Infertility is not only a medical condition and its impact in mental health is well established. Although most couples facing fertility problems and the demands of medical treatment are able to adjust, some of them may show psychological difficulties with clinical relevance, such as depression and anxiety. The Mindfulness Based Program for Infertility (MBPI) is a group intervention designed for infertile women and data from its efficacy study revealed impact in depressive symptoms reduction as well as in internal and external shame, entrapment and defeat. Based on the MBPI, a mindfulness app targeting infertile patients was developed – the MindfulSpot.

This study addresses the MindfulSpot development.

The MindfulSpot is a prototype mobile app, which seeks to offer the chance of practicing mindfulness in a comfortable and accessible way. This app covers informative audio and written texts. The audio contents correspond to mindfulness formal practices and suggestions for informal practice, making possible its use throughout different moments of the day. Beyond the practices mentioned above, users are invited to explore the informative menu, including information on the impact that infertility may have in several aspects of the patients’ lives.

The efficacy of the MindfulSpot is still under analysis and results are expected to be available soon.

The MindfulSpot was designed as a medium for training mindfulness skills and it includes useful information regarding specific aspects of the emotional impact of infertility. Additionally to its independent use, it may also be used as a support tool of the MBPI.

The authors have not supplied their declaration of competing interest.

To explore prevalence of use of substances as cognitive enhancers by Italian medical students and their attitudes towards prescription-only medication (methylphenidate, amphetamine, atomoxetine, modafinil) used for this purpose.

An ad hoc questionnaire was distributed to 433 medical students of the University of Modena and Reggio Emilia. Valid response rate was 83.8% (N=363).

271 students (74.7%) reported use of substances to improve cognition in the last 30 days. Coffee (73%, N=265) and tea (33.3%, N=121) were the most used, followed by caffeinated sodas (15.7%, N=57), tobacco (10.2%, N=37) and vitamin B supplements (8.8%, N=32). Prescription-only medicines were used by 2 students (0.6%) and, overall, only 4 students reported lifetime use (1.2%). 295 (83.3%) students mentioned concerns about safety and side effects as main reasons not to use. Use of cognitive enhancers as a group in the last 30 days slightly correlated with alcohol (r = 0.124; p = 0.023) and cannabis use (r = 0.114; p = 0.036).

Italian medical students use many substances as cognitive enhancers, but this seems not to apply to psychostimulants and modafinil. Cultural and regulatory differences may underlie this difference with other Countries, which warrants further research.

The study was undertaken to estimate an effectivenessof art therapy and psychoeducational programs in an integrated system of the rehabilitation ofpatients with schizophrenia.

It was conductedcomprehensive examination of 142 women with an established diagnosis ofschizophrenia in the period of stabilization.

According to the leading psychopathological syndrome allthe patients were divided into 4 clinical groups: apathy abulia syndrome, paranoid hallucinatory syndrome, depressiveparanoid, and paranoid syndrome.

Anintegrated system of the rehabilitation including the methods of art therapy and psychoeducational programconcluding various information modules, cognitive behavioral therapy techniques, training interactions, problem-oriented discussions.

The present study demonstrated the rapid reduction of psychiatricsymptoms, normalization of emotional state, stabilization of the behavior ofpatients, improvement of cognitive results, improvement of psychophysicalactivity, expanding of contacts, restoration of usual driving mode on thebackground of art therapy and psychoeducational approaches.

The criteria were used to estimate the effectiveness:stability of remission, rates of hospitalization, quality of life, level ofanxiety, improvement of the mental state.

In this study we sought to explore patterns of neural activity related to the self/other-agency judgment in patients with first-episode schizophrenia spectrum disorders (FES) and healthy controls (HC).

Thirty-five FES patients and 35 age-, gender- and education-matched healthy controls.

A task-related functional connectivity analysis with the use of independent component analysis (ICA).

ICA revealed that the self/other-agency judgment was dependent upon anti-correlated default mode and central-executive networks (DMN/CEN) dynamic switching. This antagonistic mechanism was substantially impaired in FES during the task.

Time-courses of DMN/CEN activity has been analyzed by means of signal power and spectral coherence. There was statistically significant difference in the variable (anti-correlation index, AI) between FES and HC. AI correlated with self-agency judgment task performance in FES.

