Changing trends in legal recreational cannabis markets necessitates the continuous monitoring of important market metrics such as price, potency, type, and availability of cannabis products which may influence consumer purchasing behavior. After initial legalization of recreational cannabis use in Canada in 2018 and expansion of the legal market in 2019, an increase in product types and decrease in prices were observed. The purpose of the present study was to provide an update on products on offer to cannabis consumers in Ontario, the largest Cannabis market in Canada, five years after initial federal legalization of non-medical cannabis use.

Data were obtained from the Ontario Cannabis Store (OCS) Website, the sole wholesaler and online market in Ontario between January and April 2024. Information on product type, prices, delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) potency and plant type was extracted and products were grouped by OCS categories and sub-categories, and by route of administration (Inhaled, ingestible, topical and others).

A total of 1727 products were mapped, of which the majority available were inhaled products, sub-divided into smoking, vaping or concentrates (n = 1271). The majority of inhaled products were predominantly indica-dominant while most ingestible products (e.g. edibles) were mainly sativa-dominant. Most inhaled products were "very strong products", i.e., THC potency of 20% or greater (greater than 97%, 96% and 99% of all dried flower, vaping and concentrate products, respectively). All edibles were within the legally acceptable limit of 10 mg of THC per container. Average prices were lowest for dried flower products ($7.91/g) among inhaled products (pre-rolls: $9.65/g, 510 thread cartridges: $37.7/g, infused flower: $18.66/g). Compared to our previous study in 2022, which utilized data from the same website and similar extraction methods, the total number of products on the legal market declined, while the number of edible products (particularly gummies) and disposable vapes, increased. Prices of all flower products (p < 0.001), most abundant vapes (disposable vapes and thread cartridges: p < 0.001) and soft chews (p < 0.027) decreased in 2024 compared to 2022 at the 5% significance level. Conversely, THC potencies of products available generally increased (p < 0.05).

Given the trend of decreasing price and changes in products available, continuous monitoring of the cannabis market is vital. This is necessary to assess the consequences of legalization and inform legal amendments such as price control and potency limits that may curb potential negative consequences possible with the current market trend.

Cognitive behavioral therapy (CBT) is one of the most widely established treatments for mental disorders in children and adolescents and is empirically supported across a wide range of disorders, including evidence from routine care. However, evidence on long-term maintenance of effects in routine outpatient care is still limited, particularly across diagnostic groups. This study examines the long-term, cross-diagnostic effectiveness of CBT in children and adolescents treated under routine outpatient care conditions.

Analyses are based on pre-existing routine outcome monitoring data from 1225 patients (mean age = 14.00 years, SD = 3.24) receiving CBT, collected between 2017 and 2025. Symptoms were assessed using the parent- and patient-reported Strengths and Difficulties Questionnaire (SDQ) at pre-treatment, post-treatment and at 6-, 12- and 24-month follow-ups. Additional self-rated treatment-success ratings were collected at follow-up (covering expectations fulfilled, perceived helpfulness, problem recurrence and perceived change). Effectiveness was described using group means as well as clinical significance. Pre- to post- and pre- to follow-up changes were analysed using paired Wilcoxon signed-rank tests. Associations between follow-up SDQ scores and self-rated treatment success were examined using partial Spearman correlations controlling for baseline SDQ.

Across both parent- and patient-reported SDQ assessments, total difficulties and problem subscales showed significant improvements from pre- to post-treatment and from pre-treatment to all follow-up time points. Effect sizes were consistently moderate-to-large (r_rb = 0.59-0.77), with sustained effects up to 24 months. Higher follow-up SDQ difficulties were associated with lower self-rated treatment success across multiple follow-up ratings, with strongest associations observed for problem recurrence and change compared to before treatment. Sensitivity analyses restricted to participants in the clinical range at baseline (SDQ ≥ 17) yielded consistent results.

Routine outpatient CBT for children and adolescents was associated with meaningful symptom improvements that persisted up to two years after treatment. Clinically significant change analyses indicated that while many patients showed reliable improvement, a substantial proportion remained classified as unchanged according to conservative criteria. Subjective follow-up ratings were consistent with standardized symptom outcomes, supporting the perceived durability of treatment success under routine care conditions in a diagnostically heterogeneous sample.

