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Introduction: Contact with pets within healthcare settings is considered worldwide an added value to assistance both in the case of animal-assisted interventions and also when pets are visiting hospitalized owners, due to the special emotional relationship between them and their pets. The goal of this work was to analyze local experiences on access of pets to healthcare facilities using a survey sent to doctors, veterinarians, and students in the region of Sardinia (Italy)., Methods: The online survey consisted of 17 questions, with the objective to evaluate knowledge and interest of study participants on some aspects of human-animal interaction with particular reference to potential access of pets to hospitals facilities and nursing homes and to promote an initial social judgment in the medical and healthcare environment. A total of 2484 subjects were invited to participate to the survey through an email explaining the purpose of the study. Statistical analysis on the survey results was conducted by comparing the characteristics of respondents with their answers to animal-assisted-intervention-related questions., Results: Results showed that over 70% of the participants owned an animal; almost 80% of responses showed that survey participants were in favor of animal presence in hospitals; furthermore, the responses showed how the concept of One Health seems not only scarcely established, but also barely known. The large majority of respondents (over 80%) positively responded on questions around the role of animals as co-therapists., Conclusions: On the one hand, this study showed lack of knowledge on the concept of One Health, whose essence is too often unknown and, on the other hand, it confirmed that women may be more inclined to show empathy and sensitivity toward animals. Regarding the profession, students seem more concerned about the introduction of animals into hospitals than healthcare workers., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

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The aim of the study was to explore the clinical significance of school refusal behavior, its negative impact on psychological well-being of children and adolescents and its relationship with the most common psychopathological conditions during childhood and adolescence (e.g. neurodevelopmental disorders, psychiatric disorders). School refusal behavior refers to a distressing condition experienced by children and adolescents that compromise regular school attendance and determine negative consequences on mental health and adaptive functioning. A narrative review of the literature published between January 2019 and March 2023 was conducted. Ten studies (n = 10) were included from a literature search of the electronic databases PubMed, CINAHL, PsycInfo, MedLine, and Cochrane Library. The results indicate that school refusal is highly present in neurodevelopmental disorders such as autism and attention-deficit/hyperactivity disorder due to the presence of behavioral problems and deficits in communication skills. As for psychiatric disorders, school refusal appears to be highly common in anxiety disorders, depressive disorders, and somatic symptoms. We also found that school refusal behavior may be associated with various emotional and behavioral conditions that act as risk factors. Especially, but are not limited to, it may be associated with a diminished self-concept, exposure to cyberbullying, specific affective profiles and excessive technology usage. Our results indicate that school refusal is a condition with many clinical facets. It can be attributed to both vulnerability factors, both temperamental and relational, and to various psychopathological conditions that differ significantly from each other, such as neurodevelopmental disorders and psychiatric disorders. Recognizing these aspects can improve the implementation of patient-tailored therapeutic interventions that are consequently more likely to produce effective outcomes. The therapeutic intervention should facilitate the recognition of cognitive biases regarding school as a threatening environment, while regulating negative emotions associated with school attendance. Additionally, therapeutic intervention programs linked to social skill training and problem-solving training, conducted directly within the school setting, can enhance children's abilities to cope with academic performance and social relationships, ultimately preventing school refusal., (© 2024. The Author(s).)

Organic pollutants are an increasing threat for wildlife and humans. Managing their removal is however complicated by the difficulties in predicting degradation rates. In this work, we demonstrate that the complexity of the pollutant profile, the set of co-existing contaminants, is a major driver of biodegradation in wastewater. We built representative assemblages out of one to five common pharmaceuticals (caffeine, atenolol, paracetamol, ibuprofen, and enalapril) selected along a gradient of biodegradability. We followed their individual removal by wastewater microbial communities. The presence of multichemical background pollution was essential for the removal of recalcitrant molecules such as ibuprofen. High-order interactions between multiple pollutants drove removal efficiency. We explain these interactions by shifts in the microbiome, with degradable molecules such as paracetamol enriching species and pathways involved in the removal of several organic pollutants. We conclude that pollutants should be treated as part of a complex system, with emerging pollutants potentially showing cascading effects and offering leverage to promote bioremediation., (© The Author(s) 2024. Published by Oxford University Press on behalf of the International Society for Microbial Ecology.)

