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Climate change is affecting both the frequency and scale of wildfires, as well as the increase in the number of days with Saharan dust intrusions. Traditionally, studies have focused on the extent to which the increase in fine particulate matter (PM) has had an impact on cardio-respiratory diseases, but (apart from PM) not on how the meteorological and pollution conditions in these situations affect other diseases, such as those linked to mental health. This study therefore sought to ascertain how daily mean PM10, PM 2.5, NO2, O3 concentrations and daily maximum temperature in heat waves influence daily emergency hospital admissions in Spain caused by mental and behavioural disorders, depression and anxiety on days with PM from biomass combustion and/or Saharan dust intrusions, as compared to days without such conditions, across the period 2009-2018. Our results indicate that on days on which there is biomass combustion, PM concentrations have a statistically significant effect on emergency admissions due to mental disorders, probably related with the toxicity of these particles. Yet on days with intrusions of Saharan dust rather than PM, it is the other variables considered in the analysis that are most closely linked to these types of admissions. The results of this study thus point to the need to implement public health prevention plans which take into account the joint effect of various environmental risk factors that act synergistically in given situations.

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OBJECTIVE: Aim: To investigate the gender and age characteristics of psychopathological symptoms in patients in the acute phase of respiratory infection SARS-CoV-2. PATIENTS AND METHODS: Materials and Methods: A total of 66 patients aged 8 to 92 years, sick with COVID-19 during inpatient treatment with lung damage from 30 to 70%, confirmed radiologically, in the period up to 20 days from the onset of the disease, were examined. To assess the mental status of patients with COVID-19, we used a clinical, clinical-psychopathological, psychometric method, which included the following questionnaires as part of psychiatric screening for studying psychopathological symptoms upon admission to the hospital. The Patient Health Questionnaire - PHQ-9, The Generalised Anxiety Disorder - GAD-7, Hamilton Test were used. The research data collection period is from 2020 to 2022. RESULTS: Results: Acute respiratory infection СОVID-19 affects the psycho-emotional state. During inpatient treatment, 60.6% of patients have symptoms of depression, 66.1% have anxiety symptoms. Most women with COVID-19 are characterized by moderate depression according to PHQ-9, mild anxiety according to GAD-7, and moderate anxiety according to Hamilton. Mild depression characterizes most men according to PHQ-9, absence of anxiety according to GAD-7, and mild anxiety according to Hamilton. Anxiety symptoms were less pronounced among men with COVID-19, with insomnia and respiratory symptoms being the most significant. Among women, anxiety (p≤0.001), tension, depression (p≤0.001), somatic muscle (p≤0.001) and respiratory symptoms (p≤0.001) predominate in the structure of anxiety during the active phase of COVID-19. CONCLUSION: Conclusions: The data obtained will be useful in the development of psychoprophylactic measures in patients with COVID-19.

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Art therapy is employed in numerous ways in rehabilitation. This study focuses on an art and movement therapy project carried out during the COVID-19 pandemic. Acting and dancing methods were adapted to produce a short musical film series for ten children from disadvantaged social backgrounds displaying nonorganic behavioural disorders. The aim was to acquire novel ways of expression on the part of the participants to release painful emotions in a safe setting using the method of catharsis through acting and dancing, triggering relaxation as a physiological response and improving their attitude. This study retrospectively analyses the changes in the children's behaviour and their active participation in the project through quantitative and qualitative research. The children improved their attention and self-esteem, their behaviour became less aggressive and impulsive, and half showed increased empathy. The active participation rate during the project was 82%.

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OBJECTIVE: An analysis of the trend of overall and primary incidence of mental and behavioral disorders, including those caused by the use of psychoactive substances, in different age groups during the COVID-19 pandemic in Penza Oblast. MATERIAL AND METHODS: The data were obtained from statistical report №12 for Penza Oblast. These included the overall and primary incidence of mental and behavioral disorders (MBD), as well as substance use-related MBD (MBDSUR), as calculated per 100.000 people for the period 2015 to 2022. The period 2015 to 2019 was the reference period and 2020 to 2022 was the pandemic period. The calculation was carried out by age groups: children (0-14 years), adolescents (15-17 years), adults (over 18 years), adults over working age (from 55 years for women and from 60 years for men). Statistical processing of the results included regression analysis, calculation of incidence forecast for 2023-2025, and assessment of the significance of the changes using the t-criterion. RESULTS: The decrease in the overall incidence of MBD in adults was highly deterministic (R2=0.82; p=0.012) and significant between 2017-2018 (p=0.009), 2018-2019 (p=0.001) and 2019-2020 (p=0.004). High determination with a logarithmic trend line was characteristic of almost all models, except for the primary incidence of MBD in children and overall incidence of MBDSUR in adults over working age, including after 2020. Among adolescents, the overall incidence of MBDSUR decreased significantly from 2015 to 2022 (p=0.042). CONCLUSION: There was no significant increase in the incidence of MBD, including MBDURS, during the pandemic. At the same time, there was a trend towards the decrease in adults, as well as the increase in the primary incidence of MBD in children and the overall incidence of MBDSUR in adults over working age, which determines the need for further identification of risk factors and development of specific rehabilitation measures for patients in these groups.

