Perspectives on Psychotropic Medication Treatment Among Young Adults Formerly Served in Public Systems of Care: A Thematic and Narrative Analysis

This study examines the perspectives of psychotropic medications held by young adults with mood disorder diagnoses. This article presents an analysis of qualitative interviews with 52 young adults who had been involved with public systems of care during adolescence and had used psychiatric medications. A concatenated analytic approach was used. First, we used a thematic analysis across cases, then a narrative analysis within selected cases. Two main themes emerged from the thematic analysis that captured aspects of the experience of taking medication. First, young adults described the effects of the medications and how they thought the medications were working. They described the impact on their moods, thinking, bodies, and functioning, and the ways in which these effects related to their lives. Second, the process of taking medications emerged as an important aspect of the medication treatment experience, including the trial-and-error nature of treatment and interactions with psychiatrists. The narrative analysis within cases identified that some youth created a medication narrative composed of three elements: why medications were needed, what medications do, and participants’ outlook on future medication use. These narratives are helpful in understanding prior patterns of service use and are instructive in framing young people’s future intentions to use medications. Findings support the importance of eliciting the perspectives of young adults about their treatment and ensuring that services are designed and delivered in developmentally appropriate ways tailored to this group

Knowledge of and Attitudes toward Behavioral Health Services among Older Youth in the Foster Care System

This study examined knowledge of and attitudes toward services among 268 17-year olds with psychiatric diagnoses preparing to exit foster care. A structured interview assessed knowledge of services with vignette scenarios and attitudes with a standardized scale. Descriptive statistics described the extent of knowledge and attitudes among this population and regression analyses examined predictors of these dimensions of literacy. Most youth suggested a help source, but responses often lacked specificity. Gender and depression were the strongest predictors of knowledge and attitudes, respectively. Knowing which aspects of literacy are low, and for whom, can inform education efforts to improve access to care in adulthood

Engagement intervention versus treatment as usual for young adults with serious mental illness: a randomized pilot trial

Background: Young adults have elevated rates of mental health disorders, yet they often do not receive consistent care. The challenge of continuing to engage young adults has been pervasive worldwide. Few engagement interventions have been designed for young adults with serious mental illness. Just Do You is a theoretically guided engagement intervention. It uses innovative modalities (i.e., technology, expressive arts activities, narrative expression, mentoring) to engage participants in conversations about services and how they work, while simultaneously orienting them to treatment. Methods/design: This pilot and feasibility study utilizes a hybrid research design, examining feasibility, acceptability, and preliminary impact, alongside implementation. The study combines qualitative methods, a small pilot randomized trial, and a small cost-benefit analysis. Respondents are clinic staff and young adults who have made initial contact with the Personalized Recovery Oriented Services (PROS) program. Quantitative survey data are collected at baseline, 2 weeks (post-intervention), 1 month, and 3 months. The assessments focus on measuring feasibility, acceptability, engagement, and mental health outcomes. Medical record extraction will be used to triangulate self-report data. We will conduct single degree of freedom contrasts to examine whether Just Do You leads to improved outcomes relative to Treatment-As-Usual using robust regression for each outcome measure. We will examine whether changes in the proposed mediating variables occur across groups using a similar contrast strategy. In addition, we will use structural equation modeling to examine the contribution of mediators to ultimate outcomes. Finally, we will use constant comparison coding techniques for qualitative analyses. Discussion: The aim of this study is to examine the feasibility of a young adult engagement meta-intervention through an intensive preliminary pilot trial, learning through collaboration with stakeholders. Just Do You has the potential to fill a gap in the service system for young adults with serious mental illnesses, improving the seemingly intractable problem of disengagement. The program uses culturally responsive strategies, is recovery-oriented, and builds upon the best evidence to date. Our efforts align with local and national health care reform efforts embedding people with lived experience. Trial registration: This trial was registered with ClinicalTrials.gov (Identifier: NCT03423212) on April 18, 2018, as Protocol Record R34 MH111861-01, New York University, as the Just Do You Program for Young Adults with Serious Mental Illness

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Hotspots of biogeochemical activity linked to aridity and plant traits across global drylands