Not applicable. This study is an observational analysis of routinely collected data. The analysis plan was preregistered at PsychArchives ( https://doi.org/10.23668/psycharchives.21444 ).

In Spain, induced abortions are covered by the public health system. In the region of Catalonia, under the scope of Primary Care, the Sexual and Reproductive Health Care Units (ASSIR) attend to women who choose to have a medical abortion (MA) up to 9.6 weeks of gestation.

To determine the perception of the quality of care received by women who have undergone a MA in the ASSIR.

Multicentre cross-sectional study, in collaboration with all of Catalonia's ASSIR units. At the follow-up visit after the MA, the women completed the SERVPERF (SERVice-PERFormance) Perceived Quality Satisfaction Scale, validated in Spanish, to evaluate the quality of care received in the dimensions of health professionals, administrative staff, organization, information, clinical aspects, impact of the process, and satisfaction.

Eight hundred and five (86.6%) women completed the SERVPERF MA questionnaire. The mean total SERVPERF score of participants' assessment of care was 96.68 (SD 15.6), with a maximum possible score of 130. The mean score per question across the entire scale was 3.72 (SD 0.6), with a maximum score of 5. The questions with the lowest scores were related to clinical aspects (pain, anxiety, bleeding), with a mean of 2.26 (SD 0.8), and the impact of the process (on life and family relationships), with a mean of 3.25 (SD 1). In contrast, satisfaction (I would use the service again or recommend it to a friend) obtained the highest mean score: 4.47 (0.8). Women who had previously had an abortion reported higher perceived quality (M = 98.54, SD = 14.52) than women without past abortions (M = 95.67, SD = 16.21), p = 0.013.

The overall satisfaction score falls within a favourable range. The clinical aspects of pain, anxiety, and bleeding scored the lowest but did not correlate with a decrease in user satisfaction; participants would return to the center and recommend it to others.

Primary care is often the first point of contact for adults with complex mental health difficulties, yet many experience persistent barriers to accessing timely and appropriate support. Despite policy commitments to integrated and equitable care, there remains a need to better understand how individuals make sense of distress and navigate services that may struggle to meet complex needs. This study aimed to better understand the experiences of adults with complex mental health difficulties as they access primary care services. It sought to further understand how they made sense of their difficulties accessing care and their psychological distress.

This study used a qualitative design with reflexive thematic analysis. Nineteen participants with complex mental health difficulties were interviewed using a semi-structured schedule. They were recruited via their GP practices.

Three themes were identified: participants' desire to understand why they felt the way they did, the mental health condition itself creating barriers to care, and the precarity of self-management and help. An overarching theme of "Contradictions" was evident across all three themes. "Contradictions" included professionals talking of connecting but then distancing, help being offered but never arriving, trauma being present but ignored, and diagnosis getting in the way of receiving care.

Overall, the study provided further evidence that those with complex mental health difficulties are currently underserved in the NHS. Novel insight into their health literacy questioned the assumptions that those with complex mental health difficulties lack understanding; rather, it provides evidence that services need to collaborate effectively with service users to enable better communication.

Social determinants of health (SDOH) are nonmedical factors that impact health outcomes and medication use. As national initiatives and value-based care models prioritize SDOH interventions, pharmacists are uniquely positioned to support these efforts. However, evidence describing pharmacist-led SDOH screening, particularly through collaborations between health-system and community pharmacists, remains limited.

To learn how community pharmacists address SDOH-related care gaps among patients with atrial fibrillation (AF) and how vertically integrated partnerships can strengthen these efforts through the Connect AF program.

Connect AF was developed through partnership among Community Pharmacy Enhanced Services Network USA (CPESN), UNC Health Pharmacy, Pfizer, and Blue Cross Blue Shield North Carolina. Pharmacists administered an adapted SDOH questionnaire to 75 AF patients receiving care at UNC Health and filling oral anticoagulants at five North Carolina CPESN pharmacies. Domains assessed included housing instability, transportation, mental health, food insecurity, community support, safety, and utilities. Pharmacists provided referrals, facilitated resource navigation, documented patient engagement, and completed pre- and post-program feasibility and acceptability surveys.

Connect AF represents a first-of-its-kind alignment between a health system, community pharmacies, a payer, and an industry partner to gain insights on pharmacist-driven SDOH strategies for AF patients.

