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Artificial Intelligence, specifically advanced language models such as ChatGPT, have the potential to revolutionize various aspects of healthcare, medical education, and research. In this narrative review, we evaluate the myriad applications of ChatGPT in diverse healthcare domains. We discuss its potential role in clinical decision-making, exploring how it can assist physicians by providing rapid, data-driven insights for diagnosis and treatment. We review the benefits of ChatGPT in personalized patient care, particularly in geriatric care, medication management, weight loss and nutrition, and physical activity guidance. We further delve into its potential to enhance medical research, through the analysis of large datasets, and the development of novel methodologies. In the realm of medical education, we investigate the utility of ChatGPT as an information retrieval tool and personalized learning resource for medical students and professionals. There are numerous promising applications of ChatGPT that will likely induce paradigm shifts in healthcare practice, education, and research. The use of ChatGPT may come with several benefits in areas such as clinical decision making, geriatric care, medication management, weight loss and nutrition, physical fitness, scientific research, and medical education. Nevertheless, it is important to note that issues surrounding ethics, data privacy, transparency, inaccuracy, and inadequacy persist. Prior to widespread use in medicine, it is imperative to objectively evaluate the impact of ChatGPT in a real-world setting using a risk-based approach. [ABSTRACT FROM AUTHOR]

The quality of the very early emotional experiences in a child's life are recognized today as foundational in the mental health of becoming an adult. Unsurprisingly, clinicians and health authorities agree on the importance of early detection and treatment of any mental health issues experienced by the preschool child. This is even more important and challenging as young children do not yet have the language skills necessary to express their distress. But do the caregivers in charge of these populations have the best tools at their disposal to carry out that important mission in an efficient and scientifically robust manner reflecting the latest research findings and scientific literature? This is the question we try to answer in this paper. We revisited the theoretical underpinnings behind the concept of mentalization as playing a key role in the ability to understand the other's inner reality. We then carried out an extensive review of scientific papers written over the past 30 years on the subject. We examined mental representations of the adult on the child and analyzed those mentalizations as key inputs. We focused on extracting cross analyses of the mentalizations of one child by several adults with different functions in the life of the child. In this process, we used the PRISMA methodology applied to large international medical databases. We found that the qualitative approach, usually associated with a lengthy process, has been overwhelmingly used in trying to assess patients' mental states and to analyze the mentalizations on the patient, adult or child. Furthermore, cross analyses of mentalizations from more than one adult on a given child were almost nonexistent, despite having high epistemic and clinical potential. There is a dearth of reliable quantitative tools, able to capture and analyze the mentalizations on a patient, that are scientifically robust, transposable, and easy to implement in a clinical setting. The absence of such tools for medical professionals in charge of assessing preschool children contributes, in our view, the low detection and poor treatment of mental disorders in that particularly vulnerable population. We believe there is here an urgent unmet need and that such tools should be designed, validated, and deployed into the target populations as early as possible. [ABSTRACT FROM AUTHOR]

Physicians generally recommend that patients resuscitated with naloxone after opioid overdose stay in the emergency department for a period of observation in order to prevent harm from delayed sequelae of opioid toxicity. Patients frequently refuse this period of observation despiteenefit to risk. Healthcare providers are thus confronted with the challenge of how best to protect the patient's interests while also respecting autonomy, including assessing whether the patient is making an autonomous choice to refuse care. Previous studies have shown that physicians have widely divergent approaches to navigating these conflicts. This paper reviews what is known about the effects of opioid use disorder on decision-making, and argues that some subset of these refusals are non-autonomous choices, even when patients appear to have decision making capacity. This conclusion has several implications for how physicians assess and respond to patients refusing medical recommendations after naloxone resuscitation. [ABSTRACT FROM AUTHOR]

Sadly, much of the world is no stranger to Psychological Trauma, particularly in poorer areas with poor health infrastructure. Western Aid Organisations frequently deploy to such areas bringing with them a western psychiatric tradition of nosology and therapy which may not be appropriate in other cultures. We argue that imposing a western system of diagnosis and treatment may not only undermine local culture but may also be bad for the patient. We discuss this with reference to the WHO's Mental Health Gap initiative (MHGap). [ABSTRACT FROM AUTHOR]

The coming years are likely to be turbulent due to a myriad of factors or polycrisis, including an escalation in climate extremes, emerging public health threats, weak productivity, increases in global economic instability and further weakening in the integrity of global democracy. These formidable challenges are not exogenous to the economy but are in some cases generated by the system itself. They can be overcome, but only with far-reaching changes to global economics. Our current socio-economic paradigm is insufficient for addressing these complex challenges, let alone sustaining human development, well-being and happiness. To support the flourishing of the global population in the age of polycrisis, we need a novel, person-centred and collective paradigm. The brain economy leverages insights from neuroscience to provide a novel way of centralising the human contribution to the economy, how the economy in turn shapes our lives and positive feedbacks between the two. The brain economy is primarily based on Brain Capital, an economic asset integrating brain health and brain skills, the social, emotional, and the diversity of cognitive brain resources of individuals and communities. People with healthy brains are essential to navigate increasingly complex systems. Policies and investments that improve brain health and hence citizens' cognitive functions and boost brain performance can increase productivity, stimulate greater creativity and economic dynamism, utilise often underdeveloped intellectual resources, afford social cohesion, and create a more resilient, adaptable and sustainability-engaged population. [ABSTRACT FROM AUTHOR]

Older adults in residential communities face loneliness and isolation, challenges exacerbated by COVID-19, leading to adverse physical and mental health outcomes. Intergenerational arts and humanities programs have been successful in addressing these challenges while also enabling medical learners to better understand aging populations. Draw YOUR Story, a program at a Houston residential senior living community, connects premedical and medical student volunteers with older adults through an art and storytelling activity. To evaluate the program, we conducted a focus group with older adults and pre and post-volunteering student surveys with questions about attitudes towards older adults and an Interpersonal Reactivity Index. Student surveys (n = 18) showed increased comfort working with older adults after volunteering (p = 0.02). Students who spent less time volunteering reported a decline in their perceptions of older adult quality of life, when compared to more frequent volunteers (p = 0.02). Older adults shared that the program encouraged learning new skills, offered time for reflection, connected them to medicine, and furthered desire for community. Draw YOUR Story benefitted students and older adults, increasing student comfort with older adults, providing aging adults opportunities to learn new skills and reflect, and building intergenerational connections. [ABSTRACT FROM AUTHOR]

