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Background: Several recent studies concerning men's pornography use have challenged past research conclusions that male pornography use negatively impacts relational outcomes in heterosexual relationships. While extant literature has explored the intersection of religion and men's experience with pornography consumption, the impact on religious wives has primarily been understudied. Purpose: The present study examined the impact of a husband's problematic pornography use on a religious woman's spirituality and religiosity. Methods: Semi-structured interviews were conducted with 27 women who self-identified as religious women. Faith traditions of the participants include Catholic, Jewish, Latter-day Saint, Native American Spiritual, non-denominational Christians, Protestant Christians, and Spiritual. The data was analyzed using interpretive phenomenology, a qualitative methodology. Results: Using a feminist hermeneutics theoretical lens to analyze the data in a way that gives preference for the woman's experience, three primary themes emerged: Wrestle with Religion, Relationships that Facilitate Healing, and Spiritual Growth. Nine subthemes were identified, including Influence of Religious Culture, Unmet Expectations of Religious Leaders, Challenges to Faith, Support from Inside the Religion, Recognizing the Need for Support Outside the Religion, Women Need Women for Healing, Divine Assistance, Relationship with God, and A Journey of Growth and Transformation. Conclusions & Implications: These primary themes and subthemes provide a rich description of the religious context, means to healing, and resilience that characterize religious women's experiences after discovering a husband's problematic pornography use. Most importantly, the authors discuss significant implications for religious leaders and clinicians seeking to provide culturally sensitive care to distressed women. [ABSTRACT FROM AUTHOR]

Awareness and knowledge of national movement behaviour guidelines are needed to influence individual behaviour and public health policies. This study assessed the awareness and knowledge of the Canadian 24-Hour Movement Guidelines for Adults Aged 18–64 Years and Adults Aged 65 Years or Older (24HMG) recommendations among adults living in Canada across three timepoints. Online surveys were distributed to representative samples of adults living in Canada over a 6-month period. Findings suggest that short-term dissemination efforts were successful in increasing awareness of the 24HMG following guideline release. However, other strategies, such as education, may be needed to influence knowledge of guideline recommendations. [ABSTRACT FROM AUTHOR]

Background The aim of this study is to investigate the effects on population level mental health literacy (MHL) of Every Mind Matters over 30 months following campaign launch. Methods To observe changes in MHL over time, we conducted regression analyses on a nationally representative, repeated cross-sectional dataset of nine survey waves from September 2019 to March 2022 and an individual participant data meta-analysis with data from October 2019 to March 2021 to examine the association between campaign awareness and the outcomes. Results There were small improvements in knowledge of management of stress, depression and anxiety, mental health vigilance, sleep literacy and psychological wellbeing self-efficacy from September 2019 to March 2020 and a deterioration in most MHL outcomes from March 2020 compared with September 2019. Campaign awareness was positively associated with symptom management of depression and anxiety, help seeking self-efficacy, stigma related to mental disorders and mental health vigilance. Conclusions There is little evidence that the campaign improved MHL in the general population beyond March 2020. Those who were aware of the campaign may have benefitted from its resources. [ABSTRACT FROM AUTHOR]

Summary: Two fast-track child and family social work training programs have been established in England — Step Up to Social Work and Frontline. Trainees' financial support is far higher than for mainstream social work degrees. One of the reasons claimed for setting up these programs is addressing retention, although critics (of Frontline) predicted graduates would not stay in social work. A 4-year study assessed retention and reasons for leaving social work. Attrition rates from statutory social work were calculated from responses (n = 2543) to annual surveys, plus looking up non-respondents in the professional register. Interviews were conducted with fast-track graduates (n = 80) and employers (n = 29). Findings: The overall rate of social work graduates not in statutory social work at 18 months post-qualification was 12% for fast-track programs, and Higher Education Statistics Agency survey data show attrition at 15 months post-qualification as 18% for all social work routes. Frontline's original national recruitment approach was less successful for retention than Step Up to Social Work's regional approach. Perceived local authority support and intrinsic job satisfaction were associated with attrition in longitudinal bivariate analysis. Fast-track graduates leaving statutory social work typically moved to work in social care (including policy roles), health, or education. Applications: Early-career attrition appears to be somewhat lower from fast-track programs than from all social work graduates. Longer-term comparison is not yet possible. In promoting retention, employers should be aware of the importance of staff perceptions of the local authority as supportive, and of their intrinsic job satisfaction. [ABSTRACT FROM AUTHOR]