Data were analyzed descriptively using frequencies and percentages.

Connect AF fostered a collaborative learning environment that enabled each partner to contribute insights, expertise, data, and resources aligned with their role. Mental health (28%), housing instability (20%), and transportation barriers (20%) were most prevalent. Though 16% of patients screened shared needs, most expressed uncertainty about engaging with referred resources (75%). All pharmacists reported strong confidence and intent to continue providing SDOH-related support.

Connect AF demonstrates how pharmacists can address SDOH-related care gaps and provides a scalable model for cross-sector collaboration to enhance patient care coordination.

Pharmacogenomic (PGx) testing for major depressive disorder (MDD) can reduce healthcare spending and improve patient outcomes. However, concerns about health equity, data privacy, and secondary usage of data require deliberation. We sought recommendations from members of the general public for policymakers' consideration.

A four-day public deliberation was held in Vancouver, British Columbia (BC), from November-December 2024. Invitations were mailed to 15,000 randomly-selected households in BC. Participant selection maximized socio-demographic diversity. Participants received an information booklet and heard from expert speakers before discussing whether and how PGx testing for MDD should be implemented. Participants then generated and voted on recommendation statements. Finally, participants engaged with policy-/decision-maker panelists. Sessions were audio recorded and transcribed.

Thirty participants generated 15 recommendations. Publicly funding PGx testing for MDD was supported under certain conditions. Participants unanimously called for strict test reporting standards, in line with evidence-based prescribing guidelines. Healthcare professional (HCP) education was seen as necessary, with ongoing access to PGx experts. To enhance accessibility and acceptability, the group suggested re-naming this "PGx testing (medication compatibility testing)" and conducting a targeted awareness/education campaign. However, participants wanted additional efficacy data collected across diverse ancestry groups to ensure PGx testing benefited everyone. While they agreed test results could be shared between HCPs, they wanted further public engagement on using PGx results in research without consent.

Knowledge gained throughout the event appeared to reduce concerns around data privacy, highlighting the importance of pre-implementation education and awareness. These recommendations provide guidance to policymakers considering PGx implementation.

Folic acid (FA) is essential for fetal development, while the benefits and optimal dose in pregnant women with epilepsy (PWWE) remain unclear. This study explores effects of FA supplementation, dose, and initiation time on offspring outcomes in PWWE.

This multi-center cohort recruited PWWE from 58 hospitals in China. Anti-seizure medication (ASM) and FA exposures were categorized by first-trimester use. The primary outcome was a composite of preterm birth, low birth weight (LBW), major congenital anomalies (MCAs), fetal death, and neurodevelopmental delay. Logistic regression models assessed the associations between FA exposure, dose, initiation time, and adverse outcomes, adjusting for demographics and epilepsy characteristics, with stratification by maternal ASM use. Dose-response relationships were analyzed using restricted cubic splines.

Among 1013 women with 1209 pregnancies, 952 received FA. In ASM-exposed pregnancies, FA supplementation was associated with lower risks of composite adverse offspring outcomes (adjusted odds ratio [aOR] .59, 95% confidence interval [CI] .387-.911) and fetal death (aOR .127, 95% CI .054-.296), whereas no significant differences were observed between preconception and first-trimester initiation. Compared to no supplement, supplementation with .4 mg/day protected against fetal death (aOR .185, 95% CI .078-.428); doses exceeding .4 mg/day further reduced risk of composite adverse outcomes (aOR .343, 95% CI .162-.675), and doses above 1 mg additionally showed trends toward decreased preterm birth in ASM-exposed pregnancies (aOR .338, 95% CI .104-.943). Compared with .4 mg supplementation, doses above 1 mg/day were associated with a lower risk of LBW (aOR .208, 95% CI .05-.58).

FA supplementation was associated with lower risks of composite adverse offspring outcomes in ASM-exposed pregnancies, specifically at doses exceeding .4 mg. No such associations were observed in pregnancies not exposed to ASMs. However, the optimal upper limit of high-dose FA supplementation requires further investigation.

