Restrictive interventions are used in the treatment of some people with severe mental disorders such as psychosis – including psychiatric intensive care unit (PICU) admission, seclusion and restraint. Early Intervention in Psychosis (EIP) service input may improve outcomes in psychosis, but it is unclear whether specific components of EIP care reduce the need for restrictive practice.

To examine associations between EIP care components, demographic characteristics and restrictive interventions.

We conducted a retrospective cohort study of 14 874 people who used EIP services in England, using linked data from the National Clinical Audit of Psychosis and the Mental Health Services Data Set. We examined associations between EIP components and time to PICU admission (primary outcome) alongside seclusion/physical restraint/injected chemical restraint/requests for police assistance (secondary outcomes), using multilevel Cox regression, adjusting for demographic factors and clustering by service.

Higher hazards of restrictive interventions were observed among men, younger people and several minority ethnic groups. Individuals eligible for clozapine who were not offered it (hazard ratio 1.51, 95% CI 1.20–1.91) or refused it (hazard ratio 1.46, 95% CI 1.02–2.10) had higher hazards of PICU admission than those not eligible, whereas those who were eligible for clozapine and received it did not. There was weaker evidence of similar effects on hazards of physical restraint and seclusion. Receipt of CBT for psychosis was associated with reduced hazards of PICU admission (hazard ratio 0.80, 95% CI 0.67–0.95) and physical restraint (hazard ratio 0.68, 95% CI 0.47–0.98). Substance use was associated with increased hazards of PICU admission and requests for police assistance, although substance use interventions appeared to partially mitigate this.

Marked demographic disparities exist in the use of restrictive practice. Specific EIP care components may be associated with reductions. Strengthening evidence-based EIP provision and addressing structural inequalities may support progress towards less coercive and more equitable care.

The present study aimed to investigate the association between adherence to the DASH diet and the risk of depression and anxiety severity in a large group of Iranian adults.

In this cross-sectional study, dietary intakes were assessed using a validated 65-item food frequency questionnaire. The Beck Anxiety Inventory and the Beck Depression Inventory II were used to assess anxiety and depression, respectively. Ordinal logistic regression was applied to evaluate the association between DASH diet and depression and anxiety severity.

Mashhad stroke and heart atherosclerosis disorder (MASHAD) study.

6537 and 6539 adults aged 35-65 years for depression and anxiety, respectively.

We found no significant association between adherence to the DASH diet and depression severity, in the total participants as well as both gender in either crude (total: OR: 0.98; 95% CI: 0.87-1.09, men: OR: 0.88; 95% CI: 0.73-1.07, and women: OR: 1.01; 95% CI: 0.88-1.17) or fully adjusted models (total: OR: 1.03; 95% CI: 0.91-1.16, men: OR: 0.95; 95% CI: 0.78-1.17, and women: OR: 1.04; 95% CI: 0.90-1.21). Regarding anxiety, we found that men in the third tertile of DASH diet score had lower risk of experiencing more severe anxiety compared to those in the first tertile (OR: 0.80; 95% CI: 0.67-0.96). However, after controlling for potential confounders, this relationship became non-significant (OR: 0.89; 95% CI: 0.74-1.07). In the total participants as well as women, we failed to find any significant association between adherence to the DASH diet and anxiety severity either before (total: OR: 0.97; 95% CI: 0.87-1.09, women: OR: 1.05; 95% CI: 0.92-1.21) or after controlling for possible confounders (total: OR: 1.01; 95% CI: 0.90-1.12, women: OR: 1.06; 95% CI: 0.92-1.22).

We found no significant association between adherence to DASH diet and depression and anxiety severity among adults.

The implementation of the World Health Organization’s multimodal strategy is crucial for strengthening infection prevention and control (IPC) programs. This study aimed to evaluate and compare the perceptions of infection prevention and control professionals (IPCPs) and healthcare workers (HCWs) regarding the effectiveness of the multimodal strategy.

