This study aimed to develop consensus-based recommendations for improving the transition of care for young adults with Attention-deficit/hyperactivity disorder (ADHD) from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS) in Italy. A modified Delphi consensus method was employed, involving 27 stakeholders, including child psychiatrists, psychiatrists, psychologists, primary care physicians, young adults with ADHD, and parents. Recommendations were drafted by combining data from prior phases of the Transition in young adults with Diabetes, Epilepsy, and ADHD (TransiDEA) project and international guidelines (e.g., NICE, Ready Steady Go). Stakeholders evaluated 33 proposed recommendations across two rounds, rating their relevance and feasibility. Consensus was defined as ≥ 75% agreement per item. Consensus was achieved on 22 recommendations organized into four categories: planning (14 items), passage (4 items), monitoring (1 item), and services (3 items). Key recommendations included starting transition planning at age 16, involving families and interdepartmental teams, implementing practical tools for information exchange, and monitoring young adults outcomes post-transition. Training for clinicians and service self-assessment were emphasized to address systemic barriers. The final shared recommendations integrate multiple perspectives and international best practices and provide a structured, adaptable framework for improving ADHD care transitions in Italy. Future efforts should evaluate their implementation and expand the methodology to other neurodevelopmental conditions.

The aim of this study was to estimate the impact of deaths of despair (DoD) on life expectancy at birth and by sex in Brazil in 2019, as well as the contribution of different age groups to this loss.

We used life tables from the Brazilian Institute of Geography and Statistics and cause-specific mortality data by age and sex from the Mortality Information System. A cause-deleted life table methodology was applied, assuming independence between DoD and other causes of death. The difference in life expectancy with and without DoD was decomposed by age using Arriaga's method. DoD included deaths from suicide, intentional or accidental poisoning, and mental and behavioral disorders due to substance use.

In 2019, there were 23,391 DoD in Brazil (1.73% of all deaths), 89% of which were due to suicide. Removing these deaths would increase life expectancy by 0.43 years for men and 0.12 years for women, with men experiencing a 3.5 times greater impact. The 35-49 age group had the highest relative contribution, especially among men, where DoD accounted for up to 9.7% of the loss in life expectancy. The impact was more concentrated and earlier in men and more diffuse among women.

Although lower in absolute numbers, DoD have a measurable impact on life expectancy, especially among young men. These findings highlight the need for public policies focused on suicide prevention and addressing the social determinants that sustain despair.

Artificial intelligence (AI) is the simulation of human intelligence by machines, especially computer systems. It includes learning, reasoning, and problem-solving. Chatbots are AI-powered programs that simulates human conversation. This paper explores the growing role of AI, particularly chatbots, in the field of mental health.

This review article is based on professional and scientific literature as the research method. The literature search was conducted using databases such as Google Scholar, PubMed, Scopus, and Web of Science that met the inclusion criteria.

The findings of this review suggest that chatbots, as AI-powered tools, provide continuous emotional support and can improve access to mental health support. They are particularly useful between therapy sessions and in crisis situations. Still, AI cannot replace human therapists. There are some ethical concerns, including misinformation and privacy risks.

It is highly likely that AI has a bright future in mental health care. A balanced and well-regulated approach is essential for understanding how chatbots work: we can use them in an informed and rational way.

This study investigated the phenomenology of tics in adults with primary tic disorders (Tourette syndrome, persistent motor or phonic tic disorders) and how these features are influenced by sex. It also examined the prevalence of comorbid psychiatric conditions and psychotropic medication use.

A cross-sectional study was conducted on 227 adults with primary tic disorders from the Calgary and Paris Adult Tic Registry. Data collected included demographics, tic characteristics (using the Yale Global Tic Severity Scale), psychiatric comorbidities, and medication use. Statistical analyses were performed to compare data between sexes.

The sex ratio was 1.8 males to 1 female. The most common motor tics were simple (eye blinking, simple head movements), and the most common phonic tic was throat clearing. There were no significant sex differences in tic phenomenology or severity. Generalized anxiety disorder (49.5%) and attention deficit hyperactivity disorder (ADHD) (35.8%) were the most common comorbidities. A lower proportion of women were diagnosed with ADHD, while a higher proportion were diagnosed with obsessive compulsive disorder.

The male predominance of tic disorders is less marked in adulthood compared to childhood. Tic phenomenology and severity do not significantly differ between sexes. These findings provide valuable insights into the clinical presentation of tic disorders in adults. Future research will explore severity of comorbid mental health conditions, how these influence tic severity, treatment outcomes and quality of life.

