Explore the vast range of titles available.

Stroke is a debilitating clinical condition resulting from a brain infarction or hemorrhage that poses significant challenges for motor function restoration. Previous studies have shown the potential of applying transcranial direct current stimulation (tDCS) to improve neuroplasticity in patients with neurological diseases or disorders. By modulating the cortical excitability, tDCS can enhance the effects of conventional therapies. While upper-limb recovery has been extensively studied, research on lower limbs is still limited, despite their important role in locomotion, independence, and good quality of life. As the life and social costs due to neuromuscular disability are significant, the relatively low cost, safety, and portability of tDCS devices, combined with low-cost robotic systems, can optimize therapy and reduce rehabilitation costs, increasing access to cutting-edge technologies for neuromuscular rehabilitation. This study explores a novel approach by utilizing the following processes in sequence: tDCS, a motor imagery (MI)-based brain-computer interface (BCI) with virtual reality (VR), and a motorized pedal end-effector. These are applied to enhance the brain plasticity and accelerate the motor recovery of post-stroke patients. The results are particularly relevant for post-stroke patients with severe lower-limb impairments, as the system proposed here provides motor training in a real-time closed-loop design, promoting cortical excitability around the foot area (Cz) while the patient directly commands with his/her brain signals the motorized pedal. This strategy has the potential to significantly improve rehabilitation outcomes. The study design follows an alternating treatment design (ATD), which involves a double-blind approach to measure improvements in both physical function and brain activity in post-stroke patients. The results indicate positive trends in the motor function, coordination, and speed of the affected limb, as well as sensory improvements. The analysis of event-related desynchronization (ERD) from EEG signals reveals significant modulations in Mu, low beta, and high beta rhythms. Although this study does not provide conclusive evidence for the superiority of adjuvant mental practice training over conventional therapy alone, it highlights the need for larger-scale investigations.

Burnout and Depression among PhysiciansDiminished well-being among physicians is of growing concern. The authors review measures of burnout and depression, causal factors, and interventions to improve well-being.

Background Schoolteachers are often the first to respond when a student presents with a mental health issue in the classroom. This places a burden on schools that impacts school staff, healthcare workers and teachers. More broadly, it places a responsibility on the education system to address students’ mental health. This study examines Australian teachers’ classroom experiences and the training areas identified by teachers as necessary to manage these issues. Method Interviews were undertaken with 18 in-service teachers between 2020 and 2021 from Catholic, Independent and Public schools. Data were gathered via multiple interviews and analysed using thematic content analysis. Results The major mental health issues identified by teachers related to mental disorders, depression, anxiety, and a complex range of negative emotional states. Teachers requested training in child and adolescent mental health, counselling skills, early detection and intervention, and training skills to manage the complex relationship with parents and external health and community personnel. Teachers also reported the need to access mental health resources, support and training, which were differentially accessed along socioeconomic status and postcodes. Conclusion The data show that teachers are often placed as first responders when a student has a mental health issue but feel inadequately trained to manage these issues in the classroom. We identified mental health issues presenting in Australian classrooms and documented critical features of mental-health training asked for by teachers in order to address those issues. Given the increasing demands on teachers to address the mental health of children and adolescents, we argue that an urgent review of mental health training for teachers is needed.

Background The teacher’s role in school mental health initiatives cannot be overemphasized. Despite global evidence of educational interventions in improving teachers’ knowledge and attitudes regarding mental health, this area remains under researched in Pakistan. This paper presents a study protocol of a pilot randomized controlled trial to examine the effectiveness of a teacher training intervention for improving mental health literacy and self-efficacy among school teachers in urban Lahore, Pakistan. Methods The randomized controlled trial will follow the CONSORT guidelines. Participants will be allocated to the Intervention group (receiving the World Health Organization, Eastern Mediterranean Region (WHO-EMRO) School Mental Health Manual-based intervention in three 6-h, face-to-face sessions) or a waitlist control group (not receiving training during the study period). Participants will be teachers of private schools with similar broad demographic characteristics in an inner city area of Lahore. The primary outcome measures for the trial is teachers’ mental health literacy. It will be assessed by using the previously applied (during WHO training of Master Trainers) self-administered questionnaire in both groups pre and post training and at 3 months’ follow-up. Secondary outcomes include: for teachers: Teachers’ self-efficacy (assessed by the Teachers’ Sense of Self Efficacy Scale (TSES) short form.); for students (11–16 years): socio-emotional skills and psychological problems measured by the Strengths and Difficulties Questionnaire (assessed at baseline and 3 months post intervention); for schools: the WHO School Psychosocial Profile Questionnaire (baseline and 3 months post intervention). Discussion Given the high prevalence of child mental health problems, stigma and lack of services, it is important to consider alternate avenues for promoting positive mental health among youth. This pilot study should establish the effectiveness of the WHO-EMRO School Mental Health Manual-based Intervention improving teacher’s mental health literacy and helping them to learn practical steps that can be implemented at low cost in school settings. It will also provide information regarding intervention implementation and sustainability. Trial registration ClinicalTrials.gov, ID: NCT02937714 . Registered on 18 October 2016.

