Tag: mental health

UT Health San Antonio launches Be Well Institute for substance use research and treatment

[ad_1]

The University of Texas Health Science Center at San Antonio (UT Health San Antonio) is establishing the Be Well Institute on Substance Use and Related Disorders, a pioneering initiative dedicated to advancing research, education and evidence-based treatments.

The new institute includes the current Be Well Texas initiative of UT Health San Antonio as part of a new overall comprehensive center of excellence with national scope for research, clinical and public health programs, as well as education and community engagement to advance the field addressing addiction and related conditions.

The goal of the Be Well Institute is to be a nationally premiere substance use and addiction institute for clinical care and research to advance the understanding of substance use.

The institute will support grants and contracts, partner with organizational entities at UT Health San Antonio whose activities are relevant to these priorities and provide person-centered, interprofessional and comprehensive care. It also will launch clinical and translational research programs to significantly advance the understanding of substance use to scientific discovery and into daily practice more quickly to improve health and reduce sickness and death.

This institute will lead transformational change in addressing substance use and substance use disorders throughout Texas and the nation.”

Robert A. Hromas, MD, FACP, acting president of UT Health San Antonio

“We support the discovery, development and implementation of new treatments, or more effective use of current treatments, and this important effort will facilitate the recruitment of outstanding scientists and clinicians to UT Health San Antonio,” he said, “accelerating collaboration among scientists, educators and clinicians to discover, validate and implement new treatments, and serve as a vehicle for partnerships among stakeholders in the community to include scientists, providers and policymakers.”

UT Health San Antonio is the largest academic research institution in South Texas with an annual research portfolio of $413 million. Spearheaded by Be Well Texas founding director Jennifer Sharpe Potter, PhD, MPH, vice president for research at UT Health San Antonio, the new institute marks a significant milestone in UT Health San Antonio’s commitment to addressing the complex challenges posed by substance use.

It will provide compassionate and transformational care of people who use substances and those with substance use disorder (SUD) – or co-occurring mental health disorders – through innovative research, local networks and engagement, thereby removing stigma and supporting recovery for patients, their families and communities.

A highly integrated, collaborative center

With more than $50 million in National Institutes of Health, state and other federal funding annually, the Be Well Institute will work as a highly integrated and collaborative center across the university and represent a comprehensive framework and programming for advancing the understanding and treatment of substance use disorders.

Through a diverse array of statewide initiatives, including the Be Well Provider Network, the Be Well Clinic, the Center for Substance Use Training and Telementoring, and the Texas Substance Use Symposium, the institute seeks to expand access to services and support for Texans and beyond.

With support from the National Institute on Drug Abuse Clinical Trials Network and other federal funding, the institute includes research, medical interventions and evidence-based treatments, psychological therapies, social and peer support, counseling on lifestyle changes, follow-up care, provider training and education, and many community outreach and educational initiatives.

Substance use is a significant public health problem that includes several challenges, from the illicit use of substances that have been available for centuries, such as opioids, to drugs that have appeared more recently, like synthetic cannabinoids. Substance use and other mental health disorders worsened significantly during the COVID-19 pandemic. Substance use among many mentally ill patients also increased during that time as many sought to self-medicate.

Although opioids are most prominent in news headlines, the most problematic drugs of abuse in some regions of the United States, including South Texas, are not opioids, but alcohol, marijuana and stimulants like methamphetamine. Alcohol use is a major contributor to morbidity, including cancer, and mortality. The rate of alcohol-related deaths in the U.S. doubled from 1999 to 2017.

There currently are no FDA-approved medications for treating substance use disorder outside of opioids and alcohol. Thus, the exploding use of stimulants and marijuana represents a vast unmet medical need.

The worsening overdose epidemic exemplifies the desperate need to improve prevention and treatment of SUD through research and programmatic efforts. An unprecedented 107,000 Americans died in 2022 from drug overdose, the highest rate ever recorded.

Often lost in the national discussion of this medical crisis is the fact that this dramatic increase in opioid use and overdose occurred despite the availability of FDA-approved medications that are effective in many patients: methadone, buprenorphine and naltrexone for opioid use disorder (OUD) and naloxone for opioid overdose. Discovering and advancing new and innovative approaches for treating opioid overdose and OUD is a critically important endeavor.

Investigators at UT Health San Antonio are conducting state-of-the-art research exploring novel approaches for understanding SUD that will uncover new targets and new methods for treatment.

Similarly, UT Health San Antonio faculty are at the forefront of addressing SUD statewide, including establishing statewide treatment networks, workforce development initiatives and distribution of life-saving naloxone to traditional and non-traditional first responders. Collectively, what is available at UT Health San Antonio is unique in Texas and ready to be expanded nationally.

