To describe changes in the community food environment between 2010 and 2022 in all municipalities in the state of Rio Grande do Sul (RS), Brazil, and to evaluate the possible associated sociodemographic inequities.

This ecological study was based on an analysis of the distribution and density of food retail establishments between 2010 and 2022 and their associations with the sociodemographic characteristics of the municipalities. Sociodemographic and food retail variables were extracted from secondary government databases. The establishments were classified according to the degree of processing of the foods they predominantly sold. Non-parametric tests and linear and Prais–Winsten regressions were used to analyse data.

State of RS, Brazil.

All 497 municipalities.

There was a significant reduction in overall food retail density (Coef.: –2·97; 95 % CI: –3·34, –2·61; P < 0·001). The greatest reduction occurred in establishments that sourced ultra-processed foods (Coef.: –3·34; 95 % CI: –3·65, –3·02; P < 0·001), which, despite the decrease, remained the most widely present. In 2022, the density of these establishments (median: 24·5; min/max: 4·4–124·8) was twice the density of establishments supplying fresh/minimally processed foods and culinary ingredients (median: 13·1; min/max: 0·0–95·8). Cities with greater social vulnerability had lower densities of establishments and greater reductions in the density of establishments over the evaluated period.

The reduction in food retail outlets disproportionately affected the most vulnerable municipalities and negatively impacted the availability of healthy foods. These findings reinforce the need for food and nutrition policies that promote equity in the food environment.

This study aimed to evaluate the impact of a pharmacist-led support system on the administration rate of vancomycin (VCM) loading dose, 0–24-hour area under the concentration–time curve (AUC0–24), incidence of acute kidney injury (AKI), and all-cause mortality in hospitalized patients.

This retrospective study with interrupted time series analysis was conducted from January 2021 to May 2024.

A public tertiary referral center providing acute and specialized inpatient care in Japan.

Among the 587 hospitalized patients who received VCM during the study period, 326 were evaluated.

The intervention comprised implementation of a pharmacist-led support system involving prospective prescription review and direct intervention when a VCM loading dose (25–30 mg/kg) was not prescribed.

The loading dose administration rate increased significantly by 43.2% immediately introducing the support system (95% confidence interval: 8.40–77.90; P = 0.0156), without significant trend change thereafter. AUC0–24 also increased significantly (241.0 vs 307.0; P < 0.001); there were no significant differences in AKI incidence or 90-day mortality.

The support system improved the loading dose administration rate and AUC0–24 without significantly increasing AKI or mortality. The improvement was immediate and sustained over 122 weeks, supporting its use in institutions aiming to optimize VCM loading doses where evidence remains limited.

Coercive control (CC) represents a significant proportion of intimate partner violence (IPV) cases in the UK and globally. While theoretical models on CC exist, none so far includes a psychological perspective. As cognitive behavioural theory (CBT) has a robust evidence base as an IPV intervention for women survivors, it can also be used in the development of a psychological model for CC, from the perspective of survivors. Such a model may have utility as a psychotherapeutic formulation tool and providing training on psychological aspects and impact of CC to other professionals involved in survivors’ care.

Fourteen women with self-identified experience of CC were screened and interviewed. Constructivist grounded theory was used to analyse the interviews.

Six theoretical codes were developed: vulnerability factors (difficult childhood experiences, negative previous romantic relationships, and low self-esteem), cognitions (thoughts about worthlessness, isolation, being deserving of the abuse, confusion, hope, being treated unfairly, and suicidal ideation), affect (shame, fear, sadness, and anger), maintaining factors (perceived consequences of leaving, financial situation, low self-esteem, and social norms), behaviours (unhelpful coping strategies of dissociation, subjugation, avoidance, and substance misuse, and protective factors were spending time with loved ones, physical activity, and committing to career and interests), and impact (poor physical health, depression, anxiety, trauma, financial difficulties, and chronic mistrust).

