Zinc (Zn) is a trace element essential for the function of over 10% of the human proteome, yet the average adult body contains only about two grams. Despite its trace status, Zn plays an indispensable role in immune regulation, inflammation control, and redox signalling. Low Zn status is associated with impaired immune function and increased oxidative stress-factors that critically contribute to the pathogenesis of cardiac inflammatory diseases (CIDs), including myocarditis and pericarditis. These conditions are rising in incidence globally, particularly in younger adults, and are linked to viral infections, autoimmune triggers, and post-vaccination inflammatory responses. Zn not only protects cysteine thiol groups from oxidation but also acts as a redox-sensitive secondary messenger via the "Redox Zinc Switch" mechanism-a key process in modulating cellular responses to oxidative stress. In the cardiovascular system, Zn influences antioxidant defence, cytokine regulation, and membrane repair pathways, including cellular responses that are regulated by protein kinase C and metallothioneins. Emerging evidence supports Zn supplementation as a strategy to mitigate myocardial inflammation, reduce cardiac remodelling, and improve outcomes in oxidative stress driven heart diseases. This review synthesizes current knowledge on Zn's biochemical, immunological, and therapeutic roles in cardiac inflammation. We argue that maintaining optimal Zn levels through diet or supplementation represents a promising, accessible intervention to reduce the burden of CIDs and improve cardiovascular resilience in at-risk populations.

Cardiovascular diseases (CVDs) remain a major global health threat, accounting for a significant proportion of deaths worldwide. Doxorubicin (DOX) and Isoproterenol (ISO) are known to induce cardiotoxicity primarily through the generation of reactive oxygen species (ROS).

Drug-likeness analysis of selected phytochemicals was performed using SwissTargetPrediction and SuperPred 3.0. Genes associated with DOX-induced cardiotoxicity were curated from GeneCards, OMIM (Online Mendelian Inheritance in Man), and DisGeNet. Molecular docking was performed to evaluate potential interactions with TOP2A, HIF1A, ABCB1, NOS3, PIK3R1, SRC, ABL1, and NR3C2. An in vivo cardiotoxicity model using DOX and ISO was employed to assess the cardioprotective effects of ethanolic extracts of Hedyotis corymbosa (EEHC). Wistar rats of either sex, weighing 200-220 g, were used in the study.

Docking scores of Corycavidine against hub genes ranged from -6.66 kcal/mol to -1.26 kcal/mol, while MM-GBSA binding energies ranged from -50.22 kcal/mol to -8.28 kcal/mol, with the strongest binding observed for ABL1 (-50.22 kcal/mol). The NBE (cumulative ΔG_Coul and ΔG_vdW) was highest for NOS3 (-87.46 kcal/mol). EEHC administration significantly decreased CK-MB, malondialdehyde, and glutathione levels, while HDL, catalase, and superoxide dismutase levels were markedly increased, accompanied by reductions in total blood cholesterol and triglyceride levels.

DOX and ISO treatment resulted in myocardial wall thickening and lipoprotein accumulation, suggesting cardiac dysfunction. Computational docking and MM-GBSA analyses of 16 hub genes revealed a favorable binding profile of Corycavidine with several key proteins implicated in cardiovascular regulation and injury responses.

These findings suggest that Corycavidine may serve as a multi-target cardioprotective agent, potentially modulating oxidative stress, inflammation, endothelial function, and cellular survival pathways.

Aim: To quantify barriers to access to essential health services and describe patterns of psychological distress and help-seeking among displaced populations during the armed conflict in Ukraine.

Materials and Methods: A cross-sectional questionnaire captured displacement status, linkage to primary care (declaration), perceived accessibility, barriers in the previous 6 months, awareness of reimbursement medicines, unmet service needs, and psychological symptoms within the last 2 weeks. The dataset (n=450) comprises anonymized real-world responses collected in this study.

Results: The 48,4% of respondents were classified as currently displaced, and 75,8% reported a primary care declaration. Primary care was rated fully accessible by 20,9%, whereas 42,7% reported difficult/very difficult access. Appointment unavailability (61,6%), lack of medicines (49,8%), and high service costs (40,0%) were common barriers. Sleep disturbance (37,6%) and anxiety/panic (36,2%) were frequent; 18,7% reported seeking any support for mental health needs.

Conclusions: In this cross-sectional survey, access constraints clustered around appointment availability, medicine supply, and affordability, while psychological symptoms were frequent and support-seeking remained limited. Interventions should combine primary care navigation and capacity measures with integrated, stigma-sensitive mental health pathways.

There is growing interest in measuring patient experience within mental health care and central to doing so is the development of appropriate measurement methods. Whilst numerous patient-reported experience measures (PREMs) are available, systematic reviews examining their psychometric properties have excluded measures designed specifically for older people.

This review aimed to identify and critically analyse all available patient and carer-reported patient experience measures designed to, or applicable in, measuring the mental health care experience of older people.

