Antibiotic overuse for asymptomatic bacteriuria is common in older adults and can lead to harmful outcomes including antimicrobial resistance. Our objective was to evaluate the impact of a simple scoring tool on urine culturing and antibiotic prescribing for adults with presumed urinary tract infections (UTI).

Quasi-experimental study using interrupted time series with segmented regression to evaluate urine culturing and urinary antibiotic use and length of stay (LOS), acute care transfers, and mortality 18 months before and 16 months after the intervention.

134-bed complex continuing care and rehabilitation hospital in Ontario, Canada.

Nurses, nurse practitioners, physicians, and other healthcare professionals.

A multifaceted intervention focusing on a 6-item mnemonic scoring tool called the BLADDER score was developed based on existing minimum criteria for prescribing antibiotics in patients with presumed UTI. The BLADDER score was combined with ward- and prescriber-level feedback and education.

Before the intervention, the mean rate of urine culturing was 12.47 cultures per 1,000 patient days; after the intervention, the rate was 7.92 cultures per 1,000 patient days (IRR 0.87; 95% CI, 0.67–1.12). Urinary antibiotic use declined after the intervention from a mean of 40.55 DDD per 1,000 patient days before and 25.96 DDD per 1,000 patient days after the intervention (IRR 0.68; 95% CI, 0.59–0.79). There was no change in mean patient LOS, acute care transfers, or mortality.

The BLADDER score may be a safe and effective tool to support improved diagnostic and antimicrobial stewardship to reduce unnecessary treatment for asymptomatic bacteriuria.

Anorexia Nervosa (AN) is common in adolescents and has a high mortality and morbidity rate with a lifetime prevalence of 0.5% to 2%.1,2 We aim to review the neurobiology correlation of Anorexia Nervosa in Autism Spectrum Disorder as they are often associated together.

1. Understand the correlation between the neurobiology of Autism Spectrum Disorder (ASD) and Anorexia Nervosa.

2. Assess the association and prevalence of Anorexia nervosa in the ASD population.

3. To focus on the implications for the pathogenesis of Anorexia Nervosa and treatment of this disorder in the ASD population.

We searched PubMed, APA PscyINFO, Embase, CINAHL, and Google scholar databases with the keywords Autism Spectrum Disorder AND Anorexia Nervosa and included 6 relevant human studies out of 187 published in English.

Neilson et al. studied the outcome of ASD in teenage onset AN, and a statistically significant negative dose-response relationship is found in all the 3 Morgan-Russell Outcome Assessment Schedule (MROAS) domains in stable ASD over time, and the results on the subscales ‘mental state,’ ‘psychosexual state’ and ‘socio-economic state, “personal contacts,’ ‘social activities’ and ‘employment record.’3 The outcome of AN onset in adolescence is generally favorable regarding mortality and the persistence of eating disorders in adulthood. A study by Pruccoli et al. noted a high prevalence of ASD traits in a group of young AN patients, predominantly seen in 4 specific EDI-3 subscales and independent of BMI.4 Margari et al. found only AN diagnosis had a statistically significant difference (p = 0.04) in females vs. males when comparing sex differences for comorbidities.5

Morphological changes in brain areas are linked to social cognition and increase the risk of eating disorders in ASD. We recommend future studies with robust study design to explore the full spectrum of pathogenesis and association of AN in ASD.

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The assessment of suicide risk remains a critical concern, especially within the psychiatric community. Mental health professionals continually work to identify and support individuals at risk, emphasizing the need for ongoing research and training in this area.

The objectives of our study were to understand the characteristics of patients hospitalized after a suicide attempt (SA), analyze the characteristics of these attempts, identify risk factors associated with suicidal behaviors, and determine predictors for recurring suicidal behavior.

The study’s methodology was retrospective, descriptive, and comparative. It was conducted with 277 patients hospitalized in the psychiatric department “C” of Razi Psychiatric Hospital in Manouba. The sample consists of 72 individuals who attempted suicide, divided into two groups: first-time attempters and recurrent patients, and 205 controls hospitalized for other reasons during the same period.

Results showed a significant increase in the frequency of hospitalizations for SA, rising from 0.7% to 2.25% of the total admissions between 2018 and 2022. Those who attempted suicide were on average 32.5 years old, predominantly female, urban residents, with a moderate socioeconomic status, secondary or higher education, unemployed, unmarried, childless, and lacking strong family support.

The study identified several risk factors associated with suicide attempts, including risky behaviors, previous life events, type II bipolar disorders, personality disorders, the number of psychiatric hospitalizations, and the quality of follow-up. However, schizophrenia was negatively correlated with SA.

Suicidal recurrence was observed in 65.5% of attempters and was linked to personal psychiatric follow-up history, mood disorders, personality disorders, the presence of stress factors, and caustic substance ingestion.

In conclusion, the study underscores the importance of assessing suicide risk among individuals with mental disorders to implement appropriate prevention strategies.

None Declared

Anxiety disorders represent the most common mental illnesses, which are listed among the ten most important causes of disability worldwide. According to DSM-5, they are defined as “disorders that share characteristics of excessive fear and anxiety and related behavioral disorders”. Patients exhibit low levels of quality of life. Their daily routine is affected negatively. However, Occupational Therapy has been proven to play a crucial role in their treatment, improving quality of life through the involvement in occupations.

