‘Safe spaces’ and community building for climate scientists, exploring emotions through a case study

The expanding petrochemical industry depends on fossil fuels both as feedstock and a source of energy and is at the heart of the intertwined global crises relating to plastics, climate, and toxic emissions. Addressing these crises requires uprooting the deep-seated lock-ins that sustain petrochemical plastics. This perspective identifies lock-ins that stand in the way of ambitious emission reductions and ending plastic pollution. We emphasize that addressing the growing plastic production and consumption requires confronting the political economy of petrochemicals. We put forward key elements needed to address the dual challenges of moving away from the unsustainable production of plastics and drastically reducing emissions from the petrochemical sector, and argue for attention to the links between fossil fuels and plastics, which in turn involves challenging entrenched power structures and vested interests linked to the fossil-based plastics economy. A critical step would be ensuring attention to the production of petrochemicals and related upstream issues in the upcoming global plastics treaty.

There is no simple, single treatment for schizophrenia and present approaches are based on clinical research and experience. Pharmacotherapy is the most common treatment for schizophrenia; however, unwanted side-effects are often problematic, and medications do not provide important coping skills. These skills are provided through forms of psychotherapy. Psychotherapy has been examined from a range of perspectives, including the effectiveness of group and individual treatments on behaviours and symptoms of schizophrenia. This review reports on the effectiveness of forms of group and individual therapy. The objective of this review was to present the best available information on the use of group therapy and individual therapy in the treatment of schizophrenia. This review summarises the findings of all relevant studies relating to these interventions. This review attempted to answer the question: which is more effective in improving symptoms in patients with schizophrenia, group or individual therapy? The review included adult patients with schizophrenia. Interventions of interest were forms of group and individual therapy aimed at lessening the symptoms of schizophrenia. For the purposes of this review, individual therapy was regarded as a one-to-one interaction between a patient and a therapist, and group therapy excluded family therapy. Studies that examined symptom reduction, including measures of mental state, quality of life and social function, were included in this review. This review attempted to determine the efficacy of group and individual therapy in the treatment of schizophrenia. Therefore, randomised or pseudo-randomised controlled trials that address the use or comparison of these treatment modalities were included. High-quality systematic reviews of evidence of effectiveness were also included. Based on the search terms used, 28 references relating to the use of some form of group or individual therapy, in the treatment of chronic schizophrenia, were identified. Of these, nine were excluded for not meeting the stated inclusion criteria and 19 were included in the analysis (17 trials and two systematic reviews). From these studies numerous treatment types were compared for the management of chronic schizophrenia. Meta-analysis was not possible given the level of heterogeneity in trial methods and measurement scales. The following recommendations are made.

