The presence of borderline personality disorder (BPD) in cancer patients can be a risk factor for adherence to oncological treatment.

To analyze problems related to adherence to treatment of patients with borderline personality disorder (BPD) in comorbidity with gynecological cancer.

Clinical histories and subsequent interviews of patients (“A” and “B”), both 25 years of age. “A” with a diagnosis of Cervical Cancer in 2022, without adherence to treatment, irritable, unmotivated, with emotional instability in her relationships, chronic emptiness, impulsivity, risky sexual behaviors, self-harm, and suicidal thoughts. B, diagnosed with endometrial cancer in January 2023, presents treatment adherence with extreme fear of abandonment, irritability, anhedonia, anxiety, low self-esteem, impulsivity, and suicidal ideas. Both receive psychotherapy at the Psychooncology and Palliative Care clinic. Scales from the General Health Questionnaire (GHQ-28) and McLean Screening Instrument for Borderline Personality Disorder were applied.

Anxiety, lack of control, and rebellion manifested A’s lack of adherence. B’s “adherence” is redefined as separation anxiety, currently deposited in her partner and the oncology team. They evoked physical and sexual violence experienced since childhood and drug abuse, which influenced her anger and attitude towards cancer treatment for being “captives” of the disease. Thus, she denied A her dependency needs and B her fear of her partner’s abandonment and her suicidal thoughts.

Internal conflicts are expressed through self-destructive behavior: addressing her fears allowed her to continue treatment. Psychotherapy limited his judgment, cognitive, and reasoning lapses. They mentalized stories of abuse, early violence, and behaviors that limited their quality of life before and after cancer, improving their treatment adherence.

None Declared

Lithium is used as a first-line treatment in perinatal bipolar disorder. Lithium is almost exclusively renal eliminated without undergoing metabolization. Renal changes associated with pregnancy are responsible for alterations in lithium pharmacokinetics that may impact lithium efficacy and toxicity in mother. Characterization of the trajectory of lithium disposition during the perinatal period (previous year of pregnancy, pregnancy and first year postpartum) is necessary to monitoring and dose adjustments to prevent bipolar symptom recurrence while minimizing adverse effects.

To characterize the disposition of lithium during the perinatal period ant to evaluate whether changes in serum lithium concentration are consistent with changes in renal function (creatinine).

Women treated with lithium carbonate and referred to the perinatal psychiatry out-patient clinic of a single tertiary university hospital (November 2006 -December 2018), were evaluated for eligibility to participate in this retrospective observational cohort study (HCB/2020/1305). The basis of this study was all samples analysed in the same laboratory for lithium during perinatal period obtained at steady-state and predose. Serum creatinine concentrations measurements were also extracted. Lithium concentrations were determined by means of an AVL 9180 electrolyte analyzer based on the ion- selective electrode (ISE) measurement principle. Detection limit (LoD) was 0.1 mEq/L and limit of quantification (LoQ) 0.2 mEq/L. Serum creatinine concentration was determined by molecular absorption spectrometry. Detection limit (LoD) was 0.10 mg/dL, and the limit of quantification (LoQ) was 0.15 mg/dL Linear mixed models were used to analyze lithium and creatinine serum concentrations.Time points extractions and lithium dose were included as fixed effects, while the individual mother was included as a random effect to account for repeated measurements.

In total, 1260 lithium and 1174 creatinine serum concentration measurements from 109 pregnancies of 95 women were available. Dose-ajusted serum lithium concentrations (C/D ratio) decreased and average of 23.9% and 27.6% during the first and second trimesters respectively, increased slightly in the third trimester but remained 16.9 % below the prconception time (reference period) and increased postpartum 11% . Serum creatinine concentration evidenced a similar longitudinal pattern during pregnancy (decreased 20%, 26.1% and 22.3% in first, second and third trimester respectively) and also decreased postpartum 4.3%.

We recommend monitoring lithium and creatinine serum concentration once every 4 weeks until 34 weeks of pregnancy, then weekly until delivery, followed in postpartum at day 2±1, (bi-)weekly during the first month, monthly until 6 months postpartum and then every 3-4 months to ensure adequate lithium dosing.

None Declared

Women generally have a later age of onset, and may therefore have a more favourable course of psychotic illness than men regarding psychopathology. Little is known about a broader range of outcomes, including well-being and recovery, and about the influence of age of onset.

This study examines longitudinal sex-related and age of onset-related differences in well-being and recovery of people with a psychotic disorder with long illness durations.