Introduction: Hypertension affects 5–10% of pregnancies in the United States. Chronic hypertension during pregnancy can have a significant impact on maternal and neonatal outcomes, especially in rural populations. Pregnancies complicated by hypertension are currently managed through frequent clinic visits or extended hospital stays. Cellular-enabled remote patient monitoring devices provide an alternative treatment method for women in rural areas. Research Aim: This study aimed to measure the feasibility of and patient satisfaction with using an integrated model of cellular-enabled remote patient monitoring devices for blood pressure supported by a 24/7 nurse call center. Methods: In a mixed methods pilot study, twelve women with chronic hypertension during pregnancy were given cellular-enabled BodyTrace™ blood pressure cuffs and weight scales. Participants' blood pressures were continuously monitored by a nurse call center. Participants completed a survey and a brief semi-structured interview after two weeks. Results: Participants scored low on stress and anxiety with mean scores of 5.45 (SD = 3.56) and 8.09 (SD 3.62), respectively. Participants scored high on behavioral intention, system usability, and perceived benefits with mean scores of 8.73 (SD = 2.53), 75.91 (SD = 23.70), and 19.64 (SD = 5.92), respectively. Participants perceived benefits to using the device, including increased monitoring by health professionals, increased self-awareness, decreased number of clinic visits, and convenience of use. Perceived disadvantages included higher readings when compared to clinical readings. Discussion: Cellular-enabled remote patient monitoring devices for blood pressure are a valuable tool for managing treatment of pregnancies complicated by hypertension. [ABSTRACT FROM AUTHOR]

Background: Little is known about the long‐term effectiveness of behavioural therapy for tics. We aimed to assess the long‐term clinical and cost‐effectiveness of online therapist‐supported exposure and response prevention (ERP) therapy for tics 12 and 18 months after treatment initiation. Methods: ORBIT (online remote behavioural intervention for tics) was a two‐arm (1:1 ratio), superiority, single‐blind, multicentre randomised controlled trial comparing online ERP for tics with online psychoeducation. The trial was conducted across two Child and Adolescent Mental Health Services in England. Participants were recruited from these two sites, across other clinics in England, or by self‐referral. This study was a naturalistic follow‐up of participants at 12‐ and 18‐month postrandomisation. Participants were permitted to use alternative treatments recommended by their clinician. The key outcome was the Yale Global Tic Severity Scale Total Tic Severity Score (YGTSS‐TTSS). A full economic evaluation was conducted. Registrations are ISRCTN (ISRCTN70758207); ClinicalTrials.gov (NCT03483493). Results: Two hundred and twenty‐four participants were enrolled: 112 to ERP and 112 to psychoeducation. The sample was predominately male (177; 79%) and of white ethnicity (195; 87%). The ERP intervention reduced baseline YGTSS‐TTSS by 2.64 points (95% CI: −4.48 to −0.79) with an effect size of −0.36 (95% CI: −0.61 to −0.11) after 12 months and by 2.01 points (95% CI: −3.86 to −0.15) with an effect size of −0.27 (95% CI ‐0.52 to −0.02) after 18 months, compared with psychoeducation. Very few participants (<10%) started new tic treatment during follow‐up. The cost difference in ERP compared with psychoeducation was £304.94 (−139.41 to 749.29). At 18 months, the cost per QALY gained was £16,708 for ERP compared with psychoeducation. Conclusions: Remotely delivered online ERP is a clinical and cost‐effective intervention with durable benefits extending for up to 18 months. This represents an efficient public mental health approach to increase access to behavioural therapy and improve outcomes for tics. [ABSTRACT FROM AUTHOR]