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The breast cancer 1 (Brca1) susceptibility gene regulates the repair of reactive oxygen species (ROS)-mediated DNA damage, which is implicated in neurodevelopmental disorders. Alcohol (ethanol, EtOH) exposure during pregnancy causes fetal alcohol spectrum disorders (FASD), including abnormal brain function, associated with enhanced ROS-initiated DNA damage. Herein, oxidative DNA damage in fetal brains and neurodevelopmental disorders were enhanced in saline-exposed +/- vs. +/+ Brca1 littermates. A single EtOH exposure during gestation further enhanced oxidative DNA damage, altered the expression of developmental/DNA damage response genes in fetal brains, and resulted in neurodevelopmental disorders, all of which were BRCA1-dependent. Pretreatment with the ROS inhibitor phenylbutylnitrone (PBN) blocked DNA damage and some neurodevelopmental disorders in both saline- and EtOH-exposed progeny, corroborating a ROS-dependent mechanism. Fetal BRCA1 protects against altered gene expression and neurodevelopmental disorders caused by both physiological and EtOH-enhanced levels of ROS formation. BRCA1 deficiencies may enhance the risk for FASD.

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Introducción: La pandemia por SARS-CoV-2 ha tenido un alto impacto en la salud física y psicológica de la población. Nuestro objetivo fue evaluar la salud mental infanto-juvenil de una cohorte poblacional a lo largo del curso 2020-2021. Métodos: Estudio longitudinal y prospectivo de una cohorte de niños escolarizados entre 5 y 14años en Cataluña entre septiembre de 2020 y julio de 2021. Los participantes fueron seleccionados de forma aleatoria y seguidos por el pediatra de referencia en la atención primaria. La evaluación del riesgo de psicopatología fue realizada a través del Strengths and Difficulties Questionnaire (SDQ), contestada por un tutor legal del niño. Fueron recogidas también variables sociodemográficas y de salud del individuo y su núcleo de convivencia. Los datos fueron recogidos mediante una encuesta on-line a través de la plataforma RedCap al inicio del curso y al final de cada trimestre (4cortes). Resultados: Al inicio del curso escolar el 9,8% de los alumnos fueron casos probables de psicopatología, frente al 6,2% de final de curso. La percepción del nivel de preocupación de los niños por su salud y la de su familia se relacionó con presentar psicopatología, especialmente al inicio del curso, mientras que la percepción de un buen ambiente familiar se relacionó en todo momento con menor riesgo. Ninguna variable relacionada con la COVID-19 se asoció con resultado alterado del SDQ. Conclusiones: A lo largo del curso escolar 2020-2021 el porcentaje de niños con probabilidad de presentar psicopatología mejoró, y pasó del 9,8% al 6,2%. (AU)

Introduction: The SARS-CoV-2 pandemic has had a great impact on the physical and psychological health of the population. The aim of our study was to assess child and adolescent mental health in a cohort throughout the 2020-2021 school year. Methods: We conducted a longitudinal prospective study in a cohort of children aged 5 to 14 years in Catalonia, Spain, from September 2020 to July 2021. Participants were randomly selected and followed up by their primary care paediatricians. The risk of mental health problems was assessed with the Strengths and Difficulties Questionnaire (SDQ), completed by one of the legal guardians of the child. In addition, we obtained information on the sociodemographic and health characteristics of the participants and their nuclear families. We collected the data by means of an online survey through the REDCap platform at the beginning of the academic year and at the end of each term (4 time points). ResultsAt the beginning of the school year, 9.8% of participants were cases of probable psychopathology compared to 6.2% at the end of the year. The perceived level of worry of the children for their own health and the health of their families was associated with the presence of psychopathology, especially at the beginning of the year, while the perception of a good family atmosphere was consistently associated with a decreased risk. No variable related to COVID-19 was associated with abnormal results in the SDQ. Conclusions: During the 2020-2021 school year, the percentage of children with probable psychopathology decreased from 9.8% to 6.2%. (AU)