Background There is a shortage of trained mental health workers in spite of the significant contribution of psychiatric disorders to the global disease burden. Task shifting, through the delegation of health care tasks to less specialised health workers such as community health workers (CHWs), is a promising approach to address the human resource shortage. CHWs in the Western Cape province of South Africa provide comprehensive chronic support which includes that for mental illness, but have thus far not received standardized mental health training. It is unknown whether a structured mental health training programme would be acceptable and feasible, and result improved knowledge, confidence and attitudes amongst CHWs. Methods We developed and piloted a mental health training programme for CHWs, in line with the UNESCO guidelines; the WHO Mental Health Gap Action Programme and the South African National framework for CHW training. In our quasi-experimental (before-after) cohort intervention study we measured outcomes at the start and end of training included: 1) Mental health knowledge, measured through the use of case vignettes and the Mental Health Knowledge Schedule; 2) confidence, measured with the Mental Health Nurse Clinical Confidence Scale; and 3) attitudes, measured with the Community Attitudes towards the Mentally Ill Scale. Knowledge measures were repeated 3 months later. Acceptability data were obtained from daily evaluation questionnaires and a training evaluation questionnaire, while feasibility was measured by participant attendance at training sessions. Results Fifty-eight CHWs received the training, with most ( n  = 56, 97.0%) attending at least 7 of the 8 sessions. Most participants ( n  = 29, 63.04%) demonstrated significant improvement in knowledge, which was sustained at 3-months. There was significant improvement in confidence, along with changes in attitude, indicating improved benevolence, reduced social restrictiveness, and increased tolerance to rehabilitation of the mentally ill in the community but there was no change in authoritarian attitudes. The training was acceptable and feasible. Conclusions Mental health training was successful in improving knowledge, confidence and attitudes amongst trained CHWs. The training was acceptable and feasible. Further controlled studies are required to evaluate the impact of such training on patient health outcomes. Trial registration PACTR PACTR201610001834198 , Registered 26 October 2016.

The Child and Adolescent Mental Health Initiative (CAMHI) aims to enhance mental health care capacity for children and adolescents across Greece. Considering the need for evidence-based policy, the program developed an open-resource dataset for researching the field within the country. A comprehensive, mixed-method, community-based research was conducted in 2022/2023 assessing the current state, needs, barriers, and opportunities according to multiple viewpoints. We surveyed geographically distributed samples of 1,756 caregivers, 1,201 children/adolescents, 404 schoolteachers, and 475 health professionals using validated instruments to assess mental health symptoms, mental health needs, literacy and stigma, service use and access, professional practices, training background, and training needs and preferences. Fourteen focus groups were conducted with informants from diverse populations (including underrepresented minorities) to reach an in-depth understanding of those topics. A dataset with quantitative and qualitative findings is now available for researchers, policymakers, and society [https://osf.io/crz6h/ and https://rpubs.com/camhi/sdashboard]. This resource offers valuable data for assessing the needs and priorities for child and adolescent mental health care in Greece. It is now freely available to consult, and is expected to inform upcoming research and evidence-based professional training. This initiative may inspire similar ones in other countries, informing methodological strategies for researching mental health needs.