The present study examines how a partner's Problematic Pornography Use impacts the overall sexual experience of the Christian woman. Using a qualitative phenomenological approach, we explored the intersection of gender, religion, and sexuality with 21 women of faith (the majority of whom had sought out mental health treatment) to better understand how the Christian woman's sexuality shifts in response to her husband's consumption of pornography. Three major themes emerged from the data: Discovery Impacts Desire, I Am Not Enough, and Sexually Disenfranchized. We discuss important implications for clinicians and clergy that promote the emotional, physical, and sexual safety of women. [ABSTRACT FROM AUTHOR]

Covid-19 brought about drastic changes in day-to-day life and working practices, and had a profound impact on the mental health and well-being of the general population. Certain professional groups have also been particularly affected. This study sought to explore how levels of psychological distress and perceptions of workplace support amongst social work staff changed during the pandemic. We present the results from a series of surveys conducted in four local authorities (LAs) in England, before and during the Covid-19 pandemic. Social workers and other social care staff (n  = 62) were asked about their experiences of psychological distress, using the twelve-item General Health Questionnaire. Overall, we found the proportion of staff reporting elevated levels of psychological distress increased and, in line with previous studies involving social workers, was high relative to the general population. Yet, most staff also said they had high levels of support from managers and colleagues, whilst a small proportion reported an increased perception of workplace support during the pandemic, compared to before. We consider these findings in relation to Organisational Support Theory and reflect on the ability of LAs to provide effective support for social care staff. [ABSTRACT FROM AUTHOR]

We aimed to explore participants' experiences of mental health during an acceptance and commitment therapy (ACT)-based guided self-help intervention to support weight management in adults with overweight or obesity during the COVID-19 pandemic (SWiM-C: Supporting Weight Management during COVID-19). We conducted semi-structured telephone interviews with twenty participants and used reflexive thematic analysis to identify patterns of meaning across the dataset relevant to mental health. Four themes were conceptualized: i) Mental health changes associated with SWiM-C, ii) External factors negatively impacted mental health and intervention engagement, iii) Use and impact of coping responses, and iv) Intervention preferences based on psychological needs. Findings suggest that participants were exposed to multiple factors, both related to and external to the intervention, that negatively impact their mental health, yet ACT-based aspects of the SWiM-C intervention appeared to support participants to adaptively manage the decline in their mental health. The findings can be used to inform the development of future weight management interventions, such as through intervention personalization and the inclusion of more strategies that target emotional regulation. Trial registration: ISRCTN 12107048, [ABSTRACT FROM AUTHOR]

Background: Suicide is one of the leading causes of death in people with schizophrenia. Identifying risk factors for suicide in schizophrenia is therefore an important clinical and research priority.Method: A cross-sectional secondary analysis was conducted on the DNA Polymorphisms in Mental Illness Study (DPIM) data. Suicidality data was extracted, and the number of positive and negative symptoms were established for a total of 1494 participants. Logistic and negative binomial regression analyses were conducted to assess for associations between positive or negative symptoms and suicidal ideation, attempt, or number of attempts, whilst adjusting for potential confounders.Results: Negative symptoms were associated with a reduction in the risk of suicidal ideation (odds ratio [OR]: 0.83; 95 % CI: 0.75-0.91) and suicide attempt (OR: 0.79; 95 % CI: 0.71-0.88) after adjusting for age and sex. Positive symptoms were associated with an increased risk of suicidal ideation (OR: 1.06; 95 % CI: 1.03-1.09), suicide attempt (OR: 1.04; 95 % CI: 1.00-1.07) and number of suicide attempts (incidence rate ratio [IRR]: 1.05; 95 % CI: 1.01-1.08). Further adjusting for depressive symptoms slightly increased the magnitude of associations with negative symptoms but attenuated associations between positive symptoms and suicidality to the null.Conclusions: Negative symptoms are associated with a reduced risk of suicidality, whilst positive symptoms are associated with an increased risk of suicidality. Depressive symptoms may confound or mediate these associations. [ABSTRACT FROM AUTHOR]

