Looking Toward the Future of Integrated Care: History, Developments, and Opportunities.

For almost five decades, the development and implementation of integrated care-the simultaneous combination of primary care with mental health and substance use care-has been a major challenge for the behavioral health care field. Integrated care is exceptionally important because many people with behavioral health conditions also have chronic physical health conditions. Early research findings in the mid-1980s showed that persons with mental illness are likely to develop chronic physical conditions earlier and more severely than other people. These findings precipitated efforts to understand this problem and to develop further appropriate integrated care solutions. Subsequently, the US Surgeon General made care integration a major focus of his landmark 1999 Report on Mental Health, as did the 2008 Mental Health Parity and Addiction Equity Act and the 2010 Patient Protection and Affordable Care Act. However, it was not until 2014, and later, that integrated care actually began to be implemented more broadly. This article reviews these major developmental milestones, examines current activities, and explores likely developments over the next several years. Major current issues include the response to the COVID-19 pandemic, adjusting to its effects on the behavioral health care workforce, and the growing realization that behavioral health care must address the social determinants of life. Likely developments over the next several years will include devising ways to address our workforce crisis, developing effective community interventions, and implementing population health management strategies; implementing the CMS Innovation in Behavioral Health Model; improving reimbursement practices; and exploring the potential of AI for integrated care. Implications for future service organization and training of behavioral health care providers also are discussed. Granted the severity of the current workforce crisis in behavioral health care, urgent efforts are needed to advance the deployment of integrated care in the short-term future.

Reciprocal relations between future time perspective and academic achievement among adolescents: A four-wave longitudinal study.

INTRODUCTION: Adolescents' academic achievement is closely associated with their future time perspective. However, the reciprocal nature of this relationship remains ambiguous due to a lack of longitudinal studies. This study investigated the developmental trajectories of future time perspective and academic achievement among adolescents, as well as reciprocal relations between future time perspective and academic achievement. METHODS: Between 2017 and 2019, we collected 373 adolescents' (baseline Mage = 14.48, SD = 1.90; 49% girls) future time perspective and academic achievement four times from Henan and Hunan Province, China. Each is separated by a 6-month interval. RESULTS: Chinese adolescents' future time perspective was relatively stable. Regarding academic achievement, two distinct developmental trajectories of academic achievement were identified (i.e., high positive growth class and low negative growth class). Those who excel tended to experience an upward trajectory, while those with poorer grades continued to experience a downward trajectory. In the high positive growth class, the intercept of future time perspective was positively correlated with the rate of academic achievement growth, whereas, in the low negative growth class, it negatively predicted the rate of academic achievement decline. More importantly, reciprocal relations existed between future time perspective and academic achievement. CONCLUSIONS: Adolescents' future time perspective may serve as a protective factor for academic achievement, while high academic achievement may also benefit future time perspective. Interventions to enhance academic achievement should prioritize cultivating adolescents' future perspectives. Additionally, preventing the adverse consequences of subpar academic achievement on future time perspective is imperative.

Zogala D. Artificial intelligence in medical imaging.

The current era witnesses a highly dynamic development of Artificial Intelligence (AI) applications, impacting various human activities. Medical imaging techniques are no exception. AI can find application in image acquisition, image processing and augmentation, as well as in the actual interpretation of images. Moreover, within the domain of radiomics, AI can be instrumental in advanced analysis surpassing the capacities of the human eye and experience. While several certified commercial solutions are available, the validation and accumulation of sufficient evidence regarding their positive impact on healthcare is currently constrained. The role of AI presently leans towards being assistive, yet further evolution is anticipated. Risks and disadvantages encompass dependency on computational power, the quality of input data, and their annotation for learning purposes. The transparency of algorithmic functioning is lacking, and issues pertaining to portability may arise. The integration and utilization of AI introduce entirely new ethical and legislative aspects. Predicting the future development of AI in imaging methods is challenging, with a further increase in implementation appearing more probable.

Body MRI in pediatrics: where we are and what the future holds.

Body magnetic resonance imaging (MRI) is increasingly used for disease diagnosis, characterization, and monitoring in children of all ages. MRI has numerous advantages when compared to other imaging modalities, including a lack of ionizing radiation, superior soft tissue image contrast, and ability to provide objective, quantitative assessments. As MRI continues to evolve, pediatric body MRI examinations of the future will certainly be different than our current and past protocols. In this review article, we will discuss the present and likely future states of pediatric body MRI, including the increasing application of quantitative MRI methods, faster imaging techniques and implementation of abbreviated targeted protocols, and the growing use of artificial intelligence methods.

