This paper reports findings from a rapid literature review that informed new guidelines for conducting patient-oriented research in forensic mental health settings. The project adopted an integrated knowledge translation approach at a mental health hospital in Ontario, Canada, engaging a project team that included current forensic patients, hospital staff, and members of an international community of practice. Sources were identified through nine academic databases and targeted grey literature searches, screened independently by two reviewers and extracted using a structured template guided by an a priori framework developed with patients and staff at a knowledge exchange event. Findings were iteratively refined through a patient advisory group, an implementation study, ethnographic observations, and related integrated knowledge translation activities conducted alongside the review. Together, 31 academic and grey literature sources informed a framework organized around five core dimensions: 1) Resourcing, orientation, and training; 2) Confidentiality, consent, and compensation; 3) Relationships, shared understanding, and support; 4) Levels of engagement; and 5) Evaluation and sustainability. Guided by cross-cutting principles common among participatory mental health research, such as dignity, trust, respect, and a commitment to redressing power and attending to forms of epistemic injustice, the guidelines respond to distinctive constraints of forensic environments while highlighting opportunities to promote authentic co-production and sustain patient involvement in research. Recommendations include dedicated resources and capacity-building for patients; relational, ongoing consent practices co-developed with patients; flexible patient researcher roles with fair, paid compensation; and sustained institutional support for participatory practices. We call on forensic hospitals and secure settings to adapt and evaluate these guidelines and to invest in expanding patient leadership to advance the field.
Vitamins A and D Help Improve Lung Function in People with Asthma
Having higher levels of vitamins A and D in the body could help improve lung function in adults with asthma, suggests research led by Brigham and Women’s Hospital in Boston.
The study, published in the journal Thorax, also showed that higher vitamin A levels could also benefit lung health in children with asthma.
“Vitamins A and D are key regulators of gene expression involved in lung development and immune function…Both vitamins have complex roles in asthma and lung function,” write lead author Michael McGeachie, PhD, assistant professor at Brigham and Women’s Hospital, and colleagues.
“Vitamin A deficiency is more common in people with asthma and is linked to airway hyperresponsiveness. Moderate intake in childhood may improve lung function and reduce asthma risk, whereas excessive intake may increase adult-onset asthma risk. Vitamin D deficiency is associated with poorer lung function, increased exacerbations and worse disease control, although results are variable due to diet, age and sun exposure.”
In this study, the researchers evaluated data from two asthma study cohorts—the Genetic Epidemiology of Asthma in Costa Rica Study including 1,165 children with asthma and the adult Omic Determinants of Longitudinal Lung Function in Asthma cohort including 1,041 adults with the condition.
The researchers looked at both circulating vitamin A and D in both groups and also looked at links with epigenetic regulation.
In children, there were no significant links between lung function and vitamin D levels. Higher vitamin A levels were linked to better breathing capacity though. For each step up in vitamin A levels, the amount of air the children could blow out in the first second was about 2.5 percentage points higher, and the total amount of air they could breathe out was about 7.6 percentage points higher.
In the adults, one step up in vitamin A levels was linked to a 4.7 unit increase in the amount of air they could blow out in the first second and a 3.4 unit increase in the total amount of air they could breathe out. The effect of vitamin D levels in this group was smaller, but statistically significant, with lung function improvements between 0.16-0.18 units per step up in vitamin D levels.
The researchers also looked at DNA methylation and at several epigenetic clocks that estimate a person’s biological age from methylation patterns in the adult cohort. They found that adults with higher vitamin A and vitamin D levels had fewer methylation tags at key control sites in the IRF5 gene than those with lower levels and showed changes in small regulatory micro RNAs that respond to vitamin levels. These epigenetic changes were linked to better lung function and slower biological aging.
The epigenetic tests suggest that vitamins influence lung function and aging partly by producing these epigenetic changes, rather than only through a direct effect, according to the researchers.
“While future studies to replicate these findings in independent populations are needed to confirm the generalizability and robustness of these observations,” write Sze Man Tse, MD, and Geneviève Mailhot, PhD, of the CHU Sainte-Justine Research Center, Montreal, and the University of Montreal in an accompanying editorial in the same journal, “subsequent interventional studies examining the impact of vitamin supplementation on biological ageing and on IRF5 function will be particularly relevant.”
The post Vitamins A and D Help Improve Lung Function in People with Asthma appeared first on Inside Precision Medicine.
Institutional Member Updates: Summer 2026
Institutional Members are clinics and programs in the US and around the globe that offer residential and/or intensive treatment for OCD and related disorders, are specialty outpatient clinics with a large staff dedicated to treating OCD, or provide low-cost treatment options through research studies.
Below are quarterly updates from our Institutional Members organized alphabetically. Click the (+) to open each menu and read updates and find contact information for clinics near you:
Do you work at a residential program, intensive outpatient program (ITP), or specialty outpatient clinic and looking to advertise your services? Learn more about becoming an Institutional Member and having your program updates included below!
