Factors associated with neurofeedback and mindfulness-based combination therapy for patients with substance use disorder: A multicenter study

Background and objectives Substance use disorder (SUD) has become a major concern in public health globally, and there is an urgent need to develop an integrated psychosocial intervention. The aims of the current study are to test the efficacy of the integrated treatment with neurofeedback and mindfulness-based therapy for SUD and identify the predictors of the efficacy. Methods This study included 110 participants with SUD into the analysis. Outcome of measures includes demographic characteristics, severity of dependence, quality of life, symptoms of depression, and anxiety. Independent t test is used to estimate the change of scores at baseline and three months follow-up. Generalized estimating equations are applied to analyze the effect of predictors on the scores of dependence severity over time by controlling for the effects of demographic characteristics. Results A total of 22 (20 %) participants were comorbid with major mental disorder (MMD). The decrement of the severity in dependence, anxiety, and depression after treatment are identified. Improved scores of qualities of life in generic, psychological, social, and environmental domains are also noticed. After controlling for the effects of demographic characteristics, the predictors of poorer outcome are comorbid with MMD, lower quality of life, and higher level of depression and anxiety. Conclusion The present study implicates the efficacy of integrated therapy. Early identification of predictors is beneficial for healthcare workers to improve the treatment efficacy. (AU)

Exploring the knowledge and skills for effective family caregiving in elderly home care: a qualitative study.

BACKGROUND: Family caregivers play a crucial role in providing physical, emotional, and social support to the elderly, allowing them to maintain their independence and stay in their preferred living environment. However, family caregivers face numerous challenges and require specific knowledge and skills to provide effective care. Therefore, understanding the knowledge and skills required for effective family caregiving in elderly home care is vital to support both the caregivers and the elderly recipients. METHODS: The research was carried out in Mekelle City, Ethiopia, utilizing the phenomenology study design and purposive sampling technique. A total of twenty-two in-depth interviews were conducted. Individuals with experience in providing care for elderly people in their homes were targeted. Data was gathered through the use of an open-ended guide, transcribed word-for-word, inputted into ATLAS.ti8 software, and translated. Codes and themes were then extracted from the transcribed data, and a thematic analysis was performed. To minimize personal biases, the collected data were coded independently by the data collection assistants and the PI. The analysis was carried out by authors who were not involved in the data collection process. The interviews were conducted in a quiet place. RESULTS: A total of 22 in-depth interviews were conducted as part of this research. The results indicated that although the participants had knowledge about common health problems experienced by older people, they were uninformed about how to manage these conditions at home and were unaware of specialized healthcare resources for the elderly. Furthermore, they had limited knowledge about suitable exercise routines, strategies to prevent falls, and home healthcare practices for older individuals. On the other hand, they exhibited a solid comprehension and awareness of abusive behaviors specifically directed at older adults. CONCLUSION: The results emphasized the importance of enhancing education and training for family caregivers in handling elderly health issues, raising awareness about specialized healthcare services catered to the elderly, improving understanding of activities of daily living (ADLs) and fall prevention, and offering inclusive training in healthcare tasks related to elder care. RECOMMENDATION: Participants should receive comprehensive education and training programs to enhance their knowledge and skills in managing these conditions. Efforts should also be made to raise awareness about the availability of geriatric hospitals or specialized nurses for the elderly. Participants need to be educated about suitable exercise routines for the elderly and fall prevention strategies. Healthcare skills training is also necessary for participants, focusing on activities such as wound dressing, vital sign monitoring, and establishing a specific schedule for changing positions.

Natural language processing (NLP) to facilitate abstract review in medical research: the application of BioBERT to exploring the 20-year use of NLP in medical research.

BACKGROUND: Abstract review is a time and labor-consuming step in the systematic and scoping literature review in medicine. Text mining methods, typically natural language processing (NLP), may efficiently replace manual abstract screening. This study applies NLP to a deliberately selected literature review problem, the trend of using NLP in medical research, to demonstrate the performance of this automated abstract review model. METHODS: Scanning PubMed, Embase, PsycINFO, and CINAHL databases, we identified 22,294 with a final selection of 12,817 English abstracts published between 2000 and 2021. We invented a manual classification of medical fields, three variables, i.e., the context of use (COU), text source (TS), and primary research field (PRF). A training dataset was developed after reviewing 485 abstracts. We used a language model called Bidirectional Encoder Representations from Transformers to classify the abstracts. To evaluate the performance of the trained models, we report a micro f1-score and accuracy. RESULTS: The trained models' micro f1-score for classifying abstracts, into three variables were 77.35% for COU, 76.24% for TS, and 85.64% for PRF. The average annual growth rate (AAGR) of the publications was 20.99% between 2000 and 2020 (72.01 articles (95% CI: 56.80-78.30) yearly increase), with 81.76% of the abstracts published between 2010 and 2020. Studies on neoplasms constituted 27.66% of the entire corpus with an AAGR of 42.41%, followed by studies on mental conditions (AAGR = 39.28%). While electronic health or medical records comprised the highest proportion of text sources (57.12%), omics databases had the highest growth among all text sources with an AAGR of 65.08%. The most common NLP application was clinical decision support (25.45%). CONCLUSIONS: BioBERT showed an acceptable performance in the abstract review. If future research shows the high performance of this language model, it can reliably replace manual abstract reviews.

