Epilepsy surgery is an effective but underutilized treatment for drug-resistant epilepsy, and concerns about postsurgical cognitive change are a prominent barrier. Refinements in surgical technique can reduce cognitive impact, but cognitive change cannot always be avoided, and approaches carrying lower cognitive risk are often less effective for seizure control. Cognitive change therefore needs to be addressed directly rather than minimized through surgical strategy alone. This article proposes cognitive prehabilitation, a structured presurgical intervention combining individualized risk-benefit education, compensatory strategy training, and recovery planning, as a potential advancement in presurgical care. A central conceptual shift is reframing potential postsurgical cognitive decline from an outcome to be feared to a cost that patients can prepare for, adapt to, and weigh against the benefits of seizure freedom. The literature specific to cognitive prehabilitation in epilepsy surgery is too limited to support systematic review; thus, we draw on adjacent evidence bases, including cognitive rehabilitation in epilepsy, prehabilitation in other surgical populations, and literatures on shared decision-making and risk communication, to outline complementary frameworks. We detail theoretical components of cognitive prehabilitation, including risk communication and expectation setting, cognitive compensatory training, attention to mental and physical wellbeing, planning for postsurgical recovery, and peer support. Clinical and structural barriers to implementation are discussed, including patient engagement challenges and healthcare constraints. Priorities for future research include standardization of prehabilitation protocols, identification of patient-level moderators of benefit, and scalable delivery formats. Cognitive prehabilitation represents an opportunity to move toward empowerment-based presurgical care and to expand access to epilepsy surgery. PLAIN LANGUAGE SUMMARY: Many people with drug-resistant epilepsy avoid surgery because of the risks associated with declines in memory and thinking. This article describes the concept of cognitive prehabilitation, which is a presurgical program that gives patients personalized information about what may change with surgery, teaches practical strategies for managing memory and thinking difficulties should they arise, and helps them plan for recovery. The aim is for patients to prepare for possible memory and thinking changes rather than simply fear them. Research is still early, and studies are needed to test whether prehabilitation improves outcomes.

Work participation is associated with improved health and wellbeing. Vocational rehabilitation (VR) programs support individuals, including those with mental health problems, in obtaining and maintaining employment. Integrating mental health and work support in VR is considered more effective but requires cross-sector collaboration. In a Dutch region, multiple stakeholders jointly implemented a collaborative initiative, covering the access route to and the delivery of three VR interventions. This study evaluated the implementation process, outcomes, and working mechanisms of this collaborative initiative.

We conducted a mixed-methods process evaluation, including 37 interviews with 12 clients, 14 professionals, and 11 managers/directors, supplemented by field notes and documents over a 3-year period. Monitoring data included intervention start and end dates, participation ladder (PL) level, and registered outcomes (i.e., paid employment or voluntary work). Data were analysed using the UK MRC guidelines for process evaluations, covering implementation outcomes (according to Proctor), mechanisms of impact, context, and both intended and unintended outcomes.

Between January 2021 and December 2023, 129 clients were reached. Recruitment was challenging. Referral was hindered by external professionals' limited awareness, knowledge, and belief in clients' potential. Mean duration (dose) of the intervention lasted or exceeded the original setup, aligning with client perceived needs. Monitoring fidelity ranged from 100% at the start to 89% at 12 months, indicating fair to good fidelity. Clients valued informal conversations equally or more than the structured monitoring conversations. Trust between clients and professionals enhanced the intervention experience and perceived effectiveness. From 111 out of 129 participants their outcomes were monitored: 62 (56%) entered voluntary or paid work, after participation in the intervention. Key collaborative mechanisms were mutual trust among professionals and belief in the added value of collaboration. Contextual factors included economic-financial, political-financial, and socio-psychological factors: Governmental support and the meaningfulness of work were facilitating factors, whereas barriers included legislation and stigma, including low expectations regarding the capabilities of individuals with mental health problems.

Professionals' knowledge and awareness of VR interventions, alongside stigma and existing legislation influenced whether individuals with mental health issues were reached for an intervention that best fits their needs. This may lead to practice variation and unequal opportunities. Clients appreciated the multifaceted support and felt they had more choices although intervention choice was usually directed by professionals. During interventions delivery both clients and professionals valued cross-sector collaboration. Trust between client and professional and among professionals was found to be a crucial mechanism for the collaborative initiative, clients progress and VR intervention success.