Increased crossing of thermal stress thresholds of vegetation under global warming.

Temperature extremes exert a significant influence on terrestrial ecosystems, but the precise levels at which these extremes trigger adverse shifts in vegetation productivity have remained elusive. In this study, we have derived two critical thresholds, using standard deviations (SDs) of growing-season temperature and satellite-based vegetation productivity as key indicators. Our findings reveal that, on average, vegetation productivity experiences rapid suppression when confronted with temperature anomalies exceeding 1.45 SD above the mean temperature during 2001-2018. Furthermore, at temperatures exceeding 2.98 SD above the mean, we observe the maximum level of suppression, particularly in response to the most extreme high-temperature events. When Earth System Models are driven by a future medium emission scenario, they project that mean temperatures will routinely surpass both of these critical thresholds by approximately the years 2050 and 2070, respectively. However, it is important to note that the timing of these threshold crossings exhibits spatial variation and will appear much earlier in tropical regions. Our finding highlights that restricting global warming to just 1.5°C can increase safe areas for vegetation growth by 13% compared to allowing warming to reach 2°C above preindustrial levels. This mitigation strategy helps avoid exposure to detrimental extreme temperatures that breach these thresholds. Our study underscores the pivotal role of climate mitigation policies in fostering the sustainable development of terrestrial ecosystems in a warming world.

Vaccine design and development: Exploring the interface with computational biology and AI.

Computational biology involves applying computer science and informatics techniques in biology to understand complex biological data. It allows us to collect, connect, and analyze biological data at a large scale and build predictive models. In the twenty first century, computational resources along with Artificial Intelligence (AI) have been widely used in various fields of biological sciences such as biochemistry, structural biology, immunology, microbiology, and genomics to handle massive data for decision-making, including in applications such as drug design and vaccine development, one of the major areas of focus for human and animal welfare. The knowledge of available computational resources and AI-enabled tools in vaccine design and development can improve our ability to conduct cutting-edge research. Therefore, this review article aims to summarize important computational resources and AI-based tools. Further, the article discusses the various applications and limitations of AI tools in vaccine development.

The application of vaccines is one of the most promising treatments for numerous infectious diseases. However, the design and development of effective vaccines involve huge investments and resources, and only a handful of candidates successfully reach the market. Only relying on traditional methods is both time-consuming and expensive. Various computational tools and software have been developed to accelerate the vaccine design and development. Further, AI-enabled computational tools have revolutionized the field of vaccine design and development by creating predictive models and data-driven decision-making processes. Therefore, information and awareness of these AI-enabled computational resources will immensely facilitate the development of vaccines against emerging pathogens. In this review, we have meticulously summarized the available computational tools for each step of in-silico vaccine design and development, delving into the transformative applications of AI and ML in this domain, which would help to choose appropriate tools for each step during vaccine development, and also highlighting the limitations of these tools to facilitate the selection of appropriate tools for each step of vaccine design.

Forever young: The end of history illusion in children.

The "end of history" illusion in adults (Quoidbach et al., 2013) is an asymmetrical pattern in which people accept that they've changed in the past but don't believe they will change in the future. We explore here whether the same psychological forces that cause the illusion in adults exist in the minds of children. Two studies with 4- to 11-year-olds (N = 256) suggest that they do, even in a within-subject design where the same child is asked questions about the past and the future. A third study (N = 83) finds that this illusion does not persist when children are asked about other people. These studies suggest that even young children believe that although they used to be different in the past, from this point on, they will remain forever young.

The perceived controllability of negatively-valenced episodic future thinking modulates delay discounting.

Intertemporal decision-making is important for both economy and physical health. Nevertheless, in daily life, individuals tend to prefer immediate and smaller rewards to delayed and larger rewards, which is known as delay discounting (DD). Episodic future thinking (EFT) has been proven to influence DD. However, there is still no inconsistent conclusion on the effect of negative EFT on DD. Considering the perceived controllability of negative EFT may address the issue (Controllability refers to the extent to which progress and result of an event could be controlled by ourselves). In the current study, we manipulated EFT conditions (baseline, neutral EFT, negative-controllable EFT and negative-uncontrollable EFT), delayed time (i.e. 1 week, 1 month, 3 months, 6 months, 1 year and 3 years) and reward magnitude (small, large). We mainly found that when experiencing negative-uncontrollable EFT compared to negative-controllable EFT in the delayed time of 6 months with large rewards, individuals chose more delayed rewards, suggesting that negative-uncontrollable EFT effectively reduced DD under conditions of both large-magnitude reward and longer delayed time. The current study provides new insight for healthy groups on optimising EFT. In that case, individuals are able to gain long-term benefits in financial management and healthcare.