A Novel Blended Transdiagnostic Intervention (eOrygen) for Youth Psychosis and Borderline Personality Disorder: Uncontrolled Single-Group Pilot Study.

BACKGROUND: Integrating innovative digital mental health interventions within specialist services is a promising strategy to address the shortcomings of both face-to-face and web-based mental health services. However, despite young people's preferences and calls for integration of these services, current mental health services rarely offer blended models of care. OBJECTIVE: This pilot study tested an integrated digital and face-to-face transdiagnostic intervention (eOrygen) as a blended model of care for youth psychosis and borderline personality disorder. The primary aim was to evaluate the feasibility, acceptability, and safety of eOrygen. The secondary aim was to assess pre-post changes in key clinical and psychosocial outcomes. An exploratory aim was to explore the barriers and facilitators identified by young people and clinicians in implementing a blended model of care into practice. METHODS: A total of 33 young people (aged 15-25 years) and 18 clinicians were recruited over 4 months from two youth mental health services in Melbourne, Victoria, Australia: (1) the Early Psychosis Prevention and Intervention Centre, an early intervention service for first-episode psychosis; and (2) the Helping Young People Early Clinic, an early intervention service for borderline personality disorder. The feasibility, acceptability, and safety of eOrygen were evaluated via an uncontrolled single-group study. Repeated measures 2-tailed t tests assessed changes in clinical and psychosocial outcomes between before and after the intervention (3 months). Eight semistructured qualitative interviews were conducted with the young people, and 3 focus groups, attended by 15 (83%) of the 18 clinicians, were conducted after the intervention. RESULTS: eOrygen was found to be feasible, acceptable, and safe. Feasibility was established owing to a low refusal rate of 25% (15/59) and by exceeding our goal of young people recruited to the study per clinician. Acceptability was established because 93% (22/24) of the young people reported that they would recommend eOrygen to others, and safety was established because no adverse events or unlawful entries were recorded and there were no worsening of clinical and social outcome measures. Interviews with the young people identified facilitators to engagement such as peer support and personalized therapy content, as well as barriers such as low motivation, social anxiety, and privacy concerns. The clinician focus groups identified evidence-based content as an implementation facilitator, whereas a lack of familiarity with the platform was identified as a barrier owing to clinicians' competing priorities, such as concerns related to risk and handling acute presentations, as well as the challenge of being understaffed. CONCLUSIONS: eOrygen as a blended transdiagnostic intervention has the potential to increase therapeutic continuity, engagement, alliance, and intensity. Future research will need to establish the effectiveness of blended models of care for young people with complex mental health conditions and determine how to optimize the implementation of such models into specialized services.

Using Project Extension for Community Healthcare Outcomes to Enhance Substance Use Disorder Care in Primary Care: Mixed Methods Study.

BACKGROUND: Substance use and overdose deaths make up a substantial portion of injury-related deaths in the United States, with the state of Ohio leading the nation in rates of diagnosed substance use disorder (SUD). Ohio's growing epidemic has indicated a need to improve SUD care in a primary care setting through the engagement of multidisciplinary providers and the use of a comprehensive approach to care. OBJECTIVE: The purpose of this study was to assess the ability of the Weitzman Extension for Community Healthcare Outcomes (ECHO): Comprehensive Substance Use Disorder Care program to both address and meet 7 series learning objectives and address substances by analyzing (1) the frequency of exposure to the learning objective topics and substance types during case discussions and (2) participants' change in knowledge, self-efficacy, attitudes, and skills related to the treatment of SUDs pre- to postseries. The 7 series learning objective themes included harm reduction, team-based care, behavioral techniques, medication-assisted treatment, trauma-informed care, co-occurring conditions, and social determinants of health. METHODS: We used a mixed methods approach using a conceptual content analysis based on series learning objectives and substances and a 2-tailed paired-samples t test of participants' self-reported learner outcomes. The content analysis gauged the frequency and dose of learning objective themes and illicit and nonillicit substances mentioned in participant case presentations and discussions, and the paired-samples t test compared participants' knowledge, self-efficacy, attitudes, and skills associated with learning objectives and medication management of substances from pre- to postseries. RESULTS: The results of the content analysis indicated that 3 learning objective themes-team-based care, harm reduction, and social determinants of health-resulted in the highest frequencies and dose, appearing in 100% (n=22) of case presentations and discussions. Alcohol had the highest frequency and dose among the illicit and nonillicit substances, appearing in 81% (n=18) of case presentations and discussions. The results of the paired-samples t test indicated statistically significant increases in knowledge domain statements related to polysubstance use (P=.02), understanding the approach other disciplines use in SUD care (P=.02), and medication management strategies for nicotine (P=.03) and opioid use disorder (P=.003). Statistically significant increases were observed for 2 self-efficacy domain statements regarding medication management for nicotine (P=.002) and alcohol use disorder (P=.02). Further, 1 statistically significant increase in the skill domain was observed regarding using the stages of change theory in interventions (P=.03). CONCLUSIONS: These findings indicate that the ECHO program's content aligned with its stated learning objectives; met its learning objectives for the 3 themes where significant improvements were measured; and met its intent to address multiple substances in case presentations and discussions. These results demonstrate that Project ECHO is a potential tool to educate multidisciplinary providers in a comprehensive approach to SUD care.