Background There is no simple, single treatment for schizophrenia and present approaches are based on clinical research and experience. Pharmacotherapy is the most common treatment for schizophrenia; however, unwanted side-effects are often problematic, and medications do not provide important coping skills. These skills are provided through forms of psychotherapy. Psychotherapy has been examined from a range of perspectives, including the effectiveness of group and individual treatments on behaviours and symptoms of schizophrenia. This review reports on the effectiveness of forms of group and individual therapy. Objectives The objective of this review was to present the best available information on the use of group therapy and individual therapy in the treatment of schizophrenia. This review summarises the findings of all relevant studies relating to these interventions. This review attempted to answer the question: which is more effective in improving symptoms in patients with schizophrenia, group or individual therapy? Inclusion criteria The review included adult patients with schizophrenia. Interventions of interest were forms of group and individual therapy aimed at lessening the symptoms of schizophrenia. For the purposes of this review, individual therapy was regarded as a one-to-one interaction between a patient and a therapist, and group therapy excluded family therapy. Studies that examined symptom reduction, including measures of mental state, quality of life and social function, were included in this review. This review attempted to determine the efficacy of group and individual therapy in the treatment of schizophrenia. Therefore, randomised or pseudo-randomised controlled trials that address the use or comparison of these treatment modalities were included. High-quality systematic reviews of evidence of effectiveness were also included. Results Based on the search terms used, 28 references relating to the use of some form of group or individual therapy, in the treatment of chronic schizophrenia, were identified. Of these, nine were excluded for not meeting the stated inclusion criteria and 19 were included in the analysis (17 trials and two systematic reviews). From these studies numerous treatment types were compared for the management of chronic schizophrenia. Meta-analysis was not possible given the level of heterogeneity in trial methods and measurement scales. Recommendations The following recommendations are made: Individual cognitive behavioural therapy (ICBT) can be effective in improving overall mental state and global functioning (level I). Relapse and readmission rates are not improved by the use of ICBT (level I). ICBT using a psychodynamic or psychotherapy approach is recommended for outpatient care (level I). ICBT can be recommended to promote a 25% improvement in insight (number needed to treat = 10) (level II). Group psychotherapy is not effective at improving global functioning when given for short periods of time (level II). Interactive behavioural training is not effective at improving social functioning (level II). Longer-term group psychotherapy or modular skills training can be effective at improving overall psychological symptoms (level II). Modular skills training is effective at improving living skills and medication compliance (level II). Group psycho-educational training is not effective for improving medication compliance (level II). Coping skills training has a longer lasting effect on improving goal attainment than problem skills group training in patients with schizophrenia (level II). Intensive group cognitive behaviour therapy and supportive counselling effectively reduce the number of psychiatric symptoms and positive psychiatric symptoms in patients with a short duration of illness and less severe symptoms in the longer term (2 years) (level II). The use of group psychotherapy can be effective at decreasing social anxiety and improving social interaction (level II). Group psychotherapy is ineffective at producing lasting improvement in polydipsia among subjects with schizophrenia (level II).

Background There is no simple, single treatment for schizophrenia and present approaches are based on clinical research and experience. Pharmacotherapy is the most common treatment for schizophrenia; however, unwanted side-effects are often problematic, and medications do not provide important coping skills. These skills are provided through forms of psychotherapy. Psychotherapy has been examined from a range of perspectives, including the effectiveness of group and individual treatments on behaviours and symptoms of schizophrenia. This review reports on the effectiveness of forms of group and individual therapy. Objectives The objective of this review was to present the best available information on the use of group therapy and individual therapy in the treatment of schizophrenia. This review summarises the findings of all relevant studies relating to these interventions. This review attempted to answer the question: which is more effective in improving symptoms in patients with schizophrenia, group or individual therapy? Inclusion criteria The review included adult patients with schizophrenia. Interventions of interest were forms of group and individual therapy aimed at lessening the symptoms of schizophrenia. For the purposes of this review, individual therapy was regarded as a one-to-one interaction between a patient and a therapist, and group therapy excluded family therapy. Studies that examined symptom reduction, including measures of mental state, quality of life and social function, were included in this review. This review attempted to determine the efficacy of group and individual therapy in the treatment of schizophrenia. Therefore, randomised or pseudo-randomised controlled trials that address the use or comparison of these treatment modalities were included. High-quality systematic reviews of evidence of effectiveness were also included. Results Based on the search terms used, 28 references relating to the use of some form of group or individual therapy, in the treatment of chronic schizophrenia, were identified. Of these, nine were excluded for not meeting the stated inclusion criteria and 19 were included in the analysis (17 trials and two systematic reviews). From these studies numerous treatment types were compared for the management of chronic schizophrenia. Meta-analysis was not possible given the level of heterogeneity in trial methods and measurement scales. Recommendations The following recommendations are made: Individual cognitive behavioural therapy (ICBT) can be effective in improving overall mental state and global functioning (level I). Relapse and readmission rates are not improved by the use of ICBT (level I). ICBT using a psychodynamic or psychotherapy approach is recommended for outpatient care (level I). ICBT can be recommended to promote a 25% improvement in insight (number needed to treat = 10) (level II). Group psychotherapy is not effective at improving global functioning when given for short periods of time (level II). Interactive behavioural training is not effective at improving social functioning (level II). Longer-term group psychotherapy or modular skills training can be effective at improving overall psychological symptoms (level II). Modular skills training is effective at improving living skills and medication compliance (level II). Group psycho-educational training is not effective for improving medication compliance (level II). Coping skills training has a longer lasting effect on improving goal attainment than problem skills group training in patients with schizophrenia (level II). Intensive group cognitive behaviour therapy and supportive counselling effectively reduce the number of psychiatric symptoms and positive psychiatric symptoms in patients with a short duration of illness and less severe symptoms in the longer term (2 years) (level II). The use of group psychotherapy can be effective at decreasing social anxiety and improving social interaction (level II). Group psychotherapy is ineffective at producing lasting improvement in polydipsia among subjects with schizophrenia (level II).