Pharmaceuticals are of concern to our planet and health as they can accumulate in the environment. The impact of these biologically active compounds on ecosystems is hard to predict, and information on their biodegradation is necessary to establish sound risk assessment. Microbial communities are promising candidates for the biodegradation of pharmaceuticals such as ibuprofen, but little is known yet about their degradation capacity of multiple micropollutants at higher concentrations (100 mg/L). In this work, microbial communities were cultivated in lab-scale membrane bioreactors (MBRs) exposed to increasing concentrations of a mixture of six micropollutants (ibuprofen, diclofenac, enalapril, caffeine, atenolol, paracetamol). Key players of biodegradation were identified using a combinatorial approach of 16S rRNA sequencing and analytics. Microbial community structure changed with increasing pharmaceutical intake (from 1 to 100 mg/L) and reached a steady-state during incubation for 7 weeks on 100 mg/L. HPLC analysis revealed a fluctuating but significant degradation (30-100%) of five pollutants (caffeine, paracetamol, ibuprofen, atenolol, enalapril) by an established and stable microbial community mainly composed of Achromobacter, Cupriavidus, Pseudomonas and Leucobacter. By using the microbial community from MBR1 as inoculum for further batch culture experiments on single micropollutants (400 mg/L substrate, respectively), different active microbial consortia were obtained for each single micropollutant. Microbial genera potentially responsible for degradation of the respective micropollutant were identified, i.e. Pseudomonas sp. and Sphingobacterium sp. for ibuprofen, caffeine and paracetamol, Sphingomonas sp. for atenolol and Klebsiella sp. for enalapril. Our study demonstrates the feasibility of cultivating stable microbial communities capable of degrading simultaneously a mixture of highly concentrated pharmaceuticals in lab-scale MBRs and the identification of microbial genera potentially responsible for the degradation of specific pollutants. KEY POINTS: • Multiple pharmaceuticals were removed by stable microbial communities. • Microbial key players of five main pharmaceuticals were identified., (© 2023. The Author(s).)

Despite significant scientific advances in research on obsessive-compulsive disorder (OCD), the psychological and behavioral symptoms of this pathological condition remain hard to understand, until they seem paradoxical. The present work seeks to consider the significance and potential contribution of a phenomenological reading of OCD and how phenomenalism has influenced some cognitive models of this disorder. Transcendental phenomenology is a philosophical approach that attaches primary importance to intuitive experience and considers all phenomena intrinsically associated with the subject's inner world. Thus, the subject's intuition is considered the starting point for understanding their essential experience. This approach has had a profound influence on modern cognitive sciences. Among current cognitive models, post-rationalist cognitivism and cognitive neuropsychological psychotherapy seem most effective in capturing the world experiences of OCD patients. Both apply a phenomenological approach to identify these experiences, which are typically characterized by hyper-reflexivity, at the expense of 'natural evidence.' The models have found that OCD patients experience the world emotionally as a sterile set of rules, and this experience determines their suffering.

The COVID-19 pandemic had an unprecedented impact on mental health. In particular, the impact on adolescents was likely significant due to vulnerability factors linked to this developmental stage and pre-existing conditions of hardship. The present work aimed at grasping the particular effects of the pandemic on social and cultural aspects of adolescence, providing a cross-sectional picture of this historical moment of contemporary youth culture. Further research is needed to verify the findings.

Although etiological and maintenance cognitive factors have proved effective in predicting the disease course in youths with OCD, their contribution to symptom severity and specific OCD dimensions has been scarcely examined. In a cohort of children and adolescents with OCD (N = 41; mean age = 14; age range = 10-18 yrs.), we investigated whether certain dysfunctional beliefs and cognitive traits could predict symptom severity, and whether they were differentially associated with specific symptom dimensions. We found that self-oriented and socially prescribed perfectionism and intolerance to uncertainty were associated with higher obsession severity, which was not uniquely related to any neuropsychological variable. Greater severity of obsessions and compulsions about harm due to aggression/injury/violence/natural disasters was predicted by excessive concerns with the expectations of other people. Severity in this dimension was additionally predicted by decreasing accuracy in performing a problem-solving, non-verbal reasoning task, which was also a significant predictor of severity of obsessions about symmetry and compulsions to count or order/arrange. Apart from corroborating both the belief-based and neuropsychological models of OCD, our findings substantiate for the first time the specificity of certain dysfunctional beliefs and cognitive traits in two definite symptom dimensions in youth. This bears important clinical implications for developing treatment strategies to deal with unique dysfunctional core beliefs, and possibly for preventing illness chronicity.

Background and Hypothesis: "Ultra-high risk" for psychosis young adults are assumed to be at higher risk of developing a psychotic spectrum disorder. Predominantly, the ultrahigh-risk population is aged 18-35 years, but it may also include younger children and adolescents. Individuals in this population experience psychosis prodromes in the form of attenuated or brief psychotic symptoms (particularly perceptual abnormalities). Albeit diagnosis is made via structured interviews, such measures fail to sufficiently assess the precise form and content of perceptual abnormalities, especially as they manifest in children and adolescents., Study Design: The present study involved a systematic review of the literature on perceptual abnormalities (particularly hallucinations) in ultrahigh-risk children and adolescents., Results: The analysis reviewed five studies and drew conclusions about the perceptual abnormalities (ie, hallucinations) experienced by the study samples, focusing on form, content, and associations with other symptoms. Of note, 2 of the investigated studies suggested a relationship between hallucinations and experiences of childhood trauma., Conclusions: The transition to psychosis and experiences of childhood trauma could correspond to different types of hallucinations in ultrahigh-risk children and adolescents. This knowledge could improve the identification of prodromal states in the young, ultrahigh-risk population., (© The Author(s) 2022. Published by Oxford University Press on behalf of the University of Maryland's school of medicine, Maryland Psychiatric Research Center.)