Implications of perceived empathy from spouses during pregnancy for health-related quality of life among pregnant women: a cross-sectional study in Anhui, China.

BACKGROUND: Empathy is a critical component of nursing care, impacting both nurses' and patients' outcomes. However, perceived empathy from spouses during pregnancy and its impact on health-related quality of life (HRQoL) are unclear. This study aimed to examine pregnant women's perceived empathy from their spouses and assess the relation of perceived empathy on HRQoL. METHODS: This cross-sectional study, performed in the obstetric clinics or wards of four well-known hospitals in Anhui Province, China, included 349 pregnant women in the second or third trimester; participants were recruited by convenience sampling and enrolled from October to December 2021. A general information questionnaire, the Interpersonal Reactivity Index (IRI), a purpose-designed empathy questionnaire and the Medical Outcomes Study 12-item Short-Form Health Survey (SF-12) were used to evaluate the pregnant women's general information, perceptions of empathy and HRQoL. Data were analysed using SPSS 22 at a threshold of P < 0.05. Descriptive analysis, Pearson correlation analysis, Student's t test, ANOVA, and multiple regression analysis were used for analysis. RESULTS: The pregnant women's total empathy, physical component summary (PCS) and mental component summary (MCS) scores were 41.6 ± 9.0, 41.6 ± 7.6, and 47.7 ± 9.1, respectively. Correlation analysis revealed that the purpose-designed empathy questionnaire items were significantly positively correlated with perspective taking and empathic concern but were not correlated with the personal distress dimension and were only partially correlated with the fantasy dimension. Maternal physical condition during pregnancy, planned pregnancy, and occupational stress were predictors of the PCS score (ß = 0.281, P < 0.01; ß = 0.132, P = 0.02; ß = -0.128, P = 0.02). The behavioural empathy item of our purpose-designed empathy questionnaire and empathic concern were important predictors of the MCS score (ß = 0.127, P = 0.02; ß = 0.158, P < 0.01), as well as other demographic and obstetric information, explaining 22.0% of the variance in MCS scores totally (F = 12.228, P < 0.01). CONCLUSIONS: Pregnant women perceived lower empathy from their spouses and reported lower HRQoL. Perceived empathy, particularly behavioural empathy, may significantly impact pregnant women's MCS scores but has no effect on their PCS scores. Strategies that foster perceived empathy from spouses among pregnant women are essential for facilitating healthy pregnancies and potentially improving maternal and child health.

Challenges for palliative care in times of COVID-19: a scoping review.

Introduction: Many of the essential practices in palliative care (PC) had to be adapted to the COVID-19 pandemic. This global spread of the infectious respiratory disease, caused by SARS-CoV-2, created unprecedented obstacles. The aim of this research was to comprehensively assess the experiences and perceptions of healthcare professionals, individuals, and families in palliative and end-of-life situations during the COVID-19 pandemic. Methods: A scoping review was conducted using the databases CINAHL Complete, MEDLINE, Scopus, SciELO, Cochrane Central Register of Controlled Trials, Psychology and Behavioral Sciences, MEDIClatina, and Portugal's Open Access Scientific Repository. The review followed the JBI® methodological approach for scoping reviews. Results: Out of the initially identified 999 articles, 22 studies were included for analysis. The deprivation of relationships due to the safety protocols required to control the spread of COVID-19 was a universally perceived experience by healthcare professionals, individuals in PC, and their families. Social isolation, with significant psychological impact, including depersonalization and despair, was among the most frequently reported experiences by individuals in palliative situation. Despite healthcare professionals' efforts to mitigate the lack of relationships, the families of these individuals emphasized the irreplaceability of in-person bedside contact. Systematic review registration: https://osf.io/xmpf2/.

