Community research site finances continue to emerge as substantial topics of concern. Financial management solutions are possible; however, they must be continuously managed and incorporated to realize optimal business quality. The current case study assessed key financial metrics prior to and one year following a clinical research site’s financial review and implementation of improved practices. Financial activity and sustainability metrics were collected and assessed. Staff were interviewed prior to and after the financial review. Results analyzed differences in processes to further elucidate impact and explore best practices. Following review and best practice implementation, the site realized not only an immediate improvement in record management and an increase in revenue realization, but also a substantial increase in 12-month metrics. Fewer visits were performed year-to-year; however, management improvements yielded overall revenue and accrual increases. The site owner and staff members noted a relief and excitement when “Finance is Everybody’s Job” cultures were adopted throughout site departments. Newly established financial processes demonstrated an immediate improvement in site sustainability and, when routinely managed, stabilized monthly finances during lower visit periods. Future studies may assess long-term effects of financial management or analyze each financial component for process refinement and optimization.

Diet plays a critical role in the development and progression of Crohn’s disease (CD). Dietary indices are important tools to evaluate diet quality and inflammatory potential, and we investigated their associations with paediatric CD compared with healthy children. A cross-sectional study including 144 children with CD (122 with clinically active and twenty-two with quiescent disease) and fifty-seven healthy controls aged 6–18 years was conducted. Dietary intake was estimated using three 24-h dietary recalls. Diet quality was assessed using the Healthy Eating Index (HEI)-2015, alternate Mediterranean diet (aMed) score and dietary inflammatory potential using the modified Children-Dietary Inflammatory Index (mC-DII). Children with active CD had lower total HEI-2015 and aMed scores than healthy controls. A similar pro-inflammatory mC-DII score was found across the three groups. A higher mC-DII score in patients with CD was associated with higher intake of refined sugars, saturated fats and protein, and lower intake of whole grains and dairy, identifying dietary components contributing to dietary nflammatory potential. Similarly, healthy children in the highest mC-DII tertile consumed more added sugars and sodium and fewer whole grains, fruits, vegetables and plant proteins. Fibre intake was significantly lower in children with active CD (median %DRI: 37·0 (22·6–48·3) vs 41·2 (34·1–49·1) vs 45·8 (35·7–62·0), P < 0·001). Overall both children with CD and healthy children in this cohort consume a poor-quality, pro-inflammatory diet low in fibre, but the quality and fibre content are significantly lower in children with active CD. Future randomised controlled trials are needed to evaluate dietary interventions on the risk and progression of paediatric CD.

In behavioral genetics, divorce is typically analyzed as an individual-level outcome, even though marital dissolution can only be experienced by couples. In this article, we discuss how assortative mating complicates the study of couple-shared outcomes because individual-level effects can be confounded by effects of the spouse. We then show how chain-linking affines (i.e., in-laws) provides sufficient information to estimate spousal similarity for couple-shared outcomes, which we incorporate into an extended twin model that we use to test for sex differences and assortative mating for individuals’ liability to divorce. We linked the Norwegian twin register to the Norwegian population register and constructed 124,544 extended family units (1196 units with monozygotic twins) comprising 353,210 marriages entered between 1983 and 2008. We found that divorce was significantly correlated among affines, and that female relatives were more highly correlated than male relatives. The extended twin model estimated a strong correlation (r = .60, SE = .10) between female and male familial factors. Couples’ liability to divorce was attributed to 18% (SE = 5%) female and 10% (SE = 3%) male familial factors, with an additional 16% (SE = 4%) accounted for by their correlation. Estimates from a classic twin model were considerably higher. These findings show that spousal similarity is an important source of variation in divorce liability and that failing to model it can inflate estimates of individual-level effects. Overall, the analytical framework offers a blueprint for dissecting any couple-shared outcome into sex-specific and assortative components.

Psalidodon bifasciatus is a small characiform, originally described as endemic to the Iguaçu River basin. However, a recent study recorded a population of P. bifasciatus in the Piquiri River basin (upper Paraná), although data on its geographic distribution and parasitological aspects are still limited. The study characterized the parasitic fauna of P. bifasciatus in two streams, one from each basin, and compared them in terms of richness, diversity, and parasite community structure. Twenty-six females were collected in a stream in the lower Iguaçu River basin, and 25 females in a stream in the Piquiri River basin (upper Paraná) in September 2018. The parasite community structure of P. bifasciatus differed between areas, with a predominance of monopisthocotyls and greater richness of parasitic taxa for hosts in the lower Iguaçu River basin. In the Piquiri River basin (upper Paraná), the parasite community was characterized by a higher prevalence of larval nematodes and a lower richness of parasite taxa. The differences in the richness and structure of the parasite communities between the two areas support the hypothesis of the introduction of P. bifasciatus into the Piquiri River basin (upper Paraná). Therefore, we emphasize the need for further studies addressing the distribution pattern of P. bifasciatus, as well as additional parasitological studies to determine whether the parasitological taxa of P. bifasciatus are shared in other hydrological systems. This study contributes to the knowledge of the biological aspects of P. bifasciatus in both basins and improves our understanding of how host-parasite interactions can be informative in species introduction scenarios.

Across psychiatry, neurodivergence is highly prevalent yet under-recognised. Psychiatric vulnerability, treatment response and prognosis are critically shaped by co-occurring neurodevelopmental conditions, including attention-deficit hyperactivity disorder, autism and tic disorder. Clinical recognition of neurodivergence and effective management can mitigate mental illness, prevent suicide and reduce societal costs. Services and training should adapt accordingly.