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CCRM Ireland Would Be Established to Hasten Translation of Advanced Therapies Into Patient Treatments
Rinn Advanced Therapies, Ireland’s national research center for personalized immune cell therapies, signed a Memorandum of Understanding (MOU) with CCRM, which focuses on cell and gene therapy development and commercialization. The agreement outlines a strategic collaboration to explore establishing a CCRM-affiliated advanced therapies hub in Ireland.
The proposed initiative, referred to as CCRM Ireland, is designed to position Ireland as a key node within CCRM’s global network of advanced therapies hubs and further strengthen Ireland’s expertise in next-generation biomedicine. CCRM’s global network comprises CCRM in Canada, CCRM Australia, and CCRM Nordic in Sweden.
“The idea of collaborating with CCRM to establish CCRM Ireland is very attractive because of our shared commitment to improving patient outcomes,” said Sakis Mantalaris, PhD, director of Rinn Advanced Therapies. “By combining Rinn Advanced Therapies’ focus on novel personalized immune cell therapeutics with CCRM’s global platform, CCRM Ireland can accelerate the translation of cutting-edge science into accessible, high-quality treatments.”
Through this collaboration, Rinn Advanced Therapies will lead the evaluation of how Ireland’s integrated ecosystem—spanning academia, health care, biomanufacturing and research—can be aligned with CCRM’s model for accelerating the development of advanced therapies. The partnership will explore how to advance the design and clinical translation and delivery of personalized immune cell therapies, while also leveraging Ireland’s biopharmaceutical manufacturing skills.
CCRM Ireland would potentially support investment, venture creation and commercialization pathways, following CCRM Canada’s proven model.
“As cell and gene therapies move from scientific promise to clinical reality, no single organization, region or country can build this industry alone,” says Michael May, president and CEO, CCRM. “CCRM’s global hubs are designed to connect world-class research, manufacturing expertise, capital and talent into a coordinated network that accelerates the development and commercialization of advanced therapies.
By creating hubs around the world, and in the spirit of the Prime Minister of Canada’s call for middle-power countries to work together, with CCRM Ireland, we can help innovators overcome barriers to scale, strengthen local ecosystems and, most importantly, bring life-changing treatments to patients faster.”
Rinn Advanced Therapies brings together a network that includes universities, hospitals, and national organizations with a shared mission to develop and deliver personalized immune cell therapies that are more effective, accessible and affordable for patients.
CCRM will contribute its expertise in establishing and operating advanced therapies hubs, drawing on its experience in Canada and its growing international network. This includes proven frameworks in governance, GMP manufacturing, quality systems and commercialization.
The post CCRM Ireland Would Be Established to Hasten Translation of Advanced Therapies Into Patient Treatments appeared first on GEN – Genetic Engineering and Biotechnology News.
Heat waves mess with your brain. Scientists are trying to figure out why.
It’s been hot in London this week. Really hot. A dangerous heat wave has hit Western Europe. Yesterday, the UK recorded its highest ever June temperature at 36.1 °C (about 97 °F). But as the weather app on my phone confirmed, it felt like 39 °C.
It’s frightening that we are seeing such temperatures in the UK in June. According to the Met Office, the country’s national weather and climate service, June temperatures peaked at an average 19 °C (66 °F) in England between 1991 and 2020. Across Europe, the heat wave is likely to cause thousands of deaths. There will be other awful consequences for agriculture, infrastructure, and the health system.
But this week I want to look at what the heat does to our minds and brains. Personally, I’ve found it almost impossible to think straight. The heat is distracting and my mind is foggy. I dread to think about the conditions of people who work outdoors, in even hotter regions.
It’s not just exhaustion and confusion. The effects of heat on the brain can be deadly. And researchers are still trying to figure out why.
Studies have confirmed that as temperatures rise, people seem to get more irritable and more violent. Most of these studies are based on associations, though. It’s difficult to directly study how a heat wave might affect our thinking, says Catherine Thompson, a cognitive psychologist at Liverpool Hope University.
She has been studying the effects of extreme heat on firefighters instead. It’s easier to measure people’s cognitive skills before and after they undergo scheduled training that involves entering a burning building.
It’s early days, but the team found that firefighters found it harder to focus and control their attention immediately after heat exposure—something people in heat waves can empathize with, I’m sure.
The firefighters’ skills returned to normal after 20 minutes or so of cooling down. But they’d experienced just 15 minutes of intense heat exposure. Thompson doesn’t know what the effects of living through a days-long heat wave might be—or how long they’ll last. Figuring that out might involve shipping cognitive test kits to thousands of people during the few days’ notice of an impending heat wave. “My guess [is] that no one’s done it because it’s just so difficult to do,” says Thompson.
Still, researchers can learn about some of the impacts of heat waves through studies after the fact. And those studies suggest that the heat seems to have more disastrous outcomes for people with mental-health disorders.
Those outcomes become apparent when temperatures rise above what is considered typical for a given region. “There seems to be a correlation where the hotter it gets, especially during the hottest times of the year, the worse the mental-health outcomes,” says Joshua Wortzel, who directs the Heat-Mind Lab at Hartford HealthCare in Connecticut.
