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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.
Methods
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.
Results
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).
Conclusions
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.
The productivity of dairy animals is heavily reliant on the timely access to sufficient, high-quality fodder. This study analyzes the ex-post impact of Model Fodder Villages on the livelihood security of dairy farmers in Bundelkhand region of central India. The study used cross-sectional data from 437 farmers and employed the inverse-propensity-weighting regression adjustment (IPWRA) method for impact evaluation and verified the robustness of the results through matching methods. The findings show that dairy farmers in model fodder villages are 14–19% more likely to improve habitat security, 19–21% more likely to enhance economic security, and 13–16% more likely to increase food security. Our findings also indicate that factors such as age, education, household size, dependency ratio, off-farm income, adult cattle units, and access to roads, markets, credit, and training play significant roles in adopting improved fodder practices. The study's methodology provides a reliable approach to evaluating the impact of interventions that improve access to fodder and related resources, aiming to enhance the livelihoods of dairy farmers and agricultural communities.
Postpartum depressive symptoms (PPDS) are mental health concerns, characterised by sadness, anxiety and suicidal ideation.
Aims
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.
Method
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.
Results
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.
Conclusions
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.
We surveyed SHEA Research Network institutions in the U.S. to characterize penicillin allergy delabeling practices. Although most institutions reported active delabeling programs, we found substantial variability in these initiatives. Reported barriers included minimal electronic health record (EHR) integration and time constraints. Expanding non-allergist-led programs and EHR integration are critical to optimizing and advancing delabeling.
Disruptions in circadian rhythms and sleep have long been associated with mood disorders. In fact, sleep disturbances are one of the key features used in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V-TR) diagnosis of major depressive disorder and bipolar disorder. Sleep/wake abnormalities can also precede mood episodes and predict treatment response. Thus, precise measurement of specific sleep/circadian features is important as these measures can be used clinically to direct appropriate treatments. These measures can also be used for research purposes to try to understand specific mechanisms by which circadian rhythm disturbances and sleep/wake perturbations may lead to specific phenotypes. The purpose of this review is to highlight recent advances in methodology which can be used to more precisely measure sleep/circadian biology. This review will examine how these new methodologies can better elucidate the mechanisms linking sleep/circadian disruptions and mood disorders, as well as how new technologies can be used therapeutically to treat sleep/circadian abnormalities.
In this study, we apply a stated preference experiment and discrete choice modelling to examine Greek primary teachers’ preferences for reward and consequences strategies in supporting students with attention-deficit/hyperactivity disorder. We also investigate how these preferences differ based on teacher gender, educational attainment, and special education training. A total of 430 general and special education teachers completed 2,948 choice cards. Each card presented hypothetical scenarios combining five behavioural management attributes: verbal praise, responses to undesired behaviours, privilege removal, point-based systems, and tangible versus intangible rewards. Data were analysed using an alternative-specific conditional logit model. Verbal praise and intangible rewards (e.g., free time, token economies) received the highest preference ratings, while reprimands and privilege revocation were consistently disfavoured. Female teachers, those with postgraduate degrees, and special education trained educators assigned significantly greater utility to informational consequences and tangible rewards. Findings reveal a strong consensus among teachers in favour of positive reinforcement strategies and a reluctance to employ punitive measures. Professional development should emphasise reward-based techniques. Future research should link these stated preferences to actual classroom practices and student outcomes to assess their real-world effectiveness.
The implementation of evidence-based practices (EBPs) does not always lead to successful outcomes due to various contextual factors. The Evidence-Based Practice Attitude Scale (EBPAS; Aarons, 2004) assesses implementers’ attitudes towards adopting EBPs (ATE), helping to understand the discrepancy between planned and implemented EBPs. Despite the growing implementation of school-based EBPs, the EBPAS has seldom been applied to general education teachers. This study aimed to validate the EBPAS for primary school teachers in Singapore using content validity and confirmatory factor analysis and to examine how the contextual characteristics influence ATE. A total of 170 teachers from 10 schools participated anonymously in an online survey. Confirmatory factor analysis results supported the four-factor structure of the EBPAS. All subscales showed excellent to acceptable internal consistency, with Divergence being the lowest. Teachers with higher educational attainment were more likely to be open to adopting EBPs. Similarly, teachers’ perceived school leadership support was significantly associated with their ATE. However, neither years of teaching experience, years of supporting students with special educational needs, nor teacher efficacy in inclusive practices significantly predicted ATE. The study highlights the need for further refinement, particularly of the Divergence subscale, through the exploration of alternative constructs and validation with larger samples.
