This month’s article was intriguing as it analyzed the evidence on whether large-scale anti-stigma campaigns could lead to increased levels of help-seeking in individuals suffering from mental illness. The main factors that increase the likelihood of treatment avoidance include lack of knowledge to identify features of mental illnesses, ignorance about how to gain access to treatment, prejudice against people who have mental illness and expectation of discrimination against people diagnosed with mental illness[2] Moreover, this article highlights the roles that stigma and discrimination play in contributing to the treatment gap and assess the evidence that public health approaches to stigma and discrimination can easier access to mental health care[2,3] Globally, there has been rapid increase in depression & anxiety in majority 70% of young people and adults; that often fail to receive any mental health treatment from the health care staff. This is impart due to the contributing factors that increase the likelihood of treatment avoidance such as lack of knowledge to identify features of mental illnesses, ignorance about how to gain access to treatment, prejudice against people who have mental illness and expectation of discrimination against people diagnosed with mental illness. The findings of this study suggested that the presence of strong positive attitudes might be more relevant to help seeking and disclosure than the absence of negative attitudes[2] Furthermore, if social marketing campaigns are proven effective at improving knowledge and positive attitudes they would result in increased help-seeking behaviors in young adults.[2] I think this study explored initial help seeking part; however, the examination of the relationship between anti-stigma programs and help-seeking should investigate initial and subsequent actions. Additional factors that may contribute to deter young adults from seeking treatment include negative experiences with mental health professionals that are perceived to be discriminatory and discrimination experienced at the hands of others because of having a mental illness. In closing, this study extrapolated that even with establishing more large-scale anti-stigma campaigns; public knowledge, attitudes, and behaviors must improve to achieve reduction in the risk of negative experiences with health professionals; otherwise it would continue to deter people from seeking further help. References: 1. Corrigan PW, Watson AC, Warpinski AC, Gracia G. Stigmatizing attitudes about mental illness and allocation of resources to mental health services. Community Ment Health J. 2004;40(4):297–307 2. Henderson, C., Evans-Lacko, S., & Thornicroft, G. (2013). Mental illness stigma, help seeking, and public health programs. American journal of public health, 103(5), 777–780. https://doi.org/10.2105/AJPH.2012.301056 3. Patel V, Koschorke M, Prince M. Closing the Treatment Gap for Mental Disorders. Routledge Handbook of Global Public Health. London, UK: Taylor & Francis; 2011:385–393 4. Thornicroft G. Physical health disparities and mental illness: the scandal of premature mortality. Br J Psychiatry. 2011;199(6):441–442 5. Thornicroft G. Most people with mental illness are not treated. Lancet. 2007;370(9590):807–808

This month’s article was an interesting read. This article assessed the clinical characteristics of hospitalized patients with fatal or non-fatal cases of EVALI. The findings of this paper confirm that most of the patients hospitalized with fatal cases reported using THC-containing e-cigarette, or vaping products. Interestingly, most of the hospitalized patients with EVALI reported using THC containing products and it is reported that the aerosols generated by e-cigarette and vapes contain nicotine, flavorings, addictive additives such as Vitamin E acetate and can deliver other substances such as THC and cannabidiol. In addition, the case reports of three patients who died from EVALI revealed that most patients had multiple preexisting medical conditions such as asthma, chronic obstructive pulmonary disease, morbid obesity and pre-existing heart failure which contributed in worsening of respiratory distress followed by death. A common denominator among the hospitalized patients with EVALI, were the prior chronic conditions such as cardiac disease, asthma, chronic obstructive pulmonary disease. Hence, it is strongly suggested that clinicians should ensure an accurate and timely assessment of exposures to vaping and cessation of those exposures. Furthermore, initial gastrointestinal symptoms such as diarrhea and vomiting are most frequently reported in hospitalized patients with fatal cases. Hence, it is recommended that clinicians should consider EVALI in patients who present primarily with constitutional symptoms, gastrointestinal symptoms, or both. In outpatient settings, when symptoms are attributable to infections, limited research suggests the use of glucocorticoids may be beneficial in the treatment of EVALI. I think there needs to be more research to evaluate the efficacy of glucocorticoids since its use is warranted in severely ill patients suffering from life-threatening infections. The data that is presented in this paper has its limitations; as the researchers only counted patients with EVALI who died as a fatal case, whereas other patients were too either too ill to be interviewed or accounted for non-fatal cases. Thus, more-in depth data collection and follow up should be used for patients with non-fatal cases to account for reported clinical differences.

This article was an interesting read. I think scientists should stay open minded when conducting research, to draw inferences and make connections with other medical issues that can be solved. In addition, researchers should be willing able to adapt different techniques and approaches if the results of their study are not what are looking for and this paper demonstrated exactly that. Firstly, the fact that nuclear membrane protein 1 (NEMP1) is not widely studied in humans but can be studied in animals using different animal models such as frogs, roundworms, zebrafish, fruit flies and mice indicates an alternative approach to study human diseases in animal models using genetic techniques. Moreover, the results of this study were fascinating as the researchers investigated the role of missing gene (NEMP1) leading to poor egg development in fruit flies, and further measured the stiffness of the egg’s nuclear envelope using atomic force microscopy. I think it is important to further investigate variants in this gene (NEMP1) using CRISPR gene-editing technique to study associations between mutations in NEMP1 and their effect on early menopause and infertility in humans. It is suggested that researchers would like to explore fertility issues linked to mutations in NEMP1 to establish a causal link between NEMP1 and infertility. However, I think researchers can gain better insight by studying the correlation between mutations in NEMP1 gene and its impact on egg’s nuclear envelope stiffness. In conclusion, I think scientists can potentially solve human infertility issues by using CRISPR-Cas9 gene editing technique in knock-out mice models to study mutations in NEMP1 gene variants to potentially fix and restore NEMP1 genes that can help support egg’s nuclear envelope stiffness.