In a study published in 2023, Emma Lawrence at the University of Oxford, who studies the effect of climate change on mental health, and her colleagues reviewed the evidence linking mental-health outcomes to ambient outdoor temperatures. They found that during heat waves, there was a 9.7% increase in the rate of hospital admissions for people with such conditions.
“People who live with mental-health conditions are among the most susceptible to the physical impacts of heat,” says Lawrence. People with schizophrenia were found to have been three times more likely to die during the record-breaking heat wave that affected Canada in 2021, for example.
In order to protect people, we need a better understanding of the mechanisms underlying these effects. After all, a lot of things change when it’s very, very hot. Some people may end up stuck indoors, avoiding outdoor play and exercise, and it can be difficult to get a good night of sleep, for example. Sleep, socializing, and exercise are all really important for our mental health.
But whether unusual heat does something specific to our brains is, as Wortzel puts it, “the million-dollar question.”
Research in lab animals suggests that excessive heat can alter the way chemical signals work in our brain. The levels of neurotransmitters like serotonin, for example, seem to increase when rats and mice are exposed to high temperatures, according to multiple studies. The heat may also interfere with the way networks in our brains communicate with each other. It might affect the way oxygen reaches our brain cells.
“There are so many biological reasons why brains may be negatively affected by heat,” says Wortzel.
Emerging research suggests that for whatever reason, children and young people are among the most vulnerable. In research published earlier this week, Wortzel and his colleagues saw a 2.97% increase in the suicide rate among people in the US aged 15 to 24 for every 1 °C increase in average monthly temperature. That’s more than double the increase seen in people over the age of 24 (which is concerning in its own right).
Other work hints that heat exposure might have long-term consequences for children’s brain development. Babies who were exposed to either extreme heat or cold appeared to have altered white matter by the time they were nine to 12 years old—although it’s not clear how these impacts might affect an individual child.
“It seems that extreme temperature exposure for very young children may affect their brain development,” says Lawrence, who spoke to me from Oxford. She was meant to be in London for Climate Action Week, but her event, which focused on extreme heat, ended up being canceled … owing to the extreme heat.
We are living through the effects of climate change. And that brings a new urgency to the question of how heat affects our brains. Children born in 2020 are predicted to experience around seven times the number of heat waves their grandparents did, says Lawrance. “[We] need to be serious about adapting to a warming world.”
This article first appeared in The Checkup, MIT Technology Review’s weekly biotech newsletter. To receive it in your inbox every Thursday, and read articles like this first, sign up here.
Inside the world’s deepest and longest subsea road tunnel
It’s cold, it’s very, very noisy, and—if I can be quite honest with you—I’m not feeling super relaxed.
I’m currently around 300 meters, or 1,000 feet, beneath the North Sea, in a dark, dank cave. It smells weird. And I am increasingly aware of the pressure from millions of tons of seawater just above my head, pushing down with a force of more than 500 pounds per square inch. Picture a baby rhino standing on a postage stamp.
Only fabulous engineering is keeping me from being crushed, drowned, disappeared. My safety goggles are foggy.
Just a few hundred meters away, someone is about to blow up a giant rock wall. Luckily, earlier that day I was given a full safety briefing, and I’ve got a special hard hat on. “Don’t worry—if you don’t make it, we’ll have your stuff sent back to your office,” geologist Anne-Merete Gilje tells me, straight-faced. Ah, Norwegian humor.
“It’s kind of a lifestyle. You have to be a little bit crazy to work underground all the time.”
Niclas Brusehed, tunnel foreman, Implenia
I’m in this odd situation under the iconic fjords of Norway to visit what will soon become the world’s longest and deepest subsea road tunnel, called Rogfast (short for “Rogaland Fixed Link”). I want to understand how you make something as audacious as a 26.7-kilometer (16.6-mile) highway that sits 390 meters (1,280 feet) below the sea at its deepest point. And also—at a time when it can feel hard to get anything done, especially in the US—to reassure myself that ambitious engineering is still possible. That we can still make things.
The Norwegians already have the world’s longest subsea tunnel, the 14.4-kilometer Ryfylke, though Rogfast will dwarf it. Their expertise has attracted attention from Japan, Spain, Morocco, and even a number of US states, whose representatives were due to visit the site in May, just weeks after I went. They, too, want to know how Norway does it.
The answer: tons of explosives.
The entire endeavor feels like an obstinate refusal to give in to physics and geology. “It’s always exciting,” Niclas Brusehed, a tunnel foreman at Implenia, a Swiss firm involved in the project, tells me. “Every blast creates a new world.” There’s not just the blasting of the tunnel itself—although that is an epic project on its own—but an immense logistics challenge involving huge ventilation shafts, extreme pressure, underground roundabouts, and the complex Norwegian geology. Oh, and the water. So much water.
“This is the longest continuous blast on the sea,” says John Olaf Østerhus, assistant project manager at Implenia. “Never been done before. We can’t buy a book to see how we do this.”
