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In healthcare and medical research, advisory boards are now commonplace, but most boards consist of a relatively homogenous, geographically collocated group, often demonstrating demographic imbalance. It is crucial to include individuals from diverse backgrounds on community advisory boards for healthcare and medical research to address ongoing health disparities and ensure studies are more culturally competent so that we can achieve more inclusive representation. We conducted purposeful recruitment to attract a demographically diverse group of community members across the United States (U.S.) to partner with the All of Us Research Program to inform our strategies including program recruitment, engagement, retention, and incentives. Recruitment of a diverse group of advisors and purposeful community building has created a psychologically safe environment where members openly share their opinions, thoughts, and perspectives to shape various aspects of this ambitious, nationwide research program.
The hippocampal formation represents a key region in the pathophysiology of schizophrenia. Aerobic exercise poses a promising add-on treatment to potentially counteract structural impairments of the hippocampal formation and associated symptomatic burden. However, current evidence regarding exercise effects on the hippocampal formation in schizophrenia is largely heterogeneous. Therefore, we conducted a systematic review and meta-analysis to assess the impact of aerobic exercise on total hippocampal formation volume. Additionally, we used data from a recent multicenter randomized-controlled trial to examine the effects of aerobic exercise on hippocampal formation subfield volumes and their respective clinical implications.
Methods
The meta-analysis comprised six studies that investigated the influence of aerobic exercise on total hippocampal formation volume compared to a control condition with a total of 186 people with schizophrenia (100 male, 86 female), while original data from 29 patients (20 male, 9 female) was considered to explore effects of six months of aerobic exercise on hippocampal formation subfield volumes.
Results
Our meta-analysis did not demonstrate a significant effect of aerobic exercise on total hippocampal formation volume in people with schizophrenia (g = 0.33 [−0.12 to 0.77]), p = 0.15), but our original data suggested significant volume increases in certain hippocampal subfields, namely the cornu ammonis and dentate gyrus.
Conclusions
Driven by the necessity of better understanding the pathophysiology of schizophrenia, the present work underlines the importance to focus on hippocampal formation subfields and to characterize subgroups of patients that show neuroplastic responses to aerobic exercise accompanied by corresponding clinical improvements.
This chapter explores the political role of business in influencing several important federal climate change policy initiatives over the last two decade. These include the Kyoto Protocol (1998), the Climate Stewardship Act (2003), the Climate Security Act (2007), the American Clean Energy and Security Act (2009), the Clean Power Plan (2015), and the Paris Climate Agreement (2015). It examines the increasing patterns of division within the business community and explains why a growing number of companies and investors have voiced support for federal policies to address the risks of global climate change. It also explores why, nonetheless, business opponent of federal regulation have been consistently so successful in preventing the enactment of comprehensive greenhouse reduction policies by the federal government. A key reason is that business opponents of regulation have more to lose than its proponents have to gain.
While most literature on federal climate change policies has focused on failures to adopt broad policies, this article describes and explains successes in two important sectors. Regulations to improve the fuel economy of motor vehicles and efficiency standards for appliances and equipment have produced substantial reductions in greenhouse gas emissions, although they largely have other goals and hence can be considered implicit climate policies. We synthesize the existing literature with our analyses of case studies to offer three explanations for the adoption of effective policies in these two sectors. First, the policies delivered politically popular co-benefits, such as reducing consumers’ energy bills, enhancing energy security, and promoting public health. Second, they gained business acceptance because they were narrow in their scope, avoided long-term economic costs, and helped industry cope with state-level regulations; industry often strategically tried to influence these policies rather than resist them. Third, the legislation that initiated and expanded these policies received bipartisan support, which was aided by co-benefits and business acceptance; more recently, these laws have been strengthened through the actions of Democratic administrations. We conclude by comparing these policy areas to the passage of the Inflation Reduction Act of 2022.
Stigma can maintain discrimination and oppression and reduce compassion and understanding. In the area of mental illness and psychological help seeking, stigma acts as a considerable barrier to recovery and adds additional burdens to be managed. This reality has led many different research groups to explore the workings of stigma and ways to intervene to help people who suffer from the stigma associated with mental health problems. We wanted to create a state-of-the-science source for the best research being done in this area and so we organized the Handbook of Stigma and Mental Health. This chapter provides an overview to the Handbook and the excellent research that is reviewed in it. In their chapters, the authors of the Handbook answer four important questions: “What are the forms of mental health stigma?”; “What are impacts of mental health stigma?”; “How can we develop interventions to reduce mental health stigma across contexts?”; “How can we understand the specific ways that mental health stigma impacts different groups (e.g., racial minorities, veterans)?” We hope that asking these questions will stimulate and drive more innovative research in the future.