To defend against hydrogen cation accumulation and muscle fatigue during exercise, sodium bicarbonate (NaHCO3) ingestion is commonplace. The individualized dose-response relationship between NaHCO3 ingestion and blood biochemistry is unclear. The present study investigated the bicarbonate, pH, base excess and sodium responses to NaHCO3 ingestion. Sixteen healthy males (23 ± 2 years; 78.6 ± 15.1 kg) attended three randomized order-balanced, nonblinded sessions, ingesting a single dose of either 0.1, 0.2 or 0.3 g⋅kg-1BM of NaHCO3 (Intralabs, UK). Fingertip capillary blood was obtained at baseline and every 10 min for 1 hr, then every 15 min for a further 2 hr. There was a significant main effect of both time and condition for all assessed blood analytes (p ≤ .001). Blood analyte responses were significantly lower following 0.1 g⋅kg-1BM compared with 0.2 g⋅kg-1BM; bicarbonate concentrations and base excess were highest following ingestion of 0.3 g⋅kg-1BM (p ≤ .01). Bicarbonate concentrations and pH significantly increased from baseline following all doses; the higher the dose the greater the increase. Large interindividual variability was shown in the magnitude of the increase in bicarbonate concentrations following each dose (+2.0-5; +5.1-8.1 ; and +6.0-12.3 mmol-L1 for 0.1, 0.2 and 0.3 g⋅kg-1BM) and in the range of time to peak concentrations (30-150; 40-165; and 75-180 min for 0.1, 0.2 and 0.3 g⋅kg-1BM). The variability in bicarbonate responses was not affected by normalization to body mass. These results challenge current practices relating to NaHCO3 supplementation and clearly show the need for athletes to individualize their ingestion protocol and trial varying dosages before competition. [ABSTRACT FROM AUTHOR]

Background: Depression is associated with lower educational attainment, but there has been little investigation of long-term educational trajectories in large cohorts with diagnosed depression.Aims: To describe the educational attainment trajectories of children with a depression diagnosis in secondary care, and to investigate whether these trajectories vary by sociodemographic characteristics.Method: We identified new referrals to South London and Maudsley's NHS Foundation Trust between 2007 and 2013 who received a depression diagnosis at under 18 years old. Linking their health records to the National Pupil Database, we standardised their performance on three assessments (typically undertaken at ages 6-7 years (school Year 2), 10-11 (Year 6) and 15-16 (Year 11)) relative to the local reference population in each academic year. We used mixed models for repeated measures to estimate attainment trajectories.Results: In our sample of 1492 children, the median age at depression diagnosis was 15 years (interquartile range = 14-16). Their attainment showed a decline between school Years 6 and 11. Attainment was consistently lower among males and those eligible for free school meals. Black ethnic groups also showed lower attainment than White ethnic groups between Years 2 and 6, but showed a less pronounced drop in attainment at Year 11.Conclusions: Those who receive a depression diagnosis during their school career show a drop in attainment in Year 11. Although this pattern was seen among multiple sociodemographic groups, gender, ethnicity and socioeconomic status predict more vulnerable subgroups within this clinical population who might benefit from additional educational support or more intensive treatment. [ABSTRACT FROM AUTHOR]

Background Compulsory admission rates under the Mental Health Act (MHA) have been on the rise for many years despite representing a costly and coercive approach to psychiatric care. There is therefore an urgent need to minimise compulsory admission rates using interventions based on known risk factors for detention. However, risk factors in the MHA assessment process have been under-researched. Methods A mixed methods service evaluation was conducted in one inner London NHS Trust. A retrospective cohort study used routinely collected assessment records to model potential risk factors for detention. Local assessors were interviewed to explore factors that might help or hinder detention minimisation. Main findings Assessments were less likely to result in detention when professionals other than the assessing team were in attendance, although this association weakened after adjusting for potential confounders. Interviewed assessors identified factors that could contribute to detention minimisation in the assessment process, in general service provision, and in wider society. Conclusion Some local assessment processes could contribute to minimising detention rates, such as community team participation in assessments. Challenges posed by limited resources and community and inpatient care were particularly evident. Consideration of these might also help reduce detentions. [ABSTRACT FROM AUTHOR]