About Jennifer Sharpe Potter

As a nationally recognized public health scientist and practitioner, Potter leads the state in groundbreaking research and treatment aimed at mitigating addiction, substance use disorders and related disorders. Her expertise spans the development, dissemination and implementation of evidence-based practices to support individuals grappling with substance use disorders.

In her role as vice president for research at UT Health San Antonio, Potter provides strategic oversight over the institution’s research initiatives, ensuring the university’s continued pursuit of excellence in scientific inquiry and innovation. Her leadership also extends to pivotal roles as principal investigator of UT Health San Antonio’s Institute for Integration of Medicine and Science (IIMS) and the National Institute on Drug Abuse (NIDA) Clinical Trials Network (CTN), underscoring her commitment to advancing the frontiers of substance use research.

Prior to joining UT Health San Antonio, Potter was with Harvard Medical School and McLean Hospital in Belmont, Mass. She earned her doctorate in clinical psychology from the University of Georgia and her Master of Public Health from the Rollins School of Public Health at Emory University.

“The launch of the Be Well Institute heralds a new era of collaboration and innovation in the field of substance use research and care,” Potter said, “and stakeholders from across the academic, health care and public sectors are encouraged to join us in this vital endeavor as we strive to improve the lives of individuals and communities affected by substance use disorders.”

Source:

University of Texas Health Science Center at San Antonio

[ad_2]

Source link

April 4, 2024
Banning smartphones is tempting but it won’t solve anxiety in children

[ad_1]

Rolf Vennenbernd/dpa/Alamy

PANIC is spreading – in the press and the playground – about the impact of social media and smartphones on children.

There are many questions around what modern technologies are doing to young minds. Some claim that when we first gave children smartphones, it was the largest uncontrolled experiment humanity ever performed on its own children. That young brains are being rewired, and that social media is responsible for an alarming rise in childhood anxiety.

There has indeed been an increase in anxiety in young people, as we report in our special issue, starting with “The new evidence that explains what anxiety really is”…

[ad_2]

Source link

April 3, 2024

Attacks on emergency room workers prompt debate over tougher penalties

[ad_1]

Ravera, an ER nurse at Sutter Medical Center in Sacramento, recalled an incident in which an agitated patient wanted to leave. “Without any warning he just reached up, grabbed my glasses, and punched me in the face,” said Ravera, 54. “And then he was getting ready to attack another patient in the room.” Ravera and hospital security guards subdued the patient so he couldn’t hurt anyone else.

Violence against health care workers is on the rise, including in the ER, where tensions can run high as staff juggle multiple urgent tasks. Covid-19 only made things worse: With routine care harder to come by, many patients ended up in the ER with serious diseases — and brimming with frustrations.

In California, simple assault against workers inside an ER is considered the same as simple assault against almost anyone else, and carries a maximum punishment of a $1,000 fine and six months in jail. In contrast, simple assault against emergency medical workers in the field, such as an EMT responding to a 911 call, carries maximum penalties of a $2,000 fine and a year in jail. Simple assault does not involve the use of a deadly weapon or the intention to inflict serious bodily injury.

State Assembly member Freddie Rodriguez, who worked as an EMT, has authored a bill to make the punishments consistent: a $2,000 fine and one year in jail for simple assault on any on-the-job emergency health care worker, whether in the field or an ER. The measure would also eliminate the discrepancy for simple battery.

Patients and family members are assaulting staff and “doing things they shouldn’t be doing to the people that are there to take care of your loved ones,” said Rodriguez, a Democrat from Pomona. The bill passed the state Assembly unanimously in January and awaits consideration in the Senate.

Rodriguez has introduced similar measures twice before. Then-Gov. Jerry Brown vetoed one in 2015, saying he doubted a longer jail sentence would deter violence. “We need to find more creative ways to protect the safety of these critical workers,” he wrote in his veto message. The 2019 bill died in the state Senate.

Rodriguez said ERs have become more dangerous for health care workers since then and that “there has to be accountability” for violent behavior. Opponents fear stiffer penalties would be levied disproportionately on patients of color or those with developmental disabilities. They also point out that violent patients can already face penalties under existing assault and battery laws.

Data from the California Division of Occupational Safety and Health shows that reported attacks on ER workers by patients, visitors, and strangers jumped about 25% from 2018 to 2023, from 2,587 to 3,238. The rate of attacks per 100,000 ER visits also increased.

Punching, kicking, pushing, and similar aggression accounted for most of the attacks. Only a small number included weapons.

These numbers are likely an undercount, said Al’ai Alvarez, an ER doctor and clinical associate professor at Stanford University’s Department of Emergency Medicine. Many hospital staffers don’t fill out workplace violence reports because they don’t have time or feel nothing will come of it, he said.