Changes in somatic and mental health indicators of instructor-officers under stress.

OBJECTIVE: Aim: To investigate changes in the indicators of somatic and mental health of instructor-officers in higher educational institutions with specific learning environment under stress. PATIENTS AND METHODS: Materials and Methods: The research involved instructor-officers of the National Academy of Internal Affairs (Ukraine, n = 86) with different teaching experiences: up to 10 years (group 1, n = 22), from 10 to 20 years (group 2, n = 31), over 20 years (group 3, n = 33). The study of somatic and mental health was carried out in September-October 2021 (Stage 1) and in September-October 2023 (Stage 2). RESULTS: Results: Significantly negative changes in the indicators of somatic and mental health of instructor-officers with different experiences of teaching under stress were found. The most pronounced negative changes were found in the body weight index, vital index, strength index, Martin-Kushelevsky index, and emotional exhaustion of instructors. Among the studied groups of instructor-officers, the greatest changes occurred in instructors with 10 to 20 years of experience and more than 20 years, and the least - in instructors with up to 10 years of experience. CONCLUSION: Conclusions: It was found that the professional activities of instructor-officers, which take place under stress, negatively affect both the somatic and mental health of instructors, regardless of their teaching experience. Such activities lead to an increase in body weight, deterioration of the functioning of the main body systems, and increased professional burnout of instructors. This can lead to several psychosomatic disorders and diseases in instructor-officers and a decrease in the quality of their teaching activities.

Protocol for the Adolescent Menstrual Experiences and Health Cohort (AMEHC) Study in Khulna, Bangladesh: A Prospective cohort to quantify the influence of menstrual health on adolescent girls' health and education outcomes.

BACKGROUND: Menstrual health is essential for gender equity and the well-being of women and girls. Qualitative research has described the burden of poor menstrual health on health and education; however, these impacts have not been quantified, curtailing investment. The Adolescent Menstrual Experiences and Health Cohort (AMEHC) Study aims to describe menstrual health and its trajectories across adolescence, and quantify the relationships between menstrual health and girls' health and education in Khulna, Bangladesh. METHODS AND ANALYSIS: AMEHC is a prospective longitudinal cohort of 2016 adolescent girls recruited at the commencement of class 6 (secondary school, mean age=12) across 101 schools selected through a proportional random sampling approach. Each year, the cohort will be asked to complete a survey capturing (1) girls' menstrual health and experiences, (2) support for menstrual health, and (3) health and education outcomes. Survey questions were refined through qualitative research, cognitive interviews and pilot survey in the year preceding the cohort. Girls' guardians will be surveyed at baseline and wave 2 to capture their perspectives and household demographics. Annual assessments will capture schools' water, sanitation and hygiene, and support for menstruation and collect data on participants' education, including school attendance and performance (in maths, literacy). Cohort enrolment and baseline survey commenced in February 2023. Follow-up waves are scheduled for 2024, 2025 and 2026, with plans for extension. A nested subcohort will follow 406 post-menarche girls at 2-month intervals throughout 2023 (May, August, October) to describe changes across menstrual periods. This protocol outlines a priori hypotheses regarding the impacts of menstrual health to be tested through the cohort. ETHICS AND DISSEMINATION: AMEHC has ethical approval from the Alfred Hospital Ethics Committee (369/22) and BRAC James P Grant School of Public Health Institutional Review Board (IRB-06 July 22-024). Study materials and outputs will be available open access through peer-reviewed publication and study web pages.

Transition of care from post-acute services for the older adults in Quebec: a pilot impact evaluation.

BACKGROUND: Early discharge of frail older adults from post-acute care service may result in individuals' reduced functional ability to carry out activities of daily living, and social, emotional, and psychological distress. To address these shortcomings, the Montreal West Island Integrated University Health and Social Services Centre in Quebec, Canada piloted a post-acute home physiotherapy program (PAHP) to facilitate the transition of older adults from the hospital to their home. This study aimed to evaluate: (1) the implementation fidelity of the PAHP program; (2) its impact on the functional independence, physical and mental health outcomes and quality of life of older adults who underwent this program (3) its potential adverse events, and (4) to identify the physical, psychological, and mental health care needs of older adults following their discharge at home. METHODS: A quasi-experimental uncontrolled design with repeated measures was conducted between April 1st, 2021 and December 31st, 2021. Implementation fidelity was assessed using three process indicators: delay between referral to and receipt of the PAHP program, frequency of PAHP interventions per week and program duration in weeks. A battery of functional outcome measures, including the Functional Independence Measure (FIM) and the Patient-Reported Outcomes Measurement Information System (PROMIS) Global-10 scale, as well as fall incidence, emergency visits, and hospitalizations were used to assess program impact and adverse events. The Patient's Global Impression of Change (PGICS) was used to determine changes in participants' perceptions of their level of improvement/deterioration. In addition, the Camberwell Assessment of Need for the Elderly (CANE) questionnaire was administered to determine the met and unmet needs of older adults. RESULTS: Twenty-four individuals (aged 60.8 to 94 years) participated in the PAHP program. Implementation fidelity was low in regards with delay between referral and receipt of the program, intensity of interventions, and total program duration. Repeated measures ANOVA revealed significant improvement in FIM scores between admission and discharge from the PAHP program and between admission and the 3-month follow-up. Participants also reported meaningful improvements in PGICS scores. However, no significant differences were observed on the physical or mental health T-scores of the PROMIS Global-10 scale, in adverse events related to the PAHP program, or in the overall unmet needs. CONCLUSION: Findings from an initial sample undergoing a PAHP program suggest that despite a low implementation fidelity of the program, functional independence outcomes and patients' global impression of change have improved. Results will help develop a stakeholder-driven action plan to improve this program. A future study with a larger sample size is currently being planned to evaluate the overall impact of this program. CLINICAL TRIAL REGISTRATION: Retrospectively registered NCT05915156 (22/06/2023).