Four databases were systematically searched and identified 21 reports dealing with the process of development and/or validation of relevant instruments.

The methodological quality and psychometric properties of the instruments were assessed according to Pesudovs et al. (2007) quality criteria, and results were heterogeneous. An inductive qualitative analysis of instrument content identified 10 key domains of patient experience applicable to OPMH: interpersonal/relational aspects, information, patient involvement, service aspects, discharge, goal setting, safety, social support, access and medication.

The heterogeneity of study designs highlights the need for greater standardization and rigour of methodological processes for the development and validation of PREMs. Further well-designed studies to appropriately validate existing and new PREMs applicable for use within older people's mental health services are required.

Despite the benefits of psychotherapy to improve mental health outcomes, therapy remains significantly underutilized among Black Americans. Yet, once therapy is initiated, Black clients experience mental health outcomes comparable to those in the general population, underscoring potential barriers to engagement. To address this gap, our qualitative study explored factors that contribute to client engagement throughout the therapeutic process, including core therapeutic skills related to therapist qualities, provider-client alliances, and nontherapeutic factors that shape the client experience. Using a qualitative hermeneutic phenomenological approach, semistructured qualitative interviews were conducted with past and current Black clients at a university-based training clinic about their experiences engaging in therapy. Data were analyzed through thematic analysis, and a codebook was developed to adequately capture patterns in perspectives across the interviews. Major themes, including therapist acknowledgment of cultural identity and perceived therapeutic collaboration, were emphasized as being integral in promoting engagement. Additionally, participants discussed factors that contributed to positive treatment experiences, including flexible procedures and accommodating clinic staff. These findings suggest that cultural acknowledgment, therapeutic collaboration, and a supportive clinic environment are essential to increasing Black clients' utilization of therapeutic services. Understanding the factors that increase accessibility and engagement for Black clients can lead to improved treatment outcomes. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

The World Health Organization (WHO) Safe Childbirth Checklist (SCC) has been adapted and implemented in at least 35 countries. Consistently, the SCC has shown increased adherence to practices, but there are mixed results regarding its association with health outcomes in different settings.

To examine the association of SCC implementation with mortality, accounting for variations in evidence-based practices (EBP) adherence.

In this meta-analysis, data were pooled from 3 cluster randomized trials of the SCC (January 1, 2014, to December 31, 2017). Intention to treat (ITT) and a complier average causal effect analysis (CACE) on EBPs and perinatal mortality were estimated via a generalized linear model. The primary facilities were in Uttar Pradesh, India; basic emergency obstetric facilities were in Aceh, Indonesia; and primary and secondary health centers were in Khyber Pakhtunkhwa, Pakistan.

In India, the 8-month SCC intervention involved facility engagement, a launch event, and 8 months of tapered coaching. In Indonesia, the 6-month SCC intervention included 11 coaching visits. In Pakistan, the 12-month SCC intervention included light touch external monitoring, skills training, and supplies assessment.

Primary outcomes were stillbirth and perinatal and early neonatal mortality. Secondary outcomes were adherence to 15 EBPs, facility supply availability, and safety culture perceptions.

Pooled data included 169 511 births, supply assessments from 163 facilities, and 6298 observed deliveries for EBPs and health workers' perceptions on safety culture. Mortality did not differ in the full sample; however, during months when EBP observations were conducted, stillbirth rates in the intervention facilities were lower by 9.8 per 1000 births (95% CI, -18.5 to -1.1; P = .03; q = .05) in the ITT analysis and 14.5 per 1000 births (95% CI, -27.2 to -1.7; P = .03; q = .05) in the CACE analysis compared with control facilities. EBP adherence was higher by 3.6 practices (95% CI, 3.3 to 4.1; P < .001; q = .001) in the ITT analysis and 6.0 practices (95% CI, 5.3 to 6.8; P < .001; q = .001) in the CACE analysis in intervention facilities.

In this meta-analysis, SCC use in lower-middle-income settings was associated with increased EBP adherence and lower rates of stillbirths when EBPs were directly observed. Further research is needed to identify additional factors to optimize SCC's potential impact on maternal and newborn safety outcomes.

Arab refugees, immigrants, and migrants (RIMs) experience barriers in accessing accurate health information. To combat this, the Refugee Reproductive Health Network (ReproNet) developed Arabic, culturally concurrent health literacy sessions that included pre-recorded presentations on postpartum care. We evaluated the impact of these group sessions on postpartum knowledge and health literacy in the Arab RIM community in Southern California.

We recruited a convenience sample of 51 Arab RIMs through community organizations and the ReproNet client list for one in-person and three virtual informational sessions on postpartum care. We administered pre- and 2-4 week post-session surveys to measure e-Health Literacy (eHL) and Postpartum Health Literacy (PHL). We conducted descriptive analyses and t-tests to assess mean differences using SAS 9.4.

