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Multiple endocrine neoplasia type 2 (MEN2) is a hereditary cancer syndrome caused by germline-activating pathogenic variants in the RET proto-oncogene. MEN2A is the most common subtype, with a risk for medullary thyroid cancer (MTC), pheochromocytoma (PHEO), and primary hyperparathyroidism (PHPT), whereas MEN2B is less common and associated with MTC and PHEO along with mucosal neuromas. Little is known about the specific RET germline heterozygous variant K666N. This variant has been described in very few families, and in most cases, patients were diagnosed with a very indolent MTC as the only feature. There is one case of MTC and bilateral PHEO. The RET K666N variant is not stratified yet by the American Thyroid Association, and data are limited on pathogenicity; therefore, appropriate screening and treatment of asymptomatic RET K666N carriers are unclear. Here, we report a family with a heterozygous germline RET K666N variant. The proband was identified when she experienced cardiogenic shock and multi-organ failure after an elective hysterectomy and subsequently was found to have PHEO, with genetic testing revealing the RET K666N germline variant. Patient consent was obtained through IRB protocol COMIRB #15-0516.

Abstract People living with mental illness experience poorer oral health outcomes compared to the general population, yet little is known about their oral health knowledge, attitudes, and practices. The aim of this mixed-methods systematic review was to synthesise evidence regarding oral health knowledge, attitudes, and practices of people living with mental illness to inform preventative strategies and interventions. Database searches were conducted in PubMed, MEDLINE, PsycINFO, CINAHL, ProQuest, and Scopus with no limitations placed on the year of study. All studies available in the English language, that explored the oral health knowledge, attitudes, and/or practices of people with a mental illness were included. Articles were excluded if they primarily pertained to intellectual disability, behavioural and psychological symptoms of dementia, drug and alcohol or substance use, or eating disorders. A thematic synthesis was undertaken of 36 studies (26 high-moderate quality), resulting in 3 themes and 9 sub-themes. Study participants ranged from n = 7 to n = 1095 and aged between 15–83 years with most having a diagnosis of schizophrenia, schizoaffective, or bipolar affective disorder. People diagnosed with a mental illness were found to have limited oral health knowledge, particularly regarding the effects of psychotropic medication. Various barriers to oral health care were identified, including high dental costs, the negative impact of mental illness, dental fears, lack of priority, and poor communication with dental and health care providers. Study participants often displayed a reduced frequency of tooth brushing and dental visits. The findings highlight the potential for mental health care providers, oral health and dental professionals, mental health consumers, and carers to work together more closely to improve oral health outcomes for people with mental illness. The systematic review protocol is registered with the International Prospective Register of Systematic Reviews (PROSPERO), (registration ID CRD42022352122).

Abstract Background Scotland currently has the highest rates of drug-related deaths in Europe, so drug checking services are being explored due to their potential role in reducing these deaths and related harms. Drug checking services allow individuals to submit presumed psychoactive drug samples for analysis, and then receive individualised feedback and counselling. This paper explores participants’ views on the advantages and challenges of three hypothetical service models, to inform future service delivery in Scotland. Methods Semi-structured interviews were conducted with 43 people: 27 professional stakeholders, 11 people with experience of drug use, and five family members across three cities. Vignettes were used to provide short descriptions of three hypothetical service models during the interviews. Interviews were audio-recorded, transcribed and analysed using thematic analysis. Results Participants identified advantages and challenges for each of the three potential service models. The third sector (not-for-profit) model was favoured overall by participants, and the NHS substance use treatment service was the least popular. Participants also noted that multiple drug checking sites within one city, along with outreach models would be advantageous, to meet the diverse needs of different groups of people who use drugs. Conclusions Drug checking services need to be tailored to local context and needs, with a range of service models being possible, in order to meet the needs of a heterogeneous group of people who use drugs. Addressing issues around stigma, accessibility, and concerns about the potential impact of accessing drug checking on access to and outcomes of drug treatment, are essential for successful service delivery.

Disinformation or ‘active measures’, in the parlance of an intelligence professional, are frequently referenced in relation to recent global events. From the feared ‘troll armies’ of the Ukraine conflict to a US election plagued by allegations of foreign meddling we are never far from this malign influence. In Active Measures Thomas Rid takes the reader on a journey through the last century of disinformation. Many may recognise the newsreel moments, but few will know the back stories of subterfuge and intrigue which Rid has researched in impressive detail. For any operator in the political, intelligence or security spheres this is a fascinating and enlightening read which illuminates the threats and myths of disinformation.