Healthcare leaders navigating complexity: a scoping review of key trends in future roles and competencies.

BACKGROUND: As healthcare systems rapidly become more complex, healthcare leaders are navigating expanding role scopes and increasingly varied tasks to ensure the provision of high-quality patient care. Despite a range of leadership theories, models, and training curricula to guide leadership development, the roles and competencies required by leaders in the context of emerging healthcare challenges (e.g., disruptive technologies, ageing populations, and burnt-out workforces) have not been sufficiently well conceptualized. This scoping review aimed to examine these roles and competencies through a deep dive into the contemporary academic and targeted gray literature on future trends in healthcare leadership roles and competencies. METHODS: Three electronic databases (Business Source Premier, Medline, and Embase) were searched from January 2018 to February 2023 for peer-reviewed literature on key future trends in leadership roles and competencies. Websites of reputable healthcare- and leadership-focused organizations were also searched. Data were analyzed using descriptive statistics and thematic analysis to explore both the range and depth of literature and the key concepts underlying leadership roles and competencies. RESULTS: From an initial 348 articles identified in the literature and screened for relevance, 39 articles were included in data synthesis. Future leadership roles and competencies were related to four key themes: innovation and adaptation (e.g., flexibility and vision setting), collaboration and communication (e.g., relationship and trust building), self-development and self-awareness (e.g., experiential learning and self-examination), and consumer and community focus (e.g., public health messaging). In each of these areas, a broad range of strategies and approaches contributed to effective leadership under conditions of growing complexity, and a diverse array of contexts and situations for which these roles and competencies are applicable. CONCLUSIONS: This research highlights the inherent interdependence of leadership requirements and health system complexity. Rather than as sets of roles and competencies, effective healthcare leadership might be better conceptualized as a set of broad goals to pursue that include fostering collaboration amongst stakeholders, building cultures of capacity, and continuously innovating for improved quality of care.

Reflective practice is a prerequisite for One Health development.

One Health is being promoted as a transformative approach in health, conservation, and environmental sustainability. The polycrisis of climate change, pandemics, food insecurity, biodiversity loss, pollution and inequity is creating an urgency to evolve the epistemology and methods of One Health. However, the amount of effort placed into critical and systematic reflection on One Health is outweighed by advocacy for its use, or for expanding its scope of practice. This paper advocates for reflective One Health practice to foster new ways of knowing and doing that are helpful in the face of a rapidly narrowing window of opportunity to preserve the social and environmental factors that secure health and resilience for all species and generations. We propose six areas for reflection; (1) how to moderate conformity so that One Health does not become its own silo; (2) finding the moral purpose of One Health to align actions with desired outcomes; (3) coping with the problem of too many interacting problems; (4) the strategic trajectory of growth to accelerate action on root causes and ensure One Health is future-ready; (5) how to identify priorities across a vast array of problems, values, and needs and (6) how to know if we are making the world healthier and safer and for whom. Reflective practice requires investment in ongoing conversation to guard against over-confidence that we have captured the "one right way" to meet changing expectations and circumstances in a fair and effective way. Our intention is to stimulate thinking and discussion within the One Health community to ensure that "doing is shaped by knowing". We hope One Health will continue to be an emergent and highly variable set of ever more effective practices that constantly changes in response to the complex, interconnected and changing problems facing the health of people, animals, and the environment.

Associations between PTSD and temporal discounting: The role of future thinking.

BACKGROUND AND OBJECTIVES: Despite documented alterations in future thinking in posttraumatic stress disorder (PTSD), our understanding of how individuals with PTSD make future-oriented decisions is limited. We tested the hypothesis that increased discounting in association with PTSD reflects failure to spontaneously envision future rewarding situations. METHODS: Thirty-seven trauma exposed war-zone veterans completed a standard temporal discounting task as well as a temporal discounting task accompanied by episodic future thinking cues. RESULTS: Severity of PTSD symptoms was associated with preference for sooner, smaller rewards in the standard task. Consistent with our hypothesis, when participants engaged in future thinking, greater PTSD symptom severity was no longer associated with steeper discounting. Moreover, difficulty anticipating future events, as measured contemporaneously in a separate task (Verfaellie et al., 2024), mediated the relationship between PTSD symptom severity and degree of discounting in the standard task. Among PTSD symptom clusters, the severity of avoidance and negative alterations in cognition and mood was related to steeper discounting. Measures of depression and alcohol use were not associated with discounting. LIMITATIONS: The sample included mostly male, predominantly White veterans who experienced primarily combat-related trauma. CONCLUSIONS: PTSD-associated alterations in temporal discounting reflect failure to spontaneously imagine future positive events. Two common correlates of PTSD, depression and alcohol use, could not account for the observed associations between PTSD and future-oriented decisions.