Orthorexia nervosa (ON) is defined as an exaggerated, obsessive, pathological fixation on healthy food, healthy eating, or health-conscious eating behaviors. In the literature, there is an ongoing debate over whether ON should be considered simply a lifestyle phenomenon or a psychiatric disorder. In this vein, ON seems to share psychopathological characteristics with both eating disorders (EDs) and obsessive-compulsive disorder (OCD). However, there are insufficient data to reconcile the debate. The present study aimed at consolidating evidence on the clinical significance of ON and its relationship with EDs and OCD. A selective review of the literature published between January 2015 and March 2022 was conducted, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Ten studies were included. Some of these studies suggested that ON might follow a full-syndrome DSM-5 ED. Other studies proposed that ON and DSM-5 EDs may co-occur. Finally, only two studies suggested a relationship between ON and OCD. To date, the clinical significance of ON and its relationship with EDs and other DSM-5 psychiatric disorders (e.g., OCD) appears complicated and unclear. Future longitudinal research on the possible clinical course of ON is needed., Competing Interests: The authors declare no conflict of interest.

KBG syndrome (KBGS; OMIM #148050) is a rare disease characterized by short stature, facial dysmorphism, macrodontia of the upper central incisors, skeletal anomalies, and neurodevelopmental disorder/intellectual disability. It is caused by a heterozygous variant or 16q24.3 microdeletions of the ANKRD11 gene (OMIM #611192), which plays a primary role in neuronal development. KBGS traits are variable, and mild expressions of the phenotype may complicate diagnosis. The present work aims at improving the characterization of KBGS in order to facilitate its recognition. A psychopathological evaluation of 17 subjects affected by KBGS found that 10 patients exhibited peculiar behavior related to "paper handling". These children and adolescents performed repetitive activities with paper, reminiscent of the hoarding and ordering behaviors characteristic of obsessive compulsive disorder. Their activities were time consuming and carried out in solitary, and forced interruption could generate intense emotional reactions. Paper handling may thus be understood as a potential distinct KBGS symptom akin to an obsessive compulsive symptom. Further research is needed to verify this claim.

The Strengths and Difficulties Questionnaire (SDQ) is a worldwide questionnaire used for the early identification of behavioural/emotional symptoms in children and adolescents with neuropsychiatric disorders. Although its prognostic power has been studied, it has not yet been tested whether SDQ: (i) can identify pathognomonic symptoms across a variety of neurodevelopmental and neuropsychiatric disorders, (ii) can capture emotional and behavioural problems associated with the main diagnosis, as well as shared transdiagnostic dimensions, and (iii) can detect changes in symptomatology with age. The present study evaluated nearly 1000 children and adolescents overall with Global Developmental Delay (GDD), Intellectual Disability (ID), Language Disorder (LD), Specific Learning Disorder (SLD), Autism Spectrum Disorder (ASD), Attention Deficit/Hyperactivity Disorder (ADHD), Mood Disorder (MD), Anxiety Disorder (AD), and Eating Disorders (ED). We found that SDQ: (i) can identify the core symptoms in children with ASD, ADHD, MD, and AD via specific subscales; (ii) can capture the associated emotional and behavioural symptoms in children with LD, GDD, ID, SLD, and ED; and (iii) can detect changes in the symptomatology, especially for GDD, LD, ASD, ADHD, and AD. SDQ is also able to recognise the transdiagnostic dimensions across disorders. Our results underscore the potential of SDQ to specifically differentiate and identify behavioural/emotional profiles associated with clinical diagnosis.