Ravera remembers when her community rallied around health care workers at the start of the pandemic, acting respectfully and bringing food and extra N95 masks to workers.

“Then something just switched,” she said. “The patients became angrier and more aggressive.”

Violence can contribute to burnout and drive workers to quit — or worse, said Alvarez, who has lost colleagues to suicide, and thinks burnout was a key factor. “The cost of burnout is more than just loss of productivity,” he said. “It’s loss of human beings that also had the potential to take care of many more people.”

The National Center for Health Workforce Analysis projects California will experience an 18% shortage of all types of nurses in 2035, the third worst in the country.

Federal legislation called the Safety From Violence for Healthcare Employees Act would set sentences of up to 10 years for assault against a health care worker, not limited to emergency workers, and up to 20 years in cases involving dangerous weapons or bodily injury. Though it was introduced in 2023, it has not yet had a committee hearing.

Opponents of the California bill, which include ACLU California Action, the California Public Defenders Association, and advocates for people with autism, argue it wouldn’t deter attacks — and would unfairly target certain patients.

“There’s no evidence to suggest that increased penalties are going to meaningfully address this conduct,” said Eric Henderson, a legislative advocate for ACLU California Action. “Most importantly, there are already laws on the books to address assaultive conduct.”

Beth Burt, executive director of the Autism Society Inland Empire, said the measure doesn’t take into account the special needs of people with autism and other developmental disorders.

The smells, lights, textures, and crowds in the ER can overstimulate a person with autism, she said. When that happens, they can struggle to articulate their feelings, which can result in a violent outburst, “whether it’s a 9-year-old or a 29-year-old,” Burt said.

She worries that hospital staff may misunderstand these reactions, and involve law enforcement when it’s not necessary. As “a parent, it is still my worst fear” that she’ll get a phone call to inform her that her adult son with autism has been arrested, she said.

Burt would rather the state prioritize de-escalation programs over penalties, such as the training programs for first responders she helped create through the Autism Society Inland Empire. After implementing the training, hospital administrators asked Burt to share some strategies with them, she said. Hospital security staffers who do not want to use physical restraints on autistic patients have also sought her advice, she said.

Supporters of the bill, including health care and law enforcement groups, counter that people with mental health conditions or autism who are charged with assault in an ER may be eligible for existing programs that provide mental health treatment in lieu of a criminal sentence.

Stephanie Jensen, an ER nurse and head of governmental affairs for the Emergency Nurses Association, California State Council, said her organization is simply arguing for equity. “If you punch me in the hospital, it’s the same as if you punch me on the street,” she said.

If lawmakers don’t act, she warned, there won’t be enough workers for the patients who need them.

“It’s hard to keep those human resources accessible when it just seems like you’re showing up to get beat up every day,” Jensen said. “The emergency department is taking it on the chin, literally and figuratively.”

This article was produced by KFF Health News, which publishes California Healthline, an editorially independent service of the California Health Care Foundation.

This article was reprinted from khn.org, a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF – the independent source for health policy research, polling, and journalism.

[ad_2]

Source link

April 3, 2024

The new evidence that explains what anxiety really is

[ad_1]

WHEN I was asked to write this article, my heart started beating faster, my hands started shaking and my thoughts went into overdrive coming up with what felt like hundreds of objectively sensible reasons why I couldn’t do it. I could tell you that as chief subeditor at New Scientist I don’t often get a chance to write. But the truth is I rarely write because I am very anxious about it. What if the people I contact don’t respond? What if I write something stupid? What if I am stupid? What if, what if, what if.

Clearly, I chose to write this article, partly because I am stubborn and hate that these anxious feelings hold me back from doing things I might enjoy, and partly because I find that doing the things that make me anxious helps me overcome that feeling (see “Five scientific ways to help reduce feelings of anxiety”). But my main motivation was to answer questions that have been bothering me for years: what exactly is anxiety and what is happening in my body and brain to cause this feeling?

Answering that first question is difficult, in part because there is no one way to feel anxious. “I’d say there’s as many types of anxiety as there are people in the world,” says Oliver Robinson, head of the Anxiety Lab at University College London.

We do know everyone experiences anxiety – it helps prime us to be ready in possibly risky situations. Consider walking home alone in the dark, where that feeling…

[ad_2]

Source link

April 2, 2024
Why do some people experience anxiety more intensely than others?

[ad_1]

WE ALL know that person, the one who, when faced with what looks like an overwhelming problem, shrugs their shoulders, comes up with a solution and moves on without so much as a furrowed brow.