Individuals with mental disorders have an increased risk for metabolic disturbances, inflammation and nutrient deficiencies. Nevertheless, nutritional aspects have so far received little attention in psychiatric care. Nutritional psychiatry and nutritional psychosomatics (NP) combine psychiatry with nutritional and lifestyle medicine to systematically integrate the interaction of these domains into the diagnostics and therapy.

Illustration of specialized structures and description of three outpatient clinics in the DACH region (Germany, Austria and Switzerland).

Overview of scientific foundations, international trends and guidelines, along with a description of the clinics based on the locations.

The outpatient clinics represent complementary approaches: Graz focuses on nutrition and mental health, the gut-brain axis and integrative therapy; Berlin emphasizes micronutrient diagnostics and functional medicine; Zurich adopts an interdisciplinary, behaviorally and pharmacologically oriented approach. Together, they highlight the need for specialized, multiprofessional structures and scientific evaluation.

The discipline of NP opens up new avenues for prevention and personalized therapy. To meet the high demand and address existing challenges, greater capacity, interdisciplinary networks, health services research and integration into regional healthcare systems are needed. Close alignment of research and clinical practice is essential to sustainably establish evidence-based care concepts and teaching approaches in psychiatry.

Intelligence testing is an important tool for clinicians to help in diagnosis and treatment planning for children with neurodevelopmental disabilities. Although interpreting IQ profiles is a common clinical practice, there are concerns regarding the validity and reliability of such scores. Previous research has shown relatively stable global measures of IQ, but less stable scores within index or subtest score. More research is needed to better understand the long-term stability of IQ scores within autistic and other neurodevelopmental populations who may have more instability in their scores over time.

We tested the long-term stability of IQ scores using the same test over time (Stanford-Binet, Fifth Edition; SB-5) in a large clinical sample of 650 youth with autism (n = 236) or other neurodevelopmental disabilities (n = 414), over a period of 4 months to 11 years. In addition to IQ scores, we also tested consistency of scatter scores, overall profiles, and strengths and weaknesses using linear mixed effects models.

Results indicated overall consistency of FSIQ scores (ICC = 0.86), slightly less stability for VIQ and NVIQ, and low stability for abbreviated IQ as well as index and subtest scores. The consistency of cognitive profiles, scatter scores, and strengths and weaknesses was poor. Younger age was the best predictor of higher FSIQ instability.

Long-term stability of IQ in neurodevelopmental disabilities appears similar to results from other studies with different clinical and nonclinical groups. Implications and recommendations are discussed.

Our study identifies sociodemographic, clinical, and behavioral factors associated with serious psychological distress (SPD) among US adult cancer survivors, highlighting actionable targets for mental health interventions in survivorship care.

We analyzed 2024 National Health Interview Survey data from adults aged ≥ 18 years with a self-reported history of cancer and complete Kessler-6 and covariate data (unweighted n = 3,680; weighted ~ 22.2 million). SPD was defined as a Kessler-6 score ≥ 13. Weighted prevalence and multivariable logistic regression identified independent correlates.

The weighted prevalence of SPD was 3.7% (95% CI, 3.0%-4.5%). SPD was higher among adults aged 18-44 years (10.2% [5.5%-14.9%]) versus ≥ 65 years (2.4% [1.7%-3.1%]), women (4.8% [3.5%-6.0%]) versus men (2.6% [1.7%-3.6%]), and those with Medicaid (14.4% [7.5%-21.2%]) or no insurance (14.1% [3.6%-24.5%]). SPD was also elevated among survivors with frequent loneliness (11.7% [8.9%-14.4%]), low social support (10.7% [7.8%-13.7%]), life dissatisfaction (24.0% [16.5%-31.5%]), and functional limitations (5.5% [4.3%-6.7%]). In multivariable analyses, frequent loneliness (aOR 5.46 [2.39-12.47]), low social support (2.92 [1.40-6.08]), and life dissatisfaction (3.92 [1.64-9.46]) were independently associated with SPD; odds were lower among non-Hispanic Black adults (0.28 [0.08-1.00]). Sensitivity analyses excluding psychosocial variables strengthened associations for younger age and Non-Hispanic Black race/ethnicity.

Serious psychological distress affected a clinically important minority of US cancer survivors and was strongly associated with psychosocial factors, including loneliness, social support, and life satisfaction.

Integrating psychosocial assessment and targeted support into survivorship care may reduce distress and improve overall well-being.