Learning styles, academic performance and mental health among medical students in King Faisal University, Saudi Arabia.

OBJECTIVE: To assess the prevalence of various learning styles and their correlation with academic performance and mental health of medical students. METHODS: The cross-sectional study was conducted at the King Faisal University, Houfof, Saudi Arabia, from January to June 2019, and comprised medical students regardless of gender or the academic year. Data was collected using the Visual Aural Read/write Kinesthetic questionnaire. Depression Anxiety Stress Scales-21 was used to assess mental health. Data was analysed using SPSS 22. RESULTS: Of the 315 students, 179(57%) were males and 136(43%) were females. Overall, 152(48.3%) subjects preferred multimodal, while 163(51.7%) preferred unimodal style; 93(29%) aural, 53(16.8%) visual, 11(3.5%) read/write and 6(1.9%) kinesthetic. Males preferred visual and quardimodal styles of learning, while females preferred aural learning (p<0.05). Academic achievement was associated with learning style (p<0.05), but no relationship was observed between depression scores and learning styles (p>0.05). CONCLUSIONS: The most preferred learning styles among medical students were found to be aural and bimodal.

Exploring mental health problems and support needs among pregnant and parenting teenagers in rural areas Of Limpopo, South Africa.

BACKGROUND: Globally, teenage pregnancy is among the most social problems, affecting 21 million adolescents aged 15-19. Due to the increased responsibility of prenatal and postnatal care for their infants without support, pregnant and parenting teenagers, tend to experience mental health problems. Factors contributing to these problems among pregnant and parenting teenagers in rural African settings have hardly received scholarly attention and, therefore, are less understood. The purpose of the study was to explore mental health and challenges among pregnant and parenting teenagers,. METHOD(S): The study adopted a qualitative descriptive, exploratory, and phenomenological design. Purposive sampling was used to select 22 pregnant and parenting teenagers 18 years or older. Data were collected in ten selected clinics within the Demographic Surveillance Systems (HDSS) of DIMAMO and analysed using qualitative content analysis. RESULTS: The findings reveal that pregnant and parenting teenagers in rural areas experience various mental challenges such as depression. These challenges are caused by social problems such as stigmatisation, lack of support from families and friends, as well as parenting demands that contribute to poor progress at school or dropouts. Pregnant teens expressed concerns about the lack of spousal support resulting from abandoning their partners. CONCLUSIONS: Stress and depression were self-reported as mental problems among participants with various psychosocial implications, such as school dropout and miscarriage. There are various contributing factors to the mental health problems identified among pregnant and parenting teenagers, including inadequate family and spousal support. Access to integrated reproductive, psychosocial, and mental health services could be essential for these pregnant and parenting teenagers, to improve their mental well-being and improve the support system.

Associations between cognitive function and lifestyle in community-living older people: a correlational study.

BACKGROUND: Previous studies have examined relationship between cognitive function and lifestyle; however, the nature of this relationship is expected to vary in diverse cultural and low-income setting where lifestyle practices differ from those in high-income countries. AIM: This study aims to investigate the correlation between lifestyle factors and cognitive function among individuals aged 60 years and older in 2021. METHODS: This cross-sectional, Community-based study involved 300 older adults from comprehensive urban health centers in Khorramabad, Iran, selected through stratified cluster sampling. Data were collected using the demographic information questionnaire, Mini-Mental State Examination, and Lifestyle Questionnaire. Data management and analysis were performed using SPSS (version 22) and independent t-tests, Pearson's correlation coefficient, ANOVA, and multiple linear regression analysis were used. A p value < 0.05 was considered significant. RESULTS: The study included 156 males (52%) and 144 females (48%). Findings revealed a significant correlation between cognitive function and lifestyle (P < 0.001). Multiple linear regression analysis indicated that physical health, environmental health, exercise, accident prevention, and avoidance of medication exerted the most significant positive effect on cognitive function. Conversely, social health exhibited a notable negative influence on cognitive function. (P < 0.001). CONCLUSION: The results suggest that specific aspects of lifestyle, such as physical health, accident prevention, and avoidance of medication are associated with cognitive function in older adults. Consequently, lifestyle promotion programs may enhance cognitive function and improve the quality of life among older adults.