Routine outcome monitoring data (2012-2021) of n=3843 patients were used. Well-being (quality of life and personal recovery) and recovery (clinical and societal recovery and psychosocial functioning) were assessed. Latent class growth analysis (LCGA) was performed to assess whether classes with different trajectories of well-being and recovery could be identified. Classes were related to sex and (early/late) age of onset of psychosis (EOP/LOP).

LCGA identified five classes with varying combinations in levels of well-being and recovery, which were stable over time. Sex, age of onset and the combination of these two were significantly related to class membership. Women and individuals with LOP were more prevalent in better functioning classes than men and individuals with EOP.

This study showed sex differences in long-term recovery patterns of psychosis. Not only women but also individuals with LOP had a higher chance of better well-being and recovery, while men with EOP were at risk for worse outcomes. Taking these sex differences into account when deciding on policy and treatment protocols for individual patients might provide better mental health care to people with psychosis.

None Declared

Child video game playing (“gaming”) may lead to decreased child academic motivation. Conversely, children with low academic motivation may seek fulfillment through gaming. We examined bidirectional associations between child gaming and academic motivation across middle childhood.

Our analyses are based on 1,631 children (boys = 785) followed in the context of the Quebec Longitudinal Study of Child Development. Data on gaming and academic motivation were collected repeatedly at ages 7, 8, and 10. Measures of child gaming were parent-reported and reflect daily video game playing time. Measures of academic motivation were child self-reported and reflect enjoyment in learning mathematics, reading, and writing. To disentangle the directionality of associations, we estimated a random-intercept cross-lagged panel model to estimate bidirectional, within-person associations between gaming and academic motivation in a cohort of school-aged Canadian children.

Our results revealed unidirectional associations whereby more frequent gaming by boys at age 7 years predicted lower academic motivation at age 8 years (β = −.11, 95% confidence interval [CI]: −.22 to −.01), and similarly, gaming by boys at age 8 years predicted lower academic motivation at age 10 years (β = −.10, 95% CI: −.19 to −.01). Changes in boys’ academic motivation did not contribute to subsequent changes in gaming. There were no associations between gaming and academic motivation for girls.

More time devoted to gaming among school-aged boys is associated with reduced academic motivation during a critical developmental period for the development of academic skills. Fostering healthy gaming habits may help promote academic motivation and success.

This study was conducted to identify dyspnea, anxiety, and death anxiety in patients with Chronic Obstructive Pulmonary Disease (COPD).

The study was carried out with 200 COPD patients who applied to the chest diseases outpatient clinic of a state hospital between December 2022 and June 2023.

A total of 73.0% of the patients with COPD participating in the study were male and their mean age was 66.73 ± 8.45 years. Their mean scores were 5.21 ± 2.46 on Modified Borg Scale, 2.62 ± 1.03 on the Modified Medical Research Council scale, 17.87 ± 7.96 on the Beck Anxiety Inventory, and 10.07 ± 4.02 on the Death Anxiety Scale. Patients with high dyspnea levels also had high levels of anxiety and death anxiety (p < 0.001).

The patients with COPD had high levels of dyspnea, anxiety, and death anxiety. Based on the results of the study, it is recommended to plan evidence-based studies to alleviate dyspnea, anxiety, and death anxiety in patients with COPD.

Ontario seniors face a range of challenges as they age, including financial, physical and social barriers. Addressing these challenges is essential to improving the health and well-being of older adults in the province. Objective: The discussion proposes that naturally occurring retirement communities (NORCs) offer a viable and safe alternative to formal retirement communities and evaluates how NORCs can support seniors when examined through the lens of the social determinants of health.

The analysis focuses on the role and impact of NORC-specific service programming, distinct from NORCs themselves, and assesses their potential in mitigating age-related challenges faced by seniors in Ontario.

NORC-specific service programs have shown success in supporting senior wellness and improving quality of life. These service address key social determinants of health and demonstrate potential for broader application across Ontario’s NORCs.

The discussion recommends increased attention from governments and policymakers, including efforts to identify NORCs across Ontario, expand affordable and accessible housing options for seniors, and invest in health and social supports. Strategic development of NORC programs can play a significant role in building capacity and delivering targeted wellness services to seniors.