Background Chronic low-grade systemic inflammation (CLGSI) is implicated in depression and its amelioration. Pro-inflammatory nutrition and inactivity are associated with CLGSI. We triangulated the degree to which recent literature on anti-inflammatory nutrition and physical activity/physical exercise (PA/PE) corroborates the extant body of knowledge related to depression management and is reflected in the guidelines of leading mental health domains (national/international mental health associations/bodies). Methods We used mini-review methodology. The search was narrowed to recent state-of-the-art literature (2024) in PubMed, on diet and exercise specifications in depression management. Then, we compared recommendations of aforementioned domains regarding diet and PA/PE in depression management. Results Of 73 nutrition source studies, 50 (68%) focused on anti-inflammatory whole food, plant-based (WFPB) nutrition to manage depression; 4 (5%) on reducing consumption of animal-sourced foods; 16 (23%) focused on the effect of ultra-processed food (UPF) and its role in depression and its avoidance vis-à-vis its anti-depressant effects. Of the 55 PA/PE source studies, 49 (89%) focused on the effects of aerobic exercise; 14 (29%) described specific parameters to achieve an anti-depressant effect and 35 (71%) were non-specific. Twelve (22%) studies focused on resistance muscle training; 2 (17%) that reported specific training parameters and 10 (83%) that were non-specific. Nine domains were identified with established depression management guidelines: Australia/New Zealand; Canada; Europe (Belgium, Scotland, Spain); United Kingdom; United States; WFSBP and ASLM; and World Health Organization. Regarding nutrition, 5 (55%) domains recommended WFPB nutrition; 4 (44%) reduced animal-sourced foods; and 3 (33%), avoidance of UPF. With respect to sedentarism, 3 (33%) domains recommended reduced prolonged sitting. Eight domains (89%) mentioned aerobic exercise; 3 (33%) resistance training. Three domains mentioned aerobic exercise non-specifically; 5 (56%) made specific recommendations. Three domains mentioned resistance muscle training; 2 (22%) made non-specific recommendations and 1 (11%) made specific recommendations. Conclusions Disparities that exist in leading depression management guidelines vis-à-vis inclusion of evidence-informed nutrition and PA/PE recommendations, warrant reconciliation. Evidence supporting anti-depressant WFPB nutrition and limiting pro-inflammatory animal-sourced food and UPF and supporting anti-inflammatory aerobic exercise and resistance training warrants being translated into national/international depression management guidelines as consistently as recommendations for pharmacotherapy and psychotherapy.

Background World Health Organization (WHO) and Thailand's national policy both advocate for recovery‐oriented, community‐based mental healthcare. Village Health Volunteers (VHVs) in Thailand have limited involvement in mental health services despite their pivotal role in Thai primary healthcare, especially in rural settings. This study aims to engage stakeholders to identify and prioritise key areas for VHVs' role expansion, stigma reduction, training needs, and common mental health conditions, thereby enhancing VHVs' contributions to recovery‐oriented mental healthcare in rural Thai communities. Methods The study utilised the Nominal Group Technique (NGT). Eight VHVs, six individuals with mental health challenges and caregivers, and four healthcare professionals (HCPs), from three rural sub‐districts in Northern Thailand, were purposively and conveniently recruited. Three NGT groups were formed: in‐person for service providers (VHVs and HCPs) and service users/caregivers, and online for HCPs. Through structured stages of idea generation, sharing, discussion and ranking, participants identified their top five priorities. Ranked priorities were synthesised, and transcripts were analysed using content analysis. Results Eighteen participants attended one of three NGT groups. Collectively, these groups generated 94 ideas in response to four questions. Four themes were identified: (1) Expansion of VHV's mental health role, including vocational support, family support, emotional support and community reintegration; (2) Stigma reduction, focusing on changing attitudes, implementing a buddy system and enhancing mental health literacy; (3) Training needs including training related to stigma reduction, improving communication skills and providing mental health awareness education; and (4) Common mental health conditions, including psychosis and depression. Conclusion The prioritisation among the three groups varies. High priorities include vocational support, family support, community reintegration and counselling skills. Addressing stigma is a starting point and can be achieved through increased awareness and literacy. Future research should focus on tailored stigma interventions and trainings to support VHVs in providing effective, recovery‐oriented care in these communities. Patient or Public Contribution Six patient and public involvement (PPI) advisors participated in the study, comprising two VHVs, one mental health nurse, one caregiver and one peer support worker, to ensure research relevance and applicability. The PPI reviewed the Thai NGT questions to assess the appropriateness of language, particularly in relation to mental health and stigma, leading to minor modifications in wording. Additionally, two VHVs and one caregiver assisted in piloting the questions to evaluate their validity and appropriateness and offered feedback on the procedure, content and timing. They recommended using probing questions to elicit more detailed responses and ensuring concise content to maintain participant engagement.

General practice has an important role within the Australian healthcare system to provide access to care and effective management of chronic health conditions. However, people with serious mental illness experience challenges associated with service access. The current paper seeks to examine drivers of access to general practice for people with common and serious mental disorders, compared with people who access care for type II diabetes, a common physical health problem managed in general practice. The Bettering the Evaluation and Care of Health (BEACH) programme provides the most comprehensive and objective measurement of general practitioner activity in Australia. Using BEACH data, this study compared general practice encounters for depression, anxiety, bipolar disorder, schizophrenia, and type II diabetes during a 10-year period between 2006 and 2016. Analysis revealed more frequent encounters for depression compared to anxiety, and a higher representation of women in encounters for bipolar disorder compared to men. The relationship between number of encounters and patient age was strongly associated with the life course and mortality characteristics associated with each disorder. The findings highlight specific challenges associated with access to primary care for people with serious mental illness, and suggest areas of focus to improve the ability of these patients to access and navigate the health system.