three different types of functions, including trigonometric functions. We specify the temporal correlation using an autoregressive model of order 1 and formulate the spatial correlation by a random effects model. Our analysis reveals a strong seasonal pattern and indicates that the MHED visit counts are significantly associated with age, gender, and a proxy for socio-economic status. The final statistical model may be used to forecast future MHED use and identify regions and groups at a higher risk to the MHEDs.

What happened to our former students five to six years after graduation? An endodontic teacher's perspective.

Endodontic teaching follows common concepts in the four Swiss dental schools. The aim of this survey was to ask former Swiss dental students how they adopted these endodontic concepts in clinical practice. All the graduates of the years 2012 and 2013 (n = 196) were targeted in 2018 using an internet-based anonymous questionnaire, which was based on five initial questions. One hundred forty-one individuals (participants) filled in these questions on their work situation and referral concepts (72% response rate). Those 111 participants who performed root canal treatments themselves were the focus group. They answered an additional 11 questions. Their affinity towards performing endodontic treatments was investigated. The use of rubber dam isolation served as a surrogate to see if biological principles were respected. Furthermore, it was asked which instrumentation systems they used in daily practice, and how they perceived the impact of their superior/employer on these choices. Of the 141 survey participants 55 were men and 86 women. Thirty-eight of these (27%) reported to refer difficult endodontic cases. Individuals in the focus group had an overall positive attitude towards endodontics. There was very little variance in the responses between the four Swiss dental schools. The vast majority (86.5%) reported to use rubber dam routinely. More than half in the focus group used reciprocating systems, and only a few (22.5%) would still use the rotary system they were taught at university. There was a significantly (p < 0.05) higher perceived impact of the employer on choice of instrumenting system versus the use of rubber dam.

Factors associated with community versus personal care home discharges after inpatient stroke rehabilitation: the need for a pre-admission predictive model.

Background: Improved risk factor management and interventions have both been shown to improve mortality in stroke patients. Although this has been a success for acute care, it has placed a higher burden on stroke rehabilitation resources.Objectives: This study sought to identify the pre-stroke rehabilitation admission factors that best predict personal care home discharge.Methods: Using a retrospective case-control, chart review design, 60 patients discharged to personal care homes from inpatient stroke rehabilitation between 2008 and 2017 were included. One hundred and eighty-two patients discharged home over the same time span were randomly selected as controls. Statistical analysis was used to identify patient factors independently associated with discharge destination.Results: Patients were more often discharged to personal care homes if they were older (OR 1.09; CI [1.05-1.15]), had a lower functional independence measure score (OR 0.95; CI [0.92-0.97]), had cognitive deficits (OR 6.19; CI [2.37-18.06]), lived alone before their stroke (OR 7.77; CI [2.75-24.55]), and whether or not there was excessive truncal instability limiting Berg balance scale measurability (OR 0.17; CI [0.06-0.45] if able to measure). Combined, the predictive value of personal care home discharge using these variables was 91.6%.Conclusions: A combination of age, admission functional independence measure, cognitive impairment, pre-stroke living situation, and measurability of the Berg balance scale on admission to stroke rehabilitation were highly predictive of eventual personal care home discharge.

Psychedelics and the new behaviourism: considering the integration of third-wave behaviour therapies with psychedelic-assisted therapy.

This narrative review examines evidence related to the potential for third wave behaviour therapies to serve as adjuncts to psychedelic-assisted therapy. It identifies shared theoretical foundations for both approaches, and notes enhanced mindfulness, decentering, emotion regulation, and distress tolerance as common mechanisms of action. It also identifies potential targets for which both approaches have demonstrated therapeutic potential, including problematic substance use, self-directed and other-directed violence, and mood disorders. Based on these commonalities, there is a call for research on the potential integration of psychedelic-assisted therapy and third wave behaviour therapies including Dialectical Behaviour Therapy, Acceptance and Commitment Therapy, and Mindfulness Based Cognitive Therapy.

Psychedelic use and intimate partner violence: The role of emotion regulation.

BACKGROUND: Recent evidence suggests that psychedelic use predicts reduced perpetration of intimate partner violence among men involved in the criminal justice system. However, the extent to which this association generalizes to community samples has not been examined, and potential mechanisms underlying this association have not been directly explored. AIMS: The present study examined the association between lifetime psychedelic use and intimate partner violence among a community sample of men and women. The study also tested the extent to which the associations were mediated by improved emotion regulation. METHODS: We surveyed 1266 community members aged 16-70 (mean age=22.78, standard deviation =7.71) using an online questionnaire that queried substance use, emotional regulation, and intimate partner violence. Respondents were coded as psychedelic users if they reported one or more instance of using lysergic acid diethylamide and/or psilocybin mushrooms in their lifetime. Results/outcomes: Males reporting any experience using lysergic acid diethylamide and/or psilocybin mushrooms had decreased odds of perpetrating physical violence against their current partner (odds ratio=0.42, p<0.05). Furthermore, our analyses revealed that male psychedelic users reported better emotion regulation when compared to males with no history of psychedelic use. Better emotion regulation mediated the relationship between psychedelic use and lower perpetration of intimate partner violence. This relationship did not extend to females within our sample. CONCLUSIONS/INTERPRETATION: These findings extend prior research showing a negative relationship between psychedelic use and intimate partner violence, and highlight the potential role of emotion regulation in this association.

Medical cannabis and mental health: A guided systematic review.

This review considers the potential influences of the use of cannabis for therapeutic purposes (CTP) on areas of interest to mental health professionals, with foci on adult psychopathology and assessment. We identified 31 articles relating to the use of CTP and mental health, and 29 review articles on cannabis use and mental health that did not focus on use for therapeutic purposes. Results reflect the prominence of mental health conditions among the reasons for CTP use, and the relative dearth of high-quality evidence related to CTP in this context, thereby highlighting the need for further research into the harms and benefits of medical cannabis relative to other therapeutic options. Preliminary evidence suggests that CTP may have potential for the treatment of PTSD, and as a substitute for problematic use of other substances. Extrapolation from reviews of non-therapeutic cannabis use suggests that the use of CTP may be problematic among individuals with psychotic disorders. The clinical implications of CTP use among individuals with mood disorders are unclear. With regard to assessment, evidence suggests that CTP use does not increase risk of harm to self or others. Acute cannabis intoxication and recent CTP use may result in reversible deficits with the potential to influence cognitive assessment, particularly on tests of short-term memory.

Hallucinogen use and intimate partner violence: Prospective evidence consistent with protective effects among men with histories of problematic substance use.

Evidence suggests that hallucinogens may have therapeutic potential for addressing a variety of problem behaviors related to the externalizing spectrum of psychopathology, such as substance misuse and criminality. Intimate partner violence (IPV) is a prevalent form of criminal violence that is related to externalizing pathology. However, the association between hallucinogen use and IPV has not been comprehensively examined. In this prospective study, we examined the association between IPV and naturalistic hallucinogen use among 302 inmates at a US county jail. Cox regression analyses indicated that hallucinogen use predicted reduced arrest for IPV independently (ß=-0.54, SE=0.20, χ(2)=7.19, exp(B)=0.58, p<0.01) and after accounting for covariates (ß=-0.48, SE=0.23, χ(2)=4.44, exp(B)=0.62, p<0.05). These results add to a growing literature suggesting distinct therapeutic potential for hallucinogens to assist in the attenuation of problematic behavior.