In this study, an online survey was designed that included five MM components: system change, education and training, monitoring and feedback, reminders and communication, and cultural change. The survey was completed by IPCPs and HCWs within the institutions.

A total of 102 IPCPs and 166 HCWs from 96 institutions participated in the survey. The mean career duration was 19.8 ± 9.5 years. An Infection Control Committee (ICC) was present in 98% of participants’ institutions, and 88% held meetings every three months. Only 10 (10.4%) institutions met the ratio of 1IPC nurse per 150 beds. Effective communication techniques training was provided annually to 55.9% of IPCPs and 59.6% of HCWs.

Eighty-one (79.4%) IPCPs reported using effective communication when explaining the five indications of hand hygiene, but only 77 (46.4%) HCWs agreed (P < .001). Ninety-one (89.2%) IPCPs confirmed that effective communication techniques were used in bundle training. But, only 25 (15.0%) HCWs agreed, while 112 (67.5%) HCWs reported being undecided (P < .001). Sixty-one (64.7%) IPCPs and 130 (78.3%) HCWs believed that their institutions effectively motivated HCWs towards IPC measures compliance. However, 44 (43.1%) IPCPs and 29 (17.5%) HCWs were undecided (P = .002).

The survey reveals significant inconsistencies among IPCPs and HCWs regarding communication effectiveness, and perceptions of compliance with infection-control measures. These findings highlight the need for more inclusive and transparent communication strategies, regular interdisciplinary training, and stronger organizational support to improve IPC practices.

This study evaluated the consumption of rice and beans in Brazil, two staples of the Brazilian diet, by describing their consumption according to sociodemographic characteristics and assessing its association with nutritional quality, environmental impact, and affordability of the diet.

Cross-sectional study.

Brazil.

We analysed food consumption data from 46,164 individuals aged 10 years and older, based on the most recent Household Budget Survey (2017–2018) in Brazil. The survey used a two-stage cluster sampling design and provides nationally representative data, covering all regions, states, metropolitan areas, capitals, and urban and rural zones in Brazil.

In Brazil, rice and beans accounted for 10.75% and 6.33% of total daily energy intake, respectively. Their consumption was important across all sociodemographic groups analysed. Rice and beans intake was associated with nutritional quality, reduced environmental impact, and lower diet costs. Higher combined consumption of rice and beans was associated with a 44.49% reduction in nutritional inadequacies in the diet, a 17.64% decrease in carbon footprint, a 21.05% decrease in water footprint, and a 38.03% reduction in total diet cost, compared to lower consumption.

Promoting increased consumption of rice and beans in Brazil offers a culturally appropriate solution in response to the global call for healthier and more sustainable diets, and is the most effective approach to improve human health and environmental sustainability in an affordable way in Brazil.

In Africa, bewitchment is described as a moral framework that helps individuals and societies make sense out of disease and misfortune. Numerous African belief systems attribute difficult-to-treat health problems to bewitchment, rather than a conventional medical diagnosis, especially if biomedical doctors are unable to resolve the condition. This study examines one such illness, known as xifula, in rural Limpopo Province, South Africa.

Using convenience sampling, 95 participants (≥18 years old) were interviewed to gauge their knowledge of the condition known as xifula. Data was analysed using NVivo software.

Xifula is a cultural concept of distress related to bewitchment. The most common symptom of xifula is swelling of the legs or hands, followed by chronic headaches. Participants noted that xifula can start as a minor ailment, but then grows into a larger problem. After a long period without healing, however, xifula can begin to represent a significant threat to the individual’s health. Nearly all participants noted that xifula cannot be treated by Western biomedical professionals and instead requires a traditional healer to treat the condition.

This research highlights the importance of context-specific education about the diagnosis and treatment of common ailments, as beliefs about afflictions, their causes, and appropriate treatments suggest a need for tailored information. As biomedical and traditional healthcare currently exist as parallel, siloed structures of diagnosis and treatment in Africa, there should also be efforts to bridge the divide between the two.

This study was funded by a grant from the John Templeton Foundation.