To highlight the contribution of Occupational Therapy in ameliorating the quality of life in anxiety disorders.

A review of 50 articles -from 2013 to 2023- on PubMed and Google Scholar, regarding the beneficial impact of Occupational Therapy in the Anxiety Disorders’ treatment.

Occupational Therapists can intervene in many negatively affected -by the disease- life domains such as: Activities of Daily Living, Education, Work, Play, Social Interaction and Sleep. The most effective Occupational Therapy methods are based on the cognitive behavioral approach and include: Psychoeducation, Relaxation techniques, Social skills training and Systematic desensitization.

Other methods involve training in Activities of Daily Living such as feeding, maintaining good personal hygiene, and using public transport. Furthermore, Art Therapy (visual arts, use of clay) has been shown to reduce feelings of anxiety, while promoting creativity and enhancing self-esteem.

Additional research is needed regarding the effectiveness of Occupational Therapy in improving the quality of life for patients suffering from Anxiety Disorders. The important “take home message” is that the amelioration of the patients’ quality of life should be the main goal of the therapeutic intervention and not a secondary result of it.

None Declared

The phenomenon of self-stimulatory behaviors, commonly referred to as “stimming,” presents a fascinating avenue of exploration within the context of neurodevelopmental disorders. While stimming behaviors are widely associated with ASD, there is emerging evidence suggesting that individuals with ADHD may also engage in similar behaviors. This study seeks to undertake a comprehensive investigation of the neurophenomenology of stimming in individuals diagnosed with ASD and ADHD, aiming to discern potential shared and distinctive characteristics.

The principal objective of this research is to conduct an intricate neurophenomenological analysis of stimming behaviors in cohorts diagnosed with ASD (n=60) and ADHD (n=60), with a concurrent control group of neurotypical individuals (n=60). The study aspires to delineate the prevalence, typology, and neurophysiological underpinnings of stimming behaviors in both ASD and ADHD populations. Moreover, this study endeavors to identify whether particular stimming behaviors exhibit differential prevalence or intensity between the two disorders.

Participants underwent rigorous neurophenomenological assessments, incorporating structured interviews, validated self-report questionnaires and direct observations. Diagnostic confirmation was established through the administration of gold-standard instruments, such as the Autism Diagnostic Observation Schedule (ADOS-2) for ASD and the Conners’ Parent Rating Scale for ADHD. Stimming behaviors were meticulously categorized (e.g., motor, vocal, sensory) and scrutinized for quantitative metrics, including frequency, duration, and complexity.

Preliminary analyses have uncovered profound disparities in the manifestation of stimming behaviors between ASD and ADHD cohorts. Individuals with ASD displayed a significantly higher prevalence of stimming behaviors, with motor stimming predominating, followed by vocal and sensory manifestations. In contrast, individuals with ADHD exhibited a comparatively reduced frequency and intensity of stimming, primarily within the motor domain, albeit notably less elaborate. Control group participants exhibited a negligible occurrence of stimming behaviors.

This multidimensional exploration illuminates the nuanced neurophenomenological distinctions in self-stimulatory behaviors between ASD and ADHD. Stimming emerges as a pivotal feature in ASD, while its presence in ADHD, though discernible, is markedly attenuated. This study’s findings hold implications for precise diagnostic delineation and the prospect of personalized interventions for these complex neurodevelopmental conditions. Future avenues of research may delve into the neural substrates underpinning stimming behaviors, further enhancing our comprehension of these phenomena.

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People with schizophrenia have multiple and persistent cognitive deficits. These defects have a deep impact on people’s psycho-social functions. Although computerized cognitive training has positive results in some people, the effect of these treatment programs in schizophrenia is not clear.

The purpose of this study was to investigate the effectiveness of computerized cognitive exercises on the components affecting the mental health and cognitive functions of schizophrenic patients.

Fifty-four adults with schizophrenia were randomly divided into two intervention and control groups. Participants in the intervention group received 30 sessions of 5-45 minutes of computerized cognitive training in addition to the usual treatment programs. While the control group only received their usual rehabilitation programs (Pharmacotherapy, psychotherapy and occupational therapy).

Mental health was evaluated with Warwick-Edinburgh Mental Well-Being Scale and Depression-Anxiety-Stress Scale (DASS), and cognitive functions with CANTAB tests Batteries before the intervention, after and two months after the intervention (follow up). The set of CANTAB tests used in this study included the following tests: Spatial Recognition Memory (SRM), Paired Associates Learning (PAL), Stockings of Cambridge(SOC), Spatial Working Memory (SWM), and Spatial Span (SSP).

The analysis of the findings showed that the patients’ performance in the cognitive tests related to memory and executive functions improved significantly in the intervention group after the intervention. In problem solving skills, despite the better performance in the intervention group, the difference between the two groups was not significant. Also, the intervention was able to significantly improve mental health and reduce stress. But no significant difference was observed in reducing anxiety and depression.

As a result, the study showed that 30 sessions of computerized cognitive training can have a positive effect on overall mental health and some cognitive functions.

None Declared