A rapidly aging population along with the increasing burden of patients with chronic conditions in Asia requires efficient health systems with integrated care. Although some efforts to integrate primary care and hospital care in Asia are underway, overall care delivery remains fragmented and diverse, eg, in terms of medical electronic record sharing and availability, patient registries, and empowerment of primary health care providers to handle chronic illnesses. The primary care sector requires more robust and effective initiatives targeted at specific diseases, particularly chronic conditions such as diabetes, hypertension, depression, and dementia. This can be achieved through integrated care – a health care model of collaborative care provision. For successful implementation of integrated care policy, key stakeholders need a thorough understanding of the high-risk patient population and relevant resources to tackle the imminent population demographic shift due to the extremely rapid rate of increase in the aging population in Asia.

This study examined aspects of clinicians' work environment that facilitated sustained use of prolonged exposure (PE) therapy. Surveys were completed by 566 U.S. Department of Veterans Affairs clinicians 6 and 18 months after intensive training in PE. The number of patients treated with PE at 18 months (reach) was modeled as a function of clinician demographics, clinician beliefs about PE, and work context factors. There were 342 clinicians (60.4%) who used PE at 6 and 18 months after training, 58 (10.2%) who used PE at 18 but not 6 months, 95 (16.7%) who used PE at 6 but not 18 months, and 71 (12.5%) who never adopted PE. Median reach was 12% of clinicians' appointments with patients with posttraumatic stress disorder. Reach was predicted by flow of interested patients (incident response ratio [IRR] = 1.21 to 1.51), PE's perceived effectiveness (IRR = 1.04 to 1.31), working in a PTSD specialty clinic (IRR = 1.06 to 1.26), seeing more patients weekly (IRR = 1.04 to 1.25), and seeing fewer patients in groups (IRR = 0.83 to 0.99). Most clinicians trained in PE sustained use of the treatment, but on a limited basis. Strategies to increase reach of PE should address organizational barriers and patient engagement.

There is a growing debate on the linkage between social networking platforms and mental health disorder, such as depressive behaviour or depression. However, the relationship between Instagram use and depression or depressive behaviour has not been exhaustively examined. This review aims to examine these two variables. Only peer-reviewed journal articles that are published between October 2010 and December 2018 were sought in central and journal databases. Studies were selected based on predefined criteria and assessed for risk of bias and quality of evidence using GRADE. One thousand eight hundred fifty-six studies were the outcome of the search, out of which 9 meets all eligible criteria. Of the 9 studies, three-quarter was published between 2017 and 2018, covering five continents: (North America: 3; Asia: 2; Australia: 2; South America: 1, Europe: 1). The final included studies broadly examined young Instagram users between the age of 19 and 35. The synthesis affirmed a linkage between Instagram and symptoms of depression or depressive behaviour. Variables that moderate this relationship are social comparison, self-esteem built on validation and approval of others, social media dependence, gender, negative or insufficient feedback, poor self-rated attractiveness, Instagram broadcasting and loneliness, younger users and risk of anxiety, and the number of strangers that users follow. There is a strong relationship between Instagram use and mental health disorders such as depression or depressive behaviour; however, no in-depth direct causality is proven yet. Further studies are needed to unravel the direct causality puzzles.

There is a growing debate on the linkage between social networking platforms and mental health disorder, such as depressive behaviour or depression. However, the relationship between Instagram use and depression or depressive behaviour has not been exhaustively examined. This review aims to examine these two variables. Only peer-reviewed journal articles that are published between October 2010 and December 2018 were sought in central and journal databases. Studies were selected based on predefined criteria and assessed for risk of bias and quality of evidence using GRADE. 1,856 studies were the outcome of the search, out of which 9 meets all eligible criteria. Of the 9 studies, three-quarter was published between 2017 and 2018, covering five continents: (North America: 3; Asia: 2; Australia: 2; South America: 1, Europe: 1). The final included studies broadly examined young Instagram users between the age of 19 and 35. The synthesis affirmed a linkage between Instagram and symptoms of depression or depressive behaviour. Variables that moderate this relationship are social comparison, self-esteem built on validation and approval of others, social media dependence, gender, negative or insufficient feedback, poor self-rated attractiveness, Instagram broadcasting and loneliness, younger users and risk of anxiety, and the number of strangers that users follow. There is a strong relationship between Instagram use and mental health disorders such as depression or depressive behaviour; however, no in-depth direct causality is proven yet. Further studies are needed to unravel the direct causality puzzles.