BACKGROUND: Endometriosis is a gynecological disease affecting 1 in 10 women of reproductive age. Endometriosis incidence has risen; however, whether this rise is due to disease awareness or environmental contamination is not known. OBJECTIVE: The objective of this study was to determine if bisphenol A (BPA) or bisphenol AF (BPAF) potentiate the development of endometriosis and if hormonal status alters how toxicant exposure affects disease. METHODS: A mouse model of endometriosis, where minced uterine tissue is injected into the peritoneal cavity of a host mouse, was used to examine the effects of BPA and BPAF on endometriosis lesion development in ovariectomized and hormonally intact mice. BPA and BPAF were delivered through diet to include no-observed-adverse-effect-level (NOAEL) and the low-observed-adverse-effect-level (LOAEL) exposure levels. After six weeks (at necropsy), lesions, ovaries, and blood were collected to examine characteristics, gene expression, and hormonal regulation. RESULTS: BPA and BPAF treatments affected endometriosis in a manner specific to dose and hormonal status of the host mouse. Estrogen and endometriosis-mediated differences in lesion target gene expression also depended on hormonal status. In intact mice, ovarian steroidogenic pathways were disrupted, progesterone levels were lowered, and atretic oocyte numbers were higher with toxicant exposure. BPAF, more so than BPA, resulted in more endometriosis lesion growth, but both toxicants disrupted normal ovarian signaling. CONCLUSION: These findings further our understanding of the effects and hormonal impacts of BPA and BPAF on endometriosis perturbation in ovariectomized and hormonally intact mice. BPAF appeared to be similar if not more estrogenic than BPA and may be affecting an environmental contribution of the increased incidence of endometriosis. [ABSTRACT FROM AUTHOR]

Background: The period of transition from pediatric to adult services represents a time when young people need support, information, and appropriate care in order to successfully move. It is a period that is associated with nonadherence and disengagement with care. Objective: To explore the experiences of young liver transplant recipients transitioning to adult services and determine what they require in order to achieve a successful move. The research also explored the possibility of using a mobile phone application (app) as a tool to support transition. Design: Qualitative approach using novel arts-based focus groups and one-to-one interviews. Participants: Twenty-one young people aged 16 to 25 years, 16 health-care professionals involved in their care, and 7 young people as follow-up. Participants used services provided by the 3 liver centers in England (Leeds, Birmingham, and London). Results: Data highlighted the variability of transition pathways in England for young people moving from child to adult health services. The results showed that they required clear information regarding transition processes including specific medical information and that there was a shortfall in such information. Support was required in the form of a designated transition coordinator or similar specialist who could act as a point of reference and guidance throughout the process. Transitions needed to be individualized and based upon transition readiness rather than age, although the research showed that age cut-offs were still used. Conclusion: Young people welcomed apps to provide information, reminders, contacts, and connections. Future research should explore the efficacy of such apps. [ABSTRACT FROM AUTHOR]

This paper explores how social workers can communicate effectively using an interpreter. It examines how child and family practitioners describe their experiences of working with interpreters and uses audio recordings of home visits to analyse how the challenges they describe manifest in practice. The analysis is based on audio recordings of nineteen interpreter-mediated meetings between workers and families, and two focus groups with practitioners. Recordings were categorised using quantitative coding, and data were analysed thematically. Although workers find using an interpreter challenging, in practice, skilled practitioners are able to work effectively providing they adopt an assertive approach. This is characterised by clarifying misunderstandings, involving the client in ‘chit-chat’ to build rapport and, where clients have differing levels of language proficiency, conducting the conversation entirely in the native language. The study demonstrates the centrality of social worker skills in managing interpreter-mediated sessions and improving practice for non-native-speaking families. This has implications for social work practice internationally. [ABSTRACT FROM AUTHOR]

