Trauma and Girls: Implementing Trauma-Informed Policies and Practices in Systems of Care.

Ayurveda, India’s ancient system of holistic medicine, offers an integrated paradigm that connects human well-being, ecological balance, and sustainable living. Achieving sustainable development requires an integrated approach that simultaneously addresses health, economic resilience, environmental stewardship, and socio-cultural well-being. Ayurveda, the ancient Indian science of life, inherently embodies this integration through its preventive health strategies, ecological ethics, and community-centered economic potential. This study investigates Ayurveda’s potential as a transdisciplinary framework for fostering holistic flourishing across health, economy, environmental stewardship, and sustainable action. A mixed-method approach, combining literature analysis and thematic synthesis, reveals that Ayurveda’s preventive and promotive health strategies, sustainable agricultural practices, and eco-conscious consumption models can bridge modern sustainability goals and traditional wisdom. Results indicate significant potential for improving public health outcomes, strengthening local economies, enhancing environmental resilience, and fostering sustainability-aligned lifestyles. The study proposes a replicable model for integrating Ayurveda into policy and practice for national and global contexts. The conceptual framework proposed in this paper demonstrates Ayurveda’s applicability as a catalyst for community well-being and economic vitality while safeguarding the environment. Keywords: – Holistic, Flourishing, Synthesis, Sustainability, Wisdom, Conceptual

Active resistance is considered to be the 'normal' reaction during rape. However, studies have indicated that similar to animals, humans exposed to extreme threat may react with a state of involuntary, temporary motor inhibition known as tonic immobility. The aim of the present study was to assess the occurrence of tonic immobility during rape and subsequent post-traumatic stress disorder and severe depression. Tonic immobility at the time of the assault was assessed using the Tonic Immobility Scale in 298 women who had visited the Emergency clinic for raped women within 1month of a sexual assault. Information about the assault and the victim characteristics were taken from the structured clinical data files. After 6months, 189 women were assessed regarding the development of post-traumatic stress disorder and depression. Of the 298 women, 70% reported significant tonic immobility and 48% reported extreme tonic immobility during the assault. Tonic immobility was associated with the development of post-traumatic stress disorder (OR 2.75; 95% CI 1.50-5.03, p=0.001) and severe depression (OR 3.42; 95% CI 1.51-7.72, p=0.003) at 6months. Further, previous trauma history (OR 2.36; 95% CI 1.48-3.77, p<0.001) and psychiatric treatment history (OR 2.00; 95% CI 1.26-3.19, p=0.003) were associated with the tonic immobility response. Tonic immobility during rape is a common reaction associated with subsequent post-traumatic stress disorder and severe depression. Knowledge of this reaction in sexual assault victims is important in legal matters and for healthcare follow up.

Le développement d’un problème de santé mentale affecte les étudiants de niveau postsecondaire sur tous les plans et peut mettre leur santé, voire leur survie, en péril. Les problèmes vécus pourraient être atténués, ou même évités dans certains cas, en intervenant plus tôt. Les stratégies en prévention et en promotion de la santé mentale mises de l’avant dans les établissements d’enseignement postsecondaire offrent les plus belles possibilités de rejoindre un grand nombre de jeunes adultes. Cependant, malgré l’intérêt grandissant pour de telles initiatives en milieu scolaire, les méta-analyses et les revues des écrits scientifiques recensés mettent en lumière les difficultés reliées à l’évaluation des stratégies utilisées et aux possibilités de répliquer les interventions, particulièrement en ce qui a trait à la promotion. Les stratégies les plus efficaces sur le plan de l’amélioration de la santé mentale semblent être associées à la supervision d’exercices en lien avec l’intervention telles que les exercices de pleine conscience (mindfulness), les techniques cognitives-comportementales, la relaxation et le développement d’habiletés sociales. Par ailleurs, même si elles présentent une plus grande hétérogénéité, les études impliquant une aide technologique (Web, ordinateur, etc.) démontrent des résultats favorables lorsqu’elles utilisent l’approche cognitive comportementale.