Gut microbiota (GM) affects muscle homeostasis, and growing evidence indicates dysbiosis of GM may be a contributing factor in the pathogenesis of dystrophies. Furthermore, GM metabolites can interact with DNA methylation. Facioscapulohumeral muscular dystrophy (FSHD) is the second common dystrophy with hypomethylation of DR1 and 5P regions of D4Z4 repeat on 4qter.

Considering alteration of GM may be a contributing factor, we investigated (i) GM alterations and (ii) the correlation of microbial-derived free fatty acids (FFAs) with methylation of DR1 and 5P regions in FSHD.

Twenty-eight FSHD patients and 28 gender-age-matched controls were included. GM characterisation was performed through 16S-rRNA sequencing. Methylation levels of DR1 and 5P regions were assessed by bisulphite sequencing. Faecal and circulating FFAs including short-chain fatty acids (SCFAs), medium-chain fatty acids (MCFAs) and long-chain fatty acids (LCFAs) were analysed with gas chromatography-mass spectrometry.

Altered GM was observed in patients, along with distinct profiles of faecal and circulating SCFAs, MCFAs and LCFAs. DR1 and 5P regions exhibited significant hypomethylation in FSHD compared to control. Hypomethylation correlated with faecal and circulating FFAs in patients, while no correlation was identified in healthy controls. The severely affected patients exhibited a notable increase in the prevalence of Pasteurellaceae, while the FFA profile was similar among mild and severely affected patients. This is the first study revealing that FSHD patients showed compositional and functional GM dysbiosis. A strong association between proximal D4Z4 hypomethylation with microbial-derived SCFAs was identified.

These findings suggest that GM modulation with its metabolites could be a promising strategy for interventions in FSHD management.

To compare the association of participation in Supplemental Nutrition Assistance Program (SNAP) alone v. in combination with Head Start (HS), Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) or both on household dietary environment (HDE) indicators: food security, nutrition security, healthfulness choice, dietary choice, perceived food store availability, utilisation barriers and healthy food access barriers in families with young children.

This study, part of SNAP-Ed Nebraska’s Needs and Assets Assessment ‘Healthy People, Healthy State’, utilised a cross-sectional design. HDE indicator means were compared across the federal assistance program (FAP) participation groups using multivariate ANCOVA, controlling for significant demographics, with Benjamini–Hochberg-adjusted P values compared with α = 0·05.

Nebraska’s low-income households.

Households (n 821) with at least one child aged 2–6 years participating in SNAP-only (n 257), SNAP + HS (n 349), SNAP + WIC (n 132) and SNAP + WIC + HS (n 83).

Compared with other groups, SNAP + HS reported comparatively higher levels of household food security, whereas SNAP + HS + WIC reported lower levels (P < 0·01). SNAP + HS also showed higher levels of nutrition security, dietary choices, perceived availability of healthy foods in stores, fewer healthy food access and utilisation barriers (P < 0·05).

The findings support recent joint policy changes by Administration for Children and Families and Food and Nutrition Service, facilitating SNAP households’ access to HS. HS performance standards for nutrition and family engagement can serve as a model for creating healthy HDE. Future research should employ quasi-experimental or longitudinal designs to establish causal relationships between FAP participation and HDE outcomes.

Over 1% of the world’s population have been forcibly displaced. Asylum seekers and refugees (ASR) are at higher risk of serious mental illnesses. Despite a high need for care, little is known about the attitudes, knowledge and competencies of psychiatrists who may treat ASR subjects.

The study aimed to identify perceived gaps in psychiatric training that could help guide medical education and policymaking related to treating ASR mental health.

We conducted the first national survey of UK-based psychiatrists to assess attitudes, knowledge and competencies around treating ASR subjects. The online survey was sent to all psychiatrists (N = 18 182) and registered trainees (N = 4700) on the Royal College of Psychiatrists databases in 2022. We used exploratory and confirmatory factor analyses to identify the optimal factor structure underlying the questionnaire. Variations in scores on extracted latent constructs by sociodemographic and clinical variables were explored using linear regression.

Data from 609 psychiatrists (77%) and trainees (22%) were included in the final analysis. We identified four latent constructs concerning perceived knowledge, positive attitudes, negative attitudes and perceived distress. Only 42% of respondents felt they had sufficient knowledge to work competently with ASR subjects, and 34.7% found the work emotionally distressing. Greater knowledge predicted both more positive (β = 0.26, 95% CI: 0.20–0.33) and more negative (β = 0.17, 95% CI: 0.09–0.26) attitudes, and was associated with less self-reported distress among psychiatrists (β = –0.34, 95% CI: –0.43 to –0.21). Female psychiatrists reported more distress related to treating ASR subjects (β = 0.29, 95% CI: 0.14–0.44).

