Health Crisis Research Articles

MH workers strike against Kaiser Permanente in Southern California

More than 2,000 unionized mental health workers in Southern California went on strike against Kaiser Permanente last week after the two sides failed to reach a new labor agreement, CNN reported Oct. 21. The National Union of Healthcare Workers (NUHW) — which represents 19,000 health care workers in California and Hawaii, including 4,700 mental health workers — picketed outside Kaiser facilities in Los Angeles, San Diego, Anaheim and Fontana, seeking an increase in salaries, restoration of pensions and increased staffing. When announcing the impending strike earlier this month, the union cited its 10‐week strike in Northern California in 2022, which resulted in higher wages, better working conditions to improve patient care and prevented rapid staff turnover (see “Kaiser agrees to historic settlement to overhaul its BH care system,” MHW, Oct. 25, 2023; https://doi.org/10.1002/mhw.33828). Union members on strike in Southern California have said their demands are in line in with what Kaiser has provided to the majority of its workforce. “Unless we strike, our coworkers are going to keep leaving and our patients are going to keep struggling in an underfunded, understaffed system that doesn't meet their needs,” Josh Garcia, a psychologist for Kaiser in San Diego, said in a press statement from the NUHW. The strike comes as employment in the mental health field — for psychiatrists, psychologists, therapists, counselors, psychiatric aides and social workers — is expected to grow three times faster than the average US job position, according to CNN's analysis of data released in September by the Bureau of Labor Statistics. A survey in 2022 from CNN in partnership with the Kaiser Family Foundation showed that nine out of 10 US adults believe the country has a mental health crisis.

The Life + Death Education Framework: Proposition of a 'Universal' Framework for Implementation.

Life and death education is a distinct field of study that has potential life relevance for consideration (e.g., self-awareness and subsequent improvement of one's own health well-being). Existing research development, situating in different learning-sociocultural contexts, has provided consistent evidence that showcases the differing viewpoints of life functioning (e.g., what is the true meaning of life?) and the intricate nature of death and dying (e.g., a death ritual that closely associates with a particular cultural group). Some of the research studies undertaken indicate the effective use of 'philosophization' or the discourse of philosophical analysis, enabling individuals to philosophize, contemplate, and seek transpersonal understanding of the subject matters of life and death (e.g., can a state of 'spiritual transcendence' help to alleviate a person's fear of death?). Such discourse, interestingly, has offered some informative yields for enriching and meaningful life purposes - for example, the seeking to attain transpersonal understanding of life (e.g., what does a state of self-transcendence actually mean?) and/or transpersonal life experience may assist a senior citizen to cope with his mental health during a temporary health crisis. Our teaching and research interest of life and death education over the past decade has led us to consider one important line of inquiry for development: namely, the proposition of a 'universal' blueprint or framework of life and death education for curriculum development, teaching, and research purposes. We are cognizant of the fact that, to date, there is no clear consensus or agreement as to what one is expected (e.g., specific learning outcome) to teach students who wish to study and learn about life and death education. On this basis, the present theoretical article introduces a theoretical framework, termed as 'The Life + Death Education Framework' (e.g., for universities), to assist educators for their quality teaching and/or research inquiries of life and death education. We firmly believe that the Life + Death Education Framework can be universal and, in this case, apply to different learning-sociocultural contexts.

A koronavírus-járvány társadalmi és gazdasági hatásai a határ menti térségek fejlődésére a magyar–szlovák határrégiók esetében

The Social and Economic Impact of the Coronavirus Pandemic on the Development of Border Regions in the Case of the Hungarian–Slovak Border Regions Borders in a given social context seem to be eternal and unchangeable, but their exact location, their permeability, their functions and the regulations assigned to them are in fact constantly changing according to the ideals of the respective societal eras. The SARS-CoV-2 neo-coronavirus infection, identified in December 2019 as the cause of Covid-19 disease, has become a global pandemic, causing a major health, economic and social crisis. The pandemic had an impact on the single market mechanisms established by the European Union, affecting freedoms—the free movement of services, goods, capital and people—and on almost every aspect of everyday life as it had been until then. In border regions, these effects were magnified. The active socio-economic interactions of the Hungarian–Slovak border regions were interrupted overnight as a result of the border traffic measures, causing significant negative changes and restructuring the functioning of cross-border processes.