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Congenital disorders of glycosylation (CDGs) are a wide group of genetic diseases characterised by a severe clinical spectrum, consisting of developmental delays, dysmorphisms, and neurological deficits. Mutations in the PIGV gene lead to a disorder called hyperphosphatasia with impaired intellectual development syndrome 1 (HPMRS1), distinct from other CDGs in terms of hyperphosphatemia related to abnormal ALP activity and brachytelephalangy. This article discusses the phenotype of six Polish patients with HPMRS1 with a special focus on behavioural and imaging features, which were not addressed in 26 previously reported cases. The medical records of six patients aged 6 to 22 years were collected and analysed. In all cases, the same PIGV homozygotic mutation (c.1022C>A; p.Ala341Glu) was found, although the patients presented a diverse spectrum of neurological and developmental disorders, concerning in most cases the muscular tonus and general developmental delay. The most prevalent dysmorphic features included hypertelorism, high palate, and finger anomalies, whereas other characteristics present in all previously described cases, such as a short, broad nose and brachytelephalangy, were less frequently observed. Similarly to previous reports, the magnetic resonance (MR) and computed tomography (CT) head scans returned varied results, including physiological and pathological brain images in equal measure, the latter of which consisted of cortical atrophy, delayed myelination, hydrocephalus, and hypoplastic corpus callosum. Each patient exhibited symptoms characteristic of autism spectrum disorders, especially in terms of attention deficits, as well as controlling and expressing emotions. The most common type of sensory processing disorder was over-responsivity. Despite the low prevalence of HPMRS1, the patients reported in the literature presented a rather uniform phenotype, which does not correspond with the one found in each individual of the studied group. Behavioural disorders and sensory impairment require additional care and awareness considering the global developmental delay often observed in these patients.

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Introduction: The SARS-CoV-2 pandemic has had a great impact on the physical and psychological health of the population. The aim of our study was to assess child and adolescent mental health in a cohort throughout the 2020-2021 school year. Methods: We conducted a longitudinal prospective study in a cohort of children aged 5 to 14 years in Catalonia, Spain, from September 2020 to July 2021. Participants were randomly selected and followed up by their primary care paediatricians. The risk of mental health problems was assessed with the Strengths and Difficulties Questionnaire (SDQ), completed by one of the legal guardians of the child. In addition, we obtained information on the sociodemographic and health characteristics of the participants and their nuclear families. We collected the data by means of an online survey through the REDCap platform at the beginning of the academic year and at the end of each term (4 time points). Results: At the beginning of the school year, 9.8% of participants were cases of probable psychopathology compared to 6.2% at the end of the year. The perceived level of worry of the children for their own health and the health of their families was associated with the presence of psychopathology, especially at the beginning of the year, while the perception of a good family atmosphere was consistently associated with a decreased risk. No variable related to COVID-19 was associated with abnormal results in the SDQ. Conclusions: During the 2020-2021 school year, the percentage of children with probable psychopathology decreased from 9.8% to 6.2%.