The results of this study constitute a preliminary CBT model of women survivors’ experiences of CC. Further research is required to test and further develop the model, especially the vulnerability factors and mental health implications of experiencing CC.

1. (1) To provide information that supports the need for healthcare professionals to be aware of and receive training on coercive control.

2. (2) To provide insight into women survivors’ experiences of coercive control within heterosexual relationships.

3. (3) To provide guidance on how psychological professionals can work with women survivors of coercive control to formulate their experiences and plan interventions.

Antimicrobial resistance (AMR) poses an escalating global threat, transforming once-treatable infections into major health challenges. Although antibiotic misuse is a well-known driver of AMR, particularly in low- and middle-income settings, the silent epidemic may be fueled by socioeconomic disparities even in high-income countries. This systematic review investigates the relationship between socioeconomic status (SES) and AMR prevalence across high-income nations based on the World Bank classification.

The studies included in this review span multiple observational designs (cross-sectional, cohort, and case-control) across various high-income nations, assessing the association between SES indicators (eg, income, education, and household crowding) and AMR strains, primarily methicillin-resistant Staphylococcus aureus (MRSA) and multidrug-resistant Escherichia coli.

Findings consistently indicate that lower SES correlates with higher AMR prevalence, particularly in MRSA infections (r = 0.76, Blakiston et al). The review highlights that indices of SES (often derived from government census data) are consistently associated with lower income, lower educational attainment, and increased household density with elevated AMR prevalence.

The variability among studies in SES metrics, including income measures and deprivation indices, limits generalizability. Exceptions to this trend, noted in select studies focusing on distinct AMR strains like ceftriaxone-resistant E. coli, underscore the complexity of SES-related AMR mechanisms. This review supports public health initiatives aimed at targeting low-SES communities with AMR mitigation strategies, advocating for continued monitoring and intervention to curb AMR spread in vulnerable populations.

Clinical response and remission may not fully reflect patient priorities in treatment-resistant depression (TRD). Health-related quality-of-life (HRQoL) outcomes should be assessed to comprehensively capture treatment benefits.

ESCAPE-TRD (NCT04338321) was a 32-week randomized, phase IIIb trial comparing esketamine nasal spray (NS) versus quetiapine extended release (XR), both alongside an ongoing selective serotonin reuptake inhibitor/serotonin-norepinephrine reuptake inhibitor, in patients with TRD. Symptom and HRQoL improvements were assessed using the Patient Health Questionnaire-9 (PHQ-9), 36-Item Short Form Survey (SF-36), Quality of Life in Depression Scale (QLDS), and EuroQoL 5-Dimension 5-Level (EQ-5D-5L) measures.

Esketamine NS-treated patients (N=336) reached PHQ-9 remission (score ≤4) quicker than quetiapine XR-treated patients (N=340), and more had remission by Week 32 (34.5% vs. 18.2%; odds ratio [OR]: 2.39 [1.67, 3.41], p<0.0001). “Role Emotional”, “Mental Health”, and “Social Functioning” SF-36 domains showed significantly greater improvements in esketamine NS-treated patients compared with quetiapine XR-treated patients at Week 32 (p<0.05), returning to levels close to general population norms. More esketamine NS-treated patients had a meaningful improvement in their QLDS score by Week 32 (60.7% vs. 41.8%; OR: 2.16 [1.59, 2.94], p<0.0001), and reached this improvement quicker than quetiapine XR-treated patients. Proportions of patients reporting an EQ-5D-5L score of 1 (no problems) were significantly higher across all domains with esketamine NS versus quetiapine XR at Week 32 (p<0.05).

Esketamine NS produced superior improvements in HRQoL compared with quetiapine XR, indicating positive impacts on aspects of patients’ lives that matter to them, alongside clinical symptoms of TRD.

Although the United States incarcerates nearly two million people, the epidemiology of psychiatric disorders in correctional populations is not well understood, and no study has examined temporal trends in psychiatric disorder prevalences within a single correctional system. This study assessed how psychiatric disorder prevalences have changed in the Texas Department of Criminal Justice (TDCJ), the largest American state prison system housing post-conviction, sentenced individuals.