Extant literature has established the effectiveness of various mental health promotion and prevention strategies, including novel interventions. However, comprehensive literature encompassing all these aspects and challenges and opportunities in implementing such interventions in different settings is still lacking. Therefore, in the current review, we aimed to synthesize existing literature on various mental health promotion and prevention interventions and their effectiveness. Additionally, we intend to highlight various novel approaches to mental health care and their implications across different resource settings and provide future directions. The review highlights the (1) concept of preventive psychiatry, including various mental health promotions and prevention approaches, (2) current level of evidence of various mental health preventive interventions, including the novel interventions, and (3) challenges and opportunities in implementing concepts of preventive psychiatry and related interventions across the settings. Although preventive psychiatry is a well-known concept, it is a poorly utilized public health strategy to address the population's mental health needs. It has wide-ranging implications for the wellbeing of society and individuals, including those suffering from chronic medical problems. The researchers and policymakers are increasingly realizing the potential of preventive psychiatry; however, its implementation is poor in low-resource settings. Utilizing novel interventions, such as mobile-and-internet-based interventions and blended and stepped-care models of care can address the vast mental health need of the population. Additionally, it provides mental health services in a less-stigmatizing and easily accessible, and flexible manner. Furthermore, employing decision support systems/algorithms for patient management and personalized care and utilizing the digital platform for the non-specialists' training in mental health care are valuable additions to the existing mental health support system. However, more research concerning this is required worldwide, especially in the low-and-middle-income countries.

Background: Exposure to tobacco smoke and tobacco smoking leads to numerous adverse health and developmental outcome including widespread cancers. The tobacco epidemic primarily roots in childhood as many adult smokers have started before the age of 18. Health prevention and promotion laws and policies are key to positive health change. Indeed, tobacco control legislation has positively impacted on child health and human rights may play a valuable basis and mechanism to foster health prevention and promotion strategies. Aim: To gain new knowledge on the added value of human rights law in fostering health prevention and promotion strategies by reference to specific findings in the case of tobacco control and children's rights. Methods: Literature research and document analysis. Interpretation on the basis of the treaty interpretation rules of the Vienna Convention on the Law of Treaties (art. 31-32). Results: Human rights are increasingly standard setting in the field of health prevention and health promotion in general. Even though human rights law largely includes open-ended norms, it provides for key legal obligations to protect child (and ultimately adult) health against the negative consequences of tobacco. The 1989 Convention on the Rights of the Child demonstrates that governments should take into account the best interests of the child, protect and promote the life, survival, and development of children, the right to health and its underlying determinants, and regulate the tobacco industry to the extent that it does not harm children's rights including health. Conclusion: The human rights framework may a valuable mechanism to support health prevention and promotion as it includes legally binding and enforceable obligations.

The utilization of online information can be used as a measure of public concern and interest. It can be explored to institute, inform, and innovate mental health promotion and strategies in addressing the ever-increasing prevalence of anxiety disorders across the globe. As such, this infodemiological study described and analyzed the public utilization of online information for anxiety disorders using relative search volumes (RSV), top and rising related queries and topics from Google Trends, and Wikipedia page views. After describing the data, autoregressive integrated mean averaging (ARIMA) models were employed to predict future RSVs and page views. Results show that RSVs for anxiety disorders have increased over the years and will further increase in succeeding years, while the use of Wikipedia information for anxiety disorders is declining. Top and rising search-related queries and topics primarily revolved around anxiety disorder concepts, management, manifestations, types, etiology, diagnostics, social consequences, and related mental disorders. Based on the search volumes, public utilization of online information about anxiety disorders has increased and will further increase in the coming years. They can be explained by the rising rates of anxiety disorder and the higher internet access across the globe. As such, the Internet is a promising medium for mental health promotion, prevention, and intervention strategies. Moreover, trustworthy and reliable online information about anxiety disorders is ever-crucial in this age of information and disinformation.

The purposes of this qualitative descriptive study were to describe the perceptions of rural, older Appalachian women who live alone regarding systems of informal and formal care and to understand if traditional cultural norms influence attitudes and decisions to access these two systems. Older Appalachian women in this study defined themselves and their health in terms of their homes and as women who care for themselves informally and value independence and privacy. Five major themes emerged from the data for informal care, and three related to formal care or use of it. The findings support a reconceptualization of informal and formal care and point out reasons why these women chose to use or not use these two systems of care. Furthermore, they reveal how changes in the formal care system could support health promotion and prevention strategies grounded in everyday ways of maintaining health within the context of home.