The process and preparation of moving from child to adult services (transition) is a challenging period of time for young people and represents significant changes in care and support systems. The proliferation of mobile phone applications for health purposes suggests that it is an area for further investigation.~Background~Background~The review explores the potential to use mobile phone technology to help support young liver transplant recipients moving to adult services. It represents the first review conducted in this specialism and considers a new model of support for young liver patients.~Objective~Objective~A systematic rapid review of the published peer-reviewed literature.~Methods~Methods~Two searches were conducted: Search 1: the use of technology to support transition to adult services (6 studies) and Search 2: how best to support liver transplant recipients during transition (6 studies).~Results~Results~Research shows that to achieve positive transition young people need information about their condition and transition. The process needs to be guided by transition readiness, rather than the young persons' age. Although parents and support networks should be in place and are valued, transition should build upon self-management and independence. Results suggest that there appears to be scope to use mobile phone technology to support transition. This is the first time a review has explored the types of issues or concerns facing liver transplant patients and how these can be addressed through mobile phone technology.~Discussion~Conclusions [ABSTRACT FROM AUTHOR]

Children with autism have atypical gaze behavior but it is unknown whether gaze differs during distinct types of reciprocal interactions. Typically developing children (N = 20) and children with autism (N = 20) (4-13 years) made similar amounts of eye contact with an examiner during a conversation. Surprisingly, there was minimal eye contact during interactive play in both groups. Gaze behavior was stable across 8 weeks in children with autism (N = 15). Lastly, gaze behavior during conversation but not play was associated with autism social affect severity scores (ADOS CSS SA) and the Social Responsiveness Scale (SRS-2). Together findings suggests that eye contact in typical and atypical development is influenced by subtle changes in context, which has implications for optimizing assessments of social communication skills. [ABSTRACT FROM AUTHOR]

Background: TKM-130803, a small interfering RNA lipid nanoparticle product, has been developed for the treatment of Ebola virus disease (EVD), but its efficacy and safety in humans has not been evaluated.Methods and Findings: In this single-arm phase 2 trial, adults with laboratory-confirmed EVD received 0.3 mg/kg of TKM-130803 by intravenous infusion once daily for up to 7 d. On days when trial enrolment capacity was reached, patients were enrolled into a concurrent observational cohort. The primary outcome was survival to day 14 after admission, excluding patients who died within 48 h of admission. After 14 adults with EVD had received TKM-130803, the pre-specified futility boundary was reached, indicating a probability of survival to day 14 of ≤0.55, and enrolment was stopped. Pre-treatment geometric mean Ebola virus load in the 14 TKM-130803 recipients was 2.24 × 109 RNA copies/ml plasma (95% CI 7.52 × 108, 6.66 × 109). Two of the TKM-130803 recipients died within 48 h of admission and were therefore excluded from the primary outcome analysis. Of the remaining 12 TKM-130803 recipients, nine died and three survived. The probability that a TKM-130803 recipient who survived for 48 h will subsequently survive to day 14 was estimated to be 0.27 (95% CI 0.06, 0.58). TKM-130803 infusions were well tolerated, with 56 doses administered and only one possible infusion-related reaction observed. Three patients were enrolled in the observational cohort, of whom two died.Conclusions: Administration of TKM-130803 at a dose of 0.3 mg/kg/d by intravenous infusion to adult patients with severe EVD was not shown to improve survival when compared to historic controls.Trial Registration: Pan African Clinical Trials Registry PACTR201501000997429. [ABSTRACT FROM AUTHOR]