The gap between mental health conditions and care uptake remains a global challenge, despite the availability of effective and affordable treatments. This gap is driven by demand-side barriers, such as lack of mental health literacy (MHL), stigma, etc., that hinder help-seeking. In this systematic review, we critically appraise interventions aimed at promoting help-seeking for mental health conditions. The review protocol was prospectively registered with PROSPERO (registration number CRD42021273843). A systematic search was conducted across MEDLINE, PsycINFO, Embase, Global Health, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Cochrane Central Register of Controlled Trials (CENTRAL). Only RCTs published after 2016, testing interventions with the aim of improving help-seeking behaviors, intentions and attitudes for any mental health conditions, were included. Due to the heterogeneity of outcomes and measures used in the studies, a narrative synthesis was conducted to examine the evidence. Fifty-four studies met the inclusion criteria. Our review confirms that MHL or psychoeducation, motivational interviewing (MI) and social contact interventions effectively improve help-seeking attitudes (n = 10), intentions (n = 17) and behaviors (n = 16). Multi-component MHL and MI-based strategies enhance help-seeking behaviors, while social contact online interventions enhance intentions. MHL/psychoeducation was effective across all outcomes, particularly when combined with other strategies. Despite a rise in help-seeking research, many studies lacked standardized frameworks, making cross-intervention comparisons difficult. Future work should align with theoretical models of help-seeking and explore mechanisms of change to better understand the link between intentions, attitudes and behaviors.

The habenula, a small brain structure involved in processing aversive stimuli, has been strongly implicated in the pathophysiology of mood disorders. While diminutions in hippocampal and medial prefrontal cortex volume have been demonstrated in individuals with a mood disorder, evidence for structural alterations in the habenula remains inconsistent. This set of meta-analyses examines whether individuals with a mood disorder show alterations in habenula volume compared to healthy controls. We conducted six meta-analyses. Two global analyses compared left and right habenula volumes between individuals with a mood disorder (MDD or BD) and healthy controls (HCs), each including 15 samples (left: 1,230 participants; right: 1,236). Four additional analyses compared MDD versus HCs and BD versus HCs for left and right volumes separately. Subgroup and meta-regression analyses tested the habenula segmentation method, medication status, and MRI resolution as moderators. The global meta-analyses pooling MDD and BD data showed small but significant volume reductions in the left (g = −0.1367, p = .0344) and right (g = −0.1562, p = .0409) habenula in mood disorder patients compared to controls. However, these effects did not survive correction for multiple comparisons. After correction, no significant group differences were found in the diagnosis-specific meta-analyses (MDD versus controls; BD versus controls), and no moderator analyses were significant. Current evidence points toward small habenula volume reductions in mood disorders, though findings did not withstand correction for multiple comparisons. Further high-resolution neuroimaging studies are needed to clarify habenula volume alterations in mood disorders.

Psychedelics are increasingly described as a new therapeutic approach in a variety of mental disorders including depression. Oral psychedelics such as psilocybin have an acute effect evolving over 6–8 h and are generally given in combination with psychological support. There is debate on the exact role of this support and how and by whom it should be delivered. This has significant implications for real-world implementation in health services post-licensing. In this feature, we discuss these issues and outline a model for psychological support delivery in publicly funded health services such as the National Health Service. We also suggest further research to explore the exact role of support in psilocybin treatment and identify the essential elements to direct service plans for clinical implementation. These steps are important: over recent decades, there have been few new treatments for depression, moreover, psychedelic drugs are appealing to patients, and accumulating data suggest that their efficacy may be long-lasting. However, realistic plans for implementation must be based on high-quality evidence and the needs of the whole patient population. This will ensure that these treatments, if licensed, are available not only for those able to pay but to all on an equitable basis.

Climate change is projected to alter the biology and distribution of many helminth species. We investigated the influence of climate on the current distribution of Parapharyngodon sceleratus, a monoxenic, generalist nematode parasite infecting 29 lizard species in South America, and evaluated its potential future range shifts under climate change. Using ecological niche modelling, we predicted the species’ current and future range distributions. Precipitation-related variables were the primary determinants of the spatial distribution of the worm. Areas of medium to high environmental suitability are concentrated in regions with seasonal tropical warm climates, as well as temperate regions with dry summers and mild winters. Future projections indicate a progressive reduction of highly suitable areas and an expansion of areas with low suitability, particularly in northern and central South America, by 2100. However, the Atlantic Forest, the northeastern Brazilian coast, a site within the semiarid Caatinga, and open vegetation areas in Chile persist as refugia of high habitat suitability. Our findings suggest that rising temperatures and altered precipitation patterns may constrict the geographic range of this helminth. Contrary to predictions for other parasite taxa, our results highlight a negative impact of climate change on the distribution of a monoxenic helminth.

With the ongoing discussion around the implementation of low-dose computed tomography (LDCT) screening for lung cancer, increasing numbers of model-based economic evaluations have been conducted. We systematically reviewed the published literature for economic evaluations of LDCT screening for lung cancer in people at high risk, updating this review in 2024. We identified a total of 57 economic evaluations; two-thirds of which developed de novo decision-analytic models. In our most recent update, of the 22 economic evaluations identified, only one used a model published before 2021. There may be advantages to developing new models, but the huge possibility of research waste cannot be ignored. Better quality of reporting (both in terms of clarity and completeness), improving the availability of existing models, and comparative analysis of different models can help to advance modeling methods in areas of complexity, such as screening for cancer. Ultimately, this should lead to policy decisions based on the best available evidence.

Proposed assisted dying legislation does not adequately consider comorbid mental illness, such as depression, which variably compromises decision-making capacity. Current tests of capacity are limited in their ability to assess any such compromise, and therefore we highlight these concerns and put forward suggestions as to how this may be rectified.