Aims: Qatar has struggled with substance use disorders among its population. Qatar has maintained a relative political and social stability, which has informed a dramatic restructuring of its health and social care services with emphasis on being led by international best practice and primacy of patient rights. However, the rehabilitative model for substance use, which Qatar has placed emphasis on so far, has been based upon voluntary engagement of people who use substances. This has led to lack of provision of care to a significant proportion of patients with substance use disorders in addition to system-wide disagreements around models of care.

Methods: This study employed a retrospective patient record review of 163 patients admitted to the Umm Slal Treatment and Rehabilitation Center between January 2022 and October 2023. The data were systematically analysed to evaluate the effectiveness of the innovative Recovery Journey model.

Results: The majority of patients (61.3%) were aged 20–29, with 54% unemployed or students. Methamphetamine (77.3%) and cannabis (76.1%) were the most commonly used substances. Notable comorbidities included drug-induced psychosis (29.4%) and depression (19.5%). Most patients (90%) had previous treatment encounters. The Recovery Journey model, consisting of court-mandated detoxification and stabilization, residential rehabilitation, and community based continuing care, facilitated treatment completion for 91 out of 149 patients advancing from detoxification to rehabilitation. Challenges included managing complex co-occurring disorders and aligning multidisciplinary teamworking efforts.

Conclusion: The innovative Recovery Journey model at the Umm Slal Treatment and Rehabilitation Center demonstrated promising results in treating individuals with substance use disorders. While initial outcomes are encouraging, challenges related to stakeholder engagement, treatment adherence, and post-discharge care remain. This model emphasizes the importance of balancing directed care with patient autonomy and may serve as a framework for similar initiatives in the region. Further research into and adaptation of cultural contexts are essential for optimizing treatment outcomes.

The present study was designed to report the prevalence of spotted fever group Rickettsia and Anaplasma in ticks from Pakistan. To address this knowledge gap, ticks were collected from October 2019 to November 2020 from livestock hosts. Three hundred ninety ticks from Punjab, Khyber Pakhtunkhwa and Islamabad were investigated for the presence of Rickettsia and Anaplasma. The collected ticks were subjected to molecular studies for detection and characterization of spotted fever group Rickettsia and Anaplasma in ticks from Pakistan. PCR amplification of the ompA gene was used for detection of Rickettsia and portions of the 16S rDNA gene for detection of Anaplasma. Nine species of ticks were tested. Of the 390 ticks tested, 7 (2.58%) ticks were positive for Rickettsia. Rickettsia spp. were detected in Haemaphysalis punctata, Hyalomma anatolicum, Hyalomma scupense, Rhipicephalus microplus and Rhipicephalus sanguineus. Unknown Rickettsia was detected in Hy. scupense. Fifty-seven (14.6%) ticks were also positive for Anaplasma spp. Anaplasma ovis was detected in Hy. anatolicum, Hy. scupense, Hy. excavatum, Rhipicephalus decoloratus, R. microplus and R. sanguineus. Anaplasma marginale was detected in Hy. anatolicum, Hy. scupense, R. microplus, R. decoloratus and R. sanguineus. The Anaplasma sequences obtained from this experiment were 99–100% similar to those of the documented strains. This study provides information and confirms the presence of spotted fever group Rickettsia and Anaplasma spp. in different tick species. It also highlights the need for control programs to prevent health risks. Further investigation to determine the prevalence and disease burden of these pathogens in Pakistan is necessary.

Recent changes to US research funding are having far-reaching consequences that imperil the integrity of science and the provision of care to vulnerable populations. Resisting these changes, the BJPsych Portfolio reaffirms its commitment to publishing mental science and advancing psychiatric knowledge that improves the mental health of one and all.