Background Incorporating supportive care into routine cancer care is an increasing priority for the multi-disciplinary team with growing evidence of its importance to patient-centred care. How to design and deliver a process which is appropriate for patients, clinicians and health services in rural areas needs further investigation. Objective To (i) examine the patient and clinician acceptability and feasibility of incorporating a supportive care screening and referral process into routine cancer care in a rural setting, and (ii) explore any potential influences of patient variables on the acceptability of the process. Methods A total of 154 cancer patients and 36 cancer clinicians across two rural areas of Victoria, Australia participated. During treatment visits, patients and clinicians participated in a supportive care process involving screening, discussion of problems, and provision of information and referrals. Structured questionnaires with open and closed questions were used to measure patient and clinician acceptability and feasibility. Results Patients and clinicians found the supportive care process highly acceptable. Screening identified relevant patient problems (90%) and problems that may not have otherwise been identified (83%). The patient-clinician discussion helped patients realize help was available (87%) and enhanced clinician-patient rapport (72%). Patients received useful referrals to services (76%). Feasibility issues included timing of screening for newly diagnosed patients, privacy in discussing problems, clinician time and availability of referral options. No patient demographic or disease factors influenced acceptability or feasibility. Conclusions Patients and clinicians reported high acceptability for the supportive care process, although mechanisms for incorporating the process into health care need to be further developed. [ABSTRACT FROM AUTHOR]

Background Caregiver report is crucial for the diagnosis of childhood onset psychiatric disorders, particularly autism. Three experiments were conducted to determine whether caregiver reports of past and current behaviors are affected by question timing and ordering. Methods Using the Autism Diagnostic Interview - Revised ( ADI-R), two studies systematically varied the order in which caregivers were asked about behaviors. In a third study, descriptions of children's current behaviors at age 5 were compared to retrospective descriptions of behaviors at age 5 collected at age 10. Results Caregivers, who were first asked about a history of symptoms, described less severe past and present behavior than caregivers reporting current behaviors as well as caregivers reporting current and history of symptoms together. Caregivers retrospectively reported more severe behaviors for age 5 when their children were age 10 than they had when their children were age 5. Conclusions Caregivers describe past behaviors differently depending on whether they are asked about current symptoms first. Methods of caregiver reporting can influence interpretations of symptom severity with effects on diagnoses and research findings. [ABSTRACT FROM AUTHOR]

Background: People with mental illness and substance use problems form a significant subgroup of the homeless population. International research has begun to document the complex experiences of this vulnerable group; however, less attention has focused on those living in rural areas. Aim: This study sought to determine the experiences of people with mental illness and/or substance use issues, experiencing significant housing problems in rural areas. Methods: Within a qualitative framework, individual interviews were conducted with 40 respondents in Australia. Results: Themes generated a discussion around three main areas; (1) current housing problems, (2) pathways into unsuitable housing, and (3) factors contributing to appropriate accommodation. Conclusion: The need for agency staff to identify and assist with the housing issues of their clients is underscored. [ABSTRACT FROM AUTHOR]

The 'extreme male brain' theory suggests females with Autism Spectrum Conditions are hyper-masculinized in certain aspects of behavior. We predicted that females with Gender Identity Disorder (who are masculinized) would have elevated Autism Spectrum Quotient (AQ) scores. AQ scores from five groups were compared: (1) n = 61 transmen (female-to-male transsexual people); (2) n = 198 transwomen (male-to-female transsexual people); (3) n = 76 typical males; (4) n = 98 typical females; and (5) n = 125 individuals with Asperger Syndrome (AS). Transmen had a higher mean AQ than typical females, typical males and transwomen, but lower than individuals with AS. Transmen have more autistic traits and may have had difficulty socializing with female peers and thus found it easier to identify with male peer groups. [ABSTRACT FROM AUTHOR]