This finding suggests that the main site of pathology in schizophrenia-spectrum disorders may originate in higher-order regulatory mechanisms subserving DMN/CEN orchestration.

The study was supported by the IGA Ministry of Health, Czech Republic, grant NT/14291.

Although spirituality is among the important dimensions of human's existence and a lot of emphasis has been given to its role in promoting the level of health, the nursing care has been always focused on the physical dimension of the patients and little attention is being given to the spiritual needs.

the aim of this study is examining the attitude and performance of Spiritual Care among nurses working in Iran University of Medical sciences Hospitals.

This was a cross-sectional study. Data gathering was done by using Nursing Spiritual Care Perspective Scale (NSCPS) questionnaires. One hundred and sixty six nurses participated in this study.

The total mean of the nurses' attitude toward spiritual care (3.67±0.51) indicated the nurses' positive attitude toward spiritual care. The nurses' practices regarding spiritual interventions indicated that they tend to do half of the spiritual interventions.

Appropriate educational methods must be used for teaching spiritual merits and increasing the nurses’ competency in confronting with spiritual needs and offering spiritual care.

To assess the effect of Ginkgo Biloba Extract (GBE) on sexual function in the menopausal women.

In this triple blind randomized placebo controlled trial, 80 healthy volunteers’ 50–60 years old menopause women, whom had been admitted in three health care centers of Tehran University of Medical Sciences (TUMS), got involved during summer and autumn 2010. The instrument of this study had two parts. The first part was personal characteristics, and the second part was Sabbatsberg Sexual Rating Scale (SSRS), which was used for subjective evaluation of the sexual function before and after intervention. The participants received GBE 120–240 mg or placebo daily for 30 days (40 participants in each group)

The most domains of sexual function was significantly more improved in the GBE than in the placebo group and included sexual desire (P < 0.05), sexual pleasure (P < 0.01), orgasm (P < 0.05), importance of sex (P < 0.01) during last month and importance of sex in comparison to previous years (P < 0.007). The mean score of total sexual function in the GBE group had significant difference with placebo group (P < 0.05).

Findings of this study support positive effect of Ginkgo Biloba on menopausal women's sexual function.

A recent study suggests that the correlation between substance use and academic performance was positive at the school level¹. As well, it is widely discussed in the literature that regular cannabis use increases the risk of learning difficulties².

to study the relationship between regular drug use and academic outcomes of young students of a vocational training institute in Mohammedia (North West of Morocco).

The present study is a cross-sectional study conducted among 441 Moroccan students of vocational institute in Mohammedia (NW of Morocco), aged 18 to 25 years. Addiction status is evaluated bythe CRAFFT-ADOSPA questionnaire and the academic achievements are recorded using the annual average (academic year: 2013-2014).

The results showed that the most commonly used drug is cannabis. Moreover, out of a total of 441 students, 29.5%are regular drug users, 10.8% of them are girls. More, 24.5% of these addicted students had academic achievements below the average and, 69% of students ranked bottom of the class are among the drug addicts.

Academic achievements appeared to be negatively influenced by regular drug use among students. However, deeper statistical studies are needed.

¹Fernando H. Andrade, <a href="http://www.sciencedirect.com/science/article/pii/S0140197114001006">Co-occurrences between adolescent substance use and academicperformance: School context influences a multilevel-longitudinal perspective</a>. Journal of Adolescence, Volume 37, Issue 6, August 2014, Pages 953-963.

²Dominique Lopez et Daniel Sansfaçon, Dommages sociaux liés à l'usage de drogues : focus sur les relationset difficultés familiales, revue toxibase n° 20 – 4e trimestre 2005.

Potentially chronic diseases often have a critical point in their course beyond which treatment becomes less effective. In support of this, early treatment in schizophrenia and other psychoses has been linked to better outcome.

The emergence of simultaneous brain volume changes in those ultra-high-risk individuals who develop psychosis indicate an active biological process, and underline the importance of pre-onset treatment. However, pre-psychotic intervention has also been questioned as, using current criteria, only 20–50% of individuals classified as prodromal develop a psychotic disorder within a 1–2 years period.

Treatment agents in the pre-psychotic phase should, therefore, not have major side effects. Bioactive lipids are molecules that have both intra- and intercellular roles, including mediation, modulation and control of neurobiological processes, such as ion channel and receptor activity, neurotransmitter release, synaptic plasticity, second messenger pathways and neuronal gene expression.

