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Ulysses looks back: a case report on the experience of using a mental health self-binding directive
Get PDFA self-binding directive (SBD) can be included in mental health advance decision documents to request future involuntary treatment. SBDs are supported by service users but controversial and empirical evidence on their application is scarce. Here we present a first case report which describes the experience of a service user with bipolar disorder (hereafter ‘bipolar’) who has chosen to use an SBD. We compare the findings of the case report with results from a systematic review of reasons for and against SBDs. We discuss that the experience of the service user supports SBDs as a tool to maximise autonomy and challenge criticisms around negative liberty, implementation, capacity assessment, and harms. We conclude that this case report adds to mounting evidence that SBDs are a feasible, ethically justifiable intervention, supported by service users. Policy makers should consider supporting SBD implementation strategies within crisis care
HIV Testing, Social Capital, and Mental Health Access Among Foreign-Born Men Who Have Sex with Men (MSM) in Japan
Get PDFHighlights: Country of birth was associated with distinct patterns of social capital, disclosure, and health-related access, underscoring the importance of structurally informed and evidence-based prevention strategies. Foreign-born MSM in Japan demonstrated higher engagement with HIV testing despite more limited access to community infrastructure and mental health services. Background: Migration and place of birth are increasingly recognised as social determinants of health among sexual minority populations. Among men who have sex with men (MSM), being born outside the country of residence may shape access to healthcare, community resources, and social capital networks. In Japan, however, little is known about how being born outside Japan is associated with social capital, health behaviours, and mental health among MSM. Methods: Data were drawn from a large cross-sectional online survey conducted in 2025 of 8150 MSM living in Japan, recruited via community-based in-person outreach and targeted geo-social networking application advertisements. Multivariable logistic regression analyses examined associations between country of birth and social, behavioural, and health-related outcomes. Results: Foreign-born MSM were younger and more concentrated in the Greater Tokyo metropolitan region. Being born outside Japan was associated with higher odds of HIV testing across all timeframes and higher levels of both gay and heterosexual social capital. Foreign-born MSM were also more likely to have disclosed their sexuality to friends and family. However, they were less likely to be aware of LGBT or HIV prevention organisations, despite higher participation once engaged. No differences were observed in suicidal ideation or unprotected anal intercourse with casual partners, although foreign-born MSM were more likely to report unmet need for mental health care. Conclusions: Foreign-born MSM in Japan demonstrate strong engagement in HIV prevention and higher social capital, alongside persistent barriers to community awareness and mental health service access. These findings highlight the importance of addressing structural and informational barriers and supporting community-based organisations to improve equitable health and wellbeing outcomes among MSM in Japan.</p
Maternal expressions of warmth and negativity and adolescent mental health: Using longitudinal monozygotic twin-difference analyses to approach causal inference.
Get PDFBackground: Emotions that mothers express about their offspring are associated with offspring mental health during childhood, but little research has explored whether this extends into adolescence. We investigated associations between maternal warmth and negativity towards twin offspring at age 10, and subsequent mental health outcomes in early and late adolescence. Methods: The Environmental Risk (E-Risk) Longitudinal Twin Study is a population-based cohort of 2,232 same-sex twins born in 1994–1995 across England and Wales. Maternal warmth and negativity were assessed from Five-Minute Speech Samples obtained when twins were aged 10. Continuous mental health outcomes were assessed in interviews with twins at ages 12 (depression, anxiety, attention-deficit hyperactivity disorder and conduct disorder) and 18 (general psychopathology, internalising, externalising and thought disorder). Linear regressions were conducted on 1906 participants with available data and adjusted for sex, family socioeconomic status, and age-5 emotional and behavioural problems. We then conducted a monozygotic twin-difference analysis to control for unmeasured shared environmental and genetic factors. Results: Lower maternal warmth and higher maternal negativity were associated with worse mental health outcomes at ages 12 and 18. For example, when comparing differences in mothers' expressed emotions and mental health outcomes within monozygotic twin pairs, higher negativity remained associated with externalising symptoms (b = 1.77, 95% CI = 0.68 to 2.86, β =.14) and poorer general psychopathology (b = 1.82, 95% CI = 0.63 to 3.01, β =.13), and lower warmth with externalising symptoms (b = −1.96, 95% CI = −3.54 to −0.37, β = −.11). These associations remained after adjusting for twin-differences in age-5 emotional and behavioural problems and birth weight. Null findings were more frequently observed for maternal warmth and internalising outcomes. Conclusions: Using a genetically sensitive design to approach causal inference, we found evidence for associations between maternal warmth/negativity and adolescent mental health outcomes. Maternal expressed emotion ratings might provide an early opportunity to identify families who would benefit from interventions and mental health disorder prevention programmes.</p
Atlas of Longitudinal Datasets