All right, time to fish my phone out of my safety suit—don’t want to forget this.
On another planet
Arriving at the rock face where the tunnel hits seabed feels like being on the moon. It’s a huge slab of stone at the end of a long, dark, wet, wide passageway that’s lit (barely) by electric lights. Giant vehicles carting tons of rocks rumble past periodically, and we pull to the side of the road to let them by.
COURTESY OF NORWEGIAN PUBLIC ROADS ADMINISTRATION
Workers clock in for 12-hour shifts, 6 a.m. until 6 p.m., deep in the bowels of the Earth where no natural light can reach. Twelve days on, 16 days off. They eat their lunch at a table in this damp cave surrounded by portacabins plastered with safety notices. “It’s kind of a lifestyle,” says Brusehed, laughing. “You have to be a little bit crazy to work underground all the time.”
These crazy engineers are here to make tunnels the Norwegian way. The nation frequently uses what’s known as the drill-and-blast method instead of the tunnel-boring machines that are more typical elsewhere. This approach offers more flexibility for long, complex operations with varied rock types. Each blast adds about five to six meters to the tunnel.
Rogfast is being built inward from the ends to speed things up. The construction company Skanska is leading from the north, coming from the island of Vestre Bokn; Implenia has joined a company called Stangeland to tunnel from Randaberg in the south, which is where I am. Both teams use multiple laser scans each day to consistently measure their orientation and check that the tunnel is exactly where it should be. The two ends should meet sometime in 2029, with no more than just a few centimeters of deviation.
COURTESY OF NORWEGIAN PUBLIC ROADS ADMINISTRATION
Norway has constructed more than a thousand kilometers of tunnels over the past several decades. The depth and length of these make the best efforts to date of Elon Musk’s Boring Company—a mere 2.7-kilometer tunnel in Las Vegas that is just 3.6 meters wide—look rather pathetic. The country’s spectacular setting makes such builds necessary; while Norwegians are proud of having the second-longest coastline in the world after Canada, getting up and down the west coast requires multiple ferry rides between islands, which can move extra slowly when the weather’s bad.
After it’s completed, which is scheduled to happen in 2033, Rogfast should help eliminate two ferry routes and cut the five-hour journey between the southwestern cities of Stavanger and Bergen by 40 minutes. It will funnel four lanes of traffic deep beneath the fjords of Boknafjord and Kvitsøyfjord, and at one section a relatively scant 50 meters of rock will separate the drivers speeding through the tunnel from the bottom of the North Sea. There are also, delightfully, two undersea roundabouts located 220 meters below sea level.
But the first job is to contend with all that water.
The never-ending battle
Subsea tunneling is defined by a constant, ultimately unwinnable battle with the ocean. The sheer weight of the sea above you, and the crushing pressure, means the water will always find a way in. “It’s the volume and the pressure that’s the biggest risk,” says Ole Magne Rønning, project leader for Implenia/Stangeland.
So before tunnel engineers blow stuff up, they need to check for leaks. Into the rock face ahead of them, they drill a number of narrow holes that go 25 to 30 meters deep to see how much water comes through. Even a small probe can unleash a torrent within seconds, says Rønning. When road traffic eventually rumbles through these tubes, water will still trickle from the rocks; it will be redirected into mini reservoirs dotted throughout the tunnel network before being pumped back out.
Since stopping the water entirely is impossible, the game is instead to push it away as best you can. If the leakage in front of the rock face exceeds a certain limit—around four liters per hole per minute—then the next stage is “grouting”: pumping a mixture of cement-like sludge into new holes that fan out in the ceiling above and around the face. Ideally, you address the leaks that are ahead of you; “it’s a lot more difficult to stop a leak that’s behind you,” says Rønning.
At one point deep below the sea, I chat with Tarald Johan Nomeland, the project’s grouting specialist. He’s big and bearded, perhaps one of the most Norwegian-looking men I’ve ever met. He stands, towering above me, and shakes my hand in his giant bear-like paw. Grouting is in Nomeland’s family; his dad did it too. He loves it. “There’s not necessarily just one solution to a problem,” he says, eyes flashing with delight as he describes fighting the interminable battle with the water. “There may be many solutions.”
The amount of grouting needed determines how fast the project can move. On the Skanska side, for example, some weeks the face moves 30 meters; others, as few as 10.
This isn’t made any easier by the rock itself. The seabed around Norway was shaped by glaciers during the Ice Age. As the ice retreated, it dragged softer rock with it, carving out the fjords for which the nation is so famous. But this legacy makes digging subsea tunnels particularly gnarly. Much of what’s left is the hard, difficult-to-break stuff.
And it’s not just one type of rock, either. There are “big wide areas where we don’t know what’s down there,” says Gilje, the geologist who is a project manager for the Norwegian Public Roads Administration, which is in charge of the entire project. Before any construction started, boats took core samples from the seabed along the planned tunnel route. Seismic surveys from the ocean surface—like those that look for oil in the region—helped fill in the gaps.