Artificial intelligence, workers, and future of work skills.

Historically, the use of technology in organizations has reshaped the nature of human work. In this article, we overview how current waves of artificially intelligent (AI) technologies are following this trend, showing how its uses can both automate and complement human labor, alongside creating new forms of human work. However, AI can also generate both upsides and downsides for workers' experiences, which are dependent upon a range of factors such as how the technology is used and the support employees receive during digital transitions. We conclude by outlining how AI literacy and other human-centered skills will play an increasingly important role in future workplaces.

Predicting climate change impacts on the distribution of endemic fish Cyprinion muscatense in the Arabian Peninsula.

Freshwater fishes are facing considerable threats in the Arabian Peninsula which is considered as a highly stressed region in the Middle East. It is predicted that northern Oman is likely to face decreasing rainfall and increasing temperature in coming decades. In this study, we focused on an endemic cyprinid fish Cyprinion muscatense, as a model to investigate impacts of climate change on the mountain fishes inhibiting in this arid region. This species is expected to be strongly affected by climate change because of its limited distribution range in a montane area surrounded by lowlands and sea, limiting the species in shift to other areas. We used an ensemble approach by considering two regressions-based species distribution modeling (SDM) algorithms: generalized linear models (GLM), and generalized additive models (GAM) to model the species habitat suitability and predict the impacts of climate change on the species habitat suitability. Based on the distribution models, the montane area located in northeastern Oman was identified as the most suitable habitat for this species. Our results indicate that, even under the minimum greenhouse gas emissions scenario (RCP 2.6), climate change will produce a high reduction in its potential future habitats. According to the results of percent contribution, elevation and annual minimum temperature were the most important variables in predicting the species suitable habitats. Results also showed that only a small percentage of suitable habitats for the species within boundaries of protected areas. Therefore, the impact of climate change on the species appears particularly alarming. Although our study was restricted to a single cyprinid freshwater species, decreases in potential habitats are likely predicted for other cyprinid fish species restricted to the mountains of this region, suggesting severe consideration is needed for aquatic systems in future conservation planning, especially for endemic freshwater fishes.

Predicting the Collapse of Pain Medicine Using the Economic Recession of 2008 as a Comparator: Lessons Remain Unlearned.

The last decade has seen a boom in pain medicine, basic science and interventional pain management. Concomitantly, there is a need to educate trainees, young attendings, and seasoned attendings on these innovations. There has been a growth in the number of societies that represent pain medicine physicians, each with its own philosophy and guiding principles. The variety of thought within pain management, within the various groups that practice this field, and amongst the societies which protect those missions inherently creates divergence and isolation within these different communities. There is the enormous opportunity for our field to grow, but we need the voices of all different specialties and sub-specialties which practice pain medicine to collectively design the future of our emerging field. The explosion of revolutionary percutaneous surgeries, medications, psychotherapy, and research and development in our field has outpaced the ability of payers to fully embrace them. There is an increased number of pain practitioners using novel therapies, postgraduate training programs do not adequately train users in these techniques thereby creating a potential for sub-optimal outcomes. In part, this is a reason why payers for many of our more novel treatments have decreased patient access or eliminated remuneration for some of them. We believe that society-based collaborative regulation of education, research, and treatment guidelines is needed to improve visibility for payers and end users who provide these treatments. Furthermore, postgraduate chronic pain fellowship education has been deemed by many to be insufficient to educate on all of the necessary requirements needed for the independent practice of pain medicine, especially the consummation of newer technologies. Here, we draw comparison with this tenuous stage in pain management history with the last United States recession to remind us of how poor institutional regulation and neglect for long-term growth hampers a community.

Multi-scale assessment of rainwater harvesting availability across the continental U.S.