Mental health and climate change: tackling invisible injustice

The Negative Bidirectional Interaction Between Climate Change and the Prevalence and Care of Liver Disease: A Joint BSG, BASL, EASL, and AASLD Commentary

<i>How to Think about the Climate Crisis: A Philosophical Guide to Saner Ways of Living</i>, by Graham Parkes

Executive summaryBackground There is no simple, single treatment for schizophrenia and present approaches are based on clinical research and experience. Pharmacotherapy is the most common treatment for schizophrenia; however, unwanted side‐effects are often problematic, and medications do not provide important coping skills. These skills are provided through forms of psychotherapy. Psychotherapy has been examined from a range of perspectives, including the effectiveness of group and individual treatments on behaviours and symptoms of schizophrenia. This review reports on the effectiveness of forms of group and individual therapy.Objectives The objective of this review was to present the best available information on the use of group therapy and individual therapy in the treatment of schizophrenia. This review summarises the findings of all relevant studies relating to these interventions. This review attempted to answer the question: which is more effective in improving symptoms in patients with schizophrenia, group or individual therapy?Inclusion criteria The review included adult patients with schizophrenia. Interventions of interest were forms of group and individual therapy aimed at lessening the symptoms of schizophrenia. For the purposes of this review, individual therapy was regarded as a one‐to‐one interaction between a patient and a therapist, and group therapy excluded family therapy. Studies that examined symptom reduction, including measures of mental state, quality of life and social function, were included in this review. This review attempted to determine the efficacy of group and individual therapy in the treatment of schizophrenia. Therefore, randomised or pseudo‐randomised controlled trials that address the use or comparison of these treatment modalities were included. High‐quality systematic reviews of evidence of effectiveness were also included.Results Based on the search terms used, 28 references relating to the use of some form of group or individual therapy, in the treatment of chronic schizophrenia, were identified. Of these, nine were excluded for not meeting the stated inclusion criteria and 19 were included in the analysis (17 trials and two systematic reviews). From these studies numerous treatment types were compared for the management of chronic schizophrenia. Meta‐analysis was not possible given the level of heterogeneity in trial methods and measurement scales.Recommendations The following recommendations are made: Individual cognitive behavioural therapy (ICBT) can be effective in improving overall mental state and global functioning (level I). Relapse and readmission rates are not improved by the use of ICBT (level I). ICBT using a psychodynamic or psychotherapy approach is recommended for outpatient care (level I). ICBT can be recommended to promote a 25% improvement in insight (number needed to treat = 10) (level II). Group psychotherapy is not effective at improving global functioning when given for short periods of time (level II). Interactive behavioural training is not effective at improving social functioning (level II). Longer‐term group psychotherapy or modular skills training can be effective at improving overall psychological symptoms (level II). Modular skills training is effective at improving living skills and medication compliance (level II). Group psycho‐educational training is not effective for improving medication compliance (level II). Coping skills training has a longer lasting effect on improving goal attainment than problem skills group training in patients with schizophrenia (level II). Intensive group cognitive behaviour therapy and supportive counselling effectively reduce the number of psychiatric symptoms and positive psychiatric symptoms in patients with a short duration of illness and less severe symptoms in the longer term (2 years) (level II). The use of group psychotherapy can be effective at decreasing social anxiety and improving social interaction (level II). Group psychotherapy is ineffective at producing lasting improvement in polydipsia among subjects with schizophrenia (level II).