Of the 51 attendees, 47 participants completed both the pre- and post-tests. Most participants were college-educated, single, and had never had a live birth. The average age was 39.3 years. We observed a significant increase in both eHL and PHL after the informational sessions. Females under the age of 35 had improved more in PHL than those over 35. Nulliparous females had a lower PHL baseline than parous females.

Group health literacy training sessions that implement culturally concurrent methods, including pre-recorded presentations, are effective in increasing postpartum knowledge and health literacy in the Arab RIM community, regardless of parity. Enhancing PHL has the potential to reduce the risks of postpartum complications, such as postpartum depression (PPD), and can potentially contribute to postpartum females' mental and physical health.

ObjectiveAs epidemiological patterns of cannabis use and internalizing problems evolve globally, it is critical to reassess their associations-particularly in the post-legalization and post-pandemic context.MethodsParticipants were assessed in the 2012 Canadian Community Health Survey's Mental Health Component (CCHS-MH; n = 25,113) and 2022 Mental Health and Access to Care Survey (MHACS; n = 9,861), two nationally representative cross-sectional epidemiologic surveys of Canadians aged 15+. Robust Poisson Regression analyses examined associations between frequency of cannabis use and past 12-month generalized anxiety disorder (GAD), major depressive episode (MDE), and suicidality assessed using the World Health Organization Composite International Diagnostic Interview.ResultsBetween 2012 and 2022, the prevalence of GAD, MDE, and cannabis use (any and 2+/week) approximately doubled, while suicidality remained unchanged in the full sample but increased by 44% among youth. Across all models, cannabis frequency was consistently associated with a higher prevalence of GAD, MDE, and suicidality in a frequency-dependent fashion. Additive interactions between year and cannabis on each of the outcomes demonstrated stronger associations in 2022 versus 2012. For example, from 2012 to 2022, those using cannabis 2+/week (relative to no use) had a: (1) prevalence ratio (PR) for GAD of 2.3 (95% CI, 1.6-3.4) increase to 4.5 (3.8-5.2); (2) PR for MDE of 3.0 (2.3-3.9) increase to 5.2 (4.6-5.7); and (3) PR for suicidality of 3.0 (2.1-4.0) increase to 5.4 (4.7-6.1). Select moderation effects indicated associations between cannabis and MDE or suicidality strengthened more among youth (15-24 vs. 25+), and associations with GAD strengthened more among females.ConclusionsCannabis use was consistently related to a higher prevalence of internalizing problems, and these associations strengthened between 2012 and 2022. Given continued escalations in co-occurring cannabis use and internalizing problems, greater investment in early identification, intervention, and access to integrated substance use and mental health treatment is needed.

Frailty is a multidomain reduction in physiologic reserve that impacts recovery and can contribute to poor outcomes following trauma beyond what chronological age, comorbidities, or injury severity predicts. In geriatric trauma patients, a large proportion are frail or prefrail on initial encounter in the emergency department, and because there are opportunities for actionable management plans, major trauma guidelines endorse systematic screening integrated into coordinated geriatric trauma care. We reviewed the literature and identified practical instruments used in the acute trauma setting for risk stratification. Additionally, we highlight the feasibility of using these instruments, as some can be completed via patient report, proxy input, or chart review when cognition, language, or caregiver availability limits history-taking. Implementation efforts succeed when shared mental models are leveraged and screening is embedded in the electronic health record system, linked to order sets and trigger-based pathways that offer downstream goal-directed care management, such as early mobility, delirium prevention, nutrition, medication review, and comprehensive geriatric assessment. Additionally, we highlight the importance of initiating early goals-of-care discussions and coordinating care with palliative care services. Resource-limited systems can preserve the same architecture by using nurse-led or allied staff-led screening, tele-geriatric consultation, and virtual interdisciplinary huddles. Lastly, we expand upon opportunities for longitudinal post-discharge follow-up. We describe how targeted initiatives translate research into practice, improve outcomes, and support longitudinal reassessment through in-person and telehealth follow-up visits.

Recent years have seen the development of conceptualisations of stigma which have moved beyond individual-level analyses towards exploring how stigma operates across multiple levels. While empirical research has examined the impact of stigma across various domains, there remains scant research exploring the lived experience of structural stigma. In this article, we examine structural stigma as a driver of multiple missed appointments, or 'missingness', in health care. We draw on qualitative data from 61 interviews with health and social care professionals and experts-by-experience of missingness in the United Kingdom, focusing on three stigmatised statuses: people from marginalised racial and ethnic groups, including those in the asylum system; people with mental health conditions; and people experiencing problem substance use. We adapt Link and colleagues' schema of stigma outcomes-keeping people down, in, and away-to explore how structural stigma shapes access to and experiences of health care. Our findings demonstrate a range of such processes through which barriers to effective engagement occur, and suggest that a focus on structural stigma will benefit policy, practice, and future research in this area.