To someone with even a fleeting relationship with anxiety, it can seem staggering how others go through life with such aplomb. Why are some protected, while others are more prone to experiencing it? Like most aspects of our behaviour, genetics play a part, as do environmental pressures and lifestyle choices. Thankfully, a better understanding of how they interact is helping us find new ways to minimise the problem.

Let’s start with your genes. Studies show that about 30 per cent of the variation of generalised anxiety disorder in the general population is attributable to genetics. This isn’t due to a particular gene, but rather to a host of interacting genetic factors.

For some people, it may be genes associated with the hormone serotonin, which passes messages around the brain. One study in marmosets found a causal relationship between the animals’ perceived level of anxiety and genes responsible for the proteins that mop up serotonin in a brain region called the amygdala, which deals with fear-related memories. When serotonin was blocked from being taken up by cells in the amygdala, the animals’ anxiety seemingly decreased.

This suggests that some people might have a genetic predisposition to absorb too much serotonin into their cells in this region. As a result, less serotonin passes between neurons, disrupting the messages that help us…

[ad_2]

Source link

April 2, 2024

For-profit companies open psychiatric hospitals in areas clamoring for care

[ad_1]

A for-profit company has proposed turning a boarded-up former nursing home here into a psychiatric hospital, joining a national trend toward having such hospitals owned by investors instead of by state governments or nonprofit health systems.

The companies see a business opportunity in the shortage of inpatient beds for people with severe mental illness.

The scarcity of inpatient psychiatric care is evident nationwide, especially in rural areas. People in crisis often are held for days or weeks in emergency rooms or jails, then transported far from their hometowns when a bed opens in a distant hospital.

Eight nonprofit Iowa hospitals have shuttered their psychiatric units since 2007, often citing staffing and financial challenges. Iowa closed two of its four mental health institutions in 2015.

The state now ranks last in the nation for access to state-run psychiatric hospitals, according to the Treatment Advocacy Center. The national group, which promotes improving care for people with severe mental illness, recommends states have at least 50 state-run psychiatric beds per 100,000 people. Iowa has just two such beds per 100,000 residents, the group said.

Two out-of-state companies have developed psychiatric hospitals in Iowa in the past four years, and now a third company has obtained a state “certificate of need” to open a 60-bed facility in Grinnell.

Before 2020, Iowa had no privately owned, free-standing psychiatric hospitals. But several national companies specialize in developing such facilities, which treat people in crisis from conditions such as depression, schizophrenia, or bipolar disorder, sometimes compounded by drug or alcohol abuse. One of the companies operating in Iowa, Universal Health Services, says it has mental health facilities in 39 states.

Lisa Dailey, the Treatment Advocacy Center’s executive director, said that for-profit hospitals don’t necessarily provide worse care than nonprofit ones but that they tend to be less transparent and more motivated by money. “Private facilities are private,” she said. “As a result, you may not have a great insight into why they make the decisions that they make.”

Dailey said solid data on privately run mental health hospitals nationwide is scarce. But she has heard for-profit companies have recently set up free-standing psychiatric hospitals in several states, including California. The California Department of Public Health confirmed three such facilities have opened there since 2021, in Aliso Viejo, Madera, and Sacramento.

The latest Iowa psychiatric hospital would be housed in a vacant nursing home on the outskirts of Grinnell, a college town of 9,500 people in a rural region of the state. The project’s developers noted there are no other inpatient mental health facilities in Poweshiek County, where Grinnell is located, or in any of the eight surrounding counties. The nearest inpatient mental health facilities are 55 miles west in Des Moines.

The Indiana-based company proposing the hospital, Hickory Recovery Network, primarily runs addiction treatment centers in Indiana. But it opened psychiatric hospitals in Ohio and Texas in 2023 and 2024, and it told Iowa regulators it could open the Grinnell hospital by August.

An affiliated company ran the facility as a nursing home, called the Grinnell Health Care Center, until 2022, according to a Hickory Recovery Network filing with Iowa regulators.

Medicare rated the nursing home’s overall quality at just two out of five stars. And in 2020, the facility was suspended indefinitely from Iowa’s Medicaid program because of billing issues, state records show.

Officials from Hickory Recovery Network responded only briefly to KFF Health News inquiries, including about how the former Iowa nursing home’s spotty record could affect the proposed psychiatric hospital.

In a short telephone interview in February, Melissa Durkin, the company’s chief operating officer, declined to say who owns Hickory Recovery Network.

Durkin denied in the interview that her organization was associated with the company that ran the defunct and troubled Grinnell nursing home.