The Impact of COVID-19 Shocks on the U.S. Unemployment Rate

Abstract: The COVID-19 pandemic has had a profound impact on the U.S. labor market, resulting in significant fluctuations in unemployment rates across various demographic and educational groups. This paper examines the trends in unemployment from January 2020 to December 2021, a period characterized by intense economic upheavals due to public health measures and subsequent economic recovery initiatives. Utilizing data from the U.S. Bureau of Labor Statistics, the study explores how unemployment rates varied among different racial groups and levels of educational attainment, identifying which groups were most vulnerable to job losses and which experienced more resilient employment patterns. The findings reveal that the pandemic exacerbated existing disparities in the labor market, with particularly severe impacts on Black or African American individuals and those with lower educational levels. The paper also discusses the gradual recovery observed in unemployment rates as the economy began to stabilize, though noting that full recovery was not uniform across all groups and make a conclusion that there are significant differences in the impact of different racial groups and levels of education on unemployment rates. Through this analysis, the research provides insights into the structural weaknesses in the labor market exposed by the pandemic and offers recommendations for targeted policy measures aimed at fostering a more equitable economic recovery. This study contributes to the broader understanding of the economic implications of global health crises and the critical role of inclusive policy interventions in mitigating these effects.

Sustainability of Treatment Programs Utilizing Medications for Opioid Use Disorders in Incarcerated Young Adults.

The epidemic of opioid overdose brought a major health crisis to the front line of public health in the United States. Early efforts have focused on the prevention of production, distribution, and consumption of the drugs. However, there is little information about youth populations at risk for opioid overdose and their response to targeted treatment plans. The San Bernardino County Youth Opioid Response (SBCYOR) coalition in collaboration with the San Bernadino County (SBC) Probation Department organized a safety net system for at-risk youth by improving communication among county resources. This program mainly focused on individuals aged 12 to 24 years in the county's detention centers along with educational and prevention projects such as naloxone programs for first responders in the region. To describe the impact of the SBCYOR program on at-risk youth, we compare the frequencies of patients referred and treated with medications for opioid use disorder (MOUD) at the SBC Probation Department, which was responsible for individuals from age 12 to less than 18 years, with those from the West Valley Detention Center (WVDC), which was responsible for adults (18 to 24 years of age), from September 2020 through June 2022. Similar proportions of youths were referred for treatment of opioid use disorder (OUD) at the respective sites (3.7% SBC Probation Department, 3.6% WVDC). Of these, however, 78.0% were treated with MOUD at SBC Probation Department compared with only 7.1% at WVDC. SBCYOR coalition partners were able to transform their services into a comprehensive medical and behavioral health program for the incarcerated youth population at risk for OUD.

Beyond humanism: telling response-able stories about significant otherness in human–chatbot relations

AI-enabled chatbots intended to build social relations with humans are becoming increasingly common in the marketplace, with millions of registered users using these chatbots as virtual companions or therapists. These chatbots make use of what is often called the “Eliza effect”—the tendency of human users to attribute human-like knowledge and understanding to a computer program. A common interpretation of this phenomenon is to consider this form of relating in terms of delusion, error, or deception, where the user misunderstands or forgets they are talking to a computer. As an alternative, we draw on the work of feminist Science and Technology Studies scholars as providing a robust and capacious tradition of thinking and engaging with human–nonhuman relationships in non-reductive ways. We closely analyze two different stories about encounters with chatbots, taking up the feminist STS challenge to attend to the agency of significant otherness in the encounter. The first is Joseph Weizenbaum's story about rejecting the ELIZA chatbot technology he designed to mimic a therapist as a monstrosity, based on his experiences watching others engage with it. The second is a story about Julie, who experiences a mental health crisis, and her chatbot Navi, as told through her descriptions of her experiences with Navi in the recent podcast Radiotopia presents: Bot Love. We argue that a reactionary humanist narrative, as presented by Weizenbaum, is incapable of attending to the possibilities of pleasure, play, or even healing that might occur in human–chatbot relatings. Other forms of engaging with, understanding, and making sense of this new technology and its potentialities are needed both in research and mental health practice, particularly as more and more patients will begin to use these technologies alongside engaging in traditional human-led psychotherapy.