14 páginas.- 4 figuras.- 67 referencias.- The online version contains supplementary material available at https://doi.org/10.1038/s41477-024-01670-7Perennial plants create productive and biodiverse hotspots, known as fertile islands, beneath their canopies. These hotspots largely determine the structure and functioning of drylands worldwide. Despite their ubiquity, the factors controlling fertile islands under conditions of contrasting grazing by livestock, the most prevalent land use in drylands, remain virtually unknown. Here we evaluated the relative importance of grazing pressure and herbivore type, climate and plant functional traits on 24 soil physical and chemical attributes that represent proxies of key ecosystem services related to decomposition, soil fertility, and soil and water conservation. To do this, we conducted a standardized global survey of 288 plots at 88 sites in 25 countries worldwide. We show that aridity and plant traits are the major factors associated with the magnitude of plant effects on fertile islands in grazed drylands worldwide. Grazing pressure had little influence on the capacity of plants to support fertile islands. Taller and wider shrubs and grasses supported stronger island effects. Stable and functional soils tended to be linked to species-rich sites with taller plants. Together, our findings dispel the notion that grazing pressure or herbivore type are linked to the formation or intensification of fertile islands in drylands. Rather, our study suggests that changes in aridity, and processes that alter island identity and therefore plant traits, will have marked effects on how perennial plants support and maintain the functioning of drylands in a more arid and grazed world.This research was supported by the European Research Council (ERC grant 647038 (BIODESERT) awarded to F.T.M.) and Generalitat Valenciana (CIDEGENT/2018/041). D.J.E. was supported by the Hermon Slade Foundation (HSF21040). J. Ding was supported by the National Natural Science Foundation of China Project (41991232) and the Fundamental Research Funds for the Central Universities of China. M.D.-B. acknowledges support from TED2021-130908B-C41/AEI/10.13039/501100011033/Unión Europea Next Generation EU/PRTR and the Spanish Ministry of Science and Innovation for the I + D + i project PID2020-115813RA-I00 funded by MCIN/AEI/10.13039/501100011033. O.S. was supported by US National Science Foundation (Grants DEB 1754106, 20-25166), and Y.L.B.-P. by a Marie Sklodowska-Curie Actions Individual Fellowship (MSCA-1018 IF) within the European Program Horizon 2020 (DRYFUN Project 656035). K.G. and N.B. acknowledge support from the German Federal Ministry of Education and Research (BMBF) SPACES projects OPTIMASS (FKZ: 01LL1302A) and ORYCS (FKZ: FKZ01LL1804A). B.B. was supported by the Taylor Family-Asia Foundation Endowed Chair in Ecology and Conservation Biology, and M. Bowker by funding from the School of Forestry, Northern Arizona University. C.B. acknowledges funding from the National Natural Science Foundation of China (41971131). D.B. acknowledges support from the Hungarian Research, Development and Innovation Office (NKFI KKP 144096), and A. Fajardo support from ANID PIA/BASAL FB 210006 and the Millennium Science Initiative Program NCN2021-050. M.F. and H.E. received funding from Ferdowsi University of Mashhad (grant 39843). A.N. and M.K. acknowledge support from FCT (CEECIND/02453/2018/CP1534/CT0001, SFRH/BD/130274/2017, PTDC/ASP-SIL/7743/2020, UIDB/00329/2020), EEA (10/CALL#5), AdaptForGrazing (PRR-C05-i03-I-000035) and LTsER Montado platform (LTER_EU_PT_001) grants. O.V. acknowledges support from the Hungarian Research, Development and Innovation Office (NKFI KKP 144096). L.W. was supported by the US National Science Foundation (EAR 1554894). Y.Z. and X.Z. were supported by the National Natural Science Foundation of China (U2003214). H.S. is supported by a María Zambrano fellowship funded by the Ministry of Universities and European Union-Next Generation plan. The use of any trade, firm or product names does not imply endorsement by any agency, institution or government. Finally, we thank the many people who assisted with field work and the landowners, corporations and national bodies that allowed us access to their land.Peer reviewe

Natural mentoring and psychosocial outcomes among older youth transitioning from foster care

This study explores the non-kin natural mentoring relationships among a group of older youth in foster care (n = 339), particularly whether or not their relationships last over time. The study also examines the associations between non-kin natural mentoring relationships and psychosocial outcomes among these older youth. Results of simultaneous and hierarchical regression analyses reveal that the presence of a mentor and the duration of the relationship at age 18 are associated with better psychological outcomes, such as fewer depression symptoms, less stress and more satisfaction with life at 18 1/2. Longitudinal data collected at age 18 and 19 on mentoring revealed that of the 339 youth, 25% (n = 85) reported no mentor at either data point, 41% (n = 139) reported a short term mentor, and 34% (n = 115) reported a long term mentoring relationship. After controlling for potential covariates, multivariate analyses revealed that compared to those youth that did not nominate a mentor, youth in long term natural mentoring relationships reported less stress and were less likely to have been arrested at age 19. Further, being in long term natural mentoring relationships was not related to current employment, or past year alcohol and marijuana use. Implications for transitioning foster care youth are discussed.Natural mentoring Transition Older youth Foster care Outcomes

Voices of parent advocates within the systems of care model of service delivery

Parent advocates Systems of care Children's mental health Qualitative methods

Satisfaction with counseling among black males in transition from the foster care system

Using the Multidimensional Adolescent Satisfaction Scale (Garland, Saltzman, & Aarons, 2000), satisfaction with counseling and associated variables were examined among Black males (n = 47) transitioning from the foster care system. Potential associated variables assessed were foster care custody status, counseling status, diagnosis of major depression and disruptive behavior disorder based DSM-IV criteria, history of placement in congregate care settings, attitudes toward mental health services, stigma beliefs, and masculine norms. Results from simultaneous multiple regression analysis showed that attitudes toward mental health services contributed significantly to satisfaction with counseling. Specifically, Black males who expressed more positive attitudes toward mental health services in terms of confidence in mental health professionals and the therapeutic process reported greater satisfaction. Implications and future research directions are discussed.Black males Foster care Client satisfaction Counseling Attitudes toward mental health services

Social Support: A Mixed Blessing for Women in Substance Abuse Treatment

Using a personal social network framework, this qualitative study sought to understand how women in substance abuse treatment describe their network members\u27 supportive and unsupportive behaviors related to recovery. Eighty-six women were interviewed from residential and outpatient substance abuse treatment programs. Positive and negative aspects of women\u27s social networks were assessed via open-ended questions. Analysis was guided by grounded theory techniques using 3 coders. The findings extend classic social support concepts such as emotional, tangible, and informational support. Practice implications are presented in light of the potential roles network members may play in substance use and recovery