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There were few differences in the hospital and community characteristics between EDs that routinely provided recommended care and those that did not, suggesting few structural barriers to implementation of these recommended services for high-risk ED patients.Black Americans face substantial barriers to mental health services that are due, in part, to historical and contemporary issues of anti-Black racism. Identifying novel models of care that increase access and engagement in mental health services is important. One such model was developed by a predominantly Black church in Harlem, New York City, which built a free mental health clinic to serve the surrounding community. However, treatment barriers and facilitators of this care model have not been reported. Therefore, the authors conducted a qualitative study to identify Black Americans' (N=15) perspectives of their experiences seeking and receiving care from this church-affiliated mental health clinic and the role of the church in promoting mental health service utilization. Treatment facilitators included health care that was free of charge, services affiliated with a trusted institution, and access to culturally competent care that integrated their faith perspectives. Participants perceived the churches as having the potential to provide psychoeducation, destigmatization, and connection to mental health services. The perspectives shared suggest that this novel model of care may address several barriers to mental health care faced by some Black American populations.

After young adults experience a first episode of psychosis, many express a need for help with education and employment. A quality improvement collaborative (QIC) launched in the Netherlands aimed to reinforce vocational recovery by improving participation in education and employment and by enhancing cognitive skills and self-management. This study examined methods used to implement interventions, barriers and facilitators, and implementation outcomes (fidelity, uptake, and availability).

The Breakthrough Series was the model for change. Three evidence-based interventions were implemented to achieve targeted goals individual placement and support (IPS), cognitive remediation, and shared decision making. Fidelity scores were obtained with fidelity scales.

Eighty-five professionals and 332 patients representing 14 teams treating patients with early psychosis were included in the 24-month QIC. Of this group, 252 patients participated in IPS, 52 in cognitive remediation, and 39 in shared decision making. By mplementing these types of interventions in this population, a multifaceted implementation model and a focused testing phase for computerized interventions appear needed, preferably with a maximum of two interventions implemented simultaneously.Every health care system requires an adequate health care workforce, service delivery, financial support, and information technology. During the COVID-19 pandemic, global health systems were ill prepared to address the rising prevalence of mental health problems, especially in low- and middle-income countries (LMICs), thereby increasing treatment gaps. SAG agonist price To close these gaps globally, task shifting and telepsychiatry should be made available and maximized, particularly in LMICs. Task shifting to nonspecialist health workers to improve essential mental health coverage and encourage efficient use of the available resources and technology has become the most viable strategy.On September 22, 2020, then-President Donald Trump signed Executive Order 13950, titled "Combating Race and Sex Stereotyping." This order restricted the types of diversity and inclusion (DI) training that federal agencies and contractors could offer with federal funding. In this column, the author denounces that order, uses this critique to examine DI training sessions in their current forms, and suggests evidence-based solutions for organizations that are committed to dismantling racism. Mental health organizations must move beyond single, standalone DI training sessions that target individual providers and initiate institution-wide activities that embrace antiracism and structural competence.

Caregivers play a key role in supporting the recovery of young adults with early psychosis. This role often involves considerable responsibilities and burden. Despite the considerable needs of caregivers, troubling service gaps addressing these needs remain. Digital technologies may increase caregivers' access to supportive resources; however, technologies developed specifically for caregivers lag far behind those developed for their relatives affected by early psychosis. In particular, little is known about the mobile health (mHealth) features that may be most acceptable to caregivers.

The authors surveyed a sample of 43 caregivers on their interests regarding various features of a proposed mHealth intervention.

Caregivers of young adults with early psychosis were highly interested in a caregiver-facing mHealth intervention, specifically one providing information about psychosis, treatments, and communication with their affected family member.

Future caregiver-focused mHealth intervention interventions may be highly acceptable to this population and may address pressing service gaps.

Future caregiver-focused mHealth intervention interventions may be highly acceptable to this population and may address pressing service gaps.

To determine the extent of acute cartilage injury by using trans-articular sutures.

Five different absorbable sutures, monofilament polydioxanone (PDS) and braided polyglactin (Vicryl), were compared on viable human osteochondral explants. An atraumatic needle with 30 cm of thread was advanced through the cartilage with the final thread left in the tissue. A representative 300 μm transversal slice from the cartilage midportion was stained with Live/Dead probes, scanned under the confocal laser microscope, and analyzed for the diameters of (a) central "Black zone" without any cells, representing

thread thickness and (b) "Green zone," including the closest Live cells, representing the maximum injury to the tissue. The exact diameters of suture needles and threads were separately measured under an optical microscope.

The diameters of the Black (from 144 to 219 µm) and the Green zones (from 282 to 487 µm) varied between the different sutures (

< 0.001). The Green/Black zone ratio remained relatively constant (from 1.