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Abstract Background Anxiety and depressive disorders typically emerge in adolescence and can be chronic and disabling if not identified and treated early. School-based universal mental health screening may identify young people in need of mental health support and facilitate access to treatment. However, few studies have assessed the potential harms of this approach. This paper examines some of the potential mental health-related harms associated with the universal screening of anxiety and depression administered in Australian secondary schools. Methods A total of 1802 adolescent students from 22 secondary schools in New South Wales, Australia, were cluster randomised (at the school level) to receive either an intensive screening procedure (intervention) or a light touch screening procedure (control). Participants in the intensive screening condition received supervised self-report web-based screening questionnaires for anxiety, depression and suicidality with the follow-up care matched to their symptom severity. Participants in the light touch condition received unsupervised web-based screening for anxiety and depression only, followed by generalised advice on help-seeking. No other care was provided in this condition. Study outcomes included the increased risk of anxiety, depression, psychological distress, decreased risk of help-seeking, increased risk of mental health stigma, determined from measures assessed at baseline, 6 weeks post-baseline, and 12 weeks post-baseline. Differences between groups were analysed using mixed effect models. Results Participants in the intensive screening group were not adversely affected when compared to the light touch screening condition across a range of potential harms. Rather, participants in the intensive screening group were found to have a decreased risk of inhibited help-seeking behaviour compared to the light touch screening condition. Conclusions The intensive screening procedure did not appear to adversely impact adolescents’ mental health relative to the light touch procedure. Future studies should examine other school-based approaches that may be more effective and efficient than universal screening for reducing mental health burden among students. Trial registration Australian and New Zealand Clinical Trials Registry (ACTRN12618001539224) https://anzctr.org.au/Trial/Registration/TrialReview.aspx?id=375821 .

Background: The management of patients with acute pulmonary embolism (aPE) depends on the severity of aPE. The timing of death in various aPE risk subgroups is only partially known. Methods: 1618 patients with an objectively established aPE diagnosis with computed tomography pulmonary angiography enrolled in the regional PE registry were included in the study. According to ESC criteria, patients were stratified at admission to the hospital in four risk strata. The timing of PE-related and non-PE-related deaths was analyzed regarding mortality risk. Results: PE-related, and non-PE-related hospital death rates were 1.1 % and 1.5 % in low, 1.1 % and 4.8 % in intermediate-low, 8.1 % and 5.9 % in intermediate-high, and 27.7 % and 6.9 % in high-risk groups, respectively. The median time of PE-related and non-PE-related death across the PE mortality risk were: 4 (1.7–7.5) and 7.0 (4–14.7) days in low, 1.5 (1.0–9.5) and 11.5 (2.0–21.0) days in intermediate-low, 4.0 (2.0–9.0) and 9.0 (5.7–18.2) days in intermediate-high, 2.0 (1.0–4.75) and 7.0 (3.0–21.2) days in high-risk subgroups. 48.2 % and 17.1 % of patients who died in the high and intermediate-high risks died during the first hospital day. After the 6th hospitalization day, PE-related deaths were recorded in 43.9 % of deaths from intermediate-high and 17.9 % from high-risk subgroups. Conclusion: PE-related mortality is prominent on the first hospitalization day in high and intermediate-high-risk PE. A substantial proportion of intermediate-high and high-risk patient's PE deaths occurred after the first 6 days of hospitalization.

This study analysed whether the assessment of head righting reflex (HRR) in babies immediately after birth can be used in prediction of early child development. In 54 healthy newborns, testing of HRR was conducted on the third day upon birth. The HRR at birth were correlated with balance ability (BA), speech and language development (SLD) and social-emotional behaviour (SEB), on the same sample of children at the age of 5. Children whose HRR was absent or incomplete immediately after birth, later start to sit, stand, walk and talk and that differences are statistically significant (p<0.02, p<0.05, p<0.01 and p<0.01 respectively). Children with better BA (t = 2,32; p<0.02) and SLD (t = 2,33; p<0.02) at the age of 5, had present HRR at birth. Although the HRR reaches its full maturity at the end of the 2nd month of life, its onset immediately after birth could serve as a predictor of early child development.