During catastrophes, physicians face significant stress and emotional challenges. This review explored existing evidence about the challenges family physicians face during infectious catastrophes, and their perceived well-being needs.

We conducted a mixed studies literature review using 2 databases, Ovid MEDLINE ALL (1946 to February 2023) and PsycInfo on Ovid (1806 to February 2023). To assess methodological quality, we used Mixed Methods Appraisal Tool. The extracted data were analyzed employing a data-based convergent mixed methods design.

Thirty-four (34) studies met the criteria for data extraction. Line-by-line coding for thematic analysis was applied to Result and Discussion sections of included articles. Findings were categorized into 4 levels: Societal, Institutional, Organizational, and Individual. Seven themes were identified in total.

Public health authorities should focus on systemic changes, including organizational development to improve coordination within and across organizations. Clinician involvement in decision-making, clear communication, mental health support, and adequate resources are crucial. Policy implications underscore the necessity for healthcare policies prioritizing physician well-being, and organizational support during infectious catastrophes. Improving work conditions extends beyond personal protective equipment (PPE) access, requiring swift betterment of service innovations, with ongoing reassessment for sustainable care planning, financing, and delivery beyond emergencies.

The general public is largely aware of meditation, and there is compelling evidence the practice has health benefits. But many people who are aware of meditation have not tried it, and those who do often struggle to establish a regular practice. The barriers to meditation are generally understood and include a lack of knowledge, a lack of time, and unclear benefits. These barriers present an impediment to self-efficacy in establishing a meditation practice. Despite these challenges, current strategies for promoting meditation may fail to address these barriers, leaving a gap in our knowledge about health communication efforts aimed at fostering meditation practices.

The objective of this research is to leverage a large-scale, real-world digital platform to understand whether breaking down the theory-based barriers to meditation can serve as an effective strategy for encouraging meditation.

This research is a digital messaging-based experiment that includes approximately 1.33 million people, aged 18 years and older, in the United States. The experiment was conducted on the Spotify mobile app and includes 1 control condition and 4 test conditions. Each of the test conditions was a message that attempted to address a specific barrier to meditation. The control message only included the call-to-action without any theory-based messaging accompaniment. When users clicked the message, they were redirected to meditation content. The click-through rate and the activation rate of each message were the dependent variables in the experiment.

The most effective message, which was designed to break down the pragmatic barriers to meditation, had a click-through rate odds ratio (OR) of 1.57 (95% CI 1.52-1.62) and an activation rate OR of 1.55 (95% CI 1.45-1.65), relative to the control. The least effective, which was designed to break down knowledge barriers, had a click-through rate OR of 0.91 (95% CI 0.88-0.94) and an activation rate OR of 0.66 (95% CI 0.61-0.71), compared to the control. After 7 days, the differences in people's engagement with the meditation content itself between experimental conditions had substantively diminished.

Theory-driven messaging can potentially encourage people to explore meditation content, but not universally so, given 2 of the experimental conditions performed better than and 2 performed worse than the control. The most successful message broke down the barrier that meditation requires being alone and in a quiet place. Addressing this barrier may have boosted self-efficacy by aligning the practice with everyday settings that fit into people's busy lifestyles. Future researchers might consider how to encourage people to engage in meditation during their daily activities. In addition, breaking down the barriers to meditation through messaging can drive interest and experimentation with meditation content, but may not be enough to compel meaningful behavior change.

As healthcare providers address the growing child and adolescent mental health (CAMH) crisis, the need for population-specific curriculum has increased. This need is especially pressing in military contexts, where service members face distinct stressors that impact the mental health of children and adolescents. In response, we developed and revised our CAMH course for Psychiatric Mental Health Nurse Practitioner (PMHNP) tri-service students. This project aimed to redesign said course with a focus on enhancing higher-order cognitive skills and preclinical readiness, ensuring that future providers are better equipped to meet the complex demands of CAMH care in military and civilian settings.

This project involved a comprehensive approach to course redesign, including the use of a pre- and post-test. To achieve the course redesign, we conducted a review of all PMHNP courses containing CAMH content. This involved creating a comprehensive matrix that mapped course objectives to all assessments. The redesign was guided by Bloom's taxonomy and Miller's clinical competence pyramid and delivered to PMHNP tri-service students in summer 2023. Participating students were asked to complete a post-course evaluation with items related to preparedness and confidence in managing CAMH.