What does it take to see how autistic people participate in social interactions? And what does it take to support and invite more participation? Western medicine and cognitive science tend to think of autism mainly in terms of social and communicative deficits. But research shows that autistic people can interact with a skill and sophistication that are hard to see when starting from a deficit idea. Research also shows that not only autistic people, but also their non-autistic interaction partners, can have difficulties interacting with each other. To do justice to these findings, we need a different approach to autistic interactions—one that helps everyone see, invite, and support better participation. I introduce such an approach, based on the enactive theory of participatory sense-making and supported by insights from indigenous epistemologies. This approach helps counteract the homogenizing tendencies of the "global mental health" movement, which attempts to erase rather than recognize difference, and often precludes respectful engagements. Based in the lived experiences of people in their socio-cultural-material and interactive contexts, I put forward an engaged—even engag ing —epistemology for understanding how we interact across difference. From this perspective, we see participatory sense-making at work across the scientific, diagnostic, therapeutic, and everyday interactions of autistic and non-autistic people, and how everyone can invite and support more of it. [ABSTRACT FROM AUTHOR]

The perceived social liberalisation of Irish culture over the past ten years has significantly impacted Irish writing, resulting in discussions of formerly tabooed topics like psychosis, menstruation, and infertility. This shift is particularly evident in the recent rise in public interest in creative non-fiction writing. This article examines the rise in popularity of illness narratives: tales of patients' and care-takers' embodied experiences of mental and physical ailments in light of Irish medical-historical developments. Focusing on chapters from recent Irish essay collections by Emilie Pine, Sinéad Gleeson, and Sophie White, this article considers how writing about the gendered experiences of women in Irish medical and mental institutions can shape political action and contribute to the formation of radical new cultures of care. [ABSTRACT FROM AUTHOR]

Burnout is common among physicians; it severely alters their health and has a negative impact on functioning of healthcare systems. Hypertension, increased cortisol levels, maladaptive behaviors with negative social consequences, and suboptimal quality of care have been associated with healthcare providers' burnout. As the number of patients with cancers, psychiatric and neurodegenerative disorders will rise, we need new solutions to maintain physicians' health and, therefore, quality of care. Coping strategies before the COVID-19 pandemic seem ineffective in scaling all the deficits of the global healthcare systems. Examples of new initiatives include new collaborative projects, such as COH-FIT (The Collaborative Outcomes study on Health and Functioning during Infection Times - https://www.coh-fit.com), which aims to collect global data and understand the impact of the COVID-19 pandemic on physical and mental health in order to identify various coping strategies for patients and healthcare workers during infection times, or MEMO (Minimizing Error, Maximizing Outcome), funded by the Agency of Healthcare Research and Quality (AHRQ). Others: i) Rome Foundation GastroPsych undertake efforts dedicated to the science and practice of psychogastroenterology, a burgeoning field with roots in behavioral intervention, cognitive science and experimental psychology focused on fostering the professional growth and collaboration of those engaged in medical practices, or ii) World Gastroenterology Organisation (WGO), Train The Trainers (TTT) program including a new topic of the impact of burnout on career longevity in order to foster strategies for staying healthy and increasing career satisfaction. There is a need for continuous development of digital technologies (e.g. training simulators, telemedicine, robots and artificial intelligence). Their implementation into medical practice is inevitable. Now more than ever, there is a need for a new spirit in healthcare. Together with others in the field, we believe this article is a desperate call for maximizing the use of novel technologies supported by collaborative interactions among healthcare providers and medical professionals of diverse medical fields. [ABSTRACT FROM AUTHOR]

The article comments on gender-affirming care for adolescents and the separation of political polarization from medicine. Trends regarding those who seek care include increase in adolescents asserting a nonbinary identity and who did not have gender-diverse expressions in childhood and inversion in assigned sex-ratio. It emphasize the need to consider factors when making treatment decisions and discusses improvements in psychological well-being, psychosocial functioning and quality of life.

L'accès aux études médicales odontologiques, pharmaceutiques ou de sage-femmes a été ouvert à des candidats n'ayant pas effectué de première année en sciences médicales depuis l'arrêté du 26 mars 1993 abrogé et remplacé par l'arrêté du 26 juillet 2010. Cette procédure « passerelles » relative aux modalités d'admission directe en deuxième ou troisième année d'études a connu différentes modifications jusqu'à aujourd'hui. Le cadre réglementaire prévoit l'accès à ce dispositif, entre autres, aux titulaires du diplôme de Master. Les psychologues (nécessairement détenteurs d'un diplôme de Master) sont éligibles à ces dispositifs permettant l'intégration aux études médicales. Les psychologues intéressés peuvent ainsi envisager la perspective d'une carrière médicale en reprenant leurs études en milieu ou fin de premier cycle universitaire. Dans cet entretien avec Jean-Pierre Bouchard, les psychologues Sarah Thierrée, Josué Masson et Théo Lemonnier échangent autour de leurs expériences. Ils présentent le dispositif, ses apports, ses limites, ainsi que les difficultés et satisfactions qu'ils ont rencontrées en empruntant cette nouvelle voie. Access to medical, pharmaceutical dentistry or midwifery studies has been opened to candidates who have not completed a first year in medical sciences since the decree of March 26, 1993 repealed and replaced by the decree of September 2, 2010. This "gateway" device relating to the procedures for direct admission to the second or third year of studies has been subject to various modifications until the decree of July 29, 2022. The regulatory framework provides for access to this device by holders according to their initial training. Among them is the Master's degree. Thus, psychologists (necessarily holders of a Master's degree) are eligible for these systems allowing integration into medical studies. Psychologists can thus consider the prospect of a medical career by resuming their studies in the middle or at the end of their first university cycle. In this interview with Jean-Pierre Bouchard, psychologists Sarah Thierrée, Josué Masson and Théo Lemonnier discuss their experiences. They present the device, the contributions, the limits, as well as the difficulties and satisfactions they may have encountered during their experience. [ABSTRACT FROM AUTHOR]

The objective of this article is to understand how students' subjectivities are interwoven in the interactions generated in clinical learning settings in medical residencies. The case study method has been used—the result of clinical ethnography—along with narratives to document how social actors do what they do. The results indicate that medical training is a complex phenomenon with a unique institutional and cultural framework marked by hierarchical structures and power relations. The described interactions and experiences reveal the preeminence of hostile spaces for learning, meshed in a hidden curriculum with expressions of violence like gossip, sexual harassment, the stigma of mental illness, and institutional omissions. [ABSTRACT FROM AUTHOR]