However, Hickory Recovery’s application for a certificate of need refers to the nursing home operator as “Hickory’s affiliated company.” In testimony before Iowa regulators, Durkin made a similar reference as she expressed confidence her organization could find sufficient staff to reopen the facility as a psychiatric hospital. “We have a history with that building. We operated a nursing home there before,” she said at the video-recorded hearing.

Durkin said in the interview that company leaders had not decided for sure to redevelop the vacant Iowa nursing home into a psychiatric hospital, although they twice went through the complicated process of applying for a state “certificate of need” for the project. The first attempt was stymied in 2023 by a tie vote of the board that considers such permits, which are a major hurdle for large health care projects. The second application was approved by a unanimous vote after a hearing on Jan. 25.

Keri Lyn Powers, a Hickory executive, told regulators the company planned to spend $1.5 million to remodel the building. The main changes would include making rooms safe for people who might be suicidal, she said.

The company predicted in its application that 90% of the hospital’s patient revenues would come from Medicare or Medicaid, public programs for seniors or people who have low incomes or disabilities. It doesn’t mention that the nursing home was suspended from Iowa’s Medicaid program, which covers about half of the state’s nursing home residents.

Iowa authorities suspended the Grinnell Health Care Center nursing home in 2020 for failing to repay nearly $25,000 in overpayments from Medicaid, state records show. When the nursing home closed in 2022, its former medical director told the local newspaper part of the reason for its demise was its inability to collect Medicaid reimbursements. Iowa administrators recently notified the owners that the former nursing home owed $284,676 to Medicaid. A state spokesperson said in March that neither amount had been repaid.

The proposal to reopen the building as a psychiatric hospital won support from patient advocates, Grinnell’s nonprofit community hospital, and the regional mental health coordinator.

The only opposition at the state hearing came from Kevin Pettit, leader of one of Iowa’s two other private free-standing psychiatric hospitals. Pettit is chief executive officer of Clive Behavioral Health Hospital, a 100-bed facility in suburban Des Moines that opened in 2021. Pettit told regulators he supports expanding mental health services, but he predicted the proposed Grinnell facility would struggle to hire qualified employees.

He said despite strong demand for care, many Iowa psychiatric facilities are limiting admissions. “The beds exist, but they’re not actually open, … because we’re dealing with staffing issues throughout the state,” Pettit testified.

Overall, Iowa has 901 licensed inpatient mental health beds, including in psychiatric units at community hospitals, in free-standing psychiatric hospitals, and in the two remaining state mental health institutes, according to the Iowa Department of Health and Human Services. But as of January, just 738 of those beds were staffed and being used.

Pettit’s facility is run by Pennsylvania-based Universal Health Services in partnership with MercyOne, a hospital system based in the Des Moines area.

In an interview, Pettit said his hospital only has enough staff to use about half of its beds. He said it’s especially difficult to recruit nurses and therapists, even in an urban area with a relatively robust labor supply.

State inspectors have cited problems at the Clive facility, including four times declaring that deficiencies put patients’ safety in “immediate jeopardy.” Those issues included insufficient staff to properly monitor patients and insufficient safeguards to prevent access to items patients could use to choke or cut themselves.

Pettit said such citations are not unusual in the tightly regulated industry. He said the organization is committed to patient safety. “We value the review by our regulatory entities during the survey process and view any finding as an opportunity for continuous improvement of our operations,” he wrote in an email.

Iowa’s other privately owned psychiatric hospital, Eagle View Behavioral Health in Bettendorf, also has been cited by state inspectors. The 72-bed hospital was purchased in 2022 by Summit BHC from Strategic Behavioral Health, which opened the facility in 2020. Both companies are based in Tennessee.

State inspectors have cited the Bettendorf facility twice for issues posing “immediate jeopardy” to patient safety. In 2023, inspectors cited the facility for insufficient supervision of patients, “resulting in inappropriate sexual activity” between adult and adolescent patients. In 2021, the facility was cited for insufficient safety checks to prevent suicide attempts and sexual misconduct.

Eagle View officials did not respond to requests for comment.

Advocates for Iowa patients have supported the development of free-standing psychiatric hospitals.

Leslie Carpenter of Iowa City, whose adult son has been hospitalized repeatedly for severe mental illness, spoke in favor of the Grinnell facility’s application for a certificate of need.

In an interview afterward, Carpenter said she was optimistic the new facility could find enough staff to help address Iowa’s critical shortage of inpatient psychiatric care.

She said she would keep a close eye on how the new facility fares. “I think if a company were willing to come in and do the job well, it could be a game changer.”

[ad_2]

Source link

April 1, 2024

Green environments linked to lower depression and anxiety risk, study finds

[ad_1]

In a prospective cohort study published in the journal Nature Mental Health, researchers in China investigated the potential association between exposure to residential greenness and the incidence of anxiety and depression and explored the underlying pathways. They found prolonged residence in green environments was linked to a lower risk of depression and anxiety, potentially via air pollution.