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BACKGROUND: Stigma toward mental illness (MI), physical disability (DA), and emotional/behavioral disorders (EBD) has been identified as a form of violence and a cause of nontake-up of help by people in need. Stigmatization can aggravate an individual's feeling of rejection and incompetence and can be detrimental to treatment-seeking and adherence behaviors. This study evaluated the attitude of healthcare students toward MI, DA, and EBDs. MATERIALS AND METHODS: This study employed a cross-sectional survey method. A disproportionate stratified sampling technique was used to recruit participants. Sixty five consenting students who met the inclusion criteria were consecutively recruited from each clinical department of the college. The students were selected from the five clinical departments of the College (Nursing sciences, Medical Rehabilitation, Radiography, Medical laboratory science, and Medicine). The questionnaires on stigmatizing attitudes toward MI, EBD, and DA were self-administered. Descriptive statistics of frequency count, percentage, range, mean, and standard deviation were used to summarize participants' sociodemographic data and their questionnaire scores. Inferential statistics of Spearman rank order correlation was used to test for correlation; Mann-Whitney U test was used to test the influence of gender, religion, and family history; and Kruskal-Wallis test was used to test the influence of department of study and level of study. Alpha level was set at 0.05. RESULTS: Three hundred twenty seven students comprising 164 (50.2%) males and 163 (49.8%) females participated. Mean age of participants was 22.89 ± 2.05 years. 45.3% of the participants reported positive family history of one or a combination of MI, DA, and EBDs. The study observed poor attitude toward MI and fair attitude toward DA and EBD. There were significant correlations between attitudes toward MI and disability (r = 0.36, P =.000033), MI and EBD (r = 0.23, P =.000023), disability and EBD (r = 0.46, P =.000001), and age and attitude toward disability (r = 0.15, P =.009). Females had significantly more positive attitude toward disability (P =.03) and EBDs (P =.03). Nursing students also demonstrated the most positive attitudes toward MI (P =.03) and EBD (P =.000416), while final year students demonstrated the most positive attitudes toward MI (P =.00145) and EBDs (P =.03). CONCLUSIONS: There was a poor attitude toward MI and a fair attitude toward DA and EBD. Attitude toward MI, DA, and EBD correlated significantly with one another. Older students, females, and higher levels of training in the healthcare profession were associated with more positive attitudes toward MI, DA, and EBDs.

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BACKGROUND: Temporomandibular disorders (TMD) are associated with musculoskeletal diseases (MSD), mental and behavioural disorders (MBD), and patients with TMD have been shown to have 2-3 times more days of sick leave (SL) and disability pension (DP) than the general population. MSD and MBD are two of the most common causes for SL and DP, and the association between TMD and the influence of comorbidities on the need for SL and DP among TMD patients need further clarification. This study investigates the impact of MSD and MBD comorbidity on SL and DP among TMD patients diagnosed in a hospital setting and/or surgically treated. METHODS: All incident TMD patients diagnosed or treated in a hospital setting between 1998 and 2016 and aged 23-59 were included. A non-exposed comparison cohort was collected from the general population. The cohorts were grouped based on the presence of comorbidity: No comorbidity (Group I); MSD comorbidity (Group II); MBD comorbidity (Group III); and combined MSD and MBD comorbidity (Group IV). Main outcomes were mean annual days of SL and DP, and statistical analysis was conducted using generalized estimated equations. RESULTS: TMD subjects with no comorbidities (Group I) and with MSD/MBD comorbidity (Group II and III) were 2-3 times more often on SL and DP than the corresponding groups from the general population. However, in the group with both MSD and MBD comorbidity (Group IV), the difference between the TMD subjects and the general population was diminishing, suggesting an additive effect. CONCLUSION: TMD patients are more dependent on SL and DP benefits compared to general population and the difference remains even after considering MSD and MBD comorbidity. In individuals with combined MSD and MBD comorbidity, concurrent TMD has less impact on the need for social insurance benefits. The results accentuate the impact TMD has on the patients' impaired ability to return to work and why TMD should be recognized as having a substantial impact on individual and economic suffering as well as on societal costs, with emphasis on the influence of comorbidities on patient suffering.

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"We are all in this together" - we often hear this phrase when we want to flag up a problem that is not for a single individual but concerns us all. A similar reflection has been recently made in the field of mental disorders where brain-centric scientists have started to zoom out their brain-focused graphical representations of the mechanisms regulating psychiatric diseases to include other organs or mediators that did not belong historically to the world of neuroscience. The brain itself - that has long been seen as a master in command secluded in its fortress (the blood brain barrier), has now become a collection of Airbnb(s) where all sorts of cells come in and out and sometimes even rearrange the furniture! Under this new framework of reference, mental disorders have become multisystem pathologies where different biological systems - not just the CNS -contribute 'all together' to the development and severity of the disease. In this narrative review article, we will focus on one of the most popular biological systems that has been shown to influence the functioning of the CNS: the immune system. We will specifically highlight the two main features of the immune system and the CNS that we think are important in the context of mental disorders: plasticity and memory.