Background: Normality is both a descriptive and a normative concept. Undoubtedly, the normal often operates normatively as an exclusionary tool of cultural authority. While it has prominently found its way into the field of medicine, it remains rather unclear in what sense it is used. Thus, our study sought to elucidate people's understanding of normality in medicine and to identify concepts that are linked to it. Methods: Using convenient sampling, we carried out a cross-sectional survey. Since the survey was advertised through social media, we employed an online survey. We performed descriptive and inferential analyses. Predictors were chosen in a theory-driven manner. Results: In total, 323 persons from 21 countries completed the survey. Analysis revealed that the overall acceptance of normality in medicine was associated with notions of injustice, authority, discrimination, and with having a medical profession. More precisely, for the field of mental health, injustice insensitivity, genderism and transphobia, and authority were positively associated with a person's acceptance of normality; and, for the field of physical health, injustice insensitivity and having a medical profession were positively associated with a person's acceptance of normality. Finally, participants' acceptance of the use of normality in the area of mental health was lower than in the area of physical health. Conclusions: What is considered normal has implications for clinical practice, both at an individual and at a policy-level. Acknowledging its normalistic condition, the discipline of medicine has to confront itself with its own contribution to the augmentation of social inequalities through the excessive reliance on the concept of normality. Research that centers the lived experiences of those who are being systematically marginalized because they are deemed abnormal is needed. By empirically elucidating the conceptual relationships between normality in medicine and other variables, we provide points of leverage to deprive normality of its normative power. For medicine, this is needed to first do no harm. [ABSTRACT FROM AUTHOR]

Background: Virtual reality can play an important role during the COVID-19 pandemic in the health care sector. This technology has the potential to supplement the traditional in-hospital medical training and treatment, and may increase access to training and therapies in various health care settings. Objective: This systematic review aimed to describe the literature on health care--targeted virtual reality applications during the COVID-19 crisis. Methods: We conducted a systematic search of the literature on the PsycINFO, Web of Science, and MEDLINE databases, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The search string was as follows: "[(virtual reality)] AND [(COVID-19) OR (coronavirus) OR (SARS-CoV-2) OR (healthcare)]." Papers published in English after December 2019 in peer-reviewed journals were selected and subjected to the inclusion and exclusion criteria. We used the Mixed Methods Appraisal Tool to assess the quality of studies and the risk of bias. Results: Thirty-nine studies met the inclusion criteria. Seventeen studies showed the usefulness of virtual reality during the COVID-19 crisis for reducing stress, anxiety, depression, and pain, and promoting physical activity. Twenty-two studies revealed that virtual reality was a helpful learning and training tool during the COVID-19 crisis in several areas, including emergency medicine, nursing, and pediatrics. This technology was also used as an educational tool for increasing public understanding of the COVID-19 pandemic. Different levels of immersion (ie, immersive and desktop virtual reality), types of head-mounted displays (ie, PC-based, mobile, and standalone), and content (ie, 360° videos and photos, virtual environments, virtual reality video games, and embodied virtual agents) have been successfully used. Virtual reality was helpful in both face-to-face and remote trials. Conclusions: Virtual reality has been applied frequently in medicine during the COVID-19 pandemic, with positive effects for treating several health conditions and for medical education and training. Some barriers need to be overcome for the broader adoption of virtual reality in the health care panorama. [ABSTRACT FROM AUTHOR]

The Global Mental Health (GMH) movement aims to provide urgently needed treatment to those with mental illness, especially in low- and middle-income countries. Due to the complexity of providing mental health services to people from various cultures, there is much debate among GMH advocates regarding the best way to proceed. While biomedical interventions offer some degree of help, complementary approaches should focus on the social/community aspects. Many cultures conduct traditional rituals involving the communal use of psychoactive plants. We propose that these practices should be respected, protected, and promoted as valuable tools with regard to mental health care at the community level. The traditional use of psychoactive plants promotes community engagement and participation, and they are relatively affordable. Furthermore, the worldviews and meaning-making systems of local population are respected. The medical systems surrounding the use of psychoactive plants can be explained in biomedical terms, and many recently published clinical trials have demonstrated their therapeutic potential. Psychoactive plants and associated rituals offer potential benefits as complementary aspects of mental health services. They should be considered as such by international practitioners and advocates of the GMH movement. [ABSTRACT FROM AUTHOR]

The article discusses the findings of a telephone survey conducted between January-June 2022 which aimed to characterize what matters most to older adults in the postacute or skilled nursing facility setting. Topics covered include how responses were separated into 48 statements and grouped into three overarching categories, several themes revealed by each category, and staff competence and professionalism as the most prevalent themes that mattered most to older patients and their caregivers.

To address the second barrier, VHA developed and delivered a 12-h training session on RMH, available virtually to all VHA clinicians. Reproductive mental health needs are prevalent, under-recognized, and under-treated throughout the United States (US).[1] This especially affects the Veterans Health Administration (VHA) as the population of US veterans who are women continues to increase. Learning from the strengths and limitations of these programs and adapting to the needs of VHA, we developed a national RMH Consultation Program to ensure access to RMH expertise across VHA. [Extracted from the article]

Psychosomatic conditions are generally discussed in broad and general terms that are difficult to conceptualize and have neither specific identified etiological factors nor consensus for treatment. This paper was written as a broad overview of psychosomatic conditions in order to provide clarity to the topic. Several databases were searched including Medline and PsychInfo and reference lists from relevant publications. Literature was sought out f or psychosomatic conditions, somatoform disorders, and medical illnesses with psychosomatic components. A general description of psychosomatic conditions and overarching themes were identified which include: lack of a universal definition, poor compatibility between psychological diagnoses and diagnoses outside of psychology, unclear etiology, psychosomatic factors occur in many illnesses, holistic perspective is preferred, poor patient insight regarding symptoms, strong family influence, and pediatric-liaison teams are strongly encouraged in diagnosis and treatment. Treatment is often highly individualized utilizing cognitive behavioral therapy, pharmacotherapy and pediatric-liaison teams with a biopsychosocial focus. [ABSTRACT FROM AUTHOR]

Introduction: Women with pre-existing morbidity arising from medical conditions or previous caesarean section are at higher risk of adverse pregnancy outcomes compared to women without such morbidity. Women often face complex pregnancy-related decision-making that may be characterized by conflicting maternal and perinatal priorities. The aim of this systematic review and meta-analysis was to assess randomised controlled trials of decision aids to evaluate whether they are effective at reducing decisional conflict scores and to evaluate what type of decision aids are most effective for women with pre-existing morbidity in pregnancy.Methods: We searched Medline (via Ovid), Embase (via Ovid), CINAHL (via EBSCO) from the earliest entries until September 2021. We selected randomised controlled trials comparing patient decision aids for women with pre-existing morbidity with usual clinical practice or a control intervention. Study characteristics and Jadad risk of bias was recorded. Meta-analysis by pre-existing morbidity type was performed using Stata 17 and the data was presented with a Forest Plot. Random effects models were used to calculate summary estimates if there was substantial clinical or statistical heterogeneity and post mean DCS scores were described in a sensitivity analysis and presented as a line graph, to improve clinical interpretation of results.. A narrative synthesis of the selected studies evaluated what type of decision aid works and for in what circumstances.Results: Ten randomised controlled trials, which reported data from 4028 women, were included. Patient decision aids were evaluated in women with pre-existing morbidity who were undertaking pregnancy-related decision-making. Patient decision aids reduced decisional conflict scale scores by an additional - 3.7, 95% Confidence Interval - 5.9% to - 1.6%) compared to the control group. Women with pre-existing medical conditions were more conflicted at baseline and had greater reductions in decisional conflict scale score (mean difference vs. control group: - 6.6%; 95% CI - 9.8% to - 3.3%), in contrast to those with previous caesarean section (mean difference - 2.4%; 95% CI - 4.8% to - 0.1%). There was limited evidence on the effect of decision aids on health outcomes. Decision aids reduced unwanted variation in decision-making support across maternity settings.Conclusion: Patient decision aids are effective tools to support personalised care planning and informed decision-making in women with pre-existing morbidity. Women with pre-existing medical morbidity were more conflicted at baseline and were more likely to benefit from decision aids. Adoption of aids in this population may lead to improve adherence and health outcomes, warranting further research. [ABSTRACT FROM AUTHOR]

