Lessons Learned or Forgotten? Impacts of COVID-19 on the Future Direction of Global (e-)Mental Health Care.

PURPOSE OF REVIEW: The COVID-19 pandemic has impacted lives globally, posing unique challenges to mental health services exposing vulnerability and limitations within these systems. During the course of the pandemic, telecommunications technologies (e-mental health care) have served a critical role in psychiatric care. It is important to understand current lessons learned in e-mental health care and implications for global mental health systems for both emerging from the pandemic and after the pandemic has ended. RECENT FINDINGS: There are significant regulatory, policy, and evaluation challenges for global e-mental health impacting patients, clinicians, health systems, and decision-makers. These include complex regulatory issues, difficulties of providing care across boundaries, and keeping pace with the implementation of new technologies in behavioral health. The collaborative development of global standards along with policies, appropriate regulations, and developing new models of research and development opens the possibility of improved access to care across national boundaries.

Arterial supply of the trigeminal ganglion, a micromorphological study.

BACKGROUND: In this study, we explored the specific microanatomical properties of the trigeminal ganglion (TG) blood supply and its close neurovascular relationships with the surrounding vessels. Possible clinical implications have been discussed. MATERIALS AND METHODS: The internal carotid and maxillary arteries of 25 adult and 4 foetal heads were injected with a 10% mixture of India ink and gelatin, and their TGs subsequently underwent microdissection, observation and morphometry under a stereoscopic microscope. RESULTS: The number of trigeminal arteries varied between 3 and 5 (mean 3.34), originating from 2 or 3 of the following sources: the inferolateral trunk (ILT) (100%), the meningohypophyseal trunk (MHT) (100%), and from the middle meningeal artery (MMA) (92%). In total, the mean diameter of the trigeminal branches was 0.222 mm. The trigeminal branch of the ILT supplied medial and middle parts of the TG, the branch of the MHT supplied the medial part of the TG, and the branch of the MMA supplied the lateral part of the TG. Additional arteries for the TG emerged from the dural vascular plexus and the vascular network of the plexal segment of the trigeminal nerve. Uniform and specific intraganglionicdense capillary network was observed for each sensory trigeminal neuron. CONCLUSIONS: The reported features of the TG vasculature could be implied in a safer setting for surgical approach to the skull base, in relation to the surrounding structures. The morphometric data on TG vasculature provide anatomical basis for better understanding the complex TG blood supply from the internal and external carotid arteries.

EPA guidance on eMental health interventions in the treatment of posttraumatic stress disorder (PTSD).

The aim of this EPA guidance was to develop recommendations on eMental health interventions in the treatment of posttraumatic stress disorder (PTSD). A systematic literature search was performed and 40 articles were retrieved and assessed with regard to study characteristics, applied technologies, therapeutic approaches, diagnostic ascertainment, efficacy, sustainability of clinical effects, practicability and acceptance, attrition rates, safety, clinician-supported vs. non-supported interventions and active vs. waiting-list controls. The reviewed studies showed a great heterogeneity concerning study type, study samples, interventions and outcome measures. Based on these findings, five graded recommendations dealing with symptom reduction, acceptability, type of administration, clinician support, self-efficacy and coping were developed.

Extramarital sexual relationships of middle-aged Danish men: attitudes and behavior.

This study explored Danish men's attitudes and behavior towards extramarital sexual relations (ESR), seen from two sides: men who had engaged in such relations (involved) and men who had not (non-involved). The participants, 439 men aged 51, completed a questionnaire concerning sexuality (behavior, attitudes and experience) as a part of a Danish cohort-investigation of health risk-factors. Thereafter 100 of the 439 men were interviewed. A high degree of permissiveness toward ESR emerged in both involved and non-involved individuals but approval of ESR was higher among the participants who were involved in ESR. The frequency of ESR increased with higher social rank. Both involved and non-involved participants mostly did not consider the ESR as a serious threat to the marital happiness. Attitudes-behavior discrepancies are discussed seen in the light of the social norms and known attitudes-behavior models.

[Periodontal disease on Yugoslav soil during the past two millennia]. / Parodontopatija na tlu Jugoslavije u poslednja dva milenijuma.

The analysis of the condition of the periodontium concerned the skeletal material of Yugoslavia dated from the first century A.D. to the beginning of the twentieth century. The following parameters were analysed: the condition of the interdental septum, the alveolar limbus, the distance from the alveolar limbus to the enamel-cement line, as well as the existence of fenestrations and dehiscences on the alveolar bone. A total of 534 skulls and 98 jaws were analysed. On the basis of the state of the interdental septum it can be concluded that periodontal disease was present in the whole examined anthropological material, whereby the highest degree of bone resorption existed in the material from the Middle Ages.

[Relationship between Wharton's duct, lingual nerve and hypoglossus nerve]. / Odnose Vartonovog kanala, jezicnog i hipoglosnog zivca.

Surgical interventions in the submandibular and the sublingual region require a thorough knowledge of the relationship between Wharton's duct, the lingual and the hypoglossus nerve. Between the above named elements certain discrepancies and imprecisions can be observed in the literature concerning their relationship. On these grounds we took it as the goal of our research to study the relationship between Wharton's duct and the consequent nerves on 40 human specimens of the sub-mandibular salivary gland with their surrounding structures of the neck. Analyzing the taken material, we arrived at the following conclusions: On the external side of the hypoglossus muscle we observe going from the top: the lingual nerve, Wharton's nerve, the anterior processus of the gland and the hypoglossus nerve. On the anterior edge of the hyoglossus muscle the relationship changes so that, looking from the top down, we have: Wharton's duct, the lingual nerve, the anterior processus of the gland and the hypoglossus nerve.