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AIMS: Residual work capacity and inability to work fulltime are important outcomes in disability benefit assessment for workers with mental and behavioural disorders. The aim of this study is to gain insight into the prevalence and associations of socio-demographic and disease-related factors of these outcomes across different mental and behavioural diagnoses groups. METHODS: A year cohort of anonymized register-data of patients diagnosed with a mental or behavioural disorder who claim a work disability benefit after two years of sick-leave was used (n = 12,325, age 44.5 ± 10.9, 55.5% female). Limitations in mental and physical functioning caused by disease are indicated according to the Functional Ability List (FAL). No residual work capacity was defined as having no possibilities to work, whereas inability to work fulltime was defined as being able to work less than 8 h per day. RESULTS: The majority (77.5%) of the applicants were assessed with residual work capacity, of these 58.6% had an ability to work fulltime. Applicants diagnosed with (post-traumatic) stress, mood affective and delusional disorders showed significant higher odds for no residual work capacity and for inability to work fulltime, while other diagnoses groups, like adjustment and anxiety disorders, showed decreased odds for both assessment outcomes. CONCLUSIONS: The type of mental and behavioural disorder seems important in the assessment of residual work capacity and inability to work fulltime, as the associations differ significantly between the specific diagnoses groups.

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Objetivos: La prevalencia de niños con dificultades en la alimentación (NDA) o malos comedores es alta en nuestro medio, si consideramos la opinión de los padres. Aunque en la mayoría no observamos enfermedad orgánica o repercusión nutricional, es frecuente que este problema repercuta en la dinámica familiar. Nos proponemos estimar su impacto en el estrés, la calidad de vida y el estado de salud psicológica familiar.Métodos: Estudio de casos (NDA) y controles (controles sanos y controles con trastornos digestivos o controles enfermos). Se evaluó el estrés parental y el riesgo de afectación psicológica en estas familias, mediante escalas validadas (Parent Stress Index Short Form y General Health Questionnaire de Goldberg) y una encuesta de opinión a los padres. Resultados: Se recogieron un total de 238 encuestas: 102 correspondientes a controles sanos, 88 con trastornos digestivos y 48 de NDA. El 45,8% de los padres de NDA se consideraban desatendidos por su pediatra y el 47,9% no estaban de acuerdo con sus recomendaciones. El 54,2% de ellos encuentra limitaciones en su vida social, el 25% problemas de pareja, el 47,9% se sienten juzgados por los demás (12,5% por sus propias parejas) sobre cómo manejan la alimentación de su hijo y un 37,5% habían solicitado o considerado ayuda psicológica. Todos estos problemas fueron significativamente más frecuentes que en los controles. Padres y madres de los NDA presentaron con mayor frecuencia riesgo de ansiedad/depresión según el General Health Questionnaire de Goldberg: un 54,2% según valores de referencia (odds ratios ajustadas frente a controles sanos 4,18; intervalo de confianza del 95% [IC95%]: 1,96 a 8,87; frente a controles enfermos odds ratio 6,25; IC95% 2,79 a 13,98) y un 33,3% según los valores de nuestros controles sanos. Asimismo, presentaron mayores puntuaciones de estrés (Parent Stress Index Short Form) que los controles sanos (diferencia de medias ajustada 21; IC95% 12,19 a 29,81) y controles enfermos (AU)

Objectives: The prevalence of feeding disorders (FDs) and picky eating in children is high in our region, based on the parents’ perceptions. Although organic disease or a nutritional impact is rarely observed in these children, the problem frequently has an effect on family dynamics. We aimed to estimate the impact of these disorders on the stress level, quality of life and psychological health of families. Methods: Study of cases (FDs) and controls (healthy controls and controls with digestive disorders or sick controls). We assessed parental stress and the risk of psychological distress in these families using validated scales (Parent Stress Index Short Form and Goldberg's General Health Questionnaire) and a parental opinion survey. Results: We collected a total of 238 surveys, 102 corresponding to healthy controls, 88 to controls with digestive disorders and 48 to children with FDs. We found that 45.8% of parents in the FD group felt neglected by their paediatricians and 47.9% did not agree with the paediatrician's recommendations. In addition, 54.2% reported limitations to their social life, 25% problems in their relationship, 47.9% feeling judged by others (12.5% by their own partner) for how they managed mealtimes, and 37.5% having sought or considered seeking psychological support. All these problems were significantly more frequent compared to controls. Based on the Goldberg's General Health Questionnaire, the risk of anxiety and depression was more frequent in parents in the FD group: 54.2% compared to the reference (adjusted odds ratio compared to controls, 4.18; 95% confidence interval [CI], 1.96-8.87; odds ratio compared to sick controls, 6.25; 95% CI, 2.79-13.98) and 33.3% compared to the healthy control group. They also had higher stress scores (Parent Stress Index Short Form) compared to the healthy control group (adjusted mean difference, 21; 95% CI, 12.19-29.81) and the sick control group (adjusted mean difference, 20; 95% CI, 9.81-30.19).