Objective: To assess the perceived stress levels amongst faculty and students of medicine, dentistry and allied health sciences during COVID-19 pandemic. Material and Method: This multi-institutional descriptive study was conducted from April to June 2020. All the students and faculty from three institutes namely University College of Medicine. University College of Dentistry and the Institute of Allied Health Sciences were invited to participate. Data was collected using a pre-validated Perceived Stress Scale (PSS -10). descriptive and inferential statistics were calculated using SPSS v.21. Results: 1199 responses were obtained. Students from the University College of Medicine reported higher scores on the Perceived Stress Scale (23.02 + 11.85) than those from the University College of Dentistry (21.87+10.86) and the Institute of Allied Health Sciences (21.95+11.32). The students and the faculty experienced stress sometimes to fairly often' during this pandemic. Females experienced more stress than males and there was no significant difference among students and faculty of various age groups. Conclusion: During the COVID-19 pandemic, the students and the faculty from medicine, dentistry and allied health sciences institutes were moderately stressed. The medical students were more affected than the allied health and dental students. A higher stress level was reported among dental faculty as compared to the other two institutes. Institutions should hence promote resilience and mental well-being and provide for more flexible work schedules. [ABSTRACT FROM AUTHOR]

The development of artificial intelligence (AI) in medicine raises fundamental ethical issues. As one example, AI systems in the field of mental health successfully detect signs of mental disorders, such as depression, by using data from social media. These AI depression detectors (AIDDs) identify users who are at risk of depression prior to any contact with the healthcare system. The article focuses on the ethical implications of AIDDs regarding affected users' health-related autonomy. Firstly, it presents the (ethical) discussion of AI in medicine and, specifically, in mental health. Secondly, two models of AIDDs using social media data and different usage scenarios are introduced. Thirdly, the concept of patient autonomy, according to Beauchamp and Childress, is critically discussed. Since this concept does not encompass the specific challenges linked with the digital context of AIDDs in social media sufficiently, the current analysis suggests, finally, an extended concept of health-related digital autonomy. [ABSTRACT FROM AUTHOR]

The increasing prevalence of mental disorders together with the uncertain validity of psychopathological diagnostics challenges psychiatry as the primary home of studying, diagnosing and treating mental health problems and developing mental healthcare. This marks an emerging paradigmatical shift towards 'alternative' mental health perspectives. With the ambition of attending authoritatively in definitory practices, contemporary scholars of psychology, sociology, anthropology and philosophy call for an interdisciplinary approach to mental health, with a predominant focus on the subject. We argue that a paradigmatical shift of mental health requires structural–historical considerations of the foundations upon which subjectivity has been and still is manifested through psychiatry. On this basis, we critically investigate fluctuating psychiatric discourses on subjectivity, normality and pathology. We conducted a genealogical analysis of 13 psychiatric sources (1938–2017) focusing on 'Psychopathy' as a fluctuating diagnosis. We elucidate how subject concepts in psychiatry develop in parallel to subject concepts in society and culture, exemplified through convincing similarities between psychopathic symptoms and neoliberal ideals. Considerations like these, offer scholars valuable bases for mental health research and debate, and also valuable insights to healthcare professionals. [ABSTRACT FROM AUTHOR]

Background: Translation science entails application of information gained through scientific research to practices intended to improve prevention and public health. The outreach arm of Land-Grant Universities—the Cooperative Extension System—is uniquely poised to facilitate this translation process and contribute to resolution of current substance misuse and other behavioral health issues. Objective: This paper summarizes selected literatures that guided the conceptualization of a framework for building Extension's capacity to enhance the translation process, in order to better address substance misuse and other behavioral health issues. Method: Peer-reviewed literature was obtained from journals representing varied disciplines including medicine, public health, education, and psychology. Journals for Extension professionals were a prominent source of relevant literature. The literature review informed the identification of relevant practice gaps, barriers in addressing those gaps, and the development of a capacity-building framework. Results: The framework described highlights opportunities for building Cooperative Extension's capacity to address goals in four key domains. These goals include (1) catalyzing Extension's organizational development to support science-driven practices, (2) bolstering prevention and behavioral health-oriented professional development for Extension faculty and staff, (3) creating a stronger culture of behavioral health in Extension, and (4) strengthening Extension's financing of prevention-oriented behavioral health efforts. Conclusion: Addressing the capacity-related goals identified in this paper could be a major catalyst for enhancing the power of proven, prevention-oriented behavioral health and, thereby, the well-being of our families, communities and nation. [ABSTRACT FROM AUTHOR]

Context: A wellness crisis exists among physicians and medical trainees. High rates of burnout, depression, stress and other states of impaired wellness have driven a sense of urgency to create solutions, and the medical education community has mobilised impressively. However, we argue—and data suggest—that this rush to find solutions has outpaced our efforts to more fully understand the nature of impaired wellness in medicine. This, we believe, has led to the implementation of solutions informed by limited understanding of the problems we intend to solve. Methods: In this paper, we explore three contributors to this situation: (i) shaky definitions and conceptualisations of wellness, (ii) the predominance of deductive, quantitative research informing our understanding and current solutions, and (iii) the reliance on a 'disease‐focused' approach to addressing impaired wellness in physicians and trainees. We discuss how these contributors have led to the current state of the science of wellness in medicine: one characterised by an expanding array of solutions built upon narrow conceptualisations of wellness and how it can be impaired. Discussion: Moving beyond the current state of the science on wellness in medicine will require three critical developments: (i) consistent use of clear definitions of wellness; (ii) expanding our methodologies to include those utilising direct interaction with participants; and (iii) moving beyond solutions informed by a disease‐model approach. We propose a different way of thinking about wellness: one based on what we view as an inherent—and potentially unavoidable—risk of experiencing impairment during a career in medicine. We argue that efforts to extinguish and eliminate all states of impaired wellness may also eliminate opportunities to develop constructive coping mechanisms and future resilience, and that wellness may best be conceptualised as healthy and authentic engagement with the inevitable adversity of a career in medicine. Shaky conceptual foundations, over‐reliance on objectivism, and use of a "disease model" have led to excess focus on solutions & loss of opportunities for resilience development in our struggle with impaired wellness. [ABSTRACT FROM AUTHOR]

