Housing is a critical social determinant of health for migrant and refugee populations, with housing inequalities leading to significant health disparities. This study aimed to explore the perspectives of recently arrived migrants and refugees on potential solutions to address housing and related health inequities.

This qualitative study recruited thirty recently arrived migrants and refugees residing in Greater Western Sydney, Australia, using purposive and snowball sampling primarily through community organisations, settlement and migrant support services, and social media platforms. Participants completed semi-structured interviews, and an inductive approach to thematic analysis was employed to identify contextual patterns and themes.

Three major themes were identified: (1) Structural and policy reforms to address housing inequities, including simplifying rental processes, regulating rent control and tenant protections, and increasing affordable housing supply; (2) Integrated housing and health support systems for equitable outcomes, encompassing emergency housing support, financial subsidies, health-focused housing improvements, and integrated housing and mental health services; and (3) Community-based housing and social integration initiatives for health equity, involving settlement and housing literacy programs, and culturally tailored support and community engagement initiatives.

These findings highlight the importance of multisectoral solutions that combine systemic policy reforms, cross-sectoral service coordination, and community-driven initiatives to address the housing and health inequities experienced by recently arrived migrants and refugees. SO WHAT?: Embedding the lived experiences and priorities of these communities within housing and health strategies is essential for advancing health equity and improving outcomes for migrant and refugee populations.

We aimed to quantify inequalities in mental health service use in Australia and identify the sociodemographic, economic, and geographic factors associated with access.

We conducted a secondary analysis of the National Study of Mental Health and Wellbeing (NSMHWB, 2020-2022). We evaluated 12-month mental health service use before the survey among people who reported a mental disorder. We fitted multivariable logistic regression models adjusted for sociodemographic covariates and tested the joint (intersectional) effects of remoteness and socioeconomic area disadvantage on service use. Jackknife replicate weights accounted for the complex survey design.

The study included 15,893 respondents (weighted population: 19,828,348). Lifetime prevalence of any mental health disorder was 42.9% (95% CI = [42.5, 43.3]), and 21.5% (95% CI = [20.7, 22.3]) reported symptoms in the past 12 months. Among those with a 12-month disorder, 45.2% (95% CI = [39.9, 50.5]) had accessed care, and 16.5% (95% CI = [15.8, 17.2]) reported using digital or telephone services. Service use was higher in university graduates and residents of advantaged areas and lower in remote/outer regional residents and the most disadvantaged quintiles. Intersectional analysis revealed compounded inequities, with the lowest service use observed among socioeconomically disadvantaged populations in remote areas and the highest among advantaged major-city residents.

Substantial and intersecting inequalities exist in access to mental health services, with the lowest coverage among remote, socioeconomically disadvantaged, older, and male populations. Targeted, place-based strategies - including expanded outreach and tailored digital and community-based models - are needed to reduce unmet need and improve equity.

To achieve expert consensus on quality indicators for evaluating discharge planning processes in inpatient mental healthcare settings. This study is part of a larger multiphase project to develop an instrument to measure and evaluate the quality of discharge planning in mental healthcare.

A modified two-round Delphi study.

A province-wide multidisciplinary expert panel comprising nurses, social workers, occupational therapists and psychiatrists across Ontario, Canada completed two online survey rounds. Panel members assessed 79 preliminary indicators identified from a prior concept analysis and focus groups, rated the importance of each indicator and provided narrative feedback to support indicator refinement.

In Round 1, 37 panellists evaluated 79 quality indicators. Seventy-four indicators achieved the predefined consensus threshold; however, further review of panel feedback resulted in the removal, consolidation and refinement of indicators due to conceptual overlap, redundancy, or feasibility concerns. Thus, fifty-three indicators were retained following Round 1. In Round 2, 36 panellists reviewed the revised indicator set and evaluated three new candidate indicators. Two additional indicators achieved consensus and one indicator was reinstated, resulting in a final set of 56 indicators across seven domains: Comprehensive Needs Assessment (n = 14), Information Gathering and Synthesis (n = 3), Patient Capacity Assessment (n = 4), Collaborative, Patient-Centred Care (n = 14), Resource Availability Management (n = 5), Care and Service Coordination (n = 7) and Discharge Plan (n = 9).

A multidisciplinary expert panel reached consensus on 56 quality indicators evaluating discharge planning processes in inpatient mental healthcare settings. The findings provide an evidence-informed foundation for future development and testing of measurement approaches to evaluate discharge planning quality in mental healthcare.

