Early childhood experiences can promote or adversely affect children's development and wellbeing with lifelong impact. The COVID-19 pandemic disrupted children's and families' lives worldwide. It is important to understand the effect on early childhood development. We aimed to examine what is known about the impact of the COVID-19 pandemic, and the related public health measures, on young children's development.

We carried out a mixed-method study which included a scoping review of review-level evidence about early childhood development over the course of the pandemic compared to beforehand and a web-based survey of early childhood development data published in the WHO European Region.

A systematic search of three databases was used to identify studies, published in English, up to November 2024. Findings were synthesised narratively by developmental domain. A web-based search was used to identify, routinely collected, national surveillance child development data in the WHO European Region. To illustrate the potential role of routine surveillance in the timely identification of developmental concerns, trend data from Scotland was examined.

Seven reviews met the inclusion criteria. Most studies examined young children's mental health, while others assessed language development, mother-child bonding, and broader developmental outcomes. Findings were inconsistent, with some studies reporting adverse effects, with others finding no significant changes. There were significant gaps in the availability of national surveillance child development data in WHO European Region countries. Scottish surveillance data identified increases in developmental concerns, which affected disadvantaged groups more.

The available evidence about the effect of the COVID-19 pandemic, and related public health measures, on early childhood development is limited and inconclusive. Strengthening data collection and reporting across the WHO European Region is essential for timely and accurate assessment of developmental outcomes and to guide policy development.

Computer-Based Training for Cognitive Behavioral Therapy (CBT4CBT) is an online intervention for individuals with substance use disorder (SUD).

The aim of this study was: (1) to investigate changes in CBT related skills, quality of life, and SUD severity in adults completing a CBT4CBT intervention, and (2) to explore the participant experience of CBT4CBT in a tertiary hospital specializing in mental health and substance use health in Canada.

Participants included 51 adults seeking treatment for SUD. Participants received access to CBT4CBT over 8 weeks. Measures assessing CBT skills and associated constructs (distress tolerance, change assessment, drug-taking confidence, and change strategies inventory), substance use outcomes, and quality of life were collected at baseline and post-treatment. A qualitative interview was conducted with 26 participants post-treatment. Statistical analysis was conducted using a series of linear mixed effects models examining changes from week 0 to week 8 across all measures.

Significant effects of time were found for SUD symptoms, change strategies, distress tolerance, and quality of life. Qualitative analysis found that participants reported the skills modules on managing triggers and dealing with cravings to be the most helpful. Further, participants found the convenience and relatability of the program scenarios most beneficial. Participants suggested that a live connection to a researcher or a practitioner and some technology enhancements would improve the program.

The results suggest that CBT4CBT is linked with a reduction in SUD symptoms and an increase in CBT skills, including change strategies and distress tolerance, as well as improved quality of life.

The U.S. is one of the only developed countries in the world without a federal requirement that employers provide paid sick leave (PSL) to workers. We evaluated the association between state and local PSL mandates and health care utilization among U.S. workers.

We conducted a cohort analysis using administrative health insurance claims for 2.3 million private sector workers aged 40 to 64 from 2011 through 2019. Difference-in-differences models compared health care utilization before and after PSL mandate enactment between workers in areas with and without mandated PSL coverage. Outcomes included visits to primary care physicians (PCP), specialists, preventive care, diagnostic services, emergency department, urgent care visits, and hospitalizations.

PSL mandates were associated with an increased probability of a past year PCP visit (4.79pp; 95% CI, 1.39-8.19), specialist visit (2.71pp, 95% CI, 0.98-4.44), preventive care visit (2.75pp; 95% CI, -0.36 to 5.86), and outpatient diagnostic visits (2.20pp, 95% CI, 1.21-3.19). PSL mandates were also associated with increases in the average annual number of specialist, preventive care, outpatient diagnostic, and urgent care visits. Estimates were generally larger for those working in industries that have historically maintained low rates of PSL coverage in the U.S.

PSL mandates were associated with greater use of PCP, specialist, diagnostic, and preventive care services. These findings highlight the role for policies that enhance workplace flexibility, including PSL, to improve access to health care services.

The research was supported by grant R01CA237888 from the National Cancer Institute.

For over 40 years, Hearing Voices Groups (HVGs) have provided a space for individuals distressed by hearing voices to share their experiences openly. Most of these groups have existed in the community and adhere to a unique ethos which, at times, may be antithetical to that of mental health services. Recently, HVGs have started to be run within statutory services, including the UK's National Health Service (NHS), raising questions about the practical and ideological barriers and facilitators to their successful implementation.

NHS staff (N = 49) and HVG members (N = 26) took part in a mixed-methods survey aimed at understanding their perspectives on delivering HVGs in the NHS.

Overall, both staff and HVG members expressed enthusiasm for HVGs in the NHS, recognising their role in fostering peer connection, though staff raised concerns about risk management and HVG members questioned whether NHS-run groups could fully uphold HVG ethos.

Whilst HVGs offer a promising user-led approach, further research is needed to understand precisely how to run these types of groups in statutory services.