Medical students have personalities that are often shown to be perfectionistic. Perfectionism can manifest as maladaptive and lead to psychological distress. This study examined the mediating role of perfectionism on the association between personality trait profiles and levels of psychological distress. First-year medical students completed a questionnaire containing measures of personality, perfectionism (Concern over Mistakes: CoM), stress, anxiety and depression. Latent profile analysis classified students based on their personality traits and identified a profile vulnerable to psychological distress. Structural equation models examined the mediation effects of perfectionism on the relationship between the vulnerable personality profile and distress. The sample totalled 376 (84% response). The vulnerable personality profile was highest in Harm Avoidance, lowest in Self-Directedness, and significantly correlated with the highest Perfectionism-CoM. High Perfectionism-CoM was associated with the highest levels of stress, anxiety and depression. Perfectionism-CoM was a significant mediator for the relationship between personality and higher levels of psychological distress. Certain personality profiles are predisposed to psychological distress such as anxiety, stress and depression. Perfectionism, as a mediator between personality and psychological distress, may be a target strategy to help increase students' self-acceptance, and self-awareness of their perfectionistic tendencies and lower their vulnerability to poor mental health. [ABSTRACT FROM AUTHOR]

Objective. To observe the influence of the catgut-embedding method in Du Meridian acupoint on the mental and psychological state of patients with gastroesophageal reflux disease (GERD) and analyze its possible mechanism. Methods. According to the random number table, 60 patients with GERD were randomly divided into groups of acupoint catgut embedding and Western medicine, 30 cases in each group. The acupoint group was given catgut embedment in the positive reaction points along the Du Meridian, while the Western medicine group received lansoprazole tablet. They were both treated for six weeks. Scores of Gastroesophageal Reflux Disease Questionnaire (GerdQ), Zung's Self-Rating Anxiety Scale (SAS), Zung's Self-Rating Depression Scale (SDS), and Health-Related Quality of Life Scale for GERD (GERD-HRQL) were measured before and after treatment to analyze and evaluate the differences of symptom scores and mental and psychological conditions between the two groups. Results. (1) The scores of GerdQ, GERD-HRQL, SAS, and SDS in the two groups both significantly decreased after treatment (P < 0.05), and those of the acupoint group were much lower than the Western medicine group (P < 0.05). (2) The total effective rate was 90.00% in the acupoint group and 53.33% in the Western medicine group, with a statistically significant difference (P < 0.05). (3) The correlation coefficients r between the GerdQ score and scores of SAS and SDS were 0.563 and 0.322, respectively, and those between the GERD-HRQL score and scores of SAS and SDS were, respectively, 0.506 and 0.435. Conclusion. (1) The main symptoms of GERD patients, such as acid reflux and heartburn, mental and psychological condition, and quality of life, were all improved in the two groups, but the efficacy in the acupoint group is superior to that of the Western medicine group. (2) The clinical symptoms and scores of patients' quality of life are positively correlated with the degree of their anxiety and depression. (3) The acupoint catgut-embedding method can effectively regulate the anxiety and depressive symptoms of patients, which complements the efficacy of proton-pump inhibitors and benefits a wider range of population. [ABSTRACT FROM AUTHOR]

Introduction. Burnout syndrome (BOS) comprises emotional exhaustion, depersonalization, and reduced personal accomplishment in those affected. Instruments such as the Maslach Burnout Inventory (MBI) can help to identify those affected. Physicians in training have been described as an at-risk group for this syndrome. Objective. Describe the association between BOS and medical training by specialty in first-year residents. Method. This is a cross-sectional analytical study of specialty residents at the Hospital Civil de Guadalajara. Sociodemographic data were obtained and the MBI was administered to identify BOS. Samples were compared, and a comparative analysis performed to identify factors associated with BOS. Results. Eighty-eight residents were included, with 21.6% (n = 19) presenting BOS, 53.4% displaying emotional exhaustion (n = 47), 53.7% showing depersonalization (n = 47), and 39.8% reduced personal accomplishment (n = 35). Presenting BOS was not associated with sociodemographic characteristics or type of specialty. Work hours (ro = .229, p = .032), and a higher number of on-call hours/week (ro = .34, p = .001) were associated with higher BOS. Discussion and conclusion. The prevalence of BOS was lower than expected. Over half scored for emotional exhaustion and depersonalization, which could be explained by a self-reporting bias. There was no association between the group/type of specialty and BOS. This study creates new knowledge that works as an institutional situational diagnosis, helps to determine the scope of the problem, and encourages to consider the contributing factors to its origin and maintenance. [ABSTRACT FROM AUTHOR]

Medical students must commit a great deal of concentration and energy during their first 2 years of study, leaving minimal time for self-care. However, once they become physicians, they are in the position of instructing their patients to engage in self-care. Objectives: In this study, first- and second-year medical students participated in a combined mental and physical (MAP) training program with meditation and aerobic exercise that targeted brain health. Design: Each weekly session began with 30 min of instructional training that emphasized the benefit of the program for brain and body health, followed by 30 min of silent meditation, and ending with 30 min of aerobic exercise. Participants monitored their heart rate to achieve 60%–80% of their personal maximum. Participants engaged in one additional session of MAP training each week on their own. Location and Subjects: First- and second-year medical students were recruited to be participants from the Robert Wood Johnson Medical School (RWJMS) in Piscataway, NJ. Outcome measures: Participants completed questionnaires of depressive symptoms, perceived stress, ruminative thoughts, and quality of life, before and after the training approximately 8–9 weeks apart. Results: After 8 weeks of training and in contrast to students who did not participate (n = 30), the medical students who completed at least 14 sessions out of 16 (n = 17) reported significantly fewer ruminations (−17%), including depressive (−16%) and brooding ruminations (−24%). Ruminations are repetitive thoughts that are typically negative in nature and associated with symptoms of depression. The medical students also reported greater quality of life at the end of training and less perceived stress. The majority (84%) would recommend these types of practices and this one in particular to their future patients. Conclusions: Previous studies have demonstrated that MAP training can reduce symptoms of depression as well as trauma-related cognitions, while increasing oxygen consumption and synchronized brain activity during cognitive control procedures. Overall, MAP training offers a time-efficient and evidence-based means of maintaining mental and physical wellness for students during medical school and into their future, as well as their patients alike. [ABSTRACT FROM AUTHOR]

