Populations affected by humanitarian crises, including conflict, disasters and displacement, are frequently exposed to elevated psychological distress, while access to mental health services remains scarce. Problem Management Plus (PM+), a low-intensity psychological intervention developed by the World Health Organization, has shown clinical efficacy. However, evidence on its implementation in humanitarian contexts remains limited. This systematic review aimed to synthesize available evidence on the implementation outcomes of PM+ and its delivery formats (individual, group and digital) in such settings. The review included individual PM+, group PM+ and Step-by-Step.

Following PRISMA 2020 guidelines, we systematically searched four databases (PubMed, Scopus, Web of Science and CENTRAL) for studies published up to June 2025. Eligible studies included populations in humanitarian settings receiving PM+ in any format and reported at least one implementation outcome based on Proctor's framework (acceptability, adoption, appropriateness, feasibility, fidelity, cost, penetration and sustainability). Data extraction and quality appraisal were conducted independently by two reviewers. The protocol for this systematic review was prospectively registered in PROSPERO (Registration No. CRD42024551943).

Of 2093 records screened, 23 studies met inclusion criteria, representing 5377 participants across diverse humanitarian contexts. Feasibility (70% of studies) and acceptability (65%) were the most frequently assessed outcomes, with consistently positive findings, including adequate recruitment, retention and cultural adaptability of PM+. Evidence was strongest for participant and provider acceptability and feasibility of delivery, whereas system-level outcomes such as sustainability, adoption, penetration and cost were rarely reported. Delivery by trained non-specialist providers was common and supported by supervision structures. Fidelity assessments (43%) demonstrated high adherence to intervention manuals. In contrast, sustainability (9%) and cost evaluations (17%) were infrequently reported. Barriers to implementation included stigma, population mobility and resource constraints, while facilitators included contextual adaptation, community engagement and ongoing supervision.

PM+ demonstrates strong feasibility and acceptability when delivered by trained non-specialist providers in humanitarian contexts. However, gaps remain in evidence on long-term sustainability, cost-effectiveness and policy integration. The limited availability of system-level implementation data constrains conclusions regarding large-scale integration of PM+ in humanitarian settings. Future research should employ standardized implementation science metrics and focus on strategies to enhance scalability and embed PM+ within existing health systems.

Over the past years, the Italian Twin Registry (ITR) has joined networks and consortiums for genetic-epidemiological research, and several opportunities have arisen for national and international collaborations involving data and tool sharing, as well as cohorts' harmonization. These networking efforts have led ITR to face complex ethico-legal challenges within the framework provided by the General Data Protection Regulation (GDPR) since 2018 but have also represented the occasion to address critical aspects in ITR organization and activities, looking for long-term solutions. This article describes some examples of: ITR international collaborations implying data and tools sharing; ITR national collaborations aimed to replicate general-population findings; ITR integration with national and regional administrative records; ethico-legal criticalities experienced by ITR in multicohort collaborations, and initiatives to overcome the GDPR bottleneck. Regarding collected data, ITR currently contains information on 30,362 twins of different ages and geographical areas, of whom 7797 are being asked to reconfirm their enrollment, having turned 18 or over. In the coming period, these figures may increase rapidly, thanks to the ongoing access to the National Register of the Resident Population, for which ITR is working to solve privacy-related legal issues. This will enable a systematic enrolment of large and representative twin cohorts, making ITR a valuable tool for genetic-epidemiological research and for the monitoring of relevant health outcomes in the Italian population.

The COVID-19 pandemic disrupted healthcare delivery and coincided with increased psychological distress worldwide. In the UK, restrictions on healthcare access, rapid adoption of remote consultations and pressures on mental health services may have influenced prescribing of psychotropic medications. However, evidence comparing prescribing trends across the four UK nations during the pandemic remains limited.

To examine trends in community prescribing of psychotropic medicines across England, Scotland, Wales and Northern Ireland before and during the COVID-19 pandemic.

We conducted a repeated cross-sectional study of national Prescription Cost Analysis data-sets covering March 2019 to March 2023. Monthly utilisation of antidepressants, anxiolytics/hypnotics, antipsychotics and antidementia medicines was measured, using two indicators: number of items dispensed per 1000 inhabitants and defined daily doses per 1000 inhabitants per day. Interrupted time-series regression was applied to assess changes in prescribing levels and trends associated with the first (March 2020) and second (November 2020) UK national lockdowns.

Psychotropic prescribing increased across most medicine classes during the study period. Antidepressant utilisation increased by 24.6% across the UK, representing the largest rise among psychotropic medicines. Antipsychotic prescribing increased by 2.7%; anxiolytic/hypnotic prescribing showed modest overall change (2.7%), but this varied between nations, increasing in Scotland (7.3%) and Northern Ireland (7.4%), and declining in Wales (-9.5%). Antidementia medicines increased modestly overall (9.3%), with variation between countries. Interrupted time-series analyses indicated that most changes occurred gradually rather than abrupt shifts following lockdowns.

Psychotropic prescribing increased during the COVID-19 period, but largely reflected continuation of pre-existing trends rather than immediate effects of lockdown restrictions.