The purpose of this study was to determine the association of mild traumatic brain injury (mTBI) with subsequent post-traumatic stress disorder (PTSD) and mental health disorders (MHD), and the intervening role of acute stress disorder (ASD). This matched case-control study utilized the Total Army Injury and Health Outcomes Database (TAIHOD) to analyze soldiers' (n = 1,261,297) medical encounter data between 2002 and 2011. International Classification of Diseases, Ninth Revision (ICD-9) codes were used to identify: mTBI (following Centers for Disease Control [CDC] surveillance definition for mTBI), MHD (ICD-9 codes for depression and anxiety, excluding PTSD), PTSD (ICD-9 309.81), and ASD (ICD-9 308.3). Incident cases of mTBI (n = 79,505), PTSD (n = 71,454), and MHD (n = 285,731) were identified. Overall incidence rates per 1000 soldier years were: mTBI = 17.23, PTSD = 15.37, and MHD = 67.99. mTBI was associated with increased risk for PTSD (risk ratio [RR] 5.09, 95% confidence interval [CI] 4.82-5.37) and MHD (RR 2.94, 95% CI 2.84-3.04). A sub-analysis of the mTBI-only soldiers found that a diagnosis ASD, compared with a diagnosis of no ASD, was associated with greater risk for subsequent PTSD (RR 2.13, 95% CI 1.96-2.32) and MHD (RR 1.90, 95% CI 1.72-2.09) following mTBI. Results indicate that soldiers with previous mTBI have a higher risk for PTSD and MHD, and that ASD may also mediate PTSD and MHD risk subsequent to mTBI. These data may help guide important surveillance and clinical rehabilitation considerations for high-risk populations.

(239) Stress-related psychological symptoms contribute to neck pain persistence after motor vehicle collision: path analysis results from a prospective longitudinal study

Depression and AnxietyVolume 11, Issue 4 p. 183-184 Brief Report Acute stress disorder and subsequent post-traumatic stress disorder in a group of exposed disaster workers Thomas A. Grieger M.D., Thomas A. Grieger M.D. Department of Psychiatry, USUHS, Bethesda, MarylandSearch for more papers by this authorJeffrey P. Staab M.D., M.S., Jeffrey P. Staab M.D., M.S. Department of Psychiatry, USUHS, Bethesda, MarylandSearch for more papers by this authorEtzel Cardeña Ph.D., Corresponding Author Etzel Cardeña Ph.D. ecardena@usuhs.mil Department of Psychiatry, USUHS, Bethesda, MarylandDepartment of Psychiatry, USUHS, 4301 Jones Bridge Road, Bethesda, MD 20814Search for more papers by this authorJames E. McCarroll Ph.D., James E. McCarroll Ph.D. Department of Psychiatry, USUHS, Bethesda, MarylandSearch for more papers by this authorGeorge T. Brandt M.D., George T. Brandt M.D. Department of Psychiatry, USUHS, Bethesda, MarylandSearch for more papers by this authorCarol S. Fullerton Ph.D., Carol S. Fullerton Ph.D. Department of Psychiatry, USUHS, Bethesda, MarylandSearch for more papers by this authorRobert I. Ursano M.D., Robert I. Ursano M.D. Department of Psychiatry, USUHS, Bethesda, MarylandSearch for more papers by this author Thomas A. Grieger M.D., Thomas A. Grieger M.D. Department of Psychiatry, USUHS, Bethesda, MarylandSearch for more papers by this authorJeffrey P. Staab M.D., M.S., Jeffrey P. Staab M.D., M.S. Department of Psychiatry, USUHS, Bethesda, MarylandSearch for more papers by this authorEtzel Cardeña Ph.D., Corresponding Author Etzel Cardeña Ph.D. ecardena@usuhs.mil Department of Psychiatry, USUHS, Bethesda, MarylandDepartment of Psychiatry, USUHS, 4301 Jones Bridge Road, Bethesda, MD 20814Search for more papers by this authorJames E. McCarroll Ph.D., James E. McCarroll Ph.D. Department of Psychiatry, USUHS, Bethesda, MarylandSearch for more papers by this authorGeorge T. Brandt M.D., George T. Brandt M.D. Department of Psychiatry, USUHS, Bethesda, MarylandSearch for more papers by this authorCarol S. Fullerton Ph.D., Carol S. Fullerton Ph.D. Department of Psychiatry, USUHS, Bethesda, MarylandSearch for more papers by this authorRobert I. Ursano M.D., Robert I. Ursano M.D. Department of Psychiatry, USUHS, Bethesda, MarylandSearch for more papers by this author First published: 26 July 2000 https://doi.org/10.1002/1520-6394(2000)11:4<183::AID-DA7>3.0.CO;2-MCitations: 20AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume11, Issue42000Pages 183-184 RelatedInformation