This paper explores self-exile as a form of feminist resistance within the Iranian diaspora, focusing on feminist activists in Germany during the Jin, Jiyan, Azadî uprising of 2022–2023. Drawing on biographical interviews and Sara Ahmed’s concept of willfulness, the study examines how activists chose visible political engagement despite the risk of permanently losing the possibility of return to Iran. Self-exile is conceptualized as a complex act of agency: simultaneously disempowering due to physical separation from the place of origin and empowering through bodily autonomy, political consciousness, and resistance to fear. The testimonies highlight the ambivalence of self-exile—its empowering and transformative dimensions alongside profound emotional loss and turmoil. By framing self-exile as a deliberate feminist stance, this research contributes to understanding exile and diaspora as evolving, overlapping categories, foregrounding the embodied, affective, and political complexities of feminist subjectivity across borders.
This Registered Report examines urban-rural tensions in Sweden – a historically egalitarian, multi-party welfare state with strong geographical equalization schemes, making it a least-likely case for place-based resentment theories. Using an online survey experiment (n = 2,051), we measured resentment through perceptions of in-group and out-group, and by experimentally varying whether political statements came from rural or urban politicians. Rural respondents showed stronger in-group identification, greater place-based resentment, and more negative stereotypes of their out-group than urban respondents. However, we find no evidence of place-based bias – that is, that rural respondents are less receptive to urban politicians’ statements, or vice versa. These findings reveal clear urban-rural tensions in a context often considered unlikely for such divides, underscoring the role of regional identities in political discourse and policy in multi-party welfare states beyond Anglo-Saxon settings, while indicating that these tensions do not translate into systematic bias in evaluating political statements.
There is increased interest in self-selected exclusionary diet patterns, specifically vegetarian, vegan, and gluten-free (GF) diets, but there is a lack of research exploring the beliefs and behaviours surrounding these diets in Canadians capable of bearing children (CCBC). The goal of this study was to explore the beliefs and behaviours of CCBC who follow vegetarian, vegan, and/or GF diets using mixed methods. A self-administered online Qualtrics™ survey containing 102 questions was conducted using open text and closed format questions. Continuous variables were summarized using mean and standard deviation while percentages were used to summarize categorical variables. Qualitative data was analysed using thematic analysis. A total of 271 CCBC between 18–45 years of age were analysed, with 27%, 22%, and 3.7% indicating they followed a vegan, vegetarian, and/or GF diet, respectively. Three main themes emerged that influenced CCBC beliefs about their chosen diet. The belief that these diets are healthy or could impart health in some way, was the main reason for following their chosen diet, especially in those who identified as vegetarian. Ethical/moral concerns, primarily around animal welfare and the environment, was the second theme for following their chosen dietary pattern, especially amongst those who identified as vegan. Perception of social judgement in the forms of criticism, guilt, and isolation were noted by some CCBC, with family, friends, and colleagues interacting differently with them because of their dietary choices. These findings serve to enhance our understanding of the beliefs and behaviours of CCBC who choose to follow exclusionary diets.
People experiencing psychosis in acute crisis should be offered cognitive behavioural therapy for psychosis (CBTp); however, there are few crisis-focused CBTp-informed models to underpin formulation development for people experiencing psychosis and receiving inpatient mental health care.
Aims:
This paper draws on existing CBTp and crisis theories to conceptualise a psychotic crisis from a cognitive behavioural perspective to inform the delivery of therapy in inpatient settings.
Method:
Previous literature is reviewed, critiqued, and synthesised. It draws upon relevant crisis and CBTp theories to outline how to best formulate a psychotic crisis.
Discussion:
Drawing on existing research and theory, this paper outlines how a psychotic crisis can develop and be maintained. It highlights the importance of the person’s context including the social, political, and cultural context, interpersonal context and trauma, and previous and current inpatient experience. It then outlines the key triggers, cognitive, behavioural, and emotional components of the crisis, and personal strenghts, values and resources. A crisis-focused CBTp-informed approach is outlined, which can be used to underpin formulation and brief therapy strategies for people experiencing a psychotic crisis. More research is required to explore the efficacy of such therapies.
We evaluated a targeted Candida auris screening program, which revealed a 0.96% positivity rate. The proportion of community-onset cases increased from 8% to 54% following implementation. No significant differences in demographic or clinical characteristics were observed between patients with colonization and those with infection.
The complexity and nuance of how social networks shape dietary behaviours and health dynamics remain underexplored, particularly in collectivist societies where family and peer relationships strongly impact health. This study applies social network analysis to examine these dynamics in Singapore.
Design:
An online household survey of young adults (age 21–35) and family (21+) assessed the consumption of healthy food groups (fruit, vegetable intake), unhealthy food groups (fast food, snack consumption) and social network characteristics (interaction frequency, emotional closeness, shared meals and perceived health influence). Data were analysed using network analysis, mixed regression models and generalised estimating equations.
