The art of endurance:implementation of lifestyle interventions in mental healthcare

BACKGROUND: An increasing number of studies in people with mental illness have demonstrated the efficacy of lifestyle interventions for both mental and physical health. However, implementing and sustaining such interventions in routine mental healthcare is challenging.&lt;br/&gt; AIM: To describe implementation barriers and facilitators of various lifestyle interventions in routine mental healthcare.&lt;br/&gt; METHOD: In this paper we summarise the results of three recent doctoral theses and provide recommendations for routine mental healthcare.&lt;br/&gt; RESULTS: Enabling factors and barriers for successful implementation appeared to be universal across various settings and patient populations. Mental healthcare professionals and patients appreciated and supported the lifestyle interventions. A lack of priority, recognition and support on the organisational level were reported as barriers in all the studies. Addressing various lifestyle behaviours simultaneously (e.g. physical activity and diet), personalised to the patients' abilities and preferences, and setting measurable and attainable goals, were important for success. Moreover, involving qualified professionals (e.g. exercise professionals and dietitians with expertise in mental healthcare) and ensuring cooperation between patients and healthcare professionals and disciplines within and outside mental healthcare appeared crucial.&lt;br/&gt; CONCLUSION: Successful implementation of lifestyle interventions in mental healthcare requires changes in culture and behaviour, a long-term strategy and endurance.</p

Less Medication Use in Inpatients With Severe Mental Illness Receiving a Multidisciplinary Lifestyle Enhancing Treatment. The MULTI Study III

Besides having an unhealthy lifestyle contributing to premature mortality, inpatients with severe mental illness (SMI) use high dosages of medication. Previous research has shown improved health after lifestyle improvements in SMI. In addition, we aimed to retrospectively study whether a multidisciplinary lifestyle enhancing treatment (MULTI) was associated with changes in medication use after 18 months, as compared with patients that continued treatment as usual (TAU) and explored mediation by a change in physical activity. We conducted an observational study within a cohort of inpatients with SMI, who received MULTI (N = 65) or continued TAU (N = 49). Data on their somatic and psychotropic medications were collected, converted into defined daily dose (DDD), and analyzed using linear multilevel regression, correcting for baseline value and differences between groups in age, diagnosis, and illness severity. Compared with TAU, the DDD for psychotropic medication significantly decreased with MULTI (B = −0.55, P = 0.02). Changes in total activity did not mediate this association, suggesting that multiple components of MULTI contributed. Corrected between-group analyses for subgroups of medication were not possible due to lack of power and skewed distributions. Within-group data showed a decreased proportion of users as well as median DDD in both groups for almost all medications. In addition to previously reported health improvements after 18 months of MULTI, we observed a significant decrease in dose of psychotropic medication in MULTI compared to TAU. This first study evaluating a wide range of medications indicates a possible effect of lifestyle improvements on medication use in inpatients with SMI. Findings need to be confirmed in future controlled studies, however

Organic Fertilizer Abrasive Grits Increase Soil Available Nitrogen, Plant Height, and Biomass

In organic cropping systems, air‐propelled abrasive grits can be used to control in‐row weeds. If the applied abrasive grit is an approved organic fertilizer, these applications may serve a dual purpose of weed control and crop fertility. Laboratory soil incubations examined the N mineralization rates of several grit types with differing C/N ratios (Agra Grit [crushed walnut shells, 170:1], corncob grit [91:1], Sustane [composted turkey litter, 5.0:1], Phytaboost Plant Food [crushed and pelletized soybean meal, 5.0:1]). A greenhouse study determined plant wheat (Triticum aestivum L.), kale (Brassica napus pabluaria DC), and velvetleaf (Abutilon theophrasti Medik.) growth response in soils amended with these grits. The N mineralization rates varied by grit type, soil, and application rate. The N mineralized from Phytaboost within 56 d was similar among the amounts of N a whereas the amount of N mineralized from Sustane was inversely related to the amount of N applied. Agra Grit and corncob grit immobilized soil N due to their high C/N ratios. In soils amended with Sustane, plant height and biomass were 15–43% and 34–83% greater than for plants grown in soils with Agra Grit, corncob grit, and the nontreated soil. Applications of organic fertilizer as air‐propelled grit may improve crop growth; however, if weed control is imperfect, these grits may increase weed growth. Grits with high C/N ratios may immobilize soil available N but not affect plant growth

Low Physical Activity and Cardiorespiratory Fitness in People With Schizophrenia: A Comparison With Matched Healthy Controls and Associations With Mental and Physical Health

Introduction: The aim of this study was to objectively assess time spent in physical activity (PA) and sedentary behavior (SB) in patients with schizophrenia compared to healthy controls matched for age, gender and socioeconomic status. Associations between both PA and cardiorespiratory fitness (CRF) and mental and physical health parameters in patients with schizophrenia were examined.Materials and Methods: Moderate and vigorous PA (MVPA), moderate PA, vigorous PA, total and active energy expenditure (TEE and AEE), number of steps, lying down and sleeping time was assessed with SenseWear Pro-2 body monitoring system for three 24-h bouts in patients with schizophrenia (n = 63) and matched healthy controls (n = 55). Severity of symptoms (Positive and Negative Syndrome Scale and Montgomery and Åsberg Depression Rating Scale), CRF (peak oxygen uptake, VO2peak), body mass index (BMI), and metabolic syndrome were assessed.Results: Patients with schizophrenia performed less MVPA and moderate activity had lower TEE and AEE, spent more time per day lying down and sleeping, and had poorer CRF compared to healthy controls. The amount of MVPA, but especially CRF was associated with severity of negative symptoms in patients with schizophrenia. Only CRF was associated with BMI.Discussion: The current data offer further evidence for interventions aiming to increase physical activity and decrease sedentary behavior. Given strong associations of CRF with both negative symptoms and BMI, treatment aimed at CRF-improvement may prove to be effective