This retrospective cohort study of TDCJ electronic medical record data from 1 January 2016 through 31 December 2023 included all persons incarcerated for any duration during that period. Diagnoses were based on International Classification of Disease (ICD-10) diagnostic codes. Outcomes were annual prevalences of depressive, bipolar and schizophrenia spectrum disorders stratified by age, race and sex. Cochran-Armitage Tests were used to assess temporal trends within each stratum. Two-way interactions were assessed by fitting Generalized Estimating Equations models using autoregressive correlation with repeated subjects.

The overall population ranged from 170,269 to 222,798 individuals. Approximately, one-third were White (34.5–35.4%), one-third Black (31.0–32.3%), and one-third Hispanic (32.7–33.5%). Most were aged 30–49 (52.8–57.3%), and men (88.9–90.7%) outnumbered women (9.3–11.1%). The prevalences (per 100 [95% CI]) of psychiatric disorders generally increased when comparing 2016 to 2023. Depressive disorders increased the most among those aged 30–49 (5.23 [5.10–5.35] to 6.71 [6.56–6.86]), Hispanic individuals (3.86 [3.72–4.00] to 5.72 [5.53–5.90]), and men (4.72 [4.63–4.82] to 6.53 [6.42–6.65]). Bipolar disorders increased the most among those aged ≥50 (2.57 [2.42–2.72] to 3.46 [3.29–3.63]), Hispanic individuals (1.31 [1.23–1.40] to 2.23 [2.11–2.35]), and men (2.26 [2.20–2.33] to 3.12 [3.04–3.20]). Schizophrenia spectrum disorders increased the most among those aged ≤29 (1.33 [1.24–1.42] to 2.52 [2.35–2.68]), Hispanic individuals (1.53 [1.44–1.62] to 3.21 [3.35–4.40]), and women (1.27 [1.56–1.89] to 4.24 [3.95–4.53]). When stratified by demographic variables, trend tests were significant for nearly all comparisons (P < 0.0001), and all two-way interactions were significant (P < 0.0001).

The prevalences of major psychiatric disorders in the Texas prison system increased when comparing 2016 to 2023, with certain disorders rising more rapidly than others within specific subgroups. These findings emphasize the need for expanded mental health treatment options and resources within correctional settings.

Postpartum depressive symptoms (PPDS) are mental health concerns, characterised by sadness, anxiety and suicidal ideation.

We aimed to estimate the prevalence of PPDS, identify its associated factors and explore the lived experiences of individuals with PPDS, to understand the psychosocial mechanisms involved.

We surveyed 400 women aged 18 years and above and conducted in-depth interviews among 19 women who screened positive for PPDS at two urban hospitals and one peri-urban polyclinic in Ho, Ghana. We used multivariable binomial generalised linear models to identify factors independently associated with PPDS. We used thematic analysis (qualitative) to identify themes that highlight pathways through which these factors influence PPDS.

Overall, 117 (29.3%) women screened positive for PPDS. Being unmarried (adjusted prevalence ratio (aPR) 1.33, 95% CI 1.02–1.72), lack of partner support (aPR 1.60, 95% CI 1.21–2.12), history of depressive or psychiatric disorders (aPR 2.44, 95% CI 1.84–3.25), unplanned pregnancy (aPR 1.63, 95% CI 1.18–2.25), low self-esteem (aPR 2.38, 95% CI 1.79–3.16) and low birth weight (aPR 1.87, 95% CI 1.33–2.65) were independently associated with PPDS. The thematic analysis revealed four key themes: (a) social isolation and limited support, (b) emotional stress and vulnerability, (c) self-image and identity challenges, and (d) resilience resources.

PPDS were common in our sample and were significantly associated with modifiable factors such as prior mental health history and low self-esteem. These findings underscore the importance of prioritising maternal mental health through the integration of depression screening and psychosocial care into routine antenatal and postnatal services.