The revised CAMH course was successfully implemented, and post-course evaluations were completed by 12 students (100% response rate). Evaluations indicated that students reported an increased sense of preparedness and confidence in delivering evidence-based mental health treatment. These results suggest that the redesign effectively enhanced students' higher-order cognitive skills and their self-evaluation of preparedness for clinicals.

The integration of the redesigned CAMH course into the PMHNP curriculum demonstrates its potential to enhance population-specific education before clinical rotations. By focusing on higher-order cognitive skills and aligning with competencies, the course supports the development of well-prepared nurse practitioners capable of meeting the complex needs of this population.

This study addresses a gap in understanding the relationship between eco-emotions, mental health and pro-climate actions among adolescents living in rural Australia. A mixed methods approach was used to triangulate survey data (N = 145, mean age = 13.09 years, SD = 0.73) and photo-elicitation focus groups (n = 21, mean age = 12.95 years, SD = 0.58). Bivariate and moderation analyses of the survey revealed that a stronger connection to nature moderated the relationship between eco-anger and mental ill-health symptoms and pro-climate actions, respectively. Thematic analysis of the focus group data provided deeper insights, showing that participants with a connection to nature felt a sense of responsibility and willingness to engage in pro-climate actions. Triangulation of the data revealed a gap between awareness and action. While survey data indicated low levels of individual and collective action, qualitative findings provided an explanation that although many participants expressed a desire to be involved in climate action, they identified a need for more practical support and guidance from adults. The study provides insights into the need for practical, targeted interventions that support mental health and encourage constructive climate-related behaviours, particularly by leveraging the protective role of connectedness to nature.

Probiotics inhibit Helicobacter pylori (H. pylori) growth and alter gut microbiome, in addition to alleviating the side effects of H. pylori eradication. It has also been reported that H. pylori be eradicated after fecal microbiota transplantation in some cases. However, whether probiotics used before H. pylori eradication improves the eradication rate remains unclear. This study evaluates their role through a systematic review and meta-analysis.

We searched PubMed, EMBASE, the Cochrane Library, and the Conference Proceedings Citation Index up to January 31, 2024, to identify randomized controlled studies (RCTs) assessing the efficacy of probiotics used before H. pylori eradication. Meta-analyses of eradication rates were performed.

Twelve eligible RCTs with 2,144 participants were included. The intention-to-treat analysis revealed that the overall eradication rate of H. pylori was higher in the probiotics pretreatment group compared to the control group (80.34% vs. 70.49%), with a risk ratio (RR) of 1.14 (95% CI: 1.08 to 1.19; I² = 36%) and side effects were less (16.0% vs. 28.3%, RR = 0.59, 95% CI 0.41 to 0.84). The per-protocol analysis yielded similar results (86.43% vs. 76.88%, RR = 1.12, 95% CI: 1.08 to 1.17; I² = 57%). Subgroup analyses, considering factors like geographic location, eradication regimens, and probiotic combinations, consistently confirmed the benefits. Finally, probiotics pretreatment durations of 14 days or more, as well as the study designs pre vs. free and pre and combine vs. free, demonstrated significant effects. Shorter durations and other study designs with fewer studies did not show significant effects.

There is moderate to high evidence to suggest that probiotics pretreatment improves H. pylori eradication rate and reduces side effects. These findings highlight the potential value of gut microbiome modulation in H. pylori treatment and offer a new direction for addressing the challenges of antibiotic resistance and treatment failure.

AIM: To investigate team collaboration experiences of the nurses and physicians working in inpatient psychiatry units related to physical restraint practices in Türkiye. METHODS: The present study was conducted in the Adult Psychiatry Inpatient Unit of a university hospital in a province in western Türkiye between May 2022 and January 2023. The study data were collected through 11 individual, face-to-face, semi-structured interviews. The present study has a descriptive qualitative research design. In the analysis of the data obtained from the interviews, the content analysis method was used. RESULTS: Nurses stated that they play a central role in patient observation and initial intervention during escalating behavior. The formal decision to apply physical restraint was legally attributed to physicians. Participants described the physical restraint process as emotionally and physically distressing, emphasizing that clinical experience, clear communication, and teamwork were essential facilitators, while staff shortages and the presence of uninformed patient relatives posed significant barriers. In the study, the following five main themes emerged: "being a part of the process but not taking part in it, staying a step away from it," "another side of psychiatry-an unpleasant practice," "facilitators," "barriers," and "recommendations." CONCLUSION: There are uncertainties in the decision-making and implementation processes of physical restraint. These research results affect patient safety in psychiatric inpatient units providing mental health services.