COVID-19 and South Asia: an overview

The article explores the global impact of the COVID-19 pandemic, highlighting its severe effects on health systems, economies, and poverty levels. With an estimated 6.9 million deaths worldwide and the deepest recession since World War II, the pandemic had diverse regional impacts. South Asia, for example, experienced varying degrees of health and economic challenges; India faced over 500,000 deaths and a sharp economic downturn, while other nations in the region were less severely affected. The pandemic’s relatively brief duration, aided by global responses like lockdowns, social distancing, and rapid vaccine distribution, facilitated a quicker economic recovery, bolstered by unprecedented counter-cyclical policies. The article also examines South Asian case studies, including regional trade integration, the economic benefits of vaccination, and the socio-economic impacts on women in Bangladesh. It further discusses Pakistan’s response, Sri Lanka’s populist policies, and Indonesia’s monetary policy adjustments, offering valuable lessons for managing global health crises and economic downturns.

Amplifying School Mental Health Literacy Through Neuroscience Education

Children and adolescents face a wide variety of developmental changes and environmental challenges, and it is estimated that at least one in five children aged 3–17 will experience behavioral or mental health issues. This period of life coincides with major changes in brain structure and function that have profound long-term consequences for learning, decision-making (including risk taking), and emotional processing. For example, continued development of the prefrontal cortex in adolescence is a sensitive period during which individuals are particularly susceptible to risky behaviors, environmental stressors, and substance use. While recent advances in mental health literacy programs have paved the way for increased awareness of the benefits of mental health curricula in schools, these efforts could be greatly bolstered with support in basic neuroscience education in developmentally appropriate and area-specific content. Here, we provide a discussion on the basic structural and functional changes occurring in the brain throughout childhood, how this contributes to changes in cognitive function, and the risk factors posed by early life adversity, stress, and drug use. Finally, we provide a perspective on the benefits of integrating findings from the field of neuroscience and suggestions for tools to better equip students, teachers, administrators, and school mental health staff to provide new directions for addressing the mental health crises faced by millions of children and youth each year.

The Perspectives of Community Pharmacists Toward the Name-Based Rationing System During the COVID-19 Pandemic in Taiwan: Cross-Sectional Survey Study.

In Taiwan's public health system, community-based pharmacists are key first-line health care providers due to their high accessibility. During the COVID-19 pandemic, the pharmacists played a central role in the distribution of these supplies through the Name-Based Rationing System (NBRS), during an acute shortage of masks and testing kits, that helped reduce the spread of the disease. The NBRS, an innovative government-guided strategy developed after the COVID-19 outbreak, provided equitable and convenient access to masks and COVID-19 test kits. This study aimed to investigate (1) Taiwanese pharmacists' knowledge, attitude, and practices (KAPs) of COVID-19, with the intention to assess their preparedness for public health emergencies and their capabilities to implement COVID-19-related policies effectively; (2) their perspectives toward the NBRS; and (3) the association between individual's KAP and corresponding perspectives toward the NBRS. A cross-sectional, web-based survey was conducted in 2 major cities in Taiwan, from June 18 to September 11, 2022, during the peak of the COVID-19 pandemic. To gauge community pharmacists' KAP, a 66-question instrument was developed using guidelines from the Taiwanese Centers for Disease Control, the International Pharmaceutical Federation, and the Taiwanese Pharmacist Association. The instrument's internal consistency reliability was ascertained using Cronbach α (0.819), and its content validity was verified by field experts. Overall, 343 Taiwanese community pharmacists were recruited in the study. Among them, 88% (303/343) scored high on knowledge domain questions related to SARS-CoV-2; 58% (201/343) and 39% (136/343) held positive and neutral attitudes toward COVID-19-related policies, respectively; and 77% (266/343) practiced infectious disease prevention measures in compliance with official guidelines. The results demonstrated a high level of competency in pharmacists in a public health crisis. It revealed that factors including age, pharmacy characteristics, and the number of customers were associated with their perceptions and willingness to continuously participate in the NBRS. Overall, the community pharmacists showed greater support for the COVID-19-testing NBRS compared with the mask NBRS, because of the more favorable influence on the revenue and workforce of the pharmacies and the well-being of the pharmacists. Responses also highlighted concerns about rapid government policy changes and supply dynamics, underscoring the importance of effective communication and considering supply availability in facilitating a successful NBRS. The strong KAP of the community pharmacists justified the government leveraging their expertise in Taiwan's COVID-19 response. While community pharmacies have proven to be essential distribution centers through the NBRS, improving community connections, communication with the government, and supply management are recommended to strengthen the system. These potential approaches aim to ensure successful NBRS implementation and better preparedness for future public health emergencies. Overall, pharmacists have demonstrated their integral role in achieving equitable outcomes and their dedication to public health efforts during crises.