Cognitive theories posit that interpretation biases (IBs), the tendency to interpret emotionally ambiguous information negatively, contribute to the development and maintenance of depression. While adult meta-analyses report a moderate association between IBs and depression, evidence in populations under 18 remains inconsistent. Therefore, this systematic review and meta-analysis aimed to (1) estimate the first overall cross-sectional effect size between IBs and child and youth depression and to summarize (2) longitudinal and (3) experimental findings from randomized controlled studies. Eligible studies included healthy and depressed participants (including comorbid conditions) younger than 18, assessed depression and IBs, and were published in English with full-text availability. A literature search in PubMed, Web of Science, PsycInfo and ProQuest Dissertations in March 2025 identified 30 eligible studies. Risk of bias was assessed using the RoB2 tool for randomized studies and an adapted Downs and Black checklist for non-randomized studies. Overall study quality was acceptable, albeit with variability (M = 67.75%, SD = 12.1). A random-effects meta-analysis of 22 cross-sectional effect sizes (N = 4763) yielded a moderate overall correlation (r = .34, 95%-CI = [.27; .42], p < .001), similar to adult findings when accounting for methodological differences. Limited longitudinal (4 studies, N = 616) and experimental evidence (3 studies, N = 239) highlight the need for further research. Included studies only examined participants aged above 7 with largely low depressive symptoms, limiting generalizability. Future research should therefore examine younger and more severely depressed populations and employ validated measures of IBs in children to better characterize developmental trajectories. Prospero Registration: ID CRD420250655580.

The balanced affect model of clergy work-related psychological wellbeing operationalised in the Francis Burnout Inventory (FBI) maintains that professional burnout is predicted by the interaction between negative affect (emotional exhaustion) and positive affect (professional satisfaction). In order to locate negative affect and positive affect alongside one another, a five-fold typology was created using scores from 505 ministers in the Church of Scotland on the two scales of the FBI, the Satisfaction in Ministry Scale (SIMS) and the Scale of Emotional Exhaustion in Ministry (SEEM). The five types were characterised as Creaking (high SEEM and low SIMS scores), Coasting (low SEEM and low SIMS scores), Central (average SEEM and average SIMS scores), Compensating (high SEEM and high SIMS scores), and Cruising (low SEEM and high SIMS scores). The construct validity of this five-fold typology was demonstrated by comparing scores on three measures of the hypothesised consequences of burnout: the Warwick Edinburgh Mental Well-Being Scale, the Purpose in Life Scale, and the frequency of thinking about leaving ministry. On these measures, Creaking types showed the greatest evidence of burnout and Cruising types the least, with other types falling between these two groups. Subsequently, mean and standard deviations scores from the combined data from 8 surveys totalling 4658 clergy were used to indicate cut-off points for this five-fold typology to be employed in future studies.

Delirium is a common and severe complication of sepsis in critically ill patients and is associated with increased mortality and prolonged hospitalization. Early identification of high-risk individuals remains challenging, particularly among non-mechanically ventilated patients who are less frequently represented in prediction studies. Using routinely collected electronic health record data, we performed a retrospective multicenter study to establish and validate an early prediction model for delirium in non-mechanically ventilated adults with sepsis. Patients from the MIMIC-IV database were used for model development, and an independent cohort from the eICU Collaborative Research Database was used for exploratory external assessment. A total of 3,015 patients in the development cohort and 1,119 patients in the exploratory test cohort were included. Among the evaluated algorithms, XGBoost achieved the best discrimination, with an area under the receiver operating characteristic curve of 0.807 in internal validation. The eICU cohort contained only 10 delirium cases (incidence < 1%), forming a sparse-event dataset; although the XGBoost model yielded an AUC of 0.833 in this cohort, the calibration and decision curve analysis results should be interpreted with extreme caution due to limited positive events. Lower Glasgow Coma Scale scores, higher illness-severity indices, exposure to sedative or analgesic agents, and metabolic disturbances such as elevated anion gap and abnormalities in hematocrit and calcium were the strongest contributors to prediction. These predictors align with recognized features of sepsis-associated brain dysfunction. This externally validated model may support early risk stratification and targeted preventive strategies in this vulnerable population.

Clinical reasoning is often studied as if it occurred inside the clinician's head. Yet, in practice, clinicians think, decide and act through constant interaction with patients, colleagues, technologies, routines and local constraints. This article challenges predominantly individual and decontextualised accounts of clinical reasoning and reframes reasoning as a situated socio-cognitive practice. We aim to show how explicit and tacit knowledge interact with the social, material and organizational environments in which clinical practice unfolds.

We develop a conceptual synthesis drawing on research in clinical reasoning, situated and distributed cognition, ecological psychology, workplace learning and knowledge translation. Tacit knowledge, particularly know-how and know-who, is used as a bridge between individual cognitive processes and the healthcare ecosystem. Distributed cognition, affordances, communities of practice and mindlines are mobilised as complementary analytical lenses.

This synthesis conceptualises clinical reasoning as an emergent capability arising from interactions among Self, Others and Context. Expertise depends not only on what clinicians know, but also on their ability to perceive what matters, mobilise the right resources, judge whom to trust, and adapt action to the situation at hand. This perspective helps explain why expert performance may deteriorate across unfamiliar settings and why artificial intelligence should be understood not as a substitute for reasoning, but as a cognitive artefact whose value depends on clinicians' capacity to critically interpret and contextualise its outputs. It also highlights the importance of authentic participation, cognitive apprenticeship and socially supported reflection in developing clinical expertise.