Suicidal ideation, attempt and associated factors among prisoners in Northwest Ethiopia: A cross-sectional study.

BACKGROUND: Suicide is a prominent source of harm and death globally, and it is the leading cause of premature death among prisoners. Therefore, the main aim of this study was to determine the prevalence and factors associated with suicidal ideation and attempt among prisoners in Northwest Ethiopia. METHODS: An institution-based cross-sectional study design was performed from May 23 to June 22, 2022. After proportional allocation to the three correctional institutions, a total of 788 study participants were randomly recruited. The World Health Organization Composite International Diagnostic Interview (CIDI) was used to evaluate suicide ideation and attempt. To determine factors associated with suicidal ideation and attempt, multivariate logistic regression analyses were conducted. At a 95% confidence interval (CI) of P-value <0.05, statistical significance was declared. RESULTS: The prevalence of suicidal ideation and attempt among prisoners was 23.6% and 10.7%, with 95% CI (20.76, 26.70) and (8.68, 13.02), respectively. Female sex (AOR = 2.38, 95% CI: 1.12, 5.05), family history of mental illness (AOR = 3.09, 95% CI: 1.93, 4.88), depression (AOR = 2.04, 95% CI: 1.43, 2.98), poor social support (AOR = 2.76, 95% CI: 1.56, 4.85) and previous incarceration (AOR = 1.84, 95% CI: 1.18, 2.86) were significantly associated with suicidal ideation. However, being single (AOR = 2.58, 95% CI: 1.47, 4.54), family history of suicide (AOR = 2.43, 95% CI: 1.18, 5.01), depression (AOR = 2.62, 95% CI: 1.59, 4.31) and previous imprisonments (AOR = 2.11, 95% CI: 1.20, 3.69) were associated with suicidal attempt. CONCLUSIONS: The prevalence of suicidal ideation and attempt among prisoners were found to be high. Therefore, the findings of this study recommend that early detection and design of prison mental health services should be delivered to develop mental health care, prevention, and intervention programs for incarcerated people to improve suicidal behavior in prison.

Sleep and circadian rhythms in adolescents with attempted suicide.

Sleep and circadian rhythm disorders are very common in adolescents and have been linked to suicidal ideation. However, little is known about adolescent sleep before a suicide attempt (SA). The objectives of this study were to compare the sleep of adolescents aged 13 to 18 over a period of 4 weeks before a SA compared to a non-SA group, then to analyze the association between sleep, support social and well-being based on information from validated questionnaires. In 2015, 250 adolescents were included, 55 were recruited the day after a SA in French hospitals (before SA evaluations were retrospective). Logistic regression analyzes showed that during school days, bedtime was equivalent in both groups, but sleep onset latency was significantly longer in SA (86 min vs. 52 min, p = 0.016), and wake-up time was earlier (6 h 22 vs. 6 h 47, p = 0.002), resulting in a shorter total sleep time of 44 min (OR = 0.76, CI 95% [0.61-0.93]) the month preceding SA. Adolescents with longer sleep time performed better on perceived psychological well-being (p = 0.005), relationship with parents (p = 0.011) and school environment (p < 0.001). Results indicate a significant change in the quantity and quality of adolescents' subjective sleep in the 4 weeks preceding SA requiring objective measures to study the predictive properties of sleep in SA.

Psychotropic medicine use without current or prior medical advice, storage at home and association with perceived stress in a primary health care setting in Greece / Uso de medicamentos psicotrópicos sin consejo médico actual o previo, almacenamiento en el hogar y asociación con estrés percibido en un entorno de atención primaria en Grecia

Objective: Psychotropic medicines use alters according to socio-economic factors and perceived stress. The study aimed to assess the prevalence of use of psychotropic medicines and supplements (PMS) without medical advice, including storage at home, and its relationship with socio-demographic characteristics and perceived stress in primary care patients. Materials and methods: A cross-sectional sample of adult attendees in an urban primary care unit in Crete, Greece, were surveyed during regularly scheduled appointments during a three-week period in October 2020. A questionnaire was distributed to investigate PMS use during the last 12 months. The validated Greek version of Perceived Stress Scale (PSS-14) was adopted to measure perceived stress. Results: Of 263 respondents (mean age 46.3±14.5 years; 66.5% females), 101 (38.4%; 95%CI 33.1–43.7%) recalled having psychotropic medicines stored at home cabinets and 72 (27.4%; 95%CI 22.4–32.3%) reported using PMS without medical advice in the last 12 months. Conclusions: This study revealed a high prevalence of PMS use without medical advice, including storage at home. People>59 years of age, experiencing irregular sleep and scoring high in PSS, displayed increased prevalence of storing PMS at home or using them without medical advice. The findings could potentially inform primary care providers to focus on patients most likely to be users of PMS without medical advice.(AU)

