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Background The primary objective is to test the effectiveness of a novel online quality of life (QoL) intervention tailored for people with late stage (≥ 10 episodes) bipolar disorder (BD) compared with psychoeducation. Relative to early stage individuals, this late stage group may not benefit as much from existing psychosocial treatments. Methods An NH&MRC funded international RCT to compare the effectiveness of two 5-week adjunctive online self-management interventions: Mindfulness for Bipolar 2.0 and an active control (Psychoeducation for Bipolar). A total of 300 participants were recruited primarily via social media channels. Evaluations occurred at pre- and post- treatment, and at 3- and 6- months follow-up. A secondary outcome measure was BD-related symptoms (depression). A longitudinal analysis was conducted using random effects mixed models. Results Preliminary results suggest no change in mean QIDS_total over time (p = 0.891). Nor does there appear to be a difference in groups (B coeff= 0.47, 95%CI (-0.60, 1.55), p = 0.613) and no difference in intervention groups over time (p = 0.828). Conclusions The effectiveness of a novel QoL focused, mindfulness based, online guided self-help intervention for late stage BD does not appear to have been any more effective than a psychoeducation intervention for reducing depression. Key messages There may be no significant benefit from using a mindfulness based, online guided self-help intervention over a psychoeducation intervention to reduce the BD symptoms of depression in late stage Bipolar disorder.

Background Migrants may be more likely to experience occupational health inequities (OHIs) than native-born workers due to higher occupational exposure, higher vulnerability to exposure-associated health impacts, or both. This study explores migrant status-related differences in vulnerability to job stressor exposures in terms of mental health in Australia. Methods Data were from wave 14 of the Household Income and Labour Dynamics in Australia Survey. Migrant status was defined by country of birth (COB), the dominant language of COB, and the years since arrival in Australia. Job stressors included skill discretion, decision authority, and job insecurity. Mental health was assessed using the Mental Health Inventory-5 score (MHI-5). Data were analysed using linear regression, adjusting for gender, age, and education. Migrant status was analysed as the effect modifier of job stressor—mental health relationships. Results As expected, skill discretion and decision authority were positively, while job insecurity was negatively associated with the MHI-5 score. However, there was no statistical evidence of migrant status acting as an effect modifier of job stressor—mental health relationships even though the dominant language of COB and years since arrival in Australia have been taken into account. Conclusions The magnitudes of job stressor—mental health relationships do not differ between migrant workers and Australia-born workers. Key messages Differential exposure rather than differential vulnerability is a more important mechanism for generating occupational mental health inequities between migrants and Australian-born workers. Reducing job stressor exposures could reduce the OHIs among migrant workers in Australia.

Background Noncommunicable diseases (NCDs) are a growing global health challenge disproportionately impacting low- and middle-income settings, including Ethiopia. Currently, the body of evidence describing the burden of NCDs is fragmented, inconsistent, health facility- or institution-based, and out-dated in Ethiopia. We conducted a systematic review of the literature and meta-analysis of the prevalence of NCDs in community settings in Ethiopia. Review methodology Community-based quantitative studies published in English between 2012 and July 2020 that reported the prevalence of NCDs in Ethiopia were included. A systematic search of Medline, Embase, Scopus, CINHAL, and Global Health using pretested search terms related to NCDs was conducted, and data were extracted using a piloted data extraction proforma adapted from the Joanna Briggs Institute tool. Meta-analysis was performed using Stata 16. We measured the overall NCD prevalence using pooled odds ratios with 95% CIs. Pooled NCD prevalence was also computed and presented using forest plots. I2 was used to assess heterogeneity. Studies that did not fulfil the criteria for meta-analysis were narratively synthesised. Results Nineteen studies met the inclusion criteria. Four studies measured the prevalence of NCDs (all NCDs together), ranging from 29% to 35% (prevalence estimates not pooled). The pooled prevalence of Diabetes Mellites (DM) across ten studies was 5% (95% CI:4%−7%). Three studies each reported on the prevalence of undiagnosed DM (pooled prevalence 8%, 95% CI: 2%−14%) and pre-DM (pooled prevalence 12%, 95% CI:3%−21%). In a narrative analysis the prevalence of cardiovascular conditions ranged from 13.4% to 32.2% (n = 3 studies), cancer mortality ranged from 4% to 18% (n = 3 studies) and respiratory conditions ranged from 1% to 18% (n = 3 studies). Conclusion and recommendations Our analysis found that approximately one-third of Ethiopians have an NCD, with cardiovascular diseases the most common of all NCDs. The prevalence of respiratory conditions also appears high, but there are insufficient data for a pooled estimate. Whilst the prevalence of DM appears relatively low, there is evidence that the magnitude is increasing. Public health actions to address the high burden of cardiovascular and respiratory diseases, as well as the increasing magnitude of DM in Ethiopia, must be prioritised. Keywords: NCD, noncommunicable diseases, Ethiopia.