Each kind of rock presents its own challenges, so the engineers “have different techniques for different problems,” Gilje explains. For example, they found that one southern section contains a lot of phyllite. Phyllite is considered “nice” to work with. It is formed from a combination of shale, siltstone, and mud over time and is pretty compact, with few cracks to let water through. Its compact nature means it requires more explosives per blast, however. It also contains a lot of quartz, which is toxic when released into the air during blasting. So workers wear monitors to measure their exposure, and a curtain of water sprayed in front of the rock face helps prevent too much from drifting into the tunnel.
The northernmost part of the route, meanwhile, is made mostly of solid granite and a similar rock called gneiss. Both are hard but contain fractures that allow the seawater to trickle through.
The rock type can also change over just a short distance. So during the dig, every 80 meters or so, an engineer sends sound waves through the face to expose its secrets and help evaluate its structural integrity. The rock is graded on a scale of 1 to 5, with 5 being the worst and least stable. “When you are reaching class 5, then it’s almost like soil. It’s not rock anymore,” says Rønning.
This investigation informs the kinds of structural supports each section will need—from steel rods that fan out above the rock face like an umbrella, for the strongest rock, to reinforced-concrete arches that hold up the weakest. To seal everything off, the team sprays a substance called “shotcrete,” liquid concrete mixed with reinforced-steel fibers, onto the walls throughout. A plastic membrane and concrete panels are fitted later.
“It’s going to be a very safe tunnel,” Gilje says. “It’s going to last for 100 years.”
Strange dangers
While I may not be brave, at least I don’t get seasick. Back at the surface, I board a small ferry that putters and sloshes its way from the mainland to Kvitsøy, a sparsely populated municipality made up of 365 separate islands and islets—something its 550 or so inhabitants are very proud of, even though most of these islands are uninhabited chunks of rock.
For the next few years, Kvitsøy’s population will experience a tiny boom as its largest island hosts a semipermanent encampment of contractors and engineers working on what is probably the most complex part of the Rogfast project: the giant ventilation shafts that will sit roughly halfway along the tunnel’s length to bring fresh air into the entire network, and remove the stale air in turn.
It’s also one of the reasons why road tunnels are much more complex than rail tunnels. Cars pump out fumes that have to be vented away. During construction, fresh air flows in via huge plastic tubes suspended from the ceiling, but eventually, Rogfast’s air will come in through two nine-meter-wide shafts that will bore down from Kvitsøy’s surface: one to bring it in, one to take it out.
COURTESY OF NORWEGIAN PUBLIC ROADS ADMINISTRATION
Creating these shafts is a wild process. First, narrow boreholes are drilled from the ground down into the tunnel 210 meters below the surface. A vertical drill rig is then pulled up through the hole from the bottom, widening the shaft to 2.4 meters as it ascends.
Then explosives are set off on the island’s surface, bashing down through the rock to widen the shaft. A large digger pushes the resulting debris down the narrower, not-yet-exploded length of shaft below, sending rocks barreling toward the tunnel at the bottom like socks tumbling down a laundry chute. Trucks haul away the fallen rocks. This process happens in stages, repeating at regular intervals, opening up the passage a bit deeper with each pass. Once it’s all done, steel rods are installed in the shaft’s walls to keep it secure.
Down below, I stand beneath one of the narrow guide holes for one of the two ventilation shafts. The ceiling soars overhead—a strangely beautiful cathedral, cragged and shadowed by lamplight.
Besides poisonous air, the epic nature of these engineering projects throws up other surprising dangers. For example, Rogfast will take about 30 minutes to drive through. It doesn’t seem that long, but the project’s designers worry that the monotonous environment may lull some drivers to sleep.
Engineers faced this problem with Ryfylke—which, as the current longest subsea road tunnel, has been a testing ground for its bigger sibling. It relieves the tedium with a large hall that opens up in the middle of the tunnel, lit by colored lights that change each day. When Rogfast is finished, artists will be invited to do something similar, using lights, colors, and shapes to keep drivers alert.
Then there are the environmental risks. What is there to do with all the loose rock created by the blasts? The engineers predict 8.5 million cubic meters’ worth. That’s enough to fill more than 2,500 Olympic-sized swimming pools. The solution is to bring it back to the surface, where it can be used to create new land. To do this, the project employs a giant barge designed to split open and dump 350 tons of rock in one go.
But adding more rock particles to the water can make it hard for fish to breathe, says Elizabeth Austdal Paulen, Implenia’s environment lead on the project and my fellow passenger on the windy (and soon to be redundant) ferry over to Kvitsøy. Her team monitors their levels in real time: If the particulate count is too high, the drops must pause until the new rock has settled on the seabed. The goal is to protect lobster fishing, a vital part of the local economy, and to safeguard the breeding time for cod, which was an issue when I visited.
Finally, of course, on top of all this are the many hazards for the people who are actually doing all this blasting and digging and hauling. Or, say, for the visitors who are finding their inner nine-year-old getting a little too giddy about what’s next.