Prostate cancer surgery has experienced significant progress in recent years, bringing forth innovative treatment options for patients. The article delves into the current controversies surrounding surgical approaches to prostatectomy and the challenges in educating urology residents, as well as provides an overview of notable advancements, including the utilization of robotic-assisted surgery, augmented reality (AR) visualization, and artificial intelligence tools. These cutting-edge technologies hold great promise in enhancing surgical outcomes and improving the quality of life for patients fighting prostate cancer. PEER REVIEWED ARTICLE

In the last two decades, next-generation sequencing (NGS) has facilitated enormous progress in cancer medicine, in both diagnosis and treatment. However, the usefulness of NGS in older cancer patients is unclear. To determine the role of NGS in older cancer patients, we retrospectively assessed demographic, clinicopathologic, and disease-specific data from 100 randomly selected cancer patients (any subtype/stage) who underwent NGS testing in 2020 at our institution and compared the treatment outcomes (progression-free survival [PFS] and overall survival [OS]) in the younger and older patient cohorts (A [n = 34] and B [n = 66]: age < 70 and ≥70 years, respectively). Overall, 27% had targetable mutations, and 8% received NGS-determined targeted therapy (45% and 19% of patients with a targetable mutation in cohorts A and B, respectively; p = 0.2), of whom 38% (3% of the whole cohort) benefited from the therapy (PFS > 6 months). The median OS (from diagnosis) was 192 and 197 weeks in cohorts A and B, respectively (p = 0.08). This pilot study revealed no significant age-stratified difference in the diagnostic approach and treatment strategy. A small, but relevant, proportion of the cohort (3%) benefited from NGS-determined treatment. Nevertheless, older cancer patients with targetable mutations less frequently received targetable therapies. [ABSTRACT FROM AUTHOR]

OBJECTIVES: The objective of this study was to investigate whether there are differences between brain natriuretic peptide (BNP) levels and computed tomography pulmonary angiography (CTPA) parameters, in patients with acute PE, with respect of sex. BACKGROUND: Acute pulmonary embolism (PE) may provoke sudden right ventricle overload and stretching of their thin walls, causing significant raise of BNP blood levels, which correlates to acute PE severity. The properties of RV are different between sexes. METHODS: This retrospective analysis was gained from the data of 1612 PE patients from the regional PE register. The patients have had CTPA verification of PE, with described localization of thrombus masses, as well as the ratio between RV and left ventricle (RV/LV), and BNP as biomarker, measured during the first 24 hours upon admission. RESULTS: Out of 96 male patients with detected central thrombus, 75.0% patients had an increase in BNP level compared to 25.0% patients with normal BNP value (p<0.001). Of the 94 female patients with central thrombus, 85.1% patients had an elevated BNP level, compared to 14.9% patients, with BNP normal values (p<0.001). Of the 135 male patients with RV/LV>1, 79.3% of them, had elevated BNP, compared to 20.7% patients whose BNP level was normal (p<0.001). Out of 123 female patients with RV/LV>1, 91.1% patients had elevated BNP compared to 8.9%, whose BNP was normal (p<0.001). CONCLUSION: Elevated BNP blood level correlates with CTPA parameters, such as the presence of central thrombus and the ratio between right and left ventricles greater than 1, in patients with acute PE, regardless of sex [ABSTRACT FROM AUTHOR]

An increase in the number of children with speech-language pathology also having a genetic disorder imposes the need for speech and language pathologists (SLPs) to have sufficient knowledge about genetic basis of speech-language disorders. Research aim was to estimate in Serbian SLPs different aspects of theoretical and practical knowledge about intercorrelation of genetics and speech and language pathology and to compare obtained results with the results of SLPs in the United States. The questionnaire from Tramontana's study was used in our study. Comparison of the results that obtained in our study with those in Tramontana's study has shown that our study respondents have higher General Knowledge Index (78.6%: 66.2%), higher mean confidence summary score (22.2: 16.7) and higher mean score of 'overall' attitudes about genetics and its relation with communication disorders (20.8: 13.6). Differences which emerge from educational programmes, educational levels and practical experience in the observed groups are indicated as possible causes of differences in the obtained results. On the basis of the obtained results, it may be concluded that it is necessary to elevate SLPs' level of general knowledge about genetics and to acquire their knowledge through clinical practice.

School counsellors play an important role in supporting student mental health but face several challenges that may increase their vulnerability to burnout. This study aimed to explore the factors associated with burnout among school counsellors in secondary schools in New South Wales (NSW), Australia. A crosssectional, online survey was conducted to measure demographics, school counsellor background, school context, school counselling practice, openness towards evidence-based practices, and use of online resources. The fnal sample consisted of the 125 participants who responded they had (n = 65) or had not (n = 60) experienced burnout. Most participants were female (86%), with an average of 9 years' experience (SD = 7.0). Burnout was associated with lower workload manageability, lower satisfaction with school mental healthcare, greater impact of work stress upon wellbeing, and greater frequency of providing care outside of school hours. No other signifcant associations were found. This study reinforces that school counsellors are vulnerable to burnout and that measuring job overload may help to identify those at increased risk. School counsellors may also beneft from additional support for students who require care beyond school hours. Greater awareness about the risks of burnout, coupled with efforts to improve resource allocation within the school setting, may improve school counsellors' sustainability and optimise the mental healthcare available to students.