Study: Long-term exposure to residential greenness and decreased risk of depression and anxiety. Image Credit: p-jitti / Shutterstock

Background

Mental disorders, including depression and anxiety, are among the most debilitating conditions, with their impact on global health burden rising steadily. These disorders affect millions worldwide and are influenced by genetic, behavioral, and environmental factors. Recognizing modifiable factors associated with mental health issues could offer valuable targets for interventions and inform potential treatment strategies.

A growing body of evidence now recognizes residential greenness as a significant environmental factor in reducing stress and improving health, particularly mental well-being. While some longitudinal studies suggest a negative association between green spaces and depression, inconsistent findings highlight the need for larger, well-designed prospective cohort studies to better understand this relationship. Although long-term exposure to greenness is hypothesized to provide cumulative mental health benefits through various pathways, there is a dearth of population-based evidence, and the predominant mechanism remains uncertain. In the present cohort study, researchers explored the link between long-term exposure to residential greenness, depression, and anxiety while examining the potential pathways and factors.

About the study

Data from 409,556 participants were obtained from the United Kingdom (UK) Biobank, a large prospective cohort. The median age of participants was 58 years, and 52.4% were female. About 90.8% of the participants were white, and 86.2% resided in urban areas. Participants provided detailed information through questionnaires, physical measurements, and biological samples. The analysis focused on associations between residential greenness and incident depression and anxiety, excluding those with pre-existing mental health issues. Subsets of participants were analyzed to explore the potential pathways. The mean follow-up duration was 11.9 years.

Greenness around residential areas was evaluated using NDVI (short for Normalized Difference Vegetation Index), a measure based on land surface reflection of infrared wavelengths within buffer regions of sizes 300 m, 500 m, 1,000 m, and 1,500 m. Data were obtained from moderate-resolution imaging spectroradiometer remote sensing. Preprocessing was performed to remove cloudy and snow-covered areas, and water body impacts were addressed. Anxiety or depression diagnoses at baseline and follow-up were confirmed using hospital admissions, death registry, primary care records, and self-reports verified by healthcare professionals. Cases were identified using the International Statistical Classification of Diseases and Related Health Problems (ICD-10) codes.

Various potential confounders and mediators were considered in the analysis, including sociodemographic factors (age, gender, ethnicity, income, education, residence location), lifestyle factors (body mass index (BMI), smoking status, drinking status), and environmental factors (air pollutants, noise, water percentage, urban morphometric measures). Statistical analyses involved time-varying Cox proportional hazard models, hazard ratios (HR), restricted cubic splines, mediation analysis, subgroup analysis, and sensitivity analysis.

Results and discussion

In the study period, about 4.1% and 3.5% of the total participants were diagnosed with anxiety (HR = HR = 0.86) and depression (HR = 0.84), respectively. Residential greenness exposure consistently showed a protective effect on depression and anxiety, with significant reductions in risk observed across different buffer sizes. Mediation analyses indicated that air pollution, mainly particulate matter of diameter 2.5 microns (PM_2.5), NO₂, NO_x, SO₂, and O₃, significantly mediated the associations between NDVI and both depression and anxiety. Further, IMD (short for index of multiple deprivation) was found to mediate the association between NDVI and depression. Additionally, factors such as distance to coast, factory, and healthcare places, as well as lifestyle factors like sleep duration and social engagement, showed small but significant mediation effects. The protective effects of green surroundings were found to be more pronounced against depression and anxiety in older adults and males.

Sensitivity analyses confirmed the robustness of the main findings. The large sample size, long follow-up duration, detailed adjustment for potential confounders, and exploration of potential mediators strengthen the findings. However, the study is limited by the lack of details on green space quality, the potential influence of extraneous factors on greenness exposure, healthy volunteer bias, and potential bias introduced by using diagnosis rather than symptom onset. Further research is warranted to confirm these findings.

Conclusion

In conclusion, this is the first prospective cohort study to provide comprehensive insights into the association between exposure to greenness and mental health. The findings reveal that long-term exposure to residential greenness is linked to lower risks of depression and anxiety. Higher levels of green surroundings showed more substantial positive effects on mental health, with reduced air pollution identified as a significant mediator. These findings call for strategic urban planning interventions by local governments to promote mental well-being by enhancing green spaces.

[ad_2]

Source link

April 1, 2024
New study to test novel psychedelic compound as potential treatment for alcohol use disorder

[ad_1]

Modern mental health company Clerkenwell Health announced today that it is working with clinical-stage biotechnology company Beckley Psytech on a Phase IIa study investigating whether a novel psychedelic compound, combined with psychological support, could be an effective treatment for alcohol use disorder (AUD).