Les étudiants de médecine sont une population à risque d'idées et de comportements suicidaires. Cependant, peu d'études ont été réalisées sur ce sujet et aucune étude marocaine n'a été publiée dans ce sens. Estimer la prévalence et préciser les facteurs associés aux idées et aux tentatives de suicide chez les étudiants de médecine au Maroc. Étude multicentrique, transversale à visée descriptive et analytique portant sur les étudiants de médecine de 1er, 2e et 3e cycle. Parmi 600 étudiants répartis sur les sept facultés de médecine et de pharmacie au Maroc ; 5 % avaient réalisé au moins une tentative de suicide et 31 % avaient eu des idées suicidaires. Les idées suicidaires étaient associées d'une façon statistiquement significative à la consommation de substances psychoactives (2,4 [1,4–3,9], p : 0,0003), à la mauvaise santé psychique (p : 0,00000) et à la réalisation de TS (p : 0,0000000). Alors que les tentatives de suicide sont associées significativement à la mauvaise santé psychique (p : 0,0000000) et à la présence d'une affection de longue durée (2 [0,94–4,2], p : 0,04). Les idées et les tentatives de suicide semblent être une problématique sérieuse chez les étudiants en médecine au Maroc. Des mesures de prévention et de soutien doivent être mises en place pour limiter ce phénomène. Medical students are a high-risk population for having suicidal thoughts and behaviors. However, few studies have been fulfilled on this subject. In Morocco, no study has ever been published in this regard. Objectives of our study were to estimate the prevalence, to clarify the factors associated with the ideas and attempts of suicide among medical students in Morocco. This is a multicentric transversal, descriptive and analytical study of medical students in the 1st, 2nd and 3rd cycle. Among 600 students from the seven Faculty of medicine in Morocco; 5% had made at least one suicide attempt and 31% had suicidal thoughts. Suicidal ideations were significantly associated with psychoactive substance use (2.4 [1.4–3.9], P : 0.0003), poor mental health (P : 0.00000), and suicide attempts (P : 0.0000000). While, suicide attempts are significantly associated with poor mental health (P : 0.0000000) and suffering from a chronic illness (2 [0.94–4.2], P : 0.04). Suicidal attempts and ideas seem to be a serious problem for medical students in Morocco. Prevention and support measures must be put in place to limit this phenomenon. [ABSTRACT FROM AUTHOR]

Mental disorders are prevalent in medical doctors, especially among females. In Mexico, there are studies showing that medical students and residents present a higher frequency of depression compared to the general population, however there are no studies in medical doctors at a later stage. Material and methods: A questionnaire was sent in an online forum for physicians that are mothers based in Mexico with the objective of estimating the point prevalence of depression among this group. The questionnaire included the hospital and anxiety scale (HADS) which assess symptoms of depression. A cut-off score of = 8 or use of antidepressants was used to define depression. Results: A total of 1,170 physicians that are mothers were included in this study. The point prevalence of depression was 10.9%. The group that had depression smoked more and took more sleeping pills that the group that did not present symptoms of depression. The point prevalence of symptoms of depression in this group of physicians in Mexico was estimated to be of 10.9%, which is similar to what is seen in the general population but lower than the estimates for medical interns and residents. [ABSTRACT FROM AUTHOR]

Buddha lived 2600 years ago in Northern India, and his teachings were established in Sri Lanka in the third-century BC. In the nineteenth century, the British established the modern mental health services in Sri Lanka. This article aimed to highlight the association between Western psychotherapeutic techniques with Buddhist teachings and the relevance of this confluence to the mental health care in the country. Many schools of Western psychotherapy employ principles which are also described in Buddhist philosophy. Understanding this connection helps to deliver a culturally acceptable and relevant mental health care to the Sri Lankan population. [ABSTRACT FROM AUTHOR]

An introduction to the Special Section Mental Health, The Mind and Consciousness: Tibetan and Western Approaches, published in this issue is presented.

This article presents an analysis of the way in which rlung ("wind, breath") functions as a mode of explanation for what Western medicine regards as "psychiatric" illness, based on field research on the topic of mental health, illness, and healing conducted within a Tibetan population in Darjeeling, northeast India. The article explores this notion of rlung and its relationship to body and mind, in order to examine its role in the causation and treatment of various forms of "mental illness", before analysing some similarities and differences between rlung-related categories and biomedical classifications of mental illness. [ABSTRACT FROM AUTHOR]

Résumé Objectif Arthur Kleinman est professeur de psychiatrie, d'anthropologie médicale et d'anthropologie à l'université de Harvard. C'est une des figures majeures des champs de l'anthropologie médicale, de la psychiatrie transculturelle, de la santé globale et des humanités médicales. Son principal terrain d'étude est la Chine contemporaine. Outre de nombreux ouvrages collectifs et articles, il est l'auteur de plusieurs livres qui abordent ses thématiques de recherche. Le but de cet article est de mieux faire connaître ses travaux au lectorat français intéressé par les liens entre la médecine, la psychiatrie et les sciences sociales. Méthode L'article proposé ici est la retranscription, traduite de l'anglais, d'un entretien réalisé avec Arthur Kleinman en décembre 2017 au département d'anthropologie de l'université de Harvard. Résultats Il y retrace son parcours et développe ses thématiques de recherche : l'étude ethnographique de l'expérience des patients souffrant de maladies chroniques, les enjeux du diagnostic psychiatrique dans le champ de la psychiatrie transculturelle, l'approche de la santé globale à partir du champ théorique des sciences sociales, puis l'abord anthropologique du soin et sa place dans l'exercice de la médecine actuelle. Discussion Que peuvent apporter les sciences sociales à la médecine et à la psychiatrie ? Quelle est la situation de la santé mentale globale ? Quelle place occupe le soin dans la médecine actuelle ? Comment faire face à la logique gestionnaire qui la domine ? Conclusion Ces différentes questions sont abordées au travers du parcours et de l'engagement d'Arthur Kleinman pour l'ouverture du champ de la médecine et de la psychiatrie au champ des sciences sociales. Abstract Purpose Arthur Kleinman is Professor of Psychiatry, Medical Anthropology at Harvard Medical School and of Anthropology at Harvard University. He is a leading figure in medical anthropology, cultural psychiatry, global health and medical humanities. He is a China scholar. In addition to numerous collective works and articles, he has published six single authored books about his research. The purpose of this article is to make his work better known in France, for those interested in the links between medicine, psychiatry and the social sciences. Method The present article is the transcript, translated from English, of an interview with Arthur Kleinman, conducted in December 2017 at the Department of Anthropology at Harvard University. Results He tells about his career and develops his research themes: the ethnographic study of the illness experiences of patients suffering from chronic diseases, the issues of psychiatric diagnosis in the field of cultural psychiatry, the approach of global health from the social sciences' field, then the anthropological approach to care and its place in the contemporary medicine. Discussion What medicine and psychiatry should learn from the social sciences? What is the situation of global mental health? What is the place of care in contemporary medicine and how to deal with the economic logic that dominates it? Conclusion These different questions are approached through Arthur Kleinman's career and advocacy to open the field of medicine and psychiatry to the field of social sciences. [ABSTRACT FROM AUTHOR]