Clinical reasoning is neither an isolated mental process nor a simple response to context. It is an accomplishment distributed across clinicians, other people, artefacts and environments. Reframing it in this way shifts attention from how clinicians think in isolation to how reasoning actually works in practice, with important implications for clinical work, education, artificial intelligence and research.

Modern medicine has traditionally emphasised certainty, which may contribute to intolerance of uncertainty, physician burnout, and premature diagnostic closure. In recent years, the concept of 'Negative Capability' (NC) has emerged as a novel perspective to address this challenge.

This study aimed to explore the perspectives of general practitioners (GPs) on the multi-layered roles of NC across individual cognition, the physician-patient relationship, and team dynamics, thereby developing a conceptual framework for clinical practice.

We conducted a qualitative study using a hermeneutic phenomenological approach in Japan. Focus group interviews were held with a total of 12 participant-sessions (comprising 11 unique general practitioners and an academic philosopher specialising in NC, including one clinician who participated iteratively across sessions to enrich data depth). The verbatim data were analysed manually using the Steps for Coding and Theorisation (SCAT) method, ensuring credibility through continuous peer debriefing and member checking.

Clinical NC was conceptualised as five interconnected layers: (1) structural limitations of the medical paradigm, (2) individual transformation, (3) cultivation within a secure base, (4) joint engagement with uncertainty, and (5) inheritance of clinical philosophy. NC functions as an internal 'mental cane' for physicians, supporting a shift from managing uncertainty to remaining with it.

This perspective reframes clinical uncertainty from an individual cognitive burden to a shared relational space, alleviating the pressure to prematurely resolve it. This multi-layered approach provides a sustainable philosophy for primary care, supporting clinician well-being and helping clinicians move from rapid resolution towards more meaningful engagement with patients by relational care in complex clinical environments.

This systematic review and meta-analysis investigated the potential links between clinically assessed oral health conditions and depressive symptoms in adults. Six databases were searched for observational studies examining dental caries, periodontal disease, or tooth loss through clinical examination, and depressive symptoms through validated instruments. Data extraction and quality assessment (JBI) were independently performed by two reviewers, and random-effects meta-analyses were conducted for compatible effect measures (OR), assessing heterogeneity. Out of 6.917 unique records, 20 studies were selected. The meta-analyses revealed increased odds of depression for patients who experienced tooth loss (pooled OR = 1.19, 95%CI: 1.09-1.30, I2 = 54.7%), supported by a dose-response gradient in subgroup analyses. Periodontal disease also increased the odds of depression (pooled OR = 1.59, 95%CI: 1.14-2.21, I2 = 0.0%). Conversely, depression as an exposure was associated with higher odds of dental caries (pooled OR = 1.20, 95%CI: 1.04-1.39, I2 = 0.0%), but not with periodontal disease. The relationship between oral and mental health seems to be condition-specific, with robust quantitative evidence indicating the importance of tooth loss in the development of depressive symptoms, which in turn increase the odds for dental caries, suggesting a possible feedback loop. Evidence for depression affecting periodontal status remains inconclusive.

to analyze the therapeutic potential of a psychosocial intervention protocol developed and administered by nurses.

a pilot, quantitative, preand post-test study, approved by the Ethics Committee and conducted with 12 women deprived of liberty in a women's penitentiary complex in a municipality in Minas Gerais. Sociodemographic data and data regarding symptoms of common mental disorders and mood modulation were collected. Descriptive statistics, measures of dispersion, and non-parametric tests were used for data analysis.

nine women completed the proposed program. Improvement was identified in all domains analyzed in relation to mood modulation, with particular emphasis on the depression and tension domains. Regarding symptoms of common mental disorders, there was a reduction in descriptive terms, but without statistical significance.

the results suggest that the proposed intervention has the potential to be considered as a non-pharmacological therapeutic option by nurses working in the prison system.

The study investigated the effect of food security (FS) on anxiety levels of women living in João Pessoa, Paraíba, Brazil, who were users of the Unified Health System during pregnancy and the postpartum period. This was a cohort study conducted between 2018 and 2020 with 122 women recruited in Family Health Units and followed up in their homes. Food security and levels of food insecurity were assessed using the Brazilian Food Insecurity Scale, and anxiety levels were measured with the State-Trait Anxiety Inventory. Sociodemographic and economic information was collected. Analyses were performed using a generalized estimating equation model adjusted for age and income. Women classified at any level of food insecurity presented higher anxiety scores. Throughout the follow-up period, women who remained food secure or transitioned from some level of food insecurity to food security showed a 9.3% reduction in their anxiety scores. The findings highlight the importance of food security not only as a human right but also as a protective factor against mental health disorders in women during a critical stage of life. Integration of mental health services with food security interventions is recommended, particularly during prenatal and postpartum care.