Public Health Interventions Targeting the Prevention of Adolescent Vaping: A Scoping Review.

Despite a brief decline during the COVID-19 pandemic, vaping behaviors among adolescents continue to be an international public health concern because of associated health risks and harms. A thorough investigation of existing interventions preventing adolescent vaping is needed to help address this public health crisis and reduce serious and avoidable vaping-related health risks. We reviewed the literature to identify public health interventions aimed at preventing adolescent vaping and summarized their key components and outcome measures. We conducted a scoping review of the literature using the Joanna Briggs Institute methodology searching in MEDLINE, CINAHL, Embase, PubMed, PsycINFO, ProQuest, and Web of Science. Two reviewers screened 589 records for relevance. Studies from any location, reported in English, and described vaping prevention interventions targeting adolescents were included. Records were excluded if they were reported in other languages, published outside the review timeframe, lacked an evaluation, focused on cessation-based interventions, or were review articles. Data extracted included intervention type, key components, and outcome measures. Thirty-eight included articles were identified and categorized into three intervention categories: school-based, public education/risk communication campaigns, and public policies/government regulations. Key components of the interventions included format, duration, and topics. Formats varied from single to multi-sessions. Prominent topics covered included risks and harms associated with vaping, and the most frequently reported outcome measures used were knowledge, attitudes, and beliefs. Our findings summarize existing public health interventions found in the literature and insights into approaches used to address the global adolescent vaping crisis.

Infodemics and Vaccine Confidence: Protocol for Social Listening and Insight Generation to Inform Action.

In the fall of 2020, the COVID-19 infodemic began to affect public confidence in and demand for COVID-19 vaccines in the United States. While polls indicated what consumers felt regarding COVID-19 vaccines, they did not provide an understanding of why they felt that way or the social and informational influences that factored into vaccine confidence and uptake. It was essential for us to better understand how information ecosystems were affecting the confidence in and demand for COVID-19 vaccines in the United States. The US Centers for Disease Control and Prevention (CDC) established an Insights Unit within the COVID-19 Response's Vaccine Task Force in January 2021 to assist the agency in acting more swiftly to address the questions, concerns, perceptions, and misinformation that appeared to be affecting uptake of COVID-19 vaccines. We established a novel methodology to rapidly detect and report on trends in vaccine confidence and demand to guide communication efforts and improve programmatic quality in near real time. We identified and assessed data sources for inclusion through an informal landscape analysis using a snowball method. Selected data sources provided an expansive look at the information ecosystem of the United States regarding COVID-19 vaccines. The CDC's Vaccinate with Confidence framework and the World Health Organization's behavioral and social drivers for vaccine decision-making framework were selected as guiding principles for interpreting generated insights and their impact. We used qualitative thematic analysis methods and a consensus-building approach to identify prevailing and emerging themes, assess their potential threat to vaccine confidence, and propose actions to increase confidence and demand. As of August 2022, we have produced and distributed 34 reports to >950 recipients within the CDC and externally. State and local health departments, nonprofit organizations, professional associations, and congressional committees have referenced and used the reports for learning about COVID-19 vaccine confidence and demand, developing communication strategies, and demonstrating how the CDC monitored and responded to misinformation. A survey of the reports' end users found that nearly 75% (40/53) of respondents found them "very" or "extremely" relevant and 52% (32/61) used the reports to inform communication strategies. In addition, our methodology underwent continuous process improvement to increase the rigor of the research process, the validity of the findings, and the usability of the reports. This methodology can serve as a diagnostic technique for rapidly identifying opportunities for public health interventions and prevention. As the methodology itself is adaptable, it could be leveraged and scaled for use in a variety of public health settings. Furthermore, it could be considered beyond acute public health crises to support adherence to guidance and recommendations and could be considered within routine monitoring and surveillance systems.