The state and local governments are implementing emissions trading systems and carbon neutral policies to reduce greenhouse gases. Nevertheless, the Earth is facing a climate crisis due to the increase in greenhouse gases generated from energy generation, steel and chemical industries, energy in the home and transportation, industrial processes such as cement, agriculture, and waste. The number of cases of youth and future generations filing climate lawsuits in the Constitutional Court and courts regarding the climate crisis is increasing, and the issue of guaranteeing basic climate rights under the Constitution is becoming a social issue.&#x0D; Therefore, a public legal response is urgently needed so that the state and local governments can protect the lives, bodies, and property of citizens in order to respond to the climate crisis and achieve sustainable development, and guarantee the right of current and future generations to live in a pleasant environment.&#x0D; In this paper, after examining the concept of climate crisis and Korea's climate crisis response legislation, we review legislative precedents and precedents in the United States, United Kingdom, Germany, and France to find implications for Korea. In addition, the provisions on climate crisis response are stipulated in the Constitution, guaranteeing basic climate rights to protect against damage caused by climate change, the role of the Climate Crisis Response Act, climate crisis response and cooperation through cooperative climate governance, and the freedom of the current generation to respond to the climate crisis. We review the role of public law by discussing emergency declarations and public law issues in response to the crisis of climate change, guaranteeing future generations' temporal climate crisis protection rights, and protecting future generations.&#x0D; For climate protection and response to the climate crisis, the Constitution should specify climate change reduction goals, basic climate rights, and cooperative measures to respond to the climate crisis, and legislatively consider the “urgent need” of the climate crisis beyond the concept of climate protection. In addition, in order to ensure equity and fairness due to infringement of basic rights related to the climate crisis, basic climate rights should be guaranteed under the constitution as well as legislative, scientific, and judicial responsibilities. In addition, the Climate Crisis Response Act should be enacted on necessary measures to make the climate crisis effective by public law. The Climate Crisis Response Act shall be guided and complementary in relation to the Building Act, the National Territory Planning Act, the Economic Act, the Disaster Safety Act, etc., and shall prescribe clear legal responsibility and due process for the climate crisis. In addition, climate crisis response requires cooperation by establishing climate governance between the state and local governments, between local governments, and between countries, so climate change reduction technologies and climate crisis response strategies should be shared, and legal countermeasures should be prepared in cooperation with each other. In addition, in order to reasonably allocate the cost burden of the climate crisis, the right to protect the temporal climate crisis should be clearly established legally and systematically to lead a life in a comfortable environment in accordance with the principle of equity and proportionality for current and future generations. The state or local government's climate emergency declaration and emergency plans on climate change crises and risks, administrative measures under executive orders, scientific predictions of climate crises and improve the vulnerability of disasters, and the role and legal responsibility of responding to climate crises should be considered in public law.

<b>Background:</b> Developing accessible community mental health centres (CMHCs) with high quality of care, has been a major health strategy in Norway. There is, however, scarce knowledge about the kinds of therapy which are practiced at the CMHCs. <b>Aims:</b> We wanted to study the extent of use of group therapy in CMHCs, types of group therapy, and characteristics of patients who receive such therapy. We also wanted to explore if the use of group therapy seemed to be according to trends suggested by the research literature. <b>Material and Methods:</b> A cross-sectional study of all patients (N=3041) receiving consultations at eight selected CMHCs during 4 weeks in 2005. The catchment areas of these CMHCs represented about 10% of the national population. Demographic, clinical, and treatment information was recorded. <b>Results:</b> 15.1% received group therapy, and of these, 40.2% received analytic group therapy, 14.6% cognitive therapy, and 45.2% received ‘other types’ of group therapy. Group patients were older, had less psychopathology, and were more often treated in day-care or in-patient units. One half also received additional individual sessions (combined therapy). Patients in combined therapy had more severe psychiatric problems than those receiving group sessions alone, and patients in analytic groups had less psychopathology than patients receiving ‘other types’ of group therapy. Analytic groups were most common in day-care services. <b>Conclusion:</b> Analytic group therapies have a more central position in everyday clinical work than cognitive group therapy. There are few evidence based guidelines for selecting group therapy methods and more research is needed to decide both what kind of group therapy should be offered to different patient categories, and what kind of group therapy approaches the community mental health centres should be able to offer, within and across the different units.