Background: Anxiety disorders pose a considerable global health challenge, ranking as the most prevalent type of mental illness. This study delineates the trends in incidence, prevalence, and years lived with disability (YLDs) for anxiety disorders at global, regional, and national levels between 1992 and 2021, with an emphasis on the independent effects of age, period, and birth cohort. Methods: Incidence, prevalence, and YLDs were selected as burden indicators of anxiety disorders, following the standardized methodologies of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021, with data presented as numerical counts and age-standardized rates (ASRs) per 100,000 population. An age-period-cohort (APC) model was applied to estimate the overall annual percentage change (net drift), annual percentage change within each age group (local drift), and the relative risks associated with age, period, and cohort. Results: From 1992 to 2021, the global age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR) and age-standardized YLDs rate (ASYR) for anxiety disorders showed an overall increase. The APC model estimated a global net drift of 0.16% (95% confidence interval [CI]: 0.03%, 0.30%) for incidence, 0.07% (95% CI: 0.02%, 0.12%) for prevalence, and 0.07% (95% CI: 0.01%, 0.12%) for YLDs. Regionally, the highest ASIR, ASPR, and ASYR were recorded in the high SDI region in 2021, with the Region of the Americas (AMR) showing the highest rates across all three metrics. Among 204 countries/territories, Portugal, Brazil, Lebanon, Iran, and Paraguay ranked as the top five highest for ASIR, ASPR, and ASYR. The age effects on incidence, prevalence, and YLDs followed similar global and regional patterns, with risk initially increasing before declining in older age. The most substantial increase in the period risk of incidence from 1992 to 2021 occurred in high SDI and AMR countries, while prevalence and YLDs saw the largest rise in low-middle SDI region and AMR. A steady increase in the risk of incidence, prevalence, and YLDs was observed across successive birth cohorts globally and regionally. Conclusion: The global burden of anxiety disorders demonstrated an overall upward trend, with considerable regional, demographic, and temporal variations. These findings provide critical insights for optimizing resource allocation and developing tailored public health strategies to address anxiety disorders.

Alzheimer's disease (AD) is a growing concern worldwide in healthcare. In Ecuador, the increasing life expectancy has raised the prevalence of age-related diseases, including dementias. The main objective of this study was to analyze the mortality from AD and other dementias in Ecuador from 2012 to 2022.

A retrospective, descriptive time series analysis was conducted on adult subjects with AD and other dementias across various geographic regions of Ecuador during the 2012-2022 period. A sample of 855,122 individuals registered in the databases of the National Institute of Statistics and Censuses (INEC) was analyzed.

Out of the total evaluated subjects, 4,836 deaths were due to AD (0.56%) and 1,317 deaths from other types of dementia (0.15%). For AD, the distribution of deaths by sex showed a predominant trend in women (n=3,008) within the group aged 65 years or older (n=4,749). For other dementias, women were also the main group (n=766), along with those aged 65 years and older (n=1,294). The national mortality rate showed an upward trend during this decade, increasing from 2.2 per 100,000 inhabitants in 2012 to 4.86 per 100,000 inhabitants in 2022.

This study reveals a worrying increase in mortality from Alzheimer's disease (AD) and other dementias in Ecuador between 2012 and 2022, especially among women, adults over 65 years of age, and residents of the Sierra region. Several factors that could negatively influence cognitive function were observed. These findings are consistent with global trends and suggest that biological, environmental, and social variables, such as aging, postmenopausal hormonal changes, chronic exposure to hypoxic altitude conditions, and unequal access to health services, could play a key role in this disease.

Mortality from Alzheimer's disease and other dementias in Ecuador showed a sustained increase between 2012 and 2022, reflecting a growing burden of these pathologies in the population and the urgent need to strengthen prevention, early diagnosis, and comprehensive treatment strategies. The disproportionate impact on women, adults over 65 years of age, and residents of the Sierra region suggests the involvement of various biological, environmental, and social determinants of health, which requires more rigorous surveillance and a differentiated approach for these particularly vulnerable populations.

Depression is a major public health issue worldwide, ranking fourth among global diseases in 2022 according to the WHO. In Indonesia, the 2018 Basic Health Research (Riskesdas) reported that over 12 million individuals aged 15 and above suffer from depression. Identifying regional disparities in depression prevalence is essential to guide targeted mental health policies and interventions.

This study employed the Natural Breaks Jenks classification to cluster depression prevalence across Indonesian provinces using data from the 2023 Indonesia Health Survey. This method effectively grouped provinces based on natural data patterns, enabling the identification of regions with low, medium, high, and very high depression prevalence.

The analysis revealed significant regional disparities. Eighteen provinces, including Papua, Maluku, and several Sulawesi regions, were classified as having low depression prevalence. Eleven provinces, such as Aceh, Bali, and Kalimantan Timur, fell into the medium category. Six provinces-including DKI Jakarta, Banten, and Sumatera Selatan-exhibited high prevalence rates, possibly due to urbanization and socio-economic factors. Critically, Jawa Barat, Jawa Tengah, and Jawa Timur were identified as having very high depression prevalence, suggesting urgent needs for intervention.