Setting:
Online Singaporean household survey.
Results:
Among 116 participants from thirty-six households, 345 unique individuals and 1145 dyadic relationships were identified, with networks averaging 9·7 nodes (sd: 4·7) and 33·2 edges (sd: 27·3). Mutual health influence was strongest in spousal (β = 0·89, 95 % CI: 0·42, 1·35) and intergenerational ties (older-to-younger: β = 0·62, 95 % CI: 0·29, 0·94; younger-to-older: β = 0·36, 95 % CI: 0·03, 0·68) and associated with emotional closeness (β = 0·38, 95 % CI: 0·30, 0·46) and shared meals (β = 0·43, 95 % CI: 0·36, 0·49). Greater family health effort correlated with lower snack (Adjusted Odds Ratio [AOR]: 0·50, 95 % CI: 0·29, 0·85) and fast-food consumption (AOR: 0·41, 95 % CI: 0·22, 0·77), while higher perceived family health associated with increased snack intake (AOR: 3·21, 95 % CI: 1·58, 6·52). Frequent meals with friends associated with lower fast-food intake (AOR: 0·50, 95 % CI: 0·30, 0·84), but no associations with fruit or vegetable intake were found.
Conclusion:
Findings highlight intergenerational and spousal ties as key health influencers, particularly through shared meals, and the complex role of social networks in shaping diet. Analyses suggest network-based interventions may be more useful in reducing unhealthy rather than promoting healthy eating behaviours.
The fungus Beauveria bassiana (Unioeste 76) was tested against the soybean pest Euschistus heros in laboratory, greenhouse, and field. In the laboratory, insects were sprayed with pure conidia (TC) suspended in distilled water or in an oil dispersion formulation (OD; vegetable oil) at a concentration of 109 conidia/mL. The UV-B radiation and heat tolerance of the conidia were also assessed. After 12 days, the mortality rates in the laboratory were 70% for the TC treatment and 80% for the OD treatment. In the greenhouse pre-infestation bioassay, which used soybean plants in cages, the fungal treatments resulted in 52% and 47% mortality for the TC and OD formulations, respectively. In the post-infestation bioassay, both fungal treatments caused 83% mortality. In the field trial conducted on soybean plots (14 × 18 m), the treatments included: (i) biological: OD (109 conidia/mL); (ii) chemical insecticide; (iii) biological + chemical, all applied at 150 L/ha. Insect numbers were evaluated using beating-sheet sampling. In the final population sample, the biological treatment showed a population density similar to the chemical treatment (0.94 and 0.83 insects/m, respectively), both below the economic threshold. Conidia tolerance to UV-B radiation was similar across both treatments, but conidia in oil were less tolerant to heat. These results suggest that strategically combining both approaches (B. bassiana with chemical insecticides), with careful consideration of application intervals, could provide a sustainable and effective method for managing natural populations of E. heros.
Hospital sinks are reservoirs for epidemiologically important pathogens (EIPs), yet practical, effective strategies for sustained decontamination are lacking.
Methods:
We conducted a randomized controlled trial of 30 in-room sinks (15 intervention, 15 control) in a newly renovated hospital unit to evaluate the efficacy of a hydrogen peroxide/peracetic acid foamed disinfectant in reducing sink contamination. Intervention sinks received foamed disinfectant to sink drains three times weekly; control sinks underwent standard daily surface cleaning. Weekly sampling was performed from three sink locations (top surface, tail pipe, P-trap) over 35 weeks. The primary outcome was sink conversion events (SCEs), defined as first detection of ≥1 EIP, defined as Pseudomonas aeruginosa, Stenotrophomonas spp., or Acinetobacter spp., and ESBL-producing or carbapenem-resistant Enterobacterales, in previously negative sinks.
Results:
A total of 2880 samples were collected. All sinks were negative at baseline for study pathogens. Nearly all sinks (29/30) experienced an SCE during the study period. However, only 44 (9%) intervention sink samples were positive for EIPs, compared to 270 (47%) in control sinks (p < 0.00001). EIPs were recovered from 4% versus 24% of P-traps and 4% versus 39% of tail pipes; sink top/handle contamination was rare and similar (3% vs 4%). The most frequent EIPs were Acinetobacter spp. and Stenotrophomonas spp. Intervention sinks experienced a delayed time to SCE (p = 0.0001). Items were stored on/in sinks in 93% of observations.
Conclusion:
Regular application of a foamed disinfectant reduced and delayed EIP contamination in renovated hospital sinks. Foam-based protocols may help mitigate environmental reservoirs of multidrug-resistant organisms.