A “lifeline out of the <scp>COVID</scp>‐19 crisis”? An ecofeminist critique of the European Green Deal

INTRODUCTIONTobacco causes more than 8 million deaths each year. Behavioral interventions such as group therapy, which provides counselling for smoking cessation, can be delivered in group form and smokers who receive cessation counselling are more likely to quit smoking compared to no assistance. We review the evidence of group-based counselling for smoking cessation for smokers in Asian countries.METHODSThe review aims to determine the availability of group-based therapy for smoking cessation in Asian countries. The outcome measured was abstinence from smoking following group therapy. Electronic database searches in PubMed, OVID Medline, SCOPUS, Google Scholar, and PsycINFO, using keywords such as: ‘smoking’, ‘cigarette’, ‘tobacco’, ‘nicotine’, ‘group therapy’ and ‘cessation’ (smok*, *cigarette*, tobacco, nicotine, group therap*, cessation) were used. The results were reported following PRISMA and PROSPERO guidelines. Review Manager was used for data analysis.RESULTSA total of 21251 records were retrieved for screening the abstracts. In all, 300 articles for review were identified and assessed for eligibility. Nine articles, including Cochrane reviews, randomized control trials, cohort, observational and cross-sectional studies, were included in the final review. There were three observational qualitative studies, two prospective cohort studies, two crosssectional studies, one non-randomized quasi-experimental study and a single cluster-randomized, controlled trial. Group therapy was found to significantly increase the abstinence rate. Group therapy provided at the workplace, smoking cessation services, availability of pharmacotherapy, and socioeconomic status, appear to be key factors determining success.CONCLUSIONSEvidence of the use of group therapy for smoking cessation in Asian countries is still lacking despite publications in the Western population showed that group therapy was effective. Further research on group-based interventions for smoking cessation in Asian countries is required and direct one-to-one comparisons between group therapy and individual therapy for smokers who want to quit smoking, are needed.

Climate change is a worldwide issue that can influence the way of life of all living beings. This study aims to perform a bibliometric analysis of climate crisis and climate change scientific studies. Bibliometric analyses give an in-depth assessment of the literature's publications on the subject, the identification of scientific research trends on the subject, the evaluation of researcher collaboration, and the evaluation of significant issues. The study is qualitative research, and a bibliometric research method was used. The research data was first accessed on 04 August 2022 (Time: 14:34) from the "Web of Science" database as an online search. However, some data were revised on 18 July 2023 (Time: 15:00) using the same database in order to include up-to-date data in the study. The obtained data were transferred to VOSviewer software and analyzed. According to the survey, climate-related articles most used keywords include climate change, climate crisis, sustainability, environment, climate justice, and Anthropocene. Most of the studied papers are from many disciplines, such as environmental sciences, meteorology atmospheric studies, ecology, geosciences multidisciplinary, and environmental studies. When the publications on climate catastrophe are examined by country, the most cited countries are England, Canada, United States, Sweden, and Norway. As a result, international scientific collaboration and data exchange are critical for a successful battle against climate change and the climate crisis. Collaboration and information exchange between disciplines can result in more effective and inclusive solutions. Encouraging studies in other languages and knowing common terminology can help to promote global collaboration. The examination and assessment of scientific findings are vital in enhancing societal awareness and resilience, as well as in developing long-term policy