These findings underscore the need for geographically targeted mental health strategies. Provinces with very high prevalence require prioritized attention for mental health services, infrastructure, and resource allocation. Understanding local socio-economic and cultural contexts will be crucial in reducing disparities and improving national mental health outcomes.

These results indicate that Indonesia has a higher number of provinces with low depression prevalence compared to those with high prevalence. This suggests that while there are regions with lower rates of depression, there are still significant areas where mental health issues need more focused attention. Given this, the government should prioritize provinces with very high depression prevalence to improve mental health outcomes in those areas. By focusing on these regions, the government can better allocate resources, implement targeted interventions, and provide necessary mental health services. Addressing the mental health needs of provinces with high depression rates is essential for reducing overall national mental health disparities and ensuring equitable access to mental health support across Indonesia. Additionally, understanding the socio-economic and cultural factors that contribute to higher depression rates in these regions will be crucial in designing effective and sustainable mental health programs.

Intimate partner violence (IPV), including sexual IPV, is a significant public health issue with serious mental, physical, and economic consequences. Trans women are disproportionately affected by sexual IPV. However, research on factors associated with sexual IPV is limited among trans women. This study seeks to identify factors associated with sexual IPV in a large cohort of trans women in the San Francisco Bay Area.

We conducted a secondary data analysis of data from the Trans*National cohort study (2016-2017), which enrolled 629 trans women via respondent-driven sampling; we conducted bivariate and multivariable logistic regression analyses to examine correlates of lifetime history of sexual IPV.

The prevalence of lifetime sexual IPV was 36%, and bivariate analyses identified several factors associated with sexual IPV, including inconsistent hormone use, non-prescribed hormone use, sex work, polysubstance use, depression, posttraumatic stress disorder, suicidality, homelessness, and discrimination. Multivariable models revealed significant associations between sexual IPV and psychosocial factors, such as substance use, mental health diagnoses, and experiences of violence and discrimination.

These findings are consistent with the substance abuse, violence, and HIV/AIDS syndemic framework, underscoring the interconnectedness of these conditions among trans women. In addition, the findings suggest that disruptions in access to gender-affirming care may be a negative consequence of sexual IPV. These results also highlight the urgent need for integrated approaches to address the mental health, substance use, and HIV prevention needs of trans women who experience sexual IPV. Interventions that address structural discrimination and provide holistic support are necessary to improve the health and wellbeing of trans women survivors of sexual IPV.

One promising solution for improving access to mental health services is integrated behavioral health models, in which behavioral health providers address mental health problems within the primary care infrastructure. Additionally, task-shifting, where non-specialists deliver certain services in the place of specialists, may be well-suited to address mental health provider shortages. The current study outlines the protocol for a hybrid type III implementation-effectiveness, cluster-randomized stepped wedge trial to evaluate the implementation of an adapted pediatric integrated behavioral health model (Peds IBH) that includes task-shifting services, explore the facilitators and barriers to the implementation of Peds IBH, and examine connection to behavioral health care pre- and post-implementation.

The trial will include 25 pediatric primary care clinics across 13 counties in a large healthcare system. Clinics will be randomized to one of three cohorts, stepped in at 6-month intervals, with a 12-month implementation period. The Peds IBH program will: 1) incorporate task-shifting to treat mild to moderate anxiety, depression, and conduct problems with flexible, transdiagnostic cognitive-behavior therapy to be delivered by bachelor's level interventionists, 2) leverage existing child psychiatry provider consultation programs, and 3) increase sustainability through a different billing model. Quantitative data collection will include surveys (primary care team members, behavioral health providers, and youth and caregivers) and tracking of implementation strategies. Qualitative interviews will be conducted with primary care providers and staff.

This trial will evaluate the implementation of the Peds IBH program. While the focus is implementation outcomes, we will assess effectiveness to inform future dissemination efforts.

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This scoping review explores factors that contribute to medical students' burnout and identifies the barriers hindering efforts to address burnout and interventions implemented to improve well-being. This scoping review was conducted using the Arksey and O'Malley York methodology. The Joanna Briggs Institute (JBI) guidelines guided the processes of data extraction, evaluation, and reporting of findings. The most common interventions included peer-mentorship programs (n = 6), well-being curriculum interventions (n = 5), virtual wellness programs (n = 1), exercise-based events (n = 1), fireside chats (n = 1), reflective writing courses (n = 1), and faculty-led life coaching (n = 1). Commonly identified risk factors consisted of failure to nurture personal relationships that support emotional resilience (n = 4), the academic rigors of medical education (n = 4), poor time management (n = 3), and poor financial planning or a high debt burden (n = 3). In summary, these studies demonstrate a diverse range of approaches to improving student wellness as influenced through peer and faculty mentoring, highlighting the importance of intervention frequency, continuity across all stages of medical training, and the value of intimate, informal settings in enhancing faculty and student engagement. Our findings will inform future efforts in improving medical student burnout through the design and implementation of various types of wellness programming and systemic changes in medical education.