The discharge planning domains and quality indicators identified in this study may support future efforts to evaluate discharge planning processes, identify gaps in care and inform quality improvement initiatives aimed at supporting continuity of care and transitions from hospital to community settings.

This study addresses the lack of standardized quality indicators for evaluating discharge planning processes in inpatient mental healthcare settings. Through a two-round Delphi process, a multidisciplinary expert panel reached consensus on 56 indicators reflecting core components of discharge planning, including comprehensive needs assessment, patient capacity evaluation, coordination of community services and supports, housing-related planning and follow-up care. The study findings provide a foundation for future development and psychometric evaluation of a standardized measurement instrument to assess discharge planning quality.

This study is reported in accordance with the Guidance on Conducting and Reporting Delphi Studies (CREDES) recommendations.

No patient or public contribution.

Workplace health promotion (WHP) plays an important role in improving employees' health and well-being and promoting health communication in the industry. However, current health promotion activities for miners achieve limited outcomes, owing to the overlook of the cultivation of miners' autonomy, and the role of the supportive work environment. This study addressed this research gap following a multistep method. First, a comprehensive qualitative method based on intervention mapping was applied to determine the stakeholders, barriers, and facilitators in promoting miners' internal health locus of control. Second, social network analysis was employed to analyze the connectivity between stakeholders' behavioral strategies and identify the key strategies which have the most significant influencing effect in the network. Last, combined with system dynamics modeling, a four-party dynamic evolutionary game model was constructed and simulated to analyze the asymptotic stability conditions of stakeholders' behavioral strategies and explore the impact of the changes in the key strategies on miners' strategic choices. As a result, among 47 items of stakeholders' behavioral strategies, strategies such as mine managers' commitment to safety and health, team leaders' tangible and intangible support, and health managers' organization of mental intervention programs, were identified as the key to WHP solutions' successful implementation. Sufficient enforcement of these significant strategies could increase the probability of miners actively participating in WHP programs. Overall, this study developed health promotion solutions aimed at promoting miners' health self-management, with the perspectives of all stakeholders involved, which contributes to improved workplace health practices in mines.

In South Africa, which has the world's highest prevalence of HIV, intimate partner violence (IPV) and common mental health conditions are barriers to retention in HIV treatment and achieving viral suppression. The Common Elements Treatment Approach (CETA), a cognitive-behavioural-therapy-based intervention designed for lay healthcare worker delivery, is effective in reducing mental and behavioural health problems but has not been trialled for effectiveness in improving HIV outcomes. We conducted a randomized control trial to evaluate the effectiveness of CETA in improving HIV treatment outcomes among women experiencing IPV in South Africa.

This was a single-blind trial conducted among women living with HIV on antiretroviral therapy (ART) who experienced sexual and/or physical IPV in the last 12 months and had either an unsuppressed viral load or were at risk for poor medication adherence in the past year (e.g. defaulted on treatment, late or missed clinic visit). Women were randomized 1:1 to receive either 8-12 CETA counselling sessions or weekly safety text messages. The primary outcome was viral suppression (≤50 copies/mL) (which requires retention) at 12 months after baseline, which was evaluated using routinely collected medical records. A linear regression model was estimated to calculate risk differences and 95% confidence intervals (CI).

Participants were enrolled from 11 November 2021 to 19 July 2023, with 202 women randomized to CETA and 197 randomized to the control arm. Median age was 41.0 years (interquartile range [IQR]: 34.0, 47.0) with a median time on ART of 8.2 years (IQR: 4.3, 12.5). Receiving CETA was associated with a 1-percentage point (95% CI: -0.11, 0.09) decrease in retention and viral suppression compared to the control. When restricted to individuals who completed CETA (N = 144) compared to all controls, we observed a 7-percentage point (95% CI: -0.03, 0.18) increase in retention and viral suppression.

Our estimates suggest overall there was no meaningful difference in retention and viral suppression at 12 months between individuals who received CETA compared to individuals who received the active safety control. Future work should seek to determine if CETA can be effective among those who complete the intervention.