A pan-genomic analysis based multi-epitope vaccine development by targeting Stenotrophomonas maltophilia using reverse vaccinology method: an in-silico approach.

Antibiotic resistance in bacteria leads to high mortality rates and healthcare costs, a significant concern for public health. A colonizer of the human respiratory system, Stenotrophomonas maltophilia is frequently associated with hospital-acquired infections in individuals with cystic fibrosis, cancer, and other chronic illnesses. The importance of this study is underscored by its capacity to meet the critical demand for effective preventive strategies against this pathogen, particularly among susceptible groups of cystic fibrosis and those undergoing cancer treatment. In this study, we engineered a multi-epitope vaccine targeting S. maltophilia through genomic analysis, reverse vaccination strategies, and immunoinformatic techniques by examining a total of 81 complete genomes of S. maltophilia strains. Our investigation revealed 1945 core protein-coding genes alongside their corresponding proteomic sequences, with 191 of these genes predicted to exhibit virulence characteristics. Out of the filtered proteins, three best antigenic proteins were selected for epitope prediction while seven epitopes each from CTL, HTL, and B cell were chosen for vaccine development. The vaccine was refined and validated, showing highly antigenic and desirable physicochemical features. Molecular docking assessments revealed stable binding with TLR-4. Molecular dynamic simulation demonstrated stable dynamics with minor alterations. The originality of this investigation is rooted in the thorough techniques aimed at designing a vaccine that directly targets S. maltophilia, a microorganism of considerable clinical relevance that currently lacks an available vaccine. This study not only responds to a pressing public health crisis but also lays the groundwork for subsequent research endeavors focused on the prevention of S. maltophilia outbreaks. Further evidence from studies in mice models is needed to confirm immune protection against S. maltophilia.

Suspending Disbelief – Using Solution Focused Practice With Young People in Mental Health Crisis

Suspending Disbelief – Using Solution Focused Practice With Young People in Mental Health Crisis

Emotional Suffering After the COVID-19 Pandemic: Grieving the Loss of Family Members in Brazil

(1) Background: Brazil has been severely affected by the COVID-19 pandemic, with over 700,000 deaths and, consequently, a drastic increase in the number of bereaved individuals. This study aims to understand the emotional suffering after the COVID-19 pandemic in Brazilian adults whose family members have died due to COVID-19. (2) Methods: A clinical–qualitative, cross-sectional, descriptive–exploratory study with a sample composed of 10 bereaved family members was used. Data collection took place in July 2021 through individual semi-structured interviews conducted via video call. The interviews were fully transcribed and subjected to thematic analysis. The corpus was analyzed based on Parkes’ theory of mourning, in dialog with research conducted in the pandemic context. (3) Results: The results were organized into three categories: Living the anticipation of loss in an unknown world; Living through grief in a changed world; and Glimpsing a new possibility of living. (4) Conclusions: The rupture of the presumed world in times of the pandemic, the impossibility of bidding farewell to deceased loved ones, and low levels of social support hindered the process of mourning during the health crisis.

A Fentanyl Hapten‐Displaying Lipid Nanoparticle Vaccine that Non‐Covalently Encapsulates a TLR7/8 Agonist and T‐helper Epitope Induces Protective Anti‐Fentanyl Immunity