Time to blow
Before I’m allowed underground, I must sit through a short safety briefing, where I learn there are multiple hazards when you’re that deep. Fires, for instance, can break out, exacerbated by the way the salt water affects electronics. Just a week earlier, a car caught fire somewhere deep within the network. “You have to be aware all the time,” says Anne Brit Moen, the project lead for Skanska. “It’s a very harsh, harsh climate.”
After the session, I’m given a hi-viz suit, the hard hat (which has built-in ear protectors), gloves, safety glasses, and reinforced boots. I get instructions on how to operate the oxygen mask that will be in the car with me, and a device to put in my pocket that will track my exact location on screens in the control room. The device also acts as a personal warning system: If it vibrates and a blue light appears, then a blast is imminent and I must get to safety; if it vibrates and glows red, umm, well, that’s bad news and it’s time to evacuate.
“If you’re the first to the rescue chamber, press the green button … close the hatch and sit down and be calm.”
Ketil Myklebost, project manager, Implenia
But let’s say I can’t—I’m too deep underground. Then there is a second, less fun option. I’m given instructions on how to access the rescue chambers. These metal boxes—about the size of a large van—can squeeze in around 16 people, and each contains chocolate, water, radio equipment, a defibrillator, and enough oxygen for 24 hours. I see them dotted throughout the tunnels as we drive through. Worst-case scenario, I’m supposed to get to the nearest one, sit tight, and hope to get rescued.
“If you’re the first to the rescue chamber, press the green button for 15 seconds to release pressure,” says Ketil Myklebost, a project manager at Implenia. “And then close the hatch and sit down and be calm.”
Calm, right. Okay.
In the hours before my visit, a huge drilling “jumbo” rig puts as many as 180 holes deep into the rock face. The number, angle, depth, and spacing of the holes is calculated in advance using software but finalized at the face—here, they’re almost six meters deep. At one point, I clamber up into the jumbo and inspect the pattern on its screen, matching it against what I can see on the huge rock face, which stands more than 12 meters tall and wide.
The holes have been stuffed with an explosive slurry. (Someone quips that if I get any on my clothes, I’ll be stopped at the airport as a terrorist. A Norwegian joke, again.) As I watch, workers in a kind of cherry picker fit each hole with a detonator and make sure they’re all connected to one another by wire, ready to be triggered remotely.
Then my personal safety device starts vibrating. When I take it out of my pocket, it’s blinking blue. Showtime.
How far back do I need to be? “It’s dangerous in this direction 500 to 600 meters, but if you’re around the corner you can be closer,” says Sveinung Brude, project manager for the Norwegian Public Roads Administration.
COURTESY OF NORWEGIAN PUBLIC ROADS ADMINISTRATION
I stand by the worker who will trigger the blast from what looks like a small briefcase with an antenna. Then he presses the button.
The shock wave hits me before I hear it. My chest vibrates. In the first few milliseconds, a propulsive thump briefly stuns my senses, followed immediately by a rolling, crumpled thunder.
Just a moment later—almost instantly, really—wind billows through the cavern. Rocks clatter as they crash off the walls. I try not to show any panic. (That was meant to sound like that, right?) A hush falls, and there’s just the tinkling of stones as they bounce and skip amid the rubble.
Dust rises into the air, and there is a strange smell.
Through my ear protection it sounds like the end of the world.
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The explosion itself is a beautiful choreography: Blasts are initiated one after another, starting from the center. In video footage, you can just about hear the sequential pitter-patter of the charges as they go off. (In person, it’s a bit more all-at-once and overwhelming.)
Rogfast has just crept another few meters closer to completion.
I find myself grinning. Maybe there’s something extremely primal about being near an explosion? I’m not sure. I look down at my hand, where I have my phone out, recording the intensity of the moment.
Except … I wasn’t recording. The stupid rubber safety gloves I’m wearing must have stopped the command from going through.
Oh no. Oh no.
A once-in-a-lifetime opportunity, and I, uh, blew it. “I WASN’T RECORDING!” I shriek.
“It’s better that way,” says Rønning, walking off into the gloom. “You’ll remember it.” How very Norwegian.