NHS figures suggest over 7.5 million people in the UK live with AUD – commonly referred to as alcohol dependency.

The open-label trial (NCT05674929), which is already underway at King’s College London, will evaluate the safety, tolerability and pharmacodynamic effects of a single dose of Beckley Psytech’s lead candidate, BPL-003, in combination with abstinence-oriented psychological support in participants with AUD. Participants will be followed for 12 weeks after initial dosing, with safety, pharmacokinetic and efficacy assessments conducted at multiple points throughout that period. The trial will now go ahead as well at Clerkenwell Health’s clinic near Harley Street, London and people interested in participating in this trial can register here.

BPL-003 is a novel, synthetic formulation of mebufotenin (5-MeO-DMT) which is a psychedelic of the tryptamine class naturally found in several plant species and the glands of at least one toad species. BPL-003 is administered intranasally and can elicit psychedelic experiences of similar intensity but shorter duration than psilocybin, which is found in ‘magic mushrooms’ and has shown early promise in substance abuse disorders.

Treating AUDs is a pressing concern for the UK health system. Data from Public Health England shows there were 20,970 deaths related to alcohol in England in 2021, and from 2021 to 2022, there were 342,795 hospital admissions that were wholly due to alcohol, equating to 1 in 160 people.

The results of this AUD trial may be used to provide support for further study of psychedelic-assisted treatment for alcohol dependency.

Dr Henry Fisher, Chief Scientific Officer at Clerkenwell Health, said: “An estimated 600,000 people are dependent on alcohol in England. This, coupled with an alarming increase in alcohol-related deaths of 89% over the past 20 years, shows the status quo isn’t working. Conventional treatments for alcohol dependency aren’t producing meaningful improvements and new avenues must be explored. This trial will assess whether psychedelic-assisted treatment can be an effective therapy for alcohol use disorder, with the hope of rolling out the treatment widely. Health professionals and policymakers should seriously consider such treatments, which could be genuinely ground-breaking for the NHS and for the hundreds of thousands of people being treated for alcohol use disorder in the UK.”

We’re committed to developing a transformative and effective treatment option for individuals struggling with alcohol use disorder. Based on our preclinical and Phase I data, we are optimistic about the potential therapeutic benefits of BPL-003 for substance use disorders and we are excited to evaluate the compound further in this clinical trial. I want to extend my thanks to the team at Clerkenwell Health and King’s, as well as to the patients who have joined, and will join, this study. Their participation, support and collaboration are absolutely critical to furthering research into this area of huge unmet need.”

Dr Rob Conley, Chief Medical and Scientific Officer, Beckley Psytech

A growing body of research suggests that psychedelic drugs could be a pioneering force in the treatment of complex mental health conditions including substance use disorders.

The novel combination of staged psychological support and the administration of a psychedelic compound in the presence of a trained counsellor is a paradigm shift for the substance abuse disorder and mental health treatment sector which has seen no significant new treatment options developed for a number of decades.

[ad_2]

Source link

March 30, 2024
Smartphones Do or Don’t Harm Kids! So Which Is It?

[ad_1]

The anti-smartphone movement is having a moment. On March 25, Florida governor Ron DeSantis signed a bill banning children under 14 from social media platforms. In February, the UK government backed tighter guidance to keep children from using their smartphones at school. In the past year, grassroots organizations like Smartphone Free Childhood have risen to national prominence as parents fret about the damage that screens and social media might be causing to young people’s mental health.

Beneath all this worry is a fiendishly difficult question: What impact are smartphones having on our mental health? The answer depends on who you ask. For some, the evidence that smartphones are eroding our well-being is overwhelming. Others counter that it isn’t all that strong. There are blogs, then counter-blogs, each often pointing to the same scientific papers and drawing opposing conclusions.

Into this maelstrom we can now add two books, published within a week of each other, that sit squarely in opposite corners in the fight. In The Anxious Generation: How the Great Rewiring of Childhood Is Causing an Epidemic of Mental Illness, social psychologist and author Jonathan Haidt lays out his argument that smartphones and social media are the key driver of the decline in youth mental health seen in many countries since the early 2010s.

The early 2010s were crucial, Haidt argues, because that was when smartphones really began to transform childhood into something unrecognizable. In June 2010, Apple introduced its first front-facing camera, and a few months later Instagram launched on the App Store. For Haidt, this was a fateful combination. Children were suddenly always online, always on display, and connected in ways that were often detrimental to their well-being. The result was a “tidal wave” of anxiety, depression, and self-harm, mostly affecting young girls.