Long-chain omega-3 polyunsaturated fatty acids (PUFAs) have been shown effective for both, mood and psychotic symptoms, and they have neuroprotective properties. Because of the controversy concerned with the extent to which an intervention may produce harm which outweighs its benefits, omega-3 PUFAs are prime candidates for evaluation in putatively prodromal individuals.

We report on the first randomized, placebo-controlled trial on the preventive use of omega-3 fatty acids in 81 ultra-high-risk individuals.

Supplementation with long-chain omega-3 PUFAs reduces the risk of progression to psychotic disorder, and offers a safe and efficacious strategy for indicated prevention in individuals at ultra-high-risk of developing a psychotic illness.

The sensitivity and specificity of a Chinese version of Montreal Cognitive Assessment (MoCA-CV) for Screening mild cognitive impairment (MCI) were examined.

MoCA-CV and MMSE together with a battery of neuropsychological tests were administered to 1056 elders who were recruited from three regions of Beijing (i.e. new town, old town, rural areas).

Twenty-six participants were diagnosed with dementia, 118 were MCI by psychiatrists and neurologists, and 875 were considered to be cognitively normal based on independent neuropsychological tested. Using the recommended cut-off score of 26, the MoCA-CV had an excellent sensitivity of 90.4% to detect MCI from controls, while the specificity was relatively poor (32.0%). Using a lower cut-off score of 22, the MoCA-CV exhibited the optimal balanced sensitivity of 68.7% and specificity of 65.2%. Among all the seven cognitive sub-domains, delayed recall performed the best differentiation of MCI from normal controls. Item analysis showed the internal consistency was relatively low in both naming and sentence repetition tasks which related with the characteristics of Chinese language and culture. Region differences were not significant when such confounding demographic variables as age, gender and education were controlled.

The MoCA-CV is a brief and effective screening tool for detecting MCI. However, presumably due to linguistic and culture issues and the lower education level of Chinese elders, the MoCA-CV did not show better screening capability than MMSE as expected. Some items may need further adaptation to accommodate the language, culture and education characteristics of Chinese participants.

To quantify the prevalence of adverse pregnancy outcomes associated with gestational exposure to paroxetine before the FDA warnings on the risk of cardiac malformations in newborns associated with the use of paroxetine during gestation were issued in 2005.

Data on all pregnancies included in the Quebec Pregnancy Registry were analysed to estimate the prevalence of planned/spontaneous abortions and deliveries during 1998-2004, before the warnings were issued. All study outcomes including congenital malformations are physician-based, and made prospectively and routinely as part of health care management; exposure to paroxetine is based on automated prescription fillings. Trends in the frequency of gestational use of paroxetine during the study period were compared to the trends in the prevalence of cardiac malformations.

Among the 109,344 eligible pregnancies, 1,612 (1.5%) were exposed to paroxetine. Amongst paroxetine users, 49% had a planned abortion, 7% a spontaneous abortion, and 44% a delivery. Amongst those who delivered, 3% had a baby with a cardiac malformation. The most prevalent cardiac malformations were atrial and ventricular septal defects (74%). During the study period, an increase in the prevalence of paroxetine use during pregnancy was correlated with an increase in the rate of cardiac malformations.

Paroxetine use during gestation is associated with an important risk of adverse pregnancy events above baseline rates. Before the warnings on paroxetine were issued, the increase in the prevalence of paroxetine use during pregnancy was already correlated with an increase in the rate of cardiac malformations, excluding the possibility of detection bias.

Sharing personal experiences and survival mechanisms about challenging conditions such as Autism on YouTube may be useful to other parents, educators, psychologists, and policy makers.

This study aimed at analysing YouTube videos of parents sharing their experiences about Autism and text comments posted by viewers.

During the period from 15 November to 15 December, 2012. YouTube was researched by three assessors for videos covering parents sharing their experiences about Autism. Only relevant videos in the English language were identified. For each video, the following information were collected: title, authors, duration, number of viewers, and total number of days on YouTube. Using criteria comprising content, technical authority and pedagogy parameters, videos were rated independently by three assessors and grouped into educationally useful and non-useful videos. A critical thematic analysis of comments posted on was conducted.