Less than half of psychiatrists in this survey believed they possessed adequate knowledge to treat ASR subjects, and some found working with such individuals distressing. Our results suggest that these issues could be mitigated by improving knowledge related to treating ASR subjects.

Nursing homes residents have a high prevalence of multidrug-resistant organism (MDRO) colonization. Recent trials demonstrated that decolonizing residents reduces infection. However, decolonization’s impact on environmental MDRO contamination is not well understood.

We performed a 9-month pilot (3-month baseline, 3-month phase-in and 3-month intervention) in 3 nursing homes implementing routine chlorhexidine bathing/showering and nasal iodophor. We repeatedly tested for colonization via skin and nasal swabs for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Enterococcus (VRE), extended-spectrum beta-lactamase producers (ESBLs), and carbapenem-resistant Enterobacterales (CRE). We also swabbed high-touch surfaces in rooms of MDRO carriers for MDRO fomite contamination.

Decolonization decreased the odds of MDRO colonization in nursing home residents by 55% (OR 0.45, P < 0.001, raw reduction from 46% (411/900) to intervention: 29% (262/900); colonization with MRSA, VRE, and ESBL all significantly decreased (P < 0.001). Among residents who remained colonized with any MDRO, 288/330 (87%) of high-touch bedroom objects were colonized with ≥1 MDRO. In a multivariable analysis, MDRO fomite contamination in rooms of MDRO carriers was associated with antibiotic use (OR = 1.54 [95% CI: 1.19–1.98], wound presence (OR = 1.34 (95% CI: 1.02–1.77), and specific fomites such as bedside table/bedrails (OR = 12.7 (95% CI: 9.37–17.25), but not the intervention period (OR = 1.02 [0.81–1.27]).

Routine chlorhexidine bathing and nasal iodophor significantly reduced MDRO body colonization among nursing home residents. However, in rooms of residents who remained MDRO carriers, environmental contamination was unchanged during the decolonization intervention. Efforts to ensure fomite surface clearance in rooms of MDRO carriers may be key to reducing environmental MDRO spread.

Cannabis use is elevated in youth with depression and attention-deficit/hyperactivity disorder (ADHD), but drivers of this increase remain underexplored. The self-medication hypothesis suggests cannabis is used by patients for mood regulation, a common difficulty in ADHD and depression. This study aimed to examine associations between mood instability and cannabis use in a large, representative clinical cohort of adolescents diagnosed with ADHD and/or depression.

Natural language processing (NLP) approaches were utilised to identify references to mood instability and cannabis use in the electronic health records of adolescents (aged 11–18 years) with primary diagnoses of ADHD (n = 7,985) or depression (n = 5,738). Logistic regression was used to examine mood instability as the main exposure for cannabis use in models stratified by ADHD and depression.

Mood instability was associated with a 25% higher probability of cannabis use in adolescents with ADHD compared to those with depression. Following adjustment for available sociodemographic and clinical covariates, mood instability was associated with increased cannabis use in both ADHD (aOR: 1.61 [95% CI: 1.41–1.84]) and depression (aOR: 1.38 [95% CI: 1.21–1.57]) groups.

This was the first study to explore the differential impact of mood instability on adolescent cannabis use across distinct diagnostic profiles. NLP analysis proved an efficient tool for examining large populations of adolescents accessing psychiatric services and provided preliminary evidence of a link between mood instability and cannabis use in ADHD and depression. Longitudinal studies using direct measures or tailored NLP techniques can further establish the directionality of these associations.

Power outages can lead to food-borne and water-borne illness risks for consumers if proper protective measures are not taken at home. The purpose of this study was to understand the behaviors of Canadians related to food and water safety preparedness at home during power outages and floods.

A qualitative descriptive study was conducted, consisting of 6 virtual focus groups, each with 8 people, in July 2023. Participants were selected from geographically dispersed locations in Ontario, Canada that had experienced power outages due to weather events. Thematic analysis was conducted to generate key themes.

Four themes were generated related to participants’ food and water safety preparedness: 1) trusted information sources and lived experiences; 2) support and resources; 3) factors beyond one’s control; and 4) differences in psychosocial determinants.

Effective risk communication targeting misconceptions, incentivization programs, and community resilience planning may help prevent or reduce enteric illness risks during such emergencies.