Abstract Supporting shelter self-recovery is a modality of humanitarian aid which remains ill-defined and misunderstood despite the many aid organizations that utilize this approach. Of the little existing knowledge and best practices regarding self-recovery support methods, most has been developed for natural disaster contexts, and not post-conflict. Post-conflict situations are much more complex than disasters due to a multitude of economic, social, and other factors. Further research is greatly needed to support self-recovery programs in post-conflict situations, especially due to the complexities involved. This research aims to highlight the unique complexities of post-conflict support to self-recovery and to identify ways of improving this support. This is done through a combination of a literature review and a case study of self-recovery support methods currently being employed in Syria. The results include a framework which identifies and categorizes common factors, barriers, and facilitators which influence the implementation of self-recovery support projects. The results also include a list of recommendations to improve these projects for stakeholders involved. Based on an analysis of these recommendations, five Key Areas for Action are discussed which are as follows: maximizing implementing organizations’ capacities, contextualizing risks, increasing adaptable and flexible programming, addressing the social dimension, and improving international coordination.

In the present article we summarised all known information on the species Lycaena helle ([Denis et Schiffermüller], 1775) from the Balkan Peninsula. A new locality of the species is given, where it is syntopic and synchronic with Clossiana eunomia (Esper, [1799]).

Contrary to the expectations and intentions of inpatient mental healthcare, reports of adverse experiences by people admitted to inpatient settings are common and on the rise. Such experiences negatively impact individuals' mental health and recovery and incur costs to their networks, mental health providers, the healthcare system, and society at large. Research indicates ongoing challenges in understanding and addressing the complex interplay of factors that contribute to a diverse range of adverse experiences, from seclusion, restraint, and coercion, to boredom, loneliness, and lack of therapeutic relationships. There is a pressing need to better understand the mechanisms of adverse inpatient mental health experiences and identify frameworks to aid in more efficient and effective translation of knowledge into practice. This paper proposes self-determination theory (SDT) as a framework that can assist nurse researchers and practitioners elucidate the nature of adverse experiences and guide developments to mitigate adverse outcomes. Critically, SDT prioritises human psychological needs and wellbeing, and thus has potential to inform rights-based, person-centred, recovery-oriented research and development. This paper provides an overview of recent literature on adverse experiences before introducing SDT. It then considers adverse inpatient mental health experiences through the lens of SDT, providing actionable guidance for nursing research and development. [ABSTRACT FROM AUTHOR]

ABSTRACT This position paper explores famous colonial Australian politician Sir Henry Parkes use of relationships to reform colonial Australian mental healthcare by facilitating the integration of Nightingale‐trained nurses into hospitals for the insane in the late nineteenth century. A review of historical sources including primary documents reveals that Parkes exhibited astute political skill by developing relationships with influential healthcare leaders such as Florence Nightingale, Lucy Osburn and Dr. Frederic Norton Manning. As Parkes cultivated friendships with such people, he was able to sow seeds for the deployment of Nightingale nurses including two members from the original group of six nurses sent by Nightingale to Australia in 1868, as well as three nurses trained under their supervision (probationers) into hospitals for the insane. This historical account provides evidence that enables current‐day nurses to understand ways in which events of the past have contributed to the development of present‐day mental health services and systems. Parkes' legacy also encourages contemporary nurses who are interested in change to consider the importance of forging diverse strategic relationships to bring their own visions into reality. [ABSTRACT FROM AUTHOR]

There is a legal duty of confidentiality on the part of nurses working in mental health care. Nonetheless, it may be necessary to release some information if a patient is assessed as posing a potential credible risk, to protect the patient or others from harm. However, contemporary research literature reveals gaps in nurses’ knowledge and practice, with respect to sharing patients’ confidential information. The aim of this study was to understand potential causal factors for these knowledge and practice gaps, so they can be addressed. A theoretical thematic analysis of focus-group data was undertaken. Findings indicated nurses had limited knowledge of confidentiality. Additionally, participants described a paucity of support networks nurses could approach for information. Participants also emphasised their perception that health services unrealistically expected them to always identify and manage patient risk. In summarising these findings, recommendations for interventions to address these knowledge and practice gaps are outlined. [ABSTRACT FROM AUTHOR]