Addressing resilience, sustainability, and water resource conservation has become increasingly important in the modern world. Challenges arise due to periodic droughts, climate change, and seasonal variability in areas with limited freshwater availability. Therefore, implementing and promoting water reuse is essential. Rainwater harvesting (RWH) is one such alternative, offering benefits in conserving water resources and mitigating droughts while reducing urban flooding and costs by generating alternative lower-cost water sources. Providing users with knowledge of available volumes for harvesting, including homeowners and governmental entities, is key to encouraging this practice. Hydrological data and geographic information systems are fundamental for managing, designing, and projecting rainwater harvesting practices. However, no tools currently integrate this information at multiple scales with current and future climate scenarios. This research aimed to develop a multi-scale assessment tool named H2O HARVEST, for evaluating the availability and potential of rainwater harvesting. Additional benefits of the H2O HARVEST app include aiding decision-making by national governmental entities and analyzing potential future scenarios for homeowner users. The app also provides regulatory policy information at the state level. We offer an app with the necessary capabilities to bridge the technology gap and promote rainwater harvesting practices. Our research demonstrated that RWH has the potential to be a sustainable water reuse practice. For more than 50% of the states, the RWH could supply at least 50% of the water demand. The regions of the US with the greatest potential are the Central and East.

Survey data on the Italian public's perception of the Russian invasion of Ukraine (March-August 2022).

This article presents data collected through Computer-Assisted Web Interviewing (CAWI), conducted in Italy with the aim of exploring the Italian population's reaction to the Russian invasion of Ukraine in February 2022 and monitoring this reaction for the first six months of the attack through a six-round survey. Each round involved a representative sample of approximately 1010 (1007-1015) Italian adult citizens. Participants were asked questions about emotional reactions to the Russian invasion, coping strategies used, solidarity behaviour toward Ukrainian refugees, perceptions of refugees as a threat to the country, trust in national and international authorities to manage the international situation, and prospects for the future. Demographic data on the respondents were also collected. The survey design was developed by a research group from two universities (the University of Salento and the University of Foggia) and a European research centre, EICAP (European Institute of Cultural Analysis for Policy). The data provided in this article is a resource for researchers, public authorities, and other parties interested in surveying and studying public opinion. This dataset can be used to explore a wide range of topics, including prosocial behaviour and attitudes towards refugees in humanitarian emergencies.

Fertility Preservation in Individuals With Cancer.

The position statement on fertility preservation was produced through collaborative efforts among the Association of Pediatric Hematology/Oncology Nurses, Canadian Association of Nurses in Oncology/Association canadienne des.

Research on the correlation between clinical nurses' self-efficacy, future time perspective, and occupational burnout.

Background: The number of clinical nurses in China experiencing professional burnout is increasing yearly, posing a serious challenge to the public health sector. Implementing effective intervention strategies is key to reducing the level of occupational burnout. At present, training aimed at alleviating occupational burnout among clinical nurses is very limited, with common training programs focusing on addressing external factors of occupational burnout rather than the internal cognitive issues of clinical nurses. Self-efficacy and future time perspective are both aspects of an individual's internal self-cognition. Meanwhile, the relationship between clinical nurses' self-efficacy, future time perspective, and occupational burnout is not clear, and further research is needed to verify this. Objective: This study aims to reveal the relationship between clinical nurses' self-efficacy, future time perspective, and occupational burnout, and to explore the mediating role of future time perspective between self-efficacy and occupational burnout among clinical nurses, providing a scientific reference for training directions to improve occupational burnout. Methods: This study used a cross-sectional design, conducting a questionnaire survey with 529 practicing clinical nurses using the General Demographics Questionnaire (GDQ), the General Self-Efficacy Scale (GSES), the Zimbardo Time Perspective Inventory (ZTPI), and the Maslach Burnout Inventory-General Survey (MBI-GS). SPSS software version 26.0 was used to analyze the correlation between variables, and AMOS 26.0 was used to test the mediation effect. Results: Clinical nurses' self-efficacy had a negative predictive effect on occupational burnout (r = -0.503, p < 0.001). Future time perspective showed significant differences in regression coefficients on both the paths of self-efficacy (r = 0.615, p < 0.001) and occupational burnout (r = -0.374, p < 0.001). Future time perspective played a partial mediating role between self-efficacy and occupational burnout, accounting for 33.8% of the total effect. Conclusion: This study suggests a significant correlation between clinical nurses' self-efficacy, future time perspective, and occupational burnout. Self-efficacy can directly affect occupational burnout in clinical nurses and can also indirectly affect occupational burnout through the future time perspective.