Opioid use disorder ‐ particularly involving fentanyl ‐ has precipitated a public health crisis characterized by a significant increase in addiction and overdose‐related deaths. Fentanyl‐specific immunotherapy, which aims at inducing fentanyl‐specific antibodies capable of binding fentanyl molecules in the bloodstream, preventing their entry in the central nervous system, is therefore gaining momentum. Conventional opioid designs rely on the covalent conjugation of fentanyl analogues to immunogenic carrier proteins that hold the inherent capacity of mounting immunodominant responses. Here, we present an alternative fentanyl vaccine design that utilizes a non‐covalent assembly of lipid nanoparticles (LNPs) to deliver fentanyl haptens in conjunction with a CD4+ T‐helper peptide epitope and an imidazoquinoline TLR7/8 agonist. Our results demonstrate that a single intramuscular administration of the LNP‐based nanovaccine elicits fentanyl‐specific antibodies, significantly mitigating the effects of opioid overdose in preclinical mouse models. Furthermore, we analyzed the immunobiological behavior of the vaccine in vivo in mouse models, providing evidence that covalent attachment of a fentanyl hapten to a carrier proteins or peptide epitope is not necessary for inducing an effective immune response. However, co‐delivery ‐ specifically, the physical assembly of all immune cues into an LNP ‐ remains essential for inducing hapten‐specific immunity.

A Fentanyl Hapten-Displaying Lipid Nanoparticle Vaccine that Non-Covalently Encapsulates a TLR7/8 Agonist and T-helper Epitope Induces Protective Anti-Fentanyl Immunity.

Opioid use disorder - particularly involving fentanyl - has precipitated a public health crisis characterized by a significant increase in addiction and overdose-related deaths. Fentanyl-specific immunotherapy, which aims at inducingfentanyl-specificantibodies capable of binding fentanyl molecules in the bloodstream, preventing their entry in the central nervous system, is therefore gaining momentum.Conventional opioid designsrely on the covalent conjugation of fentanyl analogues to immunogenic carrier proteins that hold the inherent capacity of mounting immunodominant responses. Here, we present an alternative fentanyl vaccine design that utilizes a non-covalent assembly of lipid nanoparticles (LNPs) to deliver fentanyl haptens in conjunction with a CD4+T-helper peptide epitope and an imidazoquinoline TLR7/8 agonist. Our results demonstrate that a single intramuscular administration of the LNP-based nanovaccine elicits fentanyl-specific antibodies, significantly mitigating the effects of opioid overdose in preclinical mouse models. Furthermore, we analyzed the immunobiological behavior of the vaccine in vivo in mouse models, providing evidence that covalent attachment of a fentanyl hapten to a carrier proteins or peptide epitope is not necessary for inducing an effective immune response. However, co-delivery - specifically, the physical assembly of all immune cues into an LNP - remains essential for inducing hapten-specific immunity.

Introduction: Mobilizing during COVID-19: social movements in times of crisis

ABSTRACT Early 2020 saw the beginning of a pandemic that triggered an unprecedented global health crisis and economic turmoil. The COVID-19 pandemic also crucially affected the dynamics of political mobilization in social movements. This introduction seeks to reflect on such effects. In particular, we ask: How did the pandemic change or hinder existing struggles? To what extent did new activist networks, issues, and forms of action emerge? Drawing on the special issue’s contributions, we highlight how the pandemic gave way to new incentives and forms of mobilization, in particular the anti-lockdown protests with covid-specific claims, and actor constellations that often brought together people with diverse ideological orientations. These mobilizations were crucially facilitated by social media, bringing together previously disconnected people and harnessing heightened emotions of fear, anger, distrust, uncertainty, and anxiety. At the same time, existing movements continued their work on longer standing issues and often effectively adapted their organizational infrastructures, repertoires of action, or goals to a new set of priorities and circumstances. As in other crises, the pandemic spurred mutual aid and solidarity activism for those most affected by the pandemic.

Measurement-Based Care in a Remote Intensive Outpatient Program: Pilot Implementation Initiative.