Employing novel coding methods to evaluate human rights monitoring, this article examines the influence of United Nations (UN) treaty bodies on national implementation of the human right to health. The advancement of the right to health in the UN human rights system has shifted over the past 20 years from the development of norms under international law to the implementation of those norms through national policy. Facilitating accountability for this rights-based policy implementation under the right to health, the UN Committee on Economic, Social and Cultural Rights (CESCR) monitors state implementation by reviewing periodic reports from state parties, engaging in formal sessions of ‘constructive dialogue’ with state representatives, and issuing concluding observations for state response. These concluding observations recognise the positive steps taken by states and highlight the principal areas of CESCR concern, providing recommendations for implementing human rights and detailing issues to be addressed in the next state report. Through analytic coding of the normative indicators of the right to health in both state reports and concluding observations, this article provides an empirical basis to understand the policy effects of the CESCR monitoring process on state implementation of the right to health. [ABSTRACT FROM AUTHOR]

Religious-spiritual (R/S) education helps medical students cope with caregiving stress and gain skills in interpersonal empathy needed for clinical care. Such R/S education has been introduced into K-12 and college curricula in some developed nations and has been found to positively impact student’s mental health. Such a move has not yet been seen in the Indian education system. This paper aimed to examine perspectives of teachers and parents in India on appropriateness, benefits, and challenges of including R/S education into the school curriculum and also to gather their impressions on how a R/S curriculum might promote students’ health. A cross-sectional study of religiously stratified sample of teachers and parents was initiated in three preselected schools in India and the required sample size (N = 300) was reached through snowballing technique. A semi-structured questionnaire, with questions crafted from “Religion and Spirituality in Medicine, Physicians Perspective” (RSMPP) and “American Academy of Religion’s (AAR) Guidelines for Religious Literacy,” was used to determine participants’ perspectives. Findings revealed that teachers’ and parents’ “comfort in integrating R/S into school curriculum” was associated with their gender (OR 1.68), education status (OR 1.05), and intrinsic religiosity (OR 1.05). Intrinsic religiosity was significantly (p = 0.025) high among parents while “intrinsic spirituality” was high (p = 0.020) among teachers. How participants’ R/S characteristics influence their support of R/S education in school is discussed. In conclusion, participants believe R/S education will fosters students’ emotional health and interpersonal skills needed for social leadership. A curriculum that incorporates R/S education, which is based on AAR guidelines and clinically validated interpersonal spiritual care tools would be acceptable to both teachers and parents. [ABSTRACT FROM AUTHOR]

Purpose: Many who seek primary health care advice about mental health may be using mobile applications (apps) claiming to improve well-being or relieve symptoms. We aimed to identify how prominent mental health apps frame mental health, including who has problems and how they should be managed.Methods: We conducted a qualitative content analysis of advertising material for mental health apps found online in the United States, the United Kingdom, Canada, and Australia during late 2016. Apps were included if they explicitly referenced mental health diagnoses or symptoms and offered diagnosis and guidance, or made health claims. Two independent coders analyzed app store descriptions and linked websites using a structured, open-ended instrument. We conducted interpretive analysis to identify key themes and the range of messages.Results: We identified 61 mental health apps: 34 addressed predominantly anxiety, panic, and stress (56%), 16 addressed mood disorders (26%), and 11 addressed well-being or other mental health issues (18%). Apps described mental health problems as being psychological symptoms, a risk state, or lack of life achievements. Mental health problems were framed as present in everyone, but everyone was represented as employed, white, and in a family. Explanations about mental health focused on abnormal responses to mild triggers, with minimal acknowledgment of external stressors. Therapeutic strategies included relaxation, cognitive guidance, and self-monitoring. Apps encouraged frequent use and promoted personal responsibility for improvement.Conclusions: Mental health apps may promote medicalization of normal mental states and imply individual responsibility for mental well-being. Within the health care clinician-patient relationship, such messages should be challenged, where appropriate, to prevent overdiagnosis and ensure supportive health care where needed. [ABSTRACT FROM AUTHOR]

Objective: To identify determinants of potentially inappropriate (PI) antidepressant and anxiolytic/sedative prescribing for older, community-dwelling adults.Data Sources/study Setting: Office visits from the 2010 National Ambulatory Medical Care Survey.Study Design: A cross-sectional study measuring associations between various patient and physician factors and prescribing of PI antidepressants, and PI sedatives among elderly, using Beers 2012/2015 criteria, a clinical decision model, and multivariate logistic regressions.Data Collection: Visits by older adults (≥65 years) involving medications were extracted to identify visits with antidepressants and sedatives.Principal Findings: Black race, asthma, depression, osteoporosis, payment type, consultation time, and computer systems with prescribing support were associated with reduced odds of PI antidepressant prescribing among users. Income, chronic renal failure, diabetes, and obesity were associated with reduced odds of PI sedative prescribing. Female sex, white race, depression, increasing number of medications, and physician specialty were associated with increased odds of PI sedative prescribing.Conclusions: Various patient and health-system factors influence the quality of antidepressant and sedative prescribing for older community-dwelling adults. Longer consultations and the use of computer systems with prescribing support may minimize potentially inappropriate antidepressant prescribing. As medication numbers increase, exposure to PI sedatives is more likely, requiring medication review and monitoring. [ABSTRACT FROM AUTHOR]

Implementing evidence-based practices is becoming both a goal and standard across medicine, psychology, and education. Initial successes, however, are now leading to questions about how successful demonstrations may be expanded to scales of social importance. In this paper, we review lessons learned about scaling up evidence-based practices gleaned from our experience implementing school-wide positive behavioral interventions and supports (PBIS) across more than 23,000 schools in the USA. We draw heavily from the work of Flay et al. (Prev Sci 6:151-175, 2005. doi: 10.1007/s11121-005-5553-y ) related to defining evidence-based practices, the significant contributions from the emerging "implementation science" movement (Fixsen et al. in Implementation research: a synthesis of the literature, University of South Florida, Louis de la Parte Florida Mental Health Institute, The National Implementation Research Network (FMHI Publication #231), Tampa 2005), and guidance we have received from teachers, family members, students, and administrators who have adopted PBIS. [ABSTRACT FROM AUTHOR]