No full textThe Atlas of Longitudinal Datasets is a free longitudinal data discoverability platform developed in partnership with the Wellcome Trust, MQ Mental Health Research and Lived Experience Experts. The platform allows researchers, governments, funders and members of the public to find thousands of longitudinal datasets from across the world using a search engine. The Atlas allows users to explore over 2,500 longitudinal datasets on a map, compare the features of multiple datasets, and apply filters to identify datasets most relevant to specific research questions. The Atlas provides key information about the sample size, participant demographics, data sharing policies and data collected in each dataset, as well as information about the mental health topics studied and lived experience expert involvement. The Atlas team is continuing to expand the platform by adding new datasets and information about additional types of data included in the datasets. The Atlas follows the extensive Landscaping International Longitudinal Datasets project, commissioned by the Wellcome Trust in partnership with MQ, the Open Data Institute and lived experience experts. The research team conducted a global search and review of large-scale longitudinal datasets with potential to facilitate mental health research, identifying over 3,000 unique datasets. The Atlas hosts this information to make these valuable datasets discoverable to researchers around the world.<br/
Observation of uniform supercurrent flow in polycrystalline K-doped Ba122 by combined magneto-optical imaging and finite-element modeling
No full textMacroscopic current uniformity in a (Ba,K)Fe 2As 2 bulk sample produced by a process that demonstrated high trapped magnetic fields was evaluated through a comparative experimental and modeling approach. The bulk sample, with a well-defined square geometry, exhibited ideal roof-top patterns in magneto-optical (MO) images. Comparison of the magnetic moment, MO images, and finite element modeling results showed good agreement for the critical current density, suggesting that the supercurrent circulates uniformly throughout the sample on the order of MO resolution. These results highlight the importance of enhancing flux pinning strength and microstructural control at the submicron and grain boundary scale in iron-based superconducting polycrystalline materials.</p
Archival Debts, High Stakes, and Intersubjectivities in Trauma-informed Approaches to Archives of Child Sexual Abuse
Get PDFEarly life exposures and school readiness:an observational cohort study using the Born in Bradford longitudinal birth cohort data
Get PDFObjective To assess the associations of early life exposures with school readiness. Design, setting, main outcome measure and participants Using data from the Born in Bradford (BiB) birth cohort, we investigated the association of early life exposures and the likelihood of children achieving a ‘Good Level of Development’ (GLD) as measured by the Early Years Foundation Stage Profile at the end of their first school year. Multivariable logistic regression modelling was used to estimate associations of early life exposures with school readiness. Results Outcome data were available for 10589 of 13858 BiB participants. 6272 (59%) children achieved a GLD. 17 variables were investigated, including child characteristics, maternal factors, family environment and socioeconomic exposures. In our multivariable model (n=7981), children with the following characteristics were significantly less likely to achieve a GLD: males (OR 0.43, 95%CI 0.39 to 0.47), Pakistani ethnicity (OR 0.76, 95%CI 0.66 to 0.89), younger children (OR 1.18 per month, 95%CI 1.16 to 1.19), preterm birth (gestational age<32 weeks OR 0.34, 95%CI 0.19 to 0.62; 32–36 weeks OR 0.64, 95%CI 0.51 to 0.80), younger maternal age (OR 1.01 per year of maternal age, 95%CI 1.00 to 1.02), lower maternal education (OR 0.27, 95%CI 0.20 to 0.37 with no qualifications, compared with higher degrees), never breastfed (OR 0.87, 95%CI 0.78 to 0.97), lower paternal employment status (OR 0.66, 95%CI 0.54 to 0.81, for unemployed, compared with non-manual employment), receiving benefits during pregnancy (OR 0.89, 95%CI 0.80 to 0.99) and eligible for free school meals (OR 0.71, 95%CI 0.62 to 0.81). A sensitivity analysis using multiple imputation (n=10589) found consistent results. Conclusions The exposures most strongly associated with low school readiness were male sex, low maternal education and preterm birth (<32 weeks gestation). Greater understanding of the exposures associated with school readiness can inform a proportionate universal approach to policymaking to improve school readiness and subsequent life outcomes.</p
Ferric derisomaltose augments intrinsic skeletal muscle electron transport chain activity in heart failure:A FERRIC-HF II molecular substudy
Get PDFAimsSkeletal muscle energetic augmentation might be a mechanism via which intravenous iron improves symptoms in heart failure, but no direct measurement of intrinsic mitochondrial function has been performed to support this notion. This molecular substudy of the FERRIC-HF II trial tested the hypothesis that ferric derisomaltose (FDI) would improve electron transport chain activity, given its high dependence on iron–sulfur clusters which facilitate electron transfer during oxidative phosphorylation. Methods and resultsVastus lateralis skeletal muscle biopsies were taken before and 2 weeks after randomization. Mitochondrial complex I, II, and I&II respiration were quantified with respirometry of permeabilized fresh skeletal muscle biopsies. Net respiratory capacities, reflecting respiration that is truly available for adenosine triphosphate generation, were calculated by subtracting non-phosphorylating LEAK respiration. Complex I–V and myoglobin protein levels, and skeletal muscle fibre type composition were assayed. Patients randomised to FDI (n = 21) or placebo (n = 19) were similar (age 66 ± 13 years, 73% men, left ventricular ejection fraction 37 ± 8%, 48% New York Heart Association class III, 50% diabetic). After 2 weeks, total complex I-linked respiration (0.33 [interquartile range 0.24–0.37] vs. 0.19 [0.06–0.27] nmol/min/mg, p = 0.03) and net complex I-linked respiration (0.21 [0.16–0.24] vs. 0.11 [0.04–0.16] nmol/min/mg, p = 0.01) were higher in patients allocated to FDI. There was no intergroup difference in other respiratory states, in mitochondrial abundance as reflected by complex I–V protein levels, and in skeletal muscle myoglobin and oxidative fibre type content. ConclusionsIron repletion induces an early, selective, and potentially direct enhancement of mitochondrial complex I-dependent respiration in the skeletal muscle of heart failure patients. This could be harnessed to optimize repletion protocols to maximize patient benefits.</p