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Background and Objectives: Screening instruments can be crucial in child and adolescent mental healthcare practice by allowing professionals to triage the patient flow in a limited resource setting and help in clinical decision making. Our study aimed to examine whether the Strengths and Difficulties Questionnaire (SDQ), with the application of the original UK-based scoring algorithm, can reliably detect children and adolescents with different mental disorders in a clinical population sample. Materials and Methods: a total of 363 outpatients aged 2 to 17 years from two outpatient child psychiatry centres in Latvia were screened with the parent-report version of the SDQ and assigned clinical psychiatric diagnoses. The ability of the SDQ to predict the clinical diagnosis in major diagnostic groups (emotional, conduct, hyperactivity, and developmental disorders) was assessed. Results: The subscales of the parent-report SDQ showed a significant correlation with the corresponding clinical diagnoses. The sensitivity of the SDQ ranged 65-78%, and the specificity was 57-78%. The discriminative ability of the SDQ, as measured by the diagnostic odds ratio, did not quite reach the level of clinical utility in specialised psychiatric settings. Conclusions: We suggest the SDQ be used in primary healthcare settings, where it can be an essential tool to help family physicians recognise children needing further specialised psychiatric evaluation. There is a need to assess the psychometric properties and validate the SDQ in a larger populational sample in Latvia, determine the population-specific cut-off scores, and reassess the performance of the scale in primary healthcare practice.

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OBJECTIVES: The prevalence of feeding disorders (FDs) and picky eating in children is high in our region, based on the parents' perceptions. Although organic disease or a nutritional impact is rarely observed in these children, the problem frequently has an effect on family dynamics. We aimed to estimate the impact of these disorders on the stress level, quality of life and psychological health of families. METHODS: Study of cases (FDs) and controls (healthy controls and controls with digestive disorders or other illness). We assessed parental stress and the risk of psychological distress in these families using validated scales (Parent Stress Index Short Form [PSI-SF] and Goldberg's General Health Questionnaire [GHQ-28]) and a parental opinion survey. RESULTS: We collected a total of 238 surveys, 102 corresponding to healthy controls, 88 to controls with digestive disorders and 48 to children with FDs. We found that 45.8% of parents in the FD group felt neglected by their paediatricians and 47.9% did not agree with the paediatrician's recommendations. In addition, 54.2% reported limitations to their social life, 25% problems in their relationship, 47.9% feeling judged by others (12.5% by their own partner) for how they managed mealtimes, and 37.5% having sought or considered seeking psychological support. All these problems were significantly more frequent compared to controls. Based on the GHQ-28, the risk of anxiety and depression was more frequent in parents in the FD group: 54.2% compared to the reference (adjusted odds ratio [aOR] compared to controls, 4.18; 95% confidence interval [CI], 1.96-8.87; OR compared to sick controls, 6.25; 95% CI, 2.79-13.98) and 33.3% compared to the healthy control group. They also had higher stress scores (PSI-SF) compared to the healthy control group (adjusted mean difference [AMD], 21; 95% CI, 12.19-29.81) and the sick control group (AMD, 20; 95% CI, 9.81-30.19). CONCLUSIONS: Parents of children with FDs have a high level of stress and risk of anxiety and depression, with repercussions at the social, family, couple and work levels. The relationship with the paediatrician may also be affected.

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The meaning of childhood behavioural disorders (CBD) shifts in different settings. This article is the 3 first in a series of two that explores this concept and how culture shapes its meaning. This first article 4 is a conversation. A yarn with Aboriginal community leaders about what behavioural problems mean 5 to them. The second article discusses how the concept of CBD originated.

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Childhood behavioural disorders (CBDs) are a common reason for referral to paediatric services and are associated with negative individual and societal outcomes. This article addresses how childhood became a distinct entity and how historical changes shaped its definition. Thereafter, the evolution of diagnostic criteria for CBD and associated limitations will be summarised. This will be followed by a discussion about Aboriginal culture, and the impact of colonisation on social and emotional well-being. This will provide a contextual frame for understanding how social and cultural context influences diagnoses of CBD in Aboriginal children. From this, a conversation about the journey moving forward will begin.