Objetivo: El uso de medicamentos psicotrópicos cambia según los factores socioeconómicos y el estrés percibido. El estudio tuvo como objetivo evaluar la prevalencia de uso de medicamentos y suplementos psicotrópicos (MSP) sin consejo médico, incluido el almacenamiento en el hogar y su relación con las características sociodemográficas y el estrés inferido en pacientes de atención primaria. Materiales y métodos: Se encuestó a una muestra transversal de asistentes adultos en una Unidad de Atención Primaria Urbana en Crete, Grecia, durante citas programadas regularmente durante un periodo de tres semanas en Octubre de 2020. Se distribuyó un cuestionario para investigar el uso de MSP durante los últimos 12 meses. Se adoptó la versión griega validada de la Escala de Estrés Percibido (Perceived Stress Scale 14, PSS-14) para medir el estrés percibido. Resultado: De 263 encuestados (edad media 46,3 ± 14,5 años; 66,5% mujeres), 101 (38,4%; IC 95%; 33,1-43,7%) recordaban tener medicamentos psicotrópicos almacenados en los armarios de sus casas y 72 (27,4%; IC 95%; 22,4-32,3%) informó haber usado MSP sin consejo médico en los últimos 12 meses. Conclusiones: Este estudio reveló una alta prevalencia de uso de MSP sin consejo médico, incluido el almacenamiento en el hogar. Las personas mayores de 59 años, que experimentaron sueño irregular y puntuaron alto en PSS, mostraron una mayor prevalencia de almacenar MSP en casa o usarlos sin consejo médico. Los hallazgos podrían informar potencialmente a los proveedores de atención primaria para que se centren en los pacientes con mayor probabilidad de usar MSP sin consejo médico.(AU)

The effectiveness of digital psychosocial interventions on psychological distress, depression, anxiety, and health-related quality of life in patients with gynaecological cancer: a systematic review and meta-analysis.

PURPOSE: Patients with gynaecological cancer often experience psychological issues due to multiple stressors. Psychological disturbances have debilitating effects on patients with gynaecological cancer. In recent decades, digital psychosocial interventions have rapidly advanced and been incorporated into mental health interventions. Digital psychosocial interventions could provide patients with several benefits over traditional in-person interventions, including convenience, anonymity, flexible scheduling, and geographic mobility. The aim of this systematic review was to synthesize the effectiveness of digital psychosocial intervention in reducing psychological distress, depression, and anxiety and improving health-related quality of life in patients with gynaecological cancer. METHODS: Three-step extensive search was performed on 22 December 2022 from nine bibliographic databases, trial registries and grey literature. Experimental studies involving patients with gynaecological cancer utilizing digital psychosocial interventions for the improvement of mental health outcomes were included. Meta-analysis was conducted using RevMan 5.4 software. Heterogeneity was analysed by Cochran's Q test and I2. Subgroup analyses were attempted to evaluate relative effect sizes of subgroup features. RESULTS: Meta-analysis of nine studies revealed small effect size in reduction of depression post-intervention (d = 0.24, 95% CI - 0.46 to - 0.02) and medium effect size in reduction of psychological distress post-intervention (d = 0.51, 95% CI - 0.81 to - 0.21) and follow-up (d = 0.65, 95% CI - 1.25 to - 0.05) compared to the control group. The effects of digital psychosocial interventions on anxiety and health-related quality of life were not statistically significant. CONCLUSIONS: Digital psychosocial interventions probably reduced psychological distress and slightly reduced depression amongst patients with gynaecological cancer compared to the control group, which can be integrated into clinical practice. Additional trials with rigorous methodology and bigger sample sizes are needed to validate findings. TRIAL REGISTRATION: PROSPERO (CRD42023389502).

Religious leaders' perceptions of the identification and referral of people with mental health problems in a Peruvian city.