In Haidt’s telling, though, smartphones are only part of the problem. He thinks that children in the West are prevented from developing healthily thanks to a culture of “safetyism” that keeps children indoors, shelters them from risks, and replaces rough-and-tumble free play with adult-directed organized sports or—even worse—video games. For evidence of safetyism in action, Haidt contrasts a picture of a 1970s playground merry-go-round, (“the greatest piece of playground equipment ever invented”) with a modern set of play equipment designed with safety in mind and, thus, giving children less opportunity to learn from risky play.

This is Haidt’s Great Rewiring in a nutshell: Childhood has switched from being predominantly play-based to being phone-based, and as a result, young people are less happy as children and less competent as adults. They are also, Haidt seems to argue, more boring. US high school seniors today are less likely to have drunk alcohol, had sex, have a driving license, or worked than their predecessors. Wrapped in cotton wool by their parents and absorbed by their online lives, young people aren’t transitioning into adulthood in a healthy way, Haidt argues.

These arguments are familiar from Haidt’s 2018 book, The Coddling of the American Mind, coauthored with journalist and activist Greg Lukianoff. It’s not just that American children are experiencing worse mental health than before, Haidt suggests, but that their transition to adulthood is now stymied by modern parenting and technology. “Once we had a new generation hooked on smartphones before the start of puberty, there was little space left in the stream of information entering their eyes and ears for guidance from mentors in their real-world communities during puberty,” Haidt writes in his latest work.

[ad_2]

Source link

March 29, 2024
Bridging the gap in stroke care with virtual rehabilitation

[ad_1]

A stroke often impacts a person’s ability to move their lower body from the hips down to the feet.

This leads to diminished quality of life and mental health in addition to increased susceptibility to falls. But now, UBC Okanagan researchers are exploring new treatment methods to help bridge the service delivery gap, and recovery outcomes, for patients after a stroke.

Shortened length of inpatient stays and continued challenges in transitioning back to the community-;including poor access to continued stroke rehabilitation services-;have resulted in substantial unmet recovery needs. This is especially true for lower extremity recovery. People can struggle to regain balance, stability and gait coordination for daily life activities and even proper ambulation.”

Sarah Park, master’s student with the Centre for Chronic Disease Prevention and Management (CCDPM) based at UBC Okanagan

Dr. Brodie Sakakibara, CCDPM Investigator, recently led a national team of researchers, clinicians and people with lived experiences to evaluate the feasibility of a telerehabilitation program with aims to improve lower extremity recovery poststroke.

“More people are surviving a stroke and the need for accessible rehabilitation regardless of geographic location is increasingly important,” says Dr. Sakakibara. “This program harnesses technology, the expertise of clinical therapists and the motivation of individuals to improve stroke recovery.”

For the study, more than 32 participants, all who had experienced a stroke within the past 18 months, received eight telerehabilitation sessions via videoconference with a trained physical therapist. The research team focused their efforts on improving lower body mobility through standardized exercises combined with self-management supports.

“Overall, participants saw improvements in their mobility and strength, and made noticeable progress towards their rehabilitation goals,” says co-investigator Dr. Ada Tang, an Associate Professor with the School of Rehabilitation Sciences at McMaster University. “They also gained self-management skills to empower themselves and maintain their achievements moving forward.”

While many virtual rehabilitation programs developed out of necessity during the COVID-19 pandemic, programs like this have demonstrated feasibility and increased accessibility to patients. Especially those living in rural and remote areas.

However, researchers have noted therapeutic benefits are not maintained if additional therapy is not sustained after the end of a formal program, explains Park, who was also lead author of the study. It is important to incorporate self-management skills in post-stroke rehabilitation interventions, which empower participants to continue exercising and maintain those benefits after the program ends.

“Overall, self-management programs aim to improve health outcomes by helping people adapt to their circumstances through newfound skills, which could prevent or offset some of the difficulties individuals face when discharged from care,” Park explains. “Virtual rehabilitation programs, with a level of self-management, can ultimately enhance the continuum of care for patients transitioning back into the community and help improve their overall quality of life.”

The study was published recently by the Physical Therapy and Rehabilitation Journal.

Source:

University of British Columbia Okanagan campus

Journal reference:

Park, S., et al. (2023). Investigating the Telerehabilitation with Aims to Improve Lower Extremity Recovery Post-Stroke (TRAIL) Program: A Feasibility Study. Physical Therapy and Rehabilitation Journal. doi.org/10.1093/ptj/pzad165.

[ad_2]

Source link

March 29, 2024

Tag: mental health

A highly integrated, collaborative center

About Jennifer Sharpe Potter

Background

About the study

Results and discussion

Conclusion