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BACKGROUND: Many home-dwelling older adults present abnormal behaviours related to dementia or to non-dementia cognitive impairment (e.g., agitation, anxiety, apathy, etc.). Because many older adults live at home alone or are able to hide any signs of abnormal behaviours from others, the non-healthcare workers who interact with older adults on a daily basis are key actors in detecting those behaviours and orienting older adults towards appropriate support services. To the best of our knowledge, no studies to date have explored the daily interactions experienced between older adults and the various non-healthcare workers whom they regularly encounter in the community. This work aimed to identify the non-healthcare workers who are regularly in direct contact with older adults during their day-to-day activities and then develop specific training for these workers on the subject of abnormal behaviours among the elderly. METHODS: This qualitative and ethnographic study asked 21 home-dwelling older adults aged 65 years old or more to answer open-ended questions. Sixteen had no self-reported cognitive impairments, and five had a probable or diagnosed slight cognitive impairment or mild-to-moderate dementia. A thematic analysis of the data was carried out. RESULTS: The non-healthcare workers who spent the most time with older adults with and without reported cognitive impairments were those working in cafés or tea rooms and leisure or activity centres. CONCLUSIONS: In view of the significant amounts of contact between home-dwelling older adults and non-healthcare workers, it seems necessary and sensible to increase non-healthcare workers' knowledge about abnormal behaviours, especially by offering them training. The proactive detection and identification of older adults' abnormal behaviours by non-healthcare workers will ensure earlier care and reduce avoidable hospitalisations, institutionalisations and costs linked to geriatric healthcare.

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BACKGROUND: Childhood behavioural problems are the most common mental health disorder worldwide and represent a major public health concern, particularly in socially disadvantaged communities. Treatment barriers mean that up to 70% of children do not receive recommended parenting interventions. Innovative approaches, including evidence-based peer-led models, such as Empowering Parents Empowering Communities' (EPEC) Being a Parent (BAP) programme, have the potential to reduce childhood difficulties and improve parenting if replicable and successfully delivered at scale. METHOD: This real-world quasi-experimental study, with embedded RCT benchmarking, examined the population reach, attendance, acceptability and outcomes of 128 BAP groups (n = 930 parents) delivered by 15 newly established sites participating in a UK EPEC scaling programme. RESULTS: Scaling programme (SP) sites successfully reached parents living in areas of greater social deprivation (n = 476, 75.3%), experiencing significant disadvantage (45.0% left school by 16; 39.9% lived in rental accommodation; 36.9% lone parents). The only benchmarked demographic difference was ethnicity, reflecting the greater proportion of White British parents living in scaling site areas (SP 67.9%; RCT 22.4%). Benchmark comparisons showed scaling sites' parent group leaders achieved similar levels of satisfaction. Scaling site parent participants reported substantial levels of improvement in child concerns (ES 0.6), parenting (ES 0.9), parenting goals (ES 1.2) and parent wellbeing (ES 0.6) that were of similar magnitude to RCT benchmarked results. Though large, parents reported lower levels of parenting knowledge and confidence acquisition compared with the RCT benchmark. CONCLUSION: Despite common methodological limitations associated with real-world scaling evaluations, findings suggest that this peer-led, community-based, parenting approach may be capable of successful replication at scale and may have considerable potential to improve child and parenting difficulties, particularly for socially disadvantaged populations.

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BACKGROUND: Cognitive dysfunctions are highly prevalent in multiple sclerosis (MS) and negatively impact occupational and social functioning. OBJECTIVE: In the present longitudinal study, we aimed at modeling cognitive changes and at assessing whether apathy could be a predictor of cognitive decline in MS. METHODS: We assessed 67 people with MS at two-time points (baseline, T0; 4-year follow-up, T1), by means of several clinical, behavioural, and cognitive measures. We used a delta approach to measure cognitive decline during the follow-up period. We applied a mixed factorial design and a linear regression model to explore factors associated with cognitive changes over time. RESULTS: A higher level of apathy at baseline predicted the progressive cognitive decline at follow-up, whereas a higher level of depression did not. Among demographic and clinical characteristics, only low education level was significantly associated with cognitive decline over time. Interestingly, participants with persistent apathy (diagnosis of apathy at T0 and T1, A+A+) and those who developed apathy (A-A+) showed poorer inhibitory control and a larger decline in executive functioning during the 4-year follow-up than participants who had never received the diagnosis of apathy (A-A-). CONCLUSION: Apathy represents an early marker of cognitive decline in MS. These findings have important clinical and prognostic implications.

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