A total of 834 videos were screened and only 128 were found to be relevant to parents sharing their experience. Further analysis revealed that 105 (82.1%) provided useful information; scoring (mean ± SD, 15.5 ± 0.94). The other videos 23 (17.9%) were not useful educationally, scoring (11.9 ±2.87). The differences between these two categories were significant; p <0.001. An aggregate of 2393 text comments was posted to useful videos and 951 to non-useful videos.

Despite the variability in the quality of YouTube videos, there are good videos covering parents’ experiences about Autism that can be used by other parents, publics, and professional bodies. The comments made by viewers reflect the importance of the emerging social media tools such as YouTube in sharing experiences.

The author has not supplied his/her declaration of competing interest.

The attitudes of medical students toward psychiatry have been studied extensively in other countries. A positive attitude to psychiatry may make future doctors more responsive to the psychological needs and comorbidity of patients in all branches of medicine.

The purpose of this study was to examine whether attitudes toward psychiatry improved during psychiatric attachment as well as the relationship between attitudes to psychiatry and intention to pursue psychiatry as a career.

On the first and last day of their psychiatric attachment 109 fifth year medical students of SBMU were asked to participate in the study. They completed a demographic form and “Attitude toward Psychiatry Questionnaire”. They also responded to two questions which measured their intention to pursue psychiatry as a prospective career.

Students had favorable attitude toward psychiatry before the attachment with mean score of 84.14 on Attitude to Psychiatry Questionnaire (neutral score 72). These attitudes become more positive after attachment. Students’ intention to pursue psychiatry as a career increased during attachment (t=-4.85 df =107 p=0.000). Improvement in attitudes was related to an increased intention to pursue psychiatry as a career (rho=0.170 n=109 p=0.032).

The study confirms earlier reports of a significant positive impact of undergraduate psychiatric attachment on medical students’ attitudes toward psychiatry and their intention to pursue psychiatry. Thus, teaching psychiatry at an undergraduate level may well have important implications.

Accurate and objective risk assessment is important in the evaluation of many mental disorders and behaviours. For example, in the evaluation of suicidal behaviour or the assessment of accidents in ADHD. Video games could contribute to improve the assessment and increase engagement.

Our hypothesis is that the proposed videogame can precisely evaluate risk. In addition, the developed game is able to indirectly assess the risk. This feature is useful in setups where patients are prone to lie.

We have developed a car driving video game where users are told that they should drive near to the border but not too much. We record distance to the border and each key pulsation every 0.1 seconds.

It has been observed that the median of recorded distance positively correlated with the score obtained by Self-report of Risk-taking Behaviors (SRB). In addition, the interquartile range significant correlates with the global score obtained in this questionnaire.

The proposed videogame is able of performing an accurate risk assessment. Our game takes seven minutes and it does not need complicated nor expensive hardware and could be deployed online. Results obtained open up new possibilities of creating video games which make an objective assessment risk.

Whether the modest QTc-prolonging effect of ziprasidone increases cardiovascular event risk is unknown.

The Ziprasidone Observational Study of Cardiac Outcomes (ZODIAC), an open-label, randomized, postmarketing study, enrolled patients with schizophrenia from routine clinical practice settings in 18 countries. The primary outcome was non-suicide mortality in the year after initiation of assigned treatment. A total of 18,154 subjects were randomized to ziprasidone or olanzapine, dosed according to enrolling physician's clinical judgment. A physician-administered baseline questionnaire collected information on demographics, medical and psychiatric history, and concomitant medication use. Brief follow-up questionnaires elicited hospitalization data since the last study visit, vital status, study medication continuation, and concomitant antipsychotic medication(s) use. ZODIAC study subjects reflected the general population of patients with schizophrenia.

The incidence of nonsuicide mortality within one year of initiating therapy was 0.91% for the ziprasidone group and 0.90% for the olanzapine group (both n = 9,077), relative risk (95% confidence interval [CI]) of 1.01 (0.75, 1.37). This finding was robust in numerous secondary and sensitivity analyses. Regarding secondary endpoints, the risk of all-cause mortality or cardiovascular mortality was similar among ziprasidone and olanzapine users; the incidence of all-cause hospitalizations was higher among ziprasidone users. The proportion of patients remaining on treatment at 6 months was lower for the ziprasidone group.

ZODIAC is one of the largest randomized studies conducted to date of patients with schizophrenia. With substantial statistical power, the study found no difference in risk of nonsuicide death associated with the use of ziprasidone vs. olanzapine.