Recently there has been renewed interest in basing teachers’ professional learning on medically derived models. This interest has included clinical practice models and evidence-based teaching as well as the use of various forms of ‘Rounds’ which claim to derive from medical rounds. However, many arguing for these approaches may well not have a detailed knowledge of the actuality of professional learning in medicine but may be basing their ideas on idealised models drawn from popular conceptions. In addition, the model used by some calling for medically derived teacher learning is biomedicine, an area in which parallels with Education are difficult. This paper argues that mental health and public health provide a better analogue for Education than biomedicine. It considers some of the lessons that can be drawn from research on evidence-based practice in these areas. The paper concludes that a way forward is neither uncritically to assume the superiority of medical models of professional learning nor to rely only on empirical evidence from Education, but rather to enter into dialogue with colleagues in mental and public health about shared concerns and experiences in professional learning. [ABSTRACT FROM PUBLISHER]

In 1946 Heidegger suffered a mental breakdown and received treatment by Dr. Viktor Emil Freiherr von Gebsattel. I explore the themes of health and help in Heidegger's work before and after his treatment. I begin with Heidegger's views on health while Rector in 1933-34 (1) and his abandonment of these views by war's end (2). A short while later, Heidegger's breakdown occurs and the treatment under Gebsattel begins (3). Soon after his treatment, Heidegger lauds what he terms a "broken-down" thinking, and I examine his contribution to a 1958 Festschrift for Gebsattel to better articulate such a thinking (4). Lastly, I take up Heidegger's remarks on the role of the medical profession in a technological age from a 1962 speech (5). In presenting this material, I hope to shed new light on a little known aspect of Heidegger's career and biography and to situate philosophically his relationship with Dr. Gebsattel. [ABSTRACT FROM AUTHOR]

The article discusses the infertility counseling among women delivered by mental health and medical professionals which had became more sophisticated and widespread over the past decade. Topics discussed include women in Victorian Era has been directed by male medical experts to preserve health in the home, the blog post written by Sharon Covington and Paul Feldman, and women had turn to male physician for care during the 19th century.

The association between adverse childhood experiences (ACEs) and increased risk of health problems is well established. However, many studies have relied on unrepresentative or high-risk samples and have focused on a narrow range of health problems. Prior research assessing potential age differences in the ACE-health connection is also sparse. To comprehensively examine the extent to which ACEs are associated with physical, mental, and neurodevelopmental health outcomes in childhood and assess whether these associations differ between age groups. Pooled cross-sectional data from the 2016–2019 National Survey of Children's Health (N = 98,732). We estimated age-stratified binary logistic regression models examining associations between the number of ACEs and physical, mental, and neurodevelopmental health problems net of sociodemographic and socioeconomic controls. Separate models were estimated for the total population (ages 3–17), early childhood (ages 3–5), middle childhood (ages 6–11), and adolescence (ages 12–17). We observed a dose-response relationship between ACE exposure and childhood physical, mental, and neurodevelopmental health problems in all age groups. The largest disparities exist between children with no ACEs and three or more ACEs. Compared to children without ACEs, children with three or more ACEs had significantly higher adjusted odds of externalizing disorders (OR = 4.40), internalizing disorders (OR = 5.13), neurodevelopmental disorders (OR = 2.40), and physical health problems (OR = 2.08). Our results add to evidence linking ACEs to childhood health disparities. Further, findings indicate that ACEs have persistent negative effects across age groups and that clinicians should monitor ACEs when assessing children's physical, mental, and neurodevelopmental health at any age. [ABSTRACT FROM AUTHOR]

The article considers complementary and integrative health (CIH) approaches as complementary treatments for post-traumatic stress disorder (PTSD). Topics discussed include the factors that health providers should consider when recommending CIH protocols as complementary treatments for PTSD, the reasons behind the rising number of patients opting for CIH methods and the various types of CIH approaches, including meditation, acupuncture and yoga.

The high prevalence of neurasthenia and its divergent social and cultural meanings in the late nineteenth and early twentieth centuries has been subjected to historical and anthropological studies. The present study explores the history of this elastic diagnosis in relation to the rise of "psy disciplines" in Republican China. Since the 1920s, emergent Chinese neuropsychiatric and mental health professionals eagerly entered the already vibrant culture of neurasthenia and provided their explanations. As China was under different spheres of influence, diverse systems of psy knowledge were practiced in the country. Differences in the conception of the nature of the disease were further intertwined with various reform projects with which these bodies of psychological knowledge were associated. Despite being the products of scientific internationalism, these discourses not only resonated with the epistemological and social concerns derived from Japan, Europe, and, gradually, the United States but generated their own ideas of personal, social, and national regeneration. By examining the history of neurasthenia in the light of the interactions among popular culture, the advent of modern psychiatric and psychological knowledge, and Republican China's striving for modernity amid social turmoil, the article contributes to our understanding of medical culture in modern China. [ABSTRACT FROM AUTHOR]

Background: The people of Bangladesh are currently exposed to high concentrations of arsenic and manganese in drinking water, as well as elevated lead in many regions. The objective of this study was to investigate associations between environmental exposure to these contaminants and neurodevelopmental outcomes among Bangladeshi children.Methods: We evaluated data from 524 children, members of an ongoing prospective birth cohort established to study the effects of prenatal and early childhood arsenic exposure in the Sirajdikhan and Pabna Districts of Bangladesh. Water was collected from the family's primary drinking source during the first trimester of pregnancy and at ages 1, 12 and 20-40 months. At age 20-40 months, blood lead was measured and neurodevelopmental outcomes were assessed using a translated, culturally-adapted version of the Bayley Scales of Infant and Toddler Development, Third Edition (BSID-III).Results: Median blood lead concentrations were higher in Sirajdikhan than Pabna (7.6 vs. Conclusion: Where blood lead levels are high, lead is associated with decreased cognitive scores on the BSID-III, and effects of other metals are not detected. In the setting of lower lead levels, the adverse effects of arsenic and manganese on neurodevelopment are observed. [ABSTRACT FROM AUTHOR]

This study examines the pathways through which mood perception affects perceixed stress and symptom reporting among undergraduate students. It examines depression, anxiety, positive affect, and negative affect as mediators between a) emotional intelligence (El) and b) perceived stress and symptom reporting. Results indicated that on the El measure used in this study, the Irait Meta-mood Scale (TMMS) subscales, Attention was not related to perceived stress or symptom reporting. Mood Repair and Clarity were significantly and inversely related to perceived stress and symptom reporting. Anxiety and depression were the primary mediators in these relationships. [ABSTRACT FROM AUTHOR]

The article discusses how by taking up more functions undertaken by general practitioners pharmacists can expand roles in primary care. Topics include how value to the primary healthcare outcomes for consumers can be added through innovative and expanded roles for pharmacists and how quality use of medicines can be driven through digital health through electronic medication management systems and electronic health records.