The ongoing mental health crisis, especially among youth, has led to a greater demand for intensive treatment at the intermediate level, such as intensive outpatient programs (IOPs). Defining best practices in remote IOPs more broadly is critical to understanding the impact of these offerings for individuals with high-acuity mental health service needs in the outpatient setting. Measurement-based care (MBC), or the routine and systematic collection of patient-reported data throughout the course of care to make meaningful changes to treatment, is one such practice that has been shown to improve patient outcomes in mental health treatment. Despite the literature linking MBC to beneficial clinical outcomes, the adoption of MBC in clinical practice has been slow and inconsistent, and more research is needed around MBC in youth-serving settings. The aim of this paper is to help bridge these gaps, illustrating the implementation of MBC within an organization that provides remote-first, youth-oriented IOP for individuals with high-acuity psychiatric needs. A series of 2 quality improvement pilot studies were conducted with select clinicians and their clients at Charlie Health, a remote IOP program that treats high-acuity teenagers and young adults who present with a range of mental health disorders. Both studies were carefully designed, including thorough preparation and planning, clinician training, feedback collection, and data analysis. Using process evaluation data, MBC deployment was repeatedly refined to enhance the clinical workflow and clinician experience. The survey completion rate was 80.08% (3216/4016) and 86.01% (4218/4904) for study 1 and study 2, respectively. Quantitative clinician feedback showed marked improvement from study 1 to study 2. Rates of successful treatment completion were 22% and 29% higher for MBC pilot clients in study 1 and study 2, respectively. Depression, anxiety, and psychological well-being symptom reduction were statistically significantly greater for MBC pilot clients (P<.05). Our findings support the feasibility and clinician acceptability of a rigorous MBC process in a real-world, youth-serving, remote-first, intermediate care setting. High survey completion data across both studies and improved clinician feedback over time suggest strong clinician buy-in. Client outcomes data suggest MBC is positively correlated with increased treatment completion and symptom reduction. This paper provides practical guidance for MBC implementation in IOPs and can extend to other mental health care settings.

Development will (try to) find its way: a qualitative study of Chilean adolescent mental health during and after lockdown

BackgroundThe COVID-19 pandemic has had a well-evidenced impact on adolescents, who are especially sensitive to pandemic disruptions given the critical role of socialization in their development. In Chile too, evidence shows increases in mental health complaints among adolescents over the lockdown period. Our study aimed at exploring the experiences of Chilean adolescents regarding their mental health during the lockdown and school closure (March 2020-December 2021), and during the return to on-site education (2022) as informed by adolescents and school staff, with a focus on family, school, and social sources of risk and support for adolescents’ wellbeing during these periods.MethodsUsing a qualitative approach, we conducted semi-structured interviews with 19 adolescents and 16 staff members from schools in an urban area of Chile.ResultsThrough thematic analysis, we generated five themes: [1] Adolescents in a mental health crisis, comprising a range of distressing experiences and mental health problems. This crisis was fueled by alterations in the functioning of adolescents’ systems: [2] Broken support systems (peers and school); [3] The school agenda must go on, reflecting schools’ strict compliance with the educational curriculum; and [4] Blurred boundaries between home and school life and within the family. Finally [5], Development will (try to) find its way describes how most participants experienced a bouncing back to wellbeing in the course of the school year upon return, and how some developmental milestones took place despite the abnormal conditions, providing evidence for resilience amid pandemic adversity.ConclusionsThe findings give insight into how the exchanges between the adolescent and the social systems they are embedded in were interfered. The results help us understand the challenges for mental health during and after the pandemic, and highlight adolescents’ capacity to thrive as normality was restored. The results also underscore the importance of upholding stability across adolescents’ systems and routines, in order to mitigate impacts on wellbeing amid abnormal circumstances. The findings are relevant for development-informed initiatives in policy design in the aftermath of the pandemic and in future crisis management responses.

Wireless PID-Based Control for a Single-Legged Rehabilitation Exoskeleton

The demand for remote rehabilitation is increasing, opening up convenient and effective home-based therapy for the sick and elderly. In this study, we use AnyBody simulations to analyze muscle activity and determine key parameters for designing a rehabilitation exoskeleton, as well as selecting the appropriate motor torque to assist patients during rehabilitation sessions. The exoskeleton was designed with a PID control mechanism for the precise management of motor positions and joint torques, and it operates in both automated and teleoperation modes. Hip and knee movements are monitored via smartphone-based IMU sensors, enabling real-time feedback. Bluetooth communication ensures seamless control during various training scenarios. Our study demonstrates that remotely controlled rehabilitation systems can be implemented effectively, offering vital support not only during global health crises such as pandemics but also in improving the accessibility of rehabilitation services in remote or underserved areas. This approach has the potential to transform the way physical therapy can be delivered, making it more accessible and adaptable to the needs of a larger patient population.