The Coronavirus Disease 2019 (COVID-19) pandemic had a profound impact on the lifestyles and mental health of young people. It has been hypothesized that the focus on hygiene and the fear of contamination/infection during the pandemic may have exacerbated obsessive-compulsive (OC) symptoms in this population. OC symptoms are widespread in the general population, with varying degrees of intensity. At their most extreme, they manifest in obsessive-compulsive disorder (OCD), which is characterized by obsessive thoughts and compulsive behaviors. The present narrative review aimed at evaluating the relationship between the COVID-19 pandemic and OCD and OC symptoms in young people, especially children and adolescents with and without OCD, focusing on vulnerability and risk factors and the impact of lockdown measures. Of the six studies identified, four examined clinical samples diagnosed with OCD and two looked at community-based adolescent samples. Five of the six studies found that OC symptoms increased during the pandemic. Additionally, vulnerability to anxiety may constitute a risk condition and the lockdown measures and personal stressful life events can constitute potential triggers of OC symptoms, while ongoing treatment for OCD had a protective effect. The results suggest that, during the COVID-19 pandemic, obsessive and compulsive behavior (e.g., hand washing) in young people at the greatest risk should be monitored, and the intervention of mental health services should be maintained. More research is needed in this area.

The metabolism of contemporary industrialized societies, that is their energy and material flows, leads to the overconsumption and waste of natural resources, two factors often disregarded in the global ecological equation. In this Discussion article, we examine the amount of natural resources that is increasingly being consumed and wasted by humanity, and propose solutions to reverse this pattern. Since the beginning of the 20th century, societies, especially from industrialized countries, have been wasting resources in different ways. On one hand, the metabolism of industrial societies relies on non-renewable resources. On the other hand, yearly, we directly waste or mismanage around 78% of the total water withdrawn, 49% of the food produced, 31% of the energy produced, 85% of ores and 26% of non-metallic minerals extracted, respectively. As a consequence, natural resources are getting depleted and ecosystems polluted, leading to irreversible environmental changes, biological loss and social conflicts. To reduce the anthropogenic footprint in the planet, and live in harmony with other species and ourselves, we suggest to shift the current economic model based on infinite growth and reduce inequality between and within countries, following a degrowth strategy in industrialized countries. Public education to reduce superfluous consumption is also necessary. In addition, we propose a set of technological strategies to improve the management of natural resources towards circular economies that, like ecosystems, rely only upon renewable resources., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 The Authors. Published by Elsevier B.V. All rights reserved.)

The social and environmental failure of successive Western development models imposed on the global South has led local communities to pursue alternatives to development. Such alternatives seek radical societal transformations that require the production of new knowledge, practices, technologies, and institutions that are effective to achieve more just and sustainable societies. We may think of such a production as innovation driven by social movements, organizations, collectives, indigenous peoples, and local communities. Innovation that is driven by such grassroots groups has been theorized in the academic literature as "grassroots innovation". However, research on alternatives to development has rarely examined innovation using grassroots innovation as an analytical framework. Here, we assess how grassroots innovation may contribute to building alternatives to development using Zapatismo in Chiapas (Mexico) as a case study. We focus on grassroots innovation in autonomous Zapatista education because this alternative to formal education plays a vital role in knowledge generation and the production of new social practices within Zapatista communities, which underpin the radical societal transformation being built by Zapatismo. We reviewed the academic literature on grassroots innovation as well as gray literature and audiovisual media on Zapatismo and autonomous Zapatista education. We also conducted ethnographic fieldwork in a Zapatista community and its school. We found innovative educational, pedagogical, and teaching-learning practices based on the (re)production of knowledge and learning, which are not limited to the classroom but linked to all the activities of Zapatistas. Our findings suggest that innovation self-realized by Zapatistas plays a key role on the everyday construction of Zapatismo. Therefore, we argue that a specific theoretical framework of grassroots innovation for the pluriverse, based on empirical work carried out in different alternatives to development, is an urgent task that will contribute to a better understanding of how such alternatives grassroots groups imagine, design, and build, particularly across the global South., (© The Author(s), under exclusive licence to Springer Japan KK, part of Springer Nature 2022.)

Obsessive-compulsive disorder (OCD) is a neuropsychiatric disorder that is frequently diagnosed in children and adolescents. In pediatric OCD, family plays an important role in the development and maintenance of the disease. In this relationship, both genetic and behavioral factors, such as parental modeling and family accommodation, are significant. Parental modeling concerns the daily enactment of dysfunctional behavioral patterns by a parent with OCD, which may influence children. Family accommodation, in contrast, describes the direct participation of parents in their child's compulsive rituals, by modifying daily routines or by facilitating avoidance of OCD triggers, to decrease the child's distress and time spent executing compulsions. Approximately 80-90% of the relatives of OCD patients actively participate in patients' rituals. The literature demonstrates that a high level of family accommodation is associated with OCD symptom severity, reduced response to cognitive-behavioral treatment (CBT), and a higher risk of therapy dropout.Despite this, no studies have aimed at delineating practical guidance for psychotherapists to support parents in reducing family accommodation.The main aim of this paper is to propose a psychoeducation intervention focused on cognitive-behavioral strategies to help families to manage their child's OCD behaviors without enacting dysfunctional family accommodation behaviors in order to support their child's successful therapy., (© 2021. The Author(s).)