Chronic diseases such as cardiovascular disease and diabetes are a leading cause of disability and death in Australia. These conditions are often heralded by biomarkers from blood and urine samples which indicate risk or presence of disease. The development of chronic conditions remains influenced by a set of modifiable risk factors, which includes diet. The level of food processing has recently been linked with disease risk factors and poor health outcomes(1), yet there is limited research into the direct associations between food processing and chronic disease biomarkers. This study aims to investigate the associations between varying levels of ultra-processed food consumption and chronic disease biomarkers. Participants ≥ 18 years with biomedical data who participated in both the National Nutritional and Physical Activity Survey and the National Health Measures Survey 2011–2013 were included in this secondary analysis. Chronic disease biomarkers were categorised as normal or abnormal according to cut-off values from the Royal College of Pathologists of Australasia. Dietary intake was classified according to the NOVA system for level of food processing. Data were then stratified into quintiles of daily energy share of ultra-processed foods. Associations between chronic disease biomarkers across quintiles of energy share of ultra-processed foods were examined. A significant positive trend was found between ultra-processed food consumption and high-density lipoprotein (HDL) cholesterol (p < 0.01). An inverse association was observed between ultra-processed food consumption and total cholesterol (p < 0.001). The highest consumers of ultra-processed foods were more likely to be younger, less educated, more disadvantaged, not meeting physical activity guidelines, and currently smoking (all ps < 0.001). In conclusion, ultra-processed food consumption was associated with significant changes in total and HDL cholesterol levels. This provides insight into possible interactions at a biochemical level and may help to guide future dietary recommendations on ultra-processed foods for disease management and prevention.

Maternal health and nutrition in early pregnancy play a vital role in the growth and development of the foetus. During this time, macro and micronutrients contribute to nutritional programming, which helps form the foundations of the foetus’s life course health outcomes. This study aimed to investigate dietary habits, macro and micronutrient intake, micronutrient status, and folic acid supplement adherence among Emirati pregnant women in their first trimester. Data were collected according to the UAE-BCS study protocol, which was set up to investigate maternal nutrition, health, child growth, and developmental outcomes within the first 1000 days. Pregnant Emirati women with singleton pregnancies within their first trimester of pregnancy (between 8 and 12 weeks of gestation) were enrolled. The 24-hour food recall method was administered to collect dietary intake. The maternal mean average age was 29 years. Participants had high adherence to supplementation during pregnancy compared to preconception. The mean energy intake was 1345kcal, and 56% of participants consumed saturated fats above the acceptable macronutrient distribution ranges (AMDR), while 94% consumed below AMDR for total fibre. The consumption of micronutrients was below the recommended dietary allowance (RDA). Biochemical results show a high prevalence of low haemoglobin (74%) and deficiencies in vitamin D (39%) and vitamin E (96%). There is a need for research into dietary patterns and influences in pregnant women in the UAE. Furthermore, investigations of knowledge practices and attitudes towards supplementation and the factors contributing to folic acid supplement use are needed to inform government strategies and interventions.

Coastal wetland sediments are vital to the global carbon cycle as they represent large sinks of blue carbon – carbon from atmospheric and oceanic sources – which are threatened by ecosystem loss. The forms of sequestered carbon and the sequestration capability are affected by many bio- and geochemical factors that change unpredictably along coastal locales. In the present study, we investigated three unique coastal sites – a coastal mangrove and two sabkhas with contrasting geology and tidal influence in the Qatar peninsula – for their carbon capture ability to determine how biogeochemical indices affect their blue carbon sequestration potential. We applied a suite of biological and geochemical tools, collecting the sediment cores of approximately 40 cm depth; analysed sediment porewater; performed depth-profiling of the organic matter, sedimentary minerals, microbial community and analysis of sediment surface for pH, oxygen (O2); redox potential and hydrogen sulfide (H2S) by microsensors. High-resolution transmission electron microscopy with energy-dispersive X-ray spectroscopy (TEM-EDXS) and scanning transmission X-ray microscopy (STXM) revealed templating effects that promoted Mg-carbonate nucleation in coastal hypersaline environments. Microsensing reveals the intricacy of the oxic/anoxic transition at the sediment surface. Microbial DNA sequencing at various sediment depths shows the occurrence of microbial genera, whose functions explain the geochemical trends and carbon sequestration pathways observed at each site. Notably, we found that carbon sequestration in the mangrove and carbonate-sand sabkha was correlated with organic matter degradation and inorganic carbon content, while in the siliciclastic sabkha it was solely influenced by sediment density and depth.

The key assumption of conditional independence of item responses given latent ability in item response theory (IRT) models is addressed for multistage adaptive testing (MST) designs. Routing decisions in MST designs can cause patterns in the data that are not accounted for by the IRT model. This phenomenon relates to quasi-independence in log-linear models for incomplete contingency tables and impacts certain types of statistical inference based on assumptions on observed and missing data. We demonstrate that generalized residuals for item pair frequencies under IRT models as discussed by Haberman and Sinharay (J Am Stat Assoc 108:1435–1444, 2013. https://doi.org/10.1080/01621459.2013.835660) are inappropriate for MST data without adjustments. The adjustments are dependent on the MST design, and can quickly become nontrivial as the complexity of the routing increases. However, the adjusted residuals are found to have satisfactory Type I errors in a simulation and illustrated by an application to real MST data from the Programme for International Student Assessment (PISA). Implications and suggestions for statistical inference with MST designs are discussed.