Asthma is the most common chronic disease of childhood, affecting millions of people worldwide and nearly 4.7 million children in the United States.1,2 It is inextricably linked to the climate crisis, defined as human-driven planetary warming because of increased carbon emissions from burning fossil fuels.3 The climate crisis intensifies contributing factors of asthma morbidity and mortality, including air pollution, mold, allergens, and extreme heat.4 Pediatric clinicians and health care systems have an urgent responsibility to advocate for evidenced-based solutions to address the climate crisis.In this issue of Pediatrics, Utsumi et al examined how another consequence of the climate crisis, extreme flooding, influenced asthma prescription rates for children in Japan.5 They found that inhalers (particularly controller-type) were more commonly prescribed to children who experienced flooding.5 Globally, flooding is the most common type of extreme weather event (EWE) and >500 million children reside in flood zones worldwide.6,7 Climate change increases the frequency and severity of floods, with compounding effects on child health. The study by Utsumi et al appropriately defines flood victims broadly, because flooding results in risk of injury and death, spread of infectious disease and malnutrition because of disrupted food and water supplies, and financial and property loss, etc.8 Exposure to such devastation also profoundly affects children’s mental health, with a well-documented rise in rates of depression, anxiety, and posttraumatic stress disorder after disasters.9In the United States, there is a disproportionate negative impact on the health of marginalized communities because of longstanding injustices from environmental racism.10 Historic redlining practices resulted in these groups’ overexposure to environmental hazards such as air pollution and extreme heat, both amplified by climate change.11 Concentrated poverty compounds this by limiting accessibility to adaptive measures such as adequate cooling, stable housing, and high-quality health care.12 Societal disruption from EWEs can perpetuate this imbalance by destroying homes and livelihoods, depleting families’ ability to break cycles of poverty for future generations.13Utsumi et al found increased inhaler prescription rates were most significant for older children.5 Although children <5 years old are disproportionately affected, climate-related health issues span childhood and adolescence.14 Pediatric clinicians must be aware of regional climate threats to provide evidence-based care that is comprehensive and up to date.15 Disaster preparedness should be incorporated into anticipatory guidance, such as recommending that families prepare emergency kits with essential medications and first aid supplies, sign up for emergency notifications to stay informed about EWEs, and understand how to access community resources such as shelters and food banks. Distributing disaster preparedness resources in frontline clinics (eg, educational materials, emergency kits, and safe cleaning supplies) is also necessary. For medically complex patients, clinicians should consider how power outages or disruptions in access to health care facilities could affect management of their medical conditions. Routine guidance around risks of extreme heat (eg, during sports physicals), how air quality influences asthma and allergy severity, behavioral health consequences of the climate crisis, and advocacy through civic engagement should also be addressed. Climate-specific education for learners at all levels of training and practice is needed to ensure that pediatricians can leverage evidenced-based strategies when discussing climate change during clinical encounters.16It is also critical for us to think about the role of the health care system. In the United States, 60% of power outages are attributed to EWEs, and global projections estimate that 1 in 12 hospitals is at risk for shutdown without a timely phase out of fossil fuels.17,18 Climate change increases demands on the health care system while simultaneously threatening it. Despite this vulnerability, the health care system actively contributes to the climate crisis by accounting for 8.5% of all greenhouse gas emissions in the United States.19 Health care systems must rigorously evaluate and reduce their own carbon emissions aiming to achieve carbon neutrality by 2030. National metrics, resources, and guidelines are central to achieving a systemwide transition to decarbonized, climate-resilient health care.As climate change worsens, EWEs such as flooding will continue to exacerbate child health problems, including asthma, and threaten health care infrastructure. The climate crisis places an imperative obligation on pediatricians to elevate messaging that climate change is already underway, climate solutions are health solutions, and adaptation efforts must amplify the voices of patients, families, and communities. Effective, reciprocal partnerships with local organizations and community leaders can enhance resilience, promote health equity, and ensure that the needs of overburdened populations are prioritized. Together, pediatricians and communities can advocate for policies at local, state, and federal levels to eliminate the root cause of climate change, fossil fuels, and realize a greener and healthier future for all.

Thoughts on Connections Between COVID-19 Pandemic And Climate Crisis