Fibrodysplasia ossificans progressiva (FOP) is a rare genetic disorder characterised by progressive heterotopic ossification of soft tissues due to mutations in the ACVR1 gene, leading to dysregulated bone morphogenetic protein signalling. Over time, recurrent episodes of painful inflammatory soft tissue swellings (flare-ups) lead to progressive ossification and eventual ankylosis of joints, resulting in severe restriction of mobility. Most patients become wheelchair-bound by the third decade and may succumb to complications such as thoracic insufficiency syndrome and cardiorespiratory compromise. Due to its rarity and lack of awareness, FOP is often misdiagnosed, and patients may undergo unnecessary invasive procedures such as biopsies or surgical excisions, which can precipitate rapid disease progression. Early recognition based on clinical and radiological findings is therefore critical to prevent iatrogenic harm. We present a rare case of a six-year-old girl with this condition, emphasising the diagnostic challenges and key imaging findings.

Early detection of first-episode psychosis (FEP) is critical for improving long-term outcomes. Training healthcare professionals to identify and intervene at the earliest stages is a key strategy for reducing the duration of untreated psychosis (DUP).

To describe a capacity-building programme, based on a 'Training of Trainers' (ToT) model designed to empower healthcare professionals to become multipliers of knowledge on early FEP detection within their communities.

A 72-h blended learning course using problem-based learning (PBL) was delivered to 47 healthcare professionals to build competencies in FEP identification and referral.

The 47 participants reported an increase in self-perceived confidence in identifying FEP symptoms. Participant satisfaction was high, with an average score of 9.0 out of 10.

The ToT model is a feasible and well-received strategy for training professionals in early FEP detection. Empowering professionals as educators is a critical step to strengthen community mental health and improve access to treatment.

ObjectiveMany older adults stop seeing a doctor despite having insurance and significant health needs. This study asks whether psychological distress predicts disengagement from care, beyond structural barriers.MethodUsing three waves of the Health and Retirement Study (N = 5,184 adults 65+), we model whether distress in one wave predicts no medical contact in the next, testing whether wealth weakens this link.ResultsOlder adults with more psychological distress were significantly more likely to disengage from care, even accounting for demographics, resources, and health needs. This link was stronger among those with less wealth, suggesting money helps buffer the effects of psychological strain. The pattern held even when looking at change within the same person over time.ConclusionPsychological distress independently predicts disengagement from care, and this effect is stronger among financially disadvantaged older adults. Mental health screening in primary care could help reduce disengagement in this group.

Modern healthcare systems are experiencing a rapid state of change, and it is evidence-based practice (EBP) that is playing a key role in ensuring safe and quality patient care. While EBP has been correlated with favorable patient outcomes, its predictive association with the quality of nursing work life (QNWL) has not been explored, especially in the Middle East region like Jordan.

This study evaluated EBP knowledge, attitudes, practices, and barriers among Jordanian nurses and factors that predict QNWL.

Descriptive, correlational, and cross-sectional research designs have been used. A convenience sample of 198 nurses in five Jordanian hospitals was completed in EBPQ, EBP Barriers Scale, and Brooks' QNWL Scale.

Participants (mean age 29.99; 58.1% female) reported a moderate level of EBP (M = 111.30) or QNWL (M = 153.45). Organizational issues were the greatest challenge to EBP implementation. Higher levels of QNWL had significant relationships with being female, having a bachelor's degree, and working in private hospitals. Of interest, EBP knowledge was one of the predictors of QNWL, followed by educational level.

Findings indicate that strengthening the knowledge of nurses on EBP can improve QNWL. Structured skill-based EBP training and skills development through mentorship should be given priority. Managers should encourage conducive environments with time and resource protection. Policymakers should make EBP competencies part of continuing professional development as well as licensure standards. Future studies should use longitudinal and intervention designs to investigate mechanisms of causal influence and test EBP-oriented workforce strategies.

Community violence exposure (CVE) is a pervasive risk to youth mental health, yet developmental research examining protective factors in Latin America remains scarce. This cross-sectional investigation examined CVE and psychological symptoms among early adolescents (N = 346) and young adults (N = 499) living in a chronically violent region of Michoacán, Mexico. Participants completed validated measures of witnessing violence, personal victimization, school belonging, depressive symptoms, and posttraumatic stress symptoms (PTSS). Results indicated that CVE was widespread in both age groups and consistently associated with elevated depressive symptoms and PTSS. Notably, developmentally distinct moderation patterns emerged. Among early adolescents, higher school belonging intensified the associations between CVE and depressive symptoms, consistent with a vulnerable-reactive pattern. In contrast, school belonging buffered the association between CVE and PTSS among young adults. These findings suggest that the function of school belonging may differ by developmental stage, operating as a source of potential ecological sensitivity in early adolescence and as a resilience resource in young adulthood. Results underscore the importance of developmentally tailored supports for youth navigating chronic violence in the Global South.