Health Care Providers’ Perspectives on a Hybrid Outpatient Stroke Telerehabilitation Program: Qualitative Implementation Study
Background: Although patient outcomes are improved by stroke rehabilitation, the suggested amount of therapy is rarely maintained. The COVID-19 pandemic aggravated this situation further due to disruptions in health care. One solution was the rapid and extensive transition to virtual care. A hybrid outpatient stroke telerehabilitation program (HOSTP) was introduced by St John’s Rehab—a tertiary rehabilitation hospital in Toronto, Ontario. The HOSTP integrated in-person and virtual care in an effort to alleviate long-standing obstacles that challenge stroke rehabilitation. Objective: This study explored health care providers’ (HCPs) experiences with the HOSTP and their perspectives on its implementation, quality, and impact to determine the modifications needed to optimize its delivery and sustainability. Methods: A qualitative implementation study was conducted, with semistructured interviews conducted among HCPs involved in the HOSTP. The interview guide was informed by the CFIR (Consolidated Framework for Implementation Research). In total, 14 HCPs were recruited and interviewed from St John’s Rehab outpatient program. Interview transcripts were analyzed using a 2-stage analytic approach involving inductive thematic analysis, followed by deductive categorization using CFIR. Results: Four main themes were identified across CFIR domains: (1) adaptability and flexibility of the hybrid care model (intervention characteristics), (2) alignment with patient needs and resources (outer setting), (3) the impact of organizational resources and infrastructure (inner setting), and (4) variability in provider confidence and perceptions of virtual care (characteristics of individuals). Key determinants were identified as adaptability, patient-related factors, resource availability, and provider beliefs about virtual care. Conclusions: Our findings suggest that, from HCPs’ viewpoints, optimizing virtual care processes and resources may support access and care quality within hybrid outpatient stroke rehabilitation. HCPs viewed maintaining virtual care as important for supporting ongoing access and patient-centered care. Lastly, optimizing the benefits and mitigating the drawbacks of hybrid care can ensure future integration of virtual care into standard outpatient stroke rehabilitation.
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Welcome to Our New IOCDF Advocates
The IOCDF is thrilled to announce our newest cohort of Advocate volunteers! We’re welcoming 13 incredible new Advocates to our program, bringing our total to 64 dedicated volunteers working together to create meaningful change for the OCD and related disorders community.
These passionate individuals join us from bustling cities and quiet rural towns across the United States and around the world. From California to Massachusetts, and from countries including Canada and Ireland, this mix of local and global perspectives ensures we can reach and represent diverse communities everywhere.
The Power of Diverse Voices
Our newest cohort has a wide range of experiences and interests. They are passionate about addressing critical topics including:
- Access to treatment
- Diversity, multicultural issues, and LGBTQIA+ inclusion
- Family issues and family accommodation
- Young adult mental health and academic challenges
- Public policy
- Research advancement
- Suicide prevention
- Nutrition, fitness, and anxiety in athletes
This diversity of focus areas ensures that we can better represent and serve the full spectrum of our community’s needs.
Meet the Spring 2026 Advocates:
- Dayna Altman
- Jessica Alvey
- Julia Angell
- Emily Devlin
- Madison Fankhanel
- Lily Goller
- Austin Kang
- Jin Luo
- Rose Nadershahi
- Kate Roscher
- Violet Talsma
- Jonathan Teller
- Crystal Weideman
You can see the full list of IOCDF advocates at iocdf.org/advocate-program
Your Voice Matters Too
Inspired by our Advocates? You can make a difference! Here are ways to start advocating today:
Fuel Our Mission Through Fundraising
Turn your passion into action by launching a personal fundraiser. Whether for a birthday, a race, or a creative project, you can rally your friends and family to raise critical funds. Every dollar helps build a world where everyone affected by OCD can thrive. Start your fundraiser here or explore all ways to give back here.
Advocate for policy change
Your voice can shape laws that improve access to care and insurance coverage. The IOCDF Public Policy Action Center makes it simple to find the latest bills and contact your elected officials with just a few clicks. True change starts here.
Join an IOCDF Special Interest Group
Connect with people who share your experiences or professional interests. IOCDF Special Interest Groups (SIGs) provide a platform for deeper discussion.
Whether you advocate on the national stage, share your story to fight stigma, or fundraise your way, every action creates a ripple effect of hope and understanding. Your journey, your voice, and your commitment are powerful tools.
Start today and help us build a world where everyone affected by OCD feels supported, seen, and empowered. Join a dedicated community committed to raising awareness.
Welcome again to our new IOCDF Advocates, we’re grateful to have you joining our mission!
The post Welcome to Our New IOCDF Advocates appeared first on International OCD Foundation.
Exposure to Moderate Air Pollution Raises Cardiovascular Disease Risk
Research from the University of Toronto shows long-term exposure to moderate air pollution increases a person’s risk of fatty build up in the blood vessels of the heart, which can lead to serious cardiovascular events like heart attack.
As reported in the journal Radiology, the study also showed that women were particularly badly affected and had an 81% increased risk for obstructive coronary artery disease if exposed to long-term air pollution.
“Even at exposure levels below current Canadian air quality standards, long-term air pollution was independently associated with more advanced coronary artery disease—suggesting current regulations may not be fully protective and that air pollution belongs alongside blood pressure, cholesterol and smoking as a modifiable cardiovascular risk factor,” said lead author Kate Hanneman, MD, associate professor at the University of Toronto, in a press statement.
The study included 11,128 people who underwent cardiac computed tomography (CT) scans who also had available data for air pollution exposure for around 10 years. The average age was 60 years and 52% were men.
In the cohort, median 10‑year exposures were 7.5 μg/m³ for PM2.5, a common measure of particulate air pollution and 13.4 ppb for nitrogen dioxide. These levels are relatively low compared with many historical and low‑/middle‑income settings but still above the latest World Health Organization guideline of 5 μg/m³ for PM2.5 and 5.3 ppb for nitrogen dioxide.