Background: Despite increasing opioid use in Brazil, the national epidemiological profile of opioid-related poisonings remains insufficiently characterized. Objective: To characterize opioid-notified poisonings reported in the Sistema de Informações sobre Agravos de Notificação (SINAN-Notifiable Diseases Information System), accessed through Departamento de Informática do Sistema Único de Saúde (DATASUS-Department of Informatics of the Unified Health System), between 2019 and 2025. Methods: This retrospective descriptive study used secondary national surveillance data from publicly accessible databases. Records of exogenous poisonings related to medications and drugs of abuse were screened, and notifications involving opioid analgesics were identified and standardized. Descriptive analyses were performed for demographic, clinical, and exposure-related variables. Bivariate analyses and multivariable logistic regression, regression models were conducted for selected outcomes. Incidence rates were estimated by year and federative unit, and temporal trends were assessed using generalized linear mixed models. Results: Between 2019 and 2025, 1,127,265 poisonings related to medications and drugs of abuse were reported in Brazil, of which 12,645 involved opioids. The opioids most frequently implicated in notifications were codeine (38.65%), tramadol (33.98%), and morphine (17.86%). Most cases occurred in women (70.3%), in individuals aged 26-50 years (47.8%), and in residences (85.6%). Digestive exposure predominated (92.3%), and suicide attempt was the main circumstance (73.5%). Most patients recovered without sequelae (75.1%), whereas 1.6% died due to exogenous intoxication. Co-exposure information was classifiable in 9573 records, most commonly involving opioids and medications. In multivariable analyses, suicide attempts were associated with female sex (aOR = 1.98; 95% CI: 1.68-2.34), residence-based exposure (aOR = 8.95; 95% CI: 6.29-12.72), and co-exposure (aOR = 2.17; 95% CI: 1.82-2.60). Hospitalization was less likely among females (aOR = 0.83; 95% CI: 0.75-0.91) and more likely with co-exposure (aOR = 1.14; 95% CI: 1.02-1.27). Serious outcomes were associated with older age (aOR = 1.017; 95% CI: 1.009-1.026), while residence-based exposure and suicide attempt showed lower odds. A significant increasing temporal trend was identified, with higher reported notification rates observed in the South and Southeast regions. Discussion: The predominance of suicide attempts and residential digestive exposures suggests that the notification profile captured by SINAN/DATASUS is predominantly shaped by intentional self-poisoning and household medication availability, while still representing a broader toxicovigilance scenario involving abuse, habitual use, adverse reactions, and other exposure contexts. The contrast between the most frequent notification profile and the profile associated with serious outcomes indicates that occurrence and severity may follow different epidemiological patterns. Therefore, these findings should be interpreted as a toxicovigilance signal reflecting multiple exposure contexts rather than as evidence of a single opioid-use pattern. Conclusions: Reported opioid-notified poisonings in Brazil increased over the study period and were predominantly associated with domestic exposure, suicide attempts, and co-exposure to other substances. These findings highlight the clinical and public health relevance of opioid-notified poisonings and support the need for strengthened surveillance, improved reporting quality, and preventive strategies addressing both opioid use and mental health. Limitations: Underreporting, missing data, regional reporting differences, and possible misclassification in SINAN/DATASUS records; therefore, associations, temporal increases, and projections should be interpreted as exploratory, and hypothesis generating.

The healthy development of executive function (EF) skills in childhood and adolescence provides a crucial foundation for later outcomes, from mental and physical health to academic achievement and socio-emotional functioning. Although meta-analyses have identified associations between children's EF skills and early experiential factors, these are often examined in terms of broad categories (e.g., socioeconomic status) or cumulative risk factors (e.g., adverse childhood experiences; ACEs). The current study leverages longitudinal data (N = 1295) from six cohorts from the Environmental influences on Child Health Outcomes (ECHO) program to identify unique associations among specific prenatal, perinatal, and early life conditions and three specific EF skills (inhibitory control, working memory, and cognitive flexibility) measured later in childhood. Indicators of socioeconomic status, birth outcomes, parental characteristics, and pre- and post-natal exposures to alcohol and tobacco were measured before age 6 years. EF skills and language were measured from ages 6-15 years (M = 9.95, SD = 1.92), using measures from the NIH Toolbox. Two complementary statistical methods, a psychological network approach and regression trees, were employed to disaggregate early predictors of EF development. Results from both methods converged to suggest that specific early conditions showed associations with specific EF skills, and that higher birth weight (independent of pre-term status) was a stronger predictor of better EF skills than other early conditions. Neither approach showed meaningful associations between EF skills and maternal ACEs. Birth weight appears to serve as a particularly sensitive summary index of prenatal influences on EF development.

Current models of dementia care often perpetuate the legacies of colonization, which highlights the need for a culturally congruent approach. This research describes the necessary components to co-develop a freely available Indigenous-centered dementia model of care in partnership with Indigenous individuals living with dementia, their families, and communities. To prioritize ethical and decolonial research approaches, sequential focus groups were used alongside Keeoukaywin (The Visiting Way)-an Indigenous methodology deeply rooted in Métis and Cree ways of knowing-guided by a group of advisors and Elders. The data were co-analyzed using reflexive thematic analysis guided by Indigenous principles. Three themes were generated: Indigenization, Personalization, and the Intersection of Challenges and Innovations, to illustrate how dementia care can be operationalized and adapted to various cultural and care contexts. This research offers a foundation for developing dementia care that truly aligns with Indigenous ways of doing.

Climate action initiatives primarily target environmental outcomes, but their potential for health co-benefits through green and blue space contact remains understudied. Understanding these secondary outcomes could inform dual-purpose programming addressing climate and health challenges.

This retrospective analysis examined 32 community-led climate action projects funded through Edinburgh Communities Climate Action Network (ECCAN) and their GreenLight programme (2024-2025). Projects spanned energy, transport, food, circular economy, and green space themes, with no formal health evaluation framework. Data were extracted from final reports covering 3195 direct participants.

Despite health not being a primary objