Tag: Healthcare provider

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From emotion regulation to suicide-specific coping: a qualitative study of self-regulatory processes in suicidal crises

IntroductionNegative affect is strongly associated with suicidal thoughts and behaviors (STBs). Accordingly, the ability to regulate intense negative affective states may be central to understanding the emergence and maintenance of STBs. However, very little is known about how individuals with lived experience regulate negative affect and cope with suicidal thoughts and urges. This study aimed to explore emotion-regulation strategies (ERS) and suicide-specific coping strategies (SCS) used during suicidal crises, their perceived effectiveness, and the situational and contextual factors influencing their selection.MethodsSemi-structured interviews were conducted with 12 individuals admitted to a psychiatric hospital due to an acute suicidal crisis. Data were analyzed using qualitative content analysis.ResultsBefore and during suicidal crises, participants predominantly used avoidance-oriented ERS that contributed to the maintenance of negative affect. With increasing distress, suicidal thoughts emerged as an additional ERS, providing short-term relief while contributing to the intensification of the suicidal crisis over time. A broad range of SCS was identified, differing in their motivational orientation toward suicidal behavior. Suicide-approach strategies (e.g., suppression, substance use, preparatory behaviors) often facilitated the escalation of the suicidal crisis, whereas suicide-avoidant strategies (e.g., seeking support, safety strategies) were context-dependent and not consistently effective. Strategy selection and effectiveness were shaped by situational and contextual factors.ConclusionSuicidal crises can be understood as dynamic, context-dependent self-regulatory processes characterized by escalating emotional distress, changes in strategy use, and dynamic regulatory resources. Interventions should focus on strengthening flexible coping repertoires and preserving self-regulatory capacity. Future research should further investigate these processes to improve prevention and intervention efforts.
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Opinion: The U.S. pharmaceutical supply chain problem is not about China

In 2025, there were 216 active drug shortages in the U.S., impacting Americans’ access to lifesaving medications. The resilience of our pharmaceuticals supply chains has been increasingly framed as a national security issue, including by the White House — and rightly so, as Covid-19 magnified the massive costs of a health system ill-equipped to care for its population.

But this national security framing has heavily skewed toward a U.S.-China competition lens, distracting from the real root causes of our pharmaceuticals supply chain vulnerabilities: inadequate regulation of an industry that tends to prioritize profit over America’s health.

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3-Dimensional Optical Scanning to Assess and Monitor Malnutrition in Eating Disorders (3D-ED) Study

Conditions: Anorexia in Adolescence; Anorexia Nervosa; Anorexia Nervosa, Atypical; Anorexia Nervosa, Binge Eating/Purging Type; Anorexia Nervosa Restricting Type; Anorexia Nervosa With Significantly Low Body Weight; Body Composition Changes; Growth & Development; Malnutrition Severe; Malnutrition, Calorie

Sponsors: University of California, San Francisco; Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD); Denver Health and Hospital Authority; University of Hawaii

Not yet recruiting
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Catastrophic consequences of prolonged immobilization after intracerebral hemorrhage: a case report of crush syndrome combined with capillary leak syndrome

BackgroundSpontaneous intracerebral hemorrhage is a neurological emergency with high mortality and disability rates. Prolonged immobilization after stroke can trigger severe systemic complications. The simultaneous occurrence of crush syndrome and capillary leak syndrome in the setting of acute intracerebral hemorrhage is extremely rare and life-threatening, and no established treatment protocol exists.Case summaryA 64-year-old man with hypertension was found unconscious on his home floor. The estimated time from onset to discovery exceeded 24 h. He was diagnosed with left basal ganglia intracerebral hemorrhage of approximately 5.6 mL with intraventricular extension. On admission, he was comatose with a Glasgow Coma Scale score of 9. Systemic involvement was extensive: severe bilateral leg swelling with multiple tension bullae, acute kidney injury requiring continuous renal replacement therapy, severe rhabdomyolysis with a peak creatine kinase exceeding 50,000 U/L, hyperkalemia, with an initial arterial blood gas in the emergency department showing 6.9 mEq/L, elevated liver enzymes, and distributive shock. Admission central venous pressure was negative, strongly indicating severe hypovolemia. Chest CT already showed hypostatic pneumonia. The clinical presentation was consistent with crush syndrome from prolonged compression, which then led to secondary capillary leak syndrome. The patient underwent emergency neuroendoscopic hematoma evacuation and external ventricular drainage. Postoperatively, he developed atrial fibrillation and deep vein thrombosis. After 3 weeks of multidisciplinary intensive care, his liver and kidney function gradually improved, and the hypostatic pneumonia was controlled. He survived to discharge with a Glasgow Coma Scale score of 11, left limb muscle strength grade 3/5, and right limb muscle strength grade 0/5, and was transferred to a local hospital for continued rehabilitation. At 3-month follow-up, he was walking independently (mRS 2), with significant improvements in neurological function and quality of life.ConclusionThis case reveals a frequently overlooked but deadly clinical pathway: prolonged immobilization after intracerebral hemorrhage can lead to traumatic rhabdomyolysis, crush syndrome, and secondary capillary leak syndrome. A negative central venous pressure, a rare finding, provided supportive evidence of severe hypovolemia due to capillary leak syndrome. This clinical triad represents a unique high-risk condition that demands a shift in treatment philosophy from neurocentric care to systemic resuscitation.