Australia considers string of preventive health measures

The present study assessed the risk of trauma exposure and subsequent posttraumatic stress disorder (PTSD) in an elderly community sample. Furthermore, gender differences and psychiatric comorbidity were analyzed. 3170 adults living in a German community were assessed by the PTSD module of the Structured Clinical Interview for DSM-IV and the Composite International Diagnostic-Screener. They were assigned to 3 age groups: young (44 years and younger; N = 997), middle-aged (45-64 years; N = 1322), and elderly (65 years and older; N = 851). Data for the present study were collected between December 2002 and December 2006. At least 1 trauma was reported by 54.6%, and the odds for trauma exposure were almost 4-fold in the elderly compared to the younger age groups (OR = 3.74; 95% CI = 3.13 to 4.47). Among those traumatized, the lifetime and 1-month prevalence rates of PTSD in the elderly were 3.1% and 1.5%, respectively, and did not differ from the rates of the young and middle-aged adults. Elderly men had a significantly increased risk for trauma exposure in general than elderly women (p = .012), but there were no gender differences in PTSD prevalence rates. Elderly PTSD-positive participants had significantly higher odds for any psychiatric syndrome than those without PTSD (OR = 9.10; 95% CI = 2.64 to 31.28) with depression and anxiety being the most frequent conditions. Our findings suggest that PTSD is certainly not rare in the elderly and that a lifetime diagnosis of PTSD is associated with symptoms of depression and anxiety. Assessment of trauma and PTSD should be integrated into routine examinations of the elderly to improve management and treatment provisions.

This article provides an overview of a new schoolbased mental health initiative currently being trialed in 101 primary schools in Australia. KidsMatter: the Australian Primary School Mental Health Initiative is a population model for supporting student mental health and well-being. Using a whole-school implementation model, it provides schools with a framework, a guided process and key resources to develop and implement a co-ordinated set of mental health promotion, prevention and early intervention (PPEI) strategies for the specific mental health and well-being needs of their students. Through KidsMatter primary schools are engaged in building their capacities for PPEI by promoting a positive school community, teaching social and emotional skills, providing parenting support and education, and facilitating early intervention for students experiencing mental health difficulties. The article describes the rationale and theoretical underpinnings of KidsMatter, outlines key features of the framework, implementation process and resources, and concludes with an overview of the major goals of the trial and the anticipated learning from the evaluation.

ObjectivesTo assess the global prevalence estimates of depressive symptoms, dysthymia and major depressive disorders (MDDs) among homeless people.DesignSystematic review and meta-analysis.Data sourcesDatabases including PubMed, Scopus and Web of Science were...

Cultural beliefs, norms and values regarding sexuality and gender roles forge people's sexual behaviour and understanding of sexual health risk. Acknowledging a person's cultural background is a key challenge for the promotion of sexual health programs and strategies for the prevention of sexually transmitted diseases (STDs) and HIV/AIDS. This challenge acquires larger dimensions when health promotion programs are directed towards migrant communities. This article examines narratives about past and present life experiences of Chilean women living in Australia and Chilean women in Chile. We inquire about social changes and exposure to education women experienced in their own country and in Australia and the ways in which migrant women define and articulate their experiences in relation to sexual health prevention. In comparing these experiences, we raise a number of questions about sexual health promotion and programs, including the prevention of STDs and HIV/AIDS targeted to specific migrant communities in Australia. Very few sexual health policies and strategies in Australia take into account the impact that the social and cultural background of migrants, social changes and the ‘settlement process’ has on the cultural construction of gender identity of migrants in the new country. We propose that these cultural constructs are key in the formulation of migrants' beliefs and attitudes towards sexuality and sexual health. We suggest that there is a need to build effective and culturally appropriate sexual health promotion and prevention strategies that build upon the social and cultural background and the present and past life experiences of migrant women and men.