INTRODUCTION: Religious leaders have the potential to play a significant role in the identification and referral of individuals with mental health problems. OBJECTIVE: This study sought to understand the perceptions of religious leaders in regards to identifying and referring parishioners with mental health issues to healthcare professionals, in Chimbote, Peru. METHODS: We performed a cross-sectional study that covered religious leaders of different religious groups in Chimbote. The leaders completed a survey that assessed their characteristics, past experiences of detecting and referring those with mental health problems to healthcare professionals, and perceptions of four clinical cases (for which we used the Clergy's Perception of Mental Illness Survey instrument). RESULTS: We included 109 religious' leaders of four religious groups (11 Catholics, 70 Evangelicals, 21 Mormons, and 7 Adventists). Of these, 50.5% had received at least one request for help with mental health issues from a parishioner in the previous month, over 85% expressed a desire for training in identifying mental health problems, and 22-30% reported receiving any training. While the majority of leaders were able to correctly identify cases of depression, alcohol dependence, and drug problems, only 62% correctly classified a case of schizophrenia. Despite this, 80% stated that they would refer their parishioners to healthcare professionals. CONCLUSION: Parishioners tend to consult their religious leaders regarding their mental health and approximately 80% stated they would refer such cases to a healthcare professional. However, less than one-third of the leaders had received training to detect mental health problems. These results suggest that there is a need for training programs to improve the ability of religious leaders to identify and refer individuals with mental health issues.

Psychosocial interventions for childhood cancer survivors: Systematic review and meta-analysis of randomized control trials.

PURPOSE: This study was aimed to review and analyze the evidence of the psychosocial interventions for survivors of childhood cancer. METHODS: Electronic databases (PubMed, Embase, Medline, Web of Science, Science Direct, and Scopus) and manuel search were performed for psychosocial randomised controlled trials (RCTs) conducted with survivors who were diagnosed under the age of 18 and have completed treatment. Meta-analyses were performed to evaluate the effects of interventions on psychosocial health outcomes. The trials were published in English between 1 January 2000 to 30 June 2022 were included. Extracted data were analyzed using Review Manager 5.4. RESULTS: Ten trials conducted with 955 childhood cancer survivors were included in the systematic review. Meta-analysis of six RCTs showed no difference in the general quality of life (SMD, 0.07; 95% CI: [-0.09 to 0.23], I2 0%, (p > 0.05)) and three RCTs showed no difference in the physical activity self-efficacy (SMD, 0.12; 95% CI: [-0.35 to 0.58], I2 75%, (p > 0.05)) between intervention and control group. Interventions longer than 24 weeks (including follow-up) were effective in the quality of life and physical activity self-efficacy of the survivors. The overall quality of the evidence was low due to overall low risk of bias for only half of the studies (50%). CONCLUSIONS: Psychosocial interventions were not effective on quality of life and physical activity self-efficacy of childhood cancer survivors, however, long-term interventions provided improvement in these outcomes. REGISTRATION: The protocol for the meta-analysis was registered at PROSPERO (CRD42022375053/22 Nov 2022).

Home-based Intervention with Semaglutide Treatment of Neuroleptic-Related Prediabetes (HISTORI): protocol describing a prospective, randomised, placebo controlled and double-blinded multicentre trial.

INTRODUCTION: Subjects with schizophrenia have a 2-3 fold higher mortality rate than the general population and a reduced life expectancy of 10-20 years. Approximately one-third of this excess mortality has been attributed to obesity-related type 2 diabetes (T2D) and to cardiovascular disease. Glucagon-like peptide-1 (GLP-1) analogues increase satiety and delay gastric emptying, thereby reducing food intake and weight. GLP-1 analogues also exert beneficial effects on cardiovascular outcomes in high-risk patients with T2D.Our aim is to investigate whether 30 weeks add-on treatment with the GLP-1 analogue semaglutide can reduce HbA1c sufficiently to reverse pre-diabetes and the metabolic syndrome in overweight schizophrenic patients. METHODS AND ANALYSIS: We will perform a 30 week, two-armed, multicentre, superiority, double-blinded, randomised trial investigating the effect of weekly injections of semaglutide versus placebo in mental health facilities in Region of Southern Denmark and Region of Zealand, Denmark. In total, 154 adults with schizophrenia spectrum disease, aged 18-60 years treated with second generation antipsychotic treatment, HbA1c 39-47 mmol/mol and body mass index >27 kg/m2 will be randomised to injections of 1.0 mg semaglutide or placebo. The primary outcome is changes in HbA1c. Secondary outcomes encompass metabolic measures, psychotic symptoms and quality of life. Exploratory outcomes encompass insulin sensitivity, cardiovascular risk profile, medication adherence, general well-being and physical activity. ETHICS AND DISSEMINATION: This study will be carried out in accordance with the Declaration of Helsinki and Good Clinical Practice guidelines. This research has obtained approval from both the Danish Medicines Agency and The Regional Committees on Health Research Ethics for Southern Denmark. TRIAL REGISTRATION NUMBER: NCT05193578 European Clinical Trials Database Number (EudraCT) 2020-004374-22, Regional Ethical Committee number S-20200182.