We propose a generalization of the speed–accuracy response model (SARM) introduced by Maris and van der Maas (Psychometrika 77:615–633, 2012). In these models, the scores that result from a scoring rule that incorporates both the speed and accuracy of item responses are modeled. Our generalization is similar to that of the one-parameter logistic (or Rasch) model to the two-parameter logistic (or Birnbaum) model in item response theory. An expectation–maximization (EM) algorithm for estimating model parameters and standard errors was developed. Furthermore, methods to assess model fit are provided in the form of generalized residuals for item score functions and saddlepoint approximations to the density of the sum score. The presented methods were evaluated in a small simulation study, the results of which indicated good parameter recovery and reasonable type I error rates for the residuals. Finally, the methods were applied to two real data sets. It was found that the two-parameter SARM showed improved fit compared to the one-parameter SARM in both data sets.

Limited sunshine and dietary vitamin D make vitamin D deficiency very common in Ireland. Breastfeeding is the universal recommendation and supplies the best combination of nutrients and bioactive factors for all infants(1). However, maternal diet and nutrition status impacts concentrations of certain nutrients in breastmilk and therefore vitamin D concentrations can be lower than recommended for infants(2,3). This study aimed to determine the vitamin D intakes and food sources of breastfeeding mothers in Ireland.

Data was collected as part of the WellFed study, a 4-week randomised control trial investigating the effectiveness of a food supplement containing a protein hydrolysate and beta glucan (Wellmune®) during lactation on immune and gut health (LS-23-07-OSullivan). Participant vitamin D intakes were assessed using FoodBook24 self-completed 24-hour recalls. Foods were grouped into food groups to determine their contribution to intake as well as the contribution from natural and added vitamin D foods. Data was analysed using IBM SPSS Statistics (version 27).

Dietary analysis of 45 participants indicated that maternal vitamin D intakes were low (6.4 ± 4.6μg/day). Most participants (96%) did not meet the 15μg/day recommendation, despite 56% of participants reporting they consumed some form of vitamin D supplement. Natural vitamin D foods like eggs and egg dishes, fish and fish products, meat and meat products and foods with added vitamin D including breakfast cereals, beverages, and milk and yoghurt were the key food groups contributing to intake, with the majority coming from natural food sources.

Low dietary vitamin D intake is common among breastfeeding women and diet alone is insufficient to achieve the daily vitamin D requirements even when supplements are consumed. As natural food sources of vitamin D are limited and infrequently consumed, recommendations to consume more vitamin D foods may not be successful as a standalone strategy to improve vitamin D status. A combination of approaches including the promotion of vitamin D rich food consumption, supplementation strategies, and the introduction of food fortification policies may be a feasible method for improving vitamin D across the population.

Childhood obesity is a serious public health concern worldwide. One in five children are overweight or obese in Ireland1. Suboptimal growth, either in pregnancy or infancy, can increase the risk of obesity in childhood2. National policy fails to recognise early life exposures as potential contributors to Ireland’s obesity epidemic. This research examines the impact of ‘Labour and Birth’, ‘Birth Weight Status’, and ‘Maternal BMI’ on infant growth in the first weeks of life.

This research is a secondary analysis of data collected as part of the WellFed study, a randomised placebo-controlled trial investigating the effect of a maternal dietary supplement comprised of a milk protein hydrolysate and yeast beta-glucan (Wellmune®) (LS-23-07-OSullivan). The supplement does not influence the present findings. Mother and infant anthropometrics were measured during two study visits, at approximately 4 and 8-weeks postpartum. Participants completed a series of questionnaires to obtain basic demographic, birth and lifestyle data. Infant weight and length percentiles were calculated using the UK-WHO 0-2 years: weight-for-age percentiles and the UK-WHO 0-2 Years: length-for-age percentiles for both males and females. Statistical analysis was performed using IBM SPSS Statistics (version 27).