Background: Increasing awareness of the complexity of public health problems, including obesity, has led to growing interest in whole systems approaches (WSAs), defined as those that consider the multifactorial drivers of overweight and obesity, involve transformative co-ordinated action across a broad range of disciplines and stakeholders, operate across all levels of governance and throughout the life course. This paper reports a systematic review of WSAs targeting obesity and other complex public health and societal issues, such as healthy lifestyles for prevention of non-communicable disease.Methods: Seven electronic databases were searched from 1995 to 2018. Studies were included if there had been an effort to implement a WSA. Study selection was conducted by one reviewer with a random 20% double checked. Data extraction and validity assessment were undertaken by one reviewer and checked by a second reviewer. Narrative synthesis was undertaken.Results: Sixty-five articles were included; 33 about obesity. Most examined multicomponent community approaches, and there was substantial clinical and methodological heterogeneity. Nevertheless, a range of positive health outcomes were reported, with some evidence of whole systems thinking. Positive effects were seen on health behaviours, body mass index (BMI), parental and community awareness, community capacity building, nutrition and physical activity environments, underage drinking behaviour and health, safety and wellbeing of community members, self-efficacy, smoking and tobacco-related disease outcomes. Features of successful approaches reported in process evaluations included: full engagement of relevant partners and community; time to build relationships, trust and capacity; good governance; embedding within a broader policy context; local evaluation; finance.Conclusions: Systems approaches to tackle obesity can have some benefit, but evidence of how to operationalise a WSA to address public health problems is still in its infancy. Future research should: (a) develop an agreed definition of a WSA in relation to obesity, (b) look across multiple sectors to ensure consistency of language and definition, (c) include detailed descriptions of the approaches, and (d) include process and economic evaluations. [ABSTRACT FROM AUTHOR]

The article discusses a study investigating the frequency and risk factors for prevalent, incident, and persistent genital carcinogenic human papillomavirus (HPV) infection in sexually active female students. Results revealed that the prevalence and estimated annual incidence of genital carcinogenic HPV infection were 18 percent and 13 percent, and infection was most common in women reporting multiple sexual partners. It suggests cervical screening for both vaccinated and unvaccinated women.

Background: TRACK-HD is a prospective observational study of Huntington's disease (HD) that examines disease progression in premanifest individuals carrying the mutant HTT gene and those with early stage disease. We report 12-month longitudinal changes, building on baseline findings.Methods: we did a 12-month follow-up of patients recruited from the four TRACK-HD study sites in Canada, France, the Netherlands, and the UK. Participants were premanifest individuals (preHD) carrying the mutant HTT gene, patients with early HD, and controls matched by age and sex with the combined preHD and early HD groups. Data were collected by use of 3T MRI and clinical, cognitive, quantitative motor, oculomotor, and neuropsychiatric measures. Statistical analysis assessed annualised change with the use of linear regression models to estimate differences between groups.Findings: 116 preHD individuals, 114 early HD patients, and 115 people in the control group completed follow-up. Four preHD individuals, nine early HD patients, and eight people in the control group did not complete the follow-up. A further nine participants, who completed follow-up assessments, were unable to undergo MRI. After adjustment for demographics, annualised rates of generalised and regional brain atrophy were higher in preHD and early HD groups than in controls. Whole-brain atrophy rates were 0·20% (95% CI 0·05-0·34; p=0·0071) per year higher in preHD participants and 0·60% (0·44-0·76; p<0·0001) in early HD patients, and caudate atrophy rates were 1·37% (0·99-1·75; p<0·0001) per year higher in preHD and 2·86% (2·34-3·39; p<0·0001) in early HD. Voxel-based morphometry revealed grey-matter and white-matter atrophy, even in subjects furthest from predicted disease onset. Quantitative imaging showed statistically significant associations with disease burden, an indicator of disease pathology, and total functional capacity, a widely-used clinical measure of disease severity. Relative to controls, decline in cognition and quantitative motor function was detectable in both pre- and early HD, as was deterioration in oculomotor function in early HD.Interpretation: quantitative imaging showed the greatest differentiation across the spectrum of disease and functional measures of decline were sensitive in early HD, with cognitive and quantitative motor impairment also detectable in preHD. We show longitudinal change over 12 months in generalised and regional brain volume, cognition, and quantitative motor tasks in individuals many years from predicted disease onset and show the feasibility of obtaining quantifiable endpoints for future trials. [ABSTRACT FROM AUTHOR]