Stigma is a powerful force that is not easily dismantled. The goal of the Handbook of Stigma and Mental Health is to assist with policy changes, interventions, and movement toward social justice by presenting the breadth and depth of the work on mental health stigma. The authors of the Handbook have provided a deep and more complete picture of what stigma is, how it might develop, and how it might be changed. The authors also have provided a clear picture that stigma cannot be understood in isolation, but rather intersectional and contextual approaches are best. Through the work reviewed by the authors of the Handbook, it is clear that research is still needed to expand on what situations and under what conditions stigmas could be minimized, reduced, buffered, or eliminated. Also, work needs to be done to create culturally affirming approaches to stigma reduction. We believe the work presented in the Handbook provides optimism about the changes that have been made and the progress in our knowledge and interventions. It also provides insights into developing unique perspectives on the field, challenging some of our well-worn ideas, and pushing the limits of our knowledge.
The persistence of stigma of mental illness and seeking therapy perpetuates suffering and keeps people from getting the help they need and deserve. This volume, analysing the most up-to-date research on this process and ways to intervene, is designed to give those who are working to overcome stigma a strong, research-based foundation for their work. Chapters address stigma reduction efforts at the individual, community, and national levels, and discuss what works and what doesn't. Others explore how holding different stigmatized identities compounds the burden of stigma and suggest ways to attend to these differences. Throughout, there is a focus on the current state of the research knowledge in the field, its applications, and recommendations for future research. The Handbook provides a compelling case for the benefits reaped from current research and intervention, and shows why continued work is needed.
This article explores the role of business in supporting and benefiting from nature protection during the second half of the nineteenth century. It begins with the support of business for protecting scenic wilderness in California and the creation of Yellowstone, as well as the role of the railroads in encouraging easterners to visit to the nation’s western national parks—all designed to create economic value by promoting tourism. It then examines the efforts of a wide range of business interests to protect the White Mountains of New Hampshire and the Adirondack forest in New York State. The later effort was led by business interests from New York City who worried that deforestation would impair freight traffic on the Erie Canal and Hudson River as well as endanger the city’s water supplies. This article compliments Hay’s research on business and conservation during the Progressive Era by demonstrating that business also played a critical role in supporting wilderness and forest protection.
Edited by expert scholars, this volume explores the 'imposter' through empirical cases, including click farms, bikers, business leaders and fraudulent scientists, providing insights into the social relations and cultural forms from which they emerge.
Violent criminal offenders with personality disorders (PD's) can cause immense harm, but are often deemed untreatable. This study aimed to conduct a randomized clinical trial to test the effectiveness of long-term psychotherapy for rehabilitating offenders with PDs.
Methods
We compared schema therapy (ST), an evidence-based psychotherapy for PDs, to treatment-as-usual (TAU) at eight high-security forensic hospitals in the Netherlands. Patients in both conditions received multiple treatment modalities and differed only in the individual, study-specific therapy they received. One-hundred-three male offenders with antisocial, narcissistic, borderline, or paranoid PDs, or Cluster B PD-not-otherwise-specified, were assigned to 3 years of ST or TAU and assessed every 6 months. Primary outcomes were rehabilitation, involving gradual reintegration into the community, and PD symptoms.
Results
Patients in both conditions showed moderate to large improvements in outcomes. ST was superior to TAU on both primary outcomes – rehabilitation (i.e. attaining supervised and unsupervised leave) and PD symptoms – and six of nine secondary outcomes, with small to moderate advantages over TAU. ST patients moved more rapidly through rehabilitation (supervised leave, treatment*time: F(5308) = 9.40, p < 0.001; unsupervised leave, treatment*time: F(5472) = 3.45, p = 0.004), and showed faster improvements on PD scales (treatment*time: t(1387) = −2.85, p = 0.005).
Conclusions
These findings contradict pessimistic views on the treatability of violent offenders with PDs, and support the effectiveness of long-term psychotherapy for rehabilitating these patients, facilitating their re-entry into the community.