For each addition increment of PM2.5 (1 μg/m³) people in the study had had about 11% more calcium in their coronary arteries and 13% higher odds of having more atherosclerotic plaque. For each increment of nitrogen dioxide (1 ppb) small but measurable increases in calcium (aprx 1%) and plaque (about 4%) were seen in the coronary arteries of those exposed.
After taking into account age, risk factors, medicines, and other differences, each increment higher long‑term air pollution was linked to more severe, artery‑narrowing heart disease in women, but not in men. Each increment increase in PM2.5 was associated with an 80% higher chance of women having a dangerously narrowed coronary artery and each increase in nitrogen dioxide a 6% increased chance.
There was a similar trend in men, but it was not statistically significant after correcting for possible confounding factors.
“These findings add to the growing body of evidence identifying air pollution as a modifiable risk factor for atherosclerosis,” conclude the authors.
“Considering the epidemiologic data linking air pollution to cardiovascular events, these results reinforce the urgency of global public health initiatives aimed at improving air quality to reduce cardiovascular risk.”
The post Exposure to Moderate Air Pollution Raises Cardiovascular Disease Risk appeared first on Inside Precision Medicine.
New national action plan targets gaps at the intersection of mental health and criminal justice.
FOR IMMEDIATE RELEASE
OTTAWA, ON – The Mental Health Commission of Canada (the Commission) today released “Finding New Pathways: An action plan for criminal justice and mental health in Canada”. The plan provides an evidence-based roadmap to address systemic gaps in care, coordination, and community supports, recognizing the impact of mental health on the criminal justice system.
Many are working to improve outcomes but needs remain high and progress is uneven. This action plan is a practical pan-Canadian reference point that seeks to contribute to the mental health and wellbeing of all individuals who interact with the criminal justice and forensic mental health systems, including those who work within them.
Developed through a rigorous five-year process, the action plan was shaped by input from national subject matter experts, research, and the lived and living experiences of justice-involved individuals and system workers. The action plan comes at a critical time, as individuals experiencing mental health challenges currently comprise roughly three-quarters of all federally incarcerated people in Canada.
“Meaningful and sustainable transformation is within reach for Canada,” said Lili-Anna Pereša, President and CEO of the Mental Health Commission of Canada. “While these transformative changes cannot be implemented overnight or by one group alone, this action plan serves as a starting point. It centralizes evidence-based approaches designed to break the cycle of recidivism and prioritize prevention, diversion, end-to-end supports and continuity of care.” The action plan stands on three strategic pillars:
- Care, not criminalization: Ensuring all people in Canada have access to supports that help prevent involvement with the criminal justice system, and prioritizing diversion for those with mental illnesses.
- Care during criminal justice involvement: Providing access to high-quality, trauma-informed, and culturally safe health and social supports for those within the system.
- Care after criminal justice involvement: continuity of care and seamless integration into community-based mental health
and substance use services upon release.
“Finding New Pathways” identifies 68 specific recommendations across individual, community, institutional, systemic, and societal levels. It pays particular attention to priority populations, including people from First Nations, Inuit, and Métis, and African, Caribbean, and Black, and other equity-deserving groups who are currently overrepresented in the justice system and face distinct mental health needs.
The action plan further highlights the critical importance of supporting the psychological health and safety of workers within the criminal justice and forensic mental health systems, noting that public safety personnel are significantly more likely to experience symptoms consistent with mental disorders than the general population.
Howard Sapers, current executive director of the Canadian Civil Liberties Association, former Correctional Investigator of Canada, and project advisor for the action plan, emphasized the necessity of these reforms: “ or too long, Canada’s criminal justice system has been asked to shoulder responsibilities it was never designed to carry. The over representation of people with mental health needs in police encounters, courts, and correctional facilities is a predictable consequence of systemic gaps in care, coordination, and community supports. The Mental Health Commission of Canada’s National Action Plan offers something we have been missing for years: a coherent, evidence-based roadmap that prioritizes health, human rights, and dignity.”.
Media Contact:
For English requests, please contact Josie Sabatino at jsabatino@summa.ca; 250-649-6856.
For French requests, please contact Carlene Variyan, cvariyan@summa.ca; 613-601-7456.
About the Mental Health Commission of Canada
The Commission is a national organization committed to recognizing and contributing to a new and equitable relationship with First Peoples, with its head office located on the unceded traditional territory of the Algonquin Anishinaabe Nation in Ottawa.
As an independent, not-for-profit with charitable status, the Commission collaborates with leading experts and organizations nationally and internationally, including with people with lived and living experience, to develop national guidelines, standards and strategies, promote innovation and best practices, reduce stigma, increase mental health literacy, develop and deliver training through our Opening Minds division and support all levels of government to improve mental health outcomes for everyone living in Canada.
The post New national action plan targets gaps at the intersection of mental health and criminal justice. appeared first on Mental Health Commission of Canada.