Data from 51 mother-infant dyads show infants delivered via cesarean section weighed less at the 4-week (4.1± 0.4 vs 4.5± 0.5 kg, p = 0.015) and 8-week follow-up (5.1± 0.5 vs 5.5± 0.6 kg, p = 0.021) and were shorter at the 8-week follow-up (56.3± 1.9 vs 57.7± 2.0 cm, p = 0.030) compared to infants born vaginally. Infants born following induction were significantly heavier at the 8-week follow-up compared to those not-induced (5.8± 0.7 vs 5.2± 0.5 kg, p = 0.006). In this cohort, 40% of infants were classified as large-for-gestational-age (LGA). Across the 8-week study period, 50% of LGA infants dropped two or more growth percentiles.

Observations from this study highlight a high prevalence of LGA infants in this cohort which raises concern for the national prevalence of LGA infants in Ireland. Interventions during labour and birth were shown to influence infant growth in this study. These findings highlight the need for further investigation into the relationship between early life exposures and growth during infancy and childhood. Implementing healthcare policies focusing on reducing the number of elective birthing procedures performed and targeting obesity amongst women of reproductive age are possible measures that can be implemented to help tackle the obesity crisis in Ireland.

Early childhood growth is associated with cognitive function. However, the independent associations of fat mass (FM) and fat-free mass (FFM) with cognitive function are not well understood. We investigated associations of FM and FFM at birth and 0–5 years accretion with cognitive function at 10 years. Healthy-term newborns were enrolled in this cohort. FM and FFM were measured at birth, 1·5, 2·5, 3·5, 4·5 and 6 months and 4 and 5 years. Cognitive function was assessed using the Peabody Picture Vocabulary Test (PPVT) at 10 years. FM and FFM accretions were computed using statistically independent conditional accretion from 0 to 3 months, 3 to 6 months, 6 months to 4 years and 4 to 5 years. Multiple linear regression was used to assess associations. At the 10-year follow-up, we assessed 318 children with a mean (sd) age of 9·8 (1·0) years. A 1 sd higher birth FFM was associated with a 0·14 sd (95 % CI 0·01, 0·28) higher PPVT at 10 years. FFM accretion from 0 to 3 and 3 to 6 months was associated with PPVT at 10 years: β = 0·5 sd (95 % CI 0·08, 0·93) and β = −0·48 sd (95 % CI −0·90, −0·07, respectively. FFM accretion after 6 months showed no association with PPVT. Neither FM at birth nor 0–5 years accretion showed an association with PPVT. Overall, birth FFM, but not FM, was associated with cognitive function at 10 years, while the association of FFM accretion and cognitive function varied across distinct developmental stages in infancy. The mechanisms underlying this varying association between body composition and cognitive function need further investigation.

Efficient evidence generation to assess the clinical and economic impact of medical therapies is critical amid rising healthcare costs and aging populations. However, drug development and clinical trials remain far too expensive and inefficient for all stakeholders. On October 25–26, 2023, the Duke Clinical Research Institute brought together leaders from academia, industry, government agencies, patient advocacy, and nonprofit organizations to explore how different entities and influencers in drug development and healthcare can realign incentive structures to efficiently accelerate evidence generation that addresses the highest public health needs. Prominent themes surfaced, including competing research priorities and incentives, inadequate representation of patient population in clinical trials, opportunities to better leverage existing technology and infrastructure in trial design, and a need for heightened transparency and accountability in research practices. The group determined that together these elements contribute to an inefficient and costly clinical research enterprise, amplifying disparities in population health and sustaining gaps in evidence that impede advancements in equitable healthcare delivery and outcomes. The goal of addressing the identified challenges is to ultimately make clinical trials faster, more inclusive, and more efficient across diverse communities and settings.

From early on, infants show a preference for infant-directed speech (IDS) over adult-directed speech (ADS), and exposure to IDS has been correlated with language outcome measures such as vocabulary. The present multi-laboratory study explores this issue by investigating whether there is a link between early preference for IDS and later vocabulary size. Infants’ preference for IDS was tested as part of the ManyBabies 1 project, and follow-up CDI data were collected from a subsample of this dataset at 18 and 24 months. A total of 341 (18 months) and 327 (24 months) infants were tested across 21 laboratories. In neither preregistered analyses with North American and UK English, nor exploratory analyses with a larger sample did we find evidence for a relation between IDS preference and later vocabulary. We discuss implications of this finding in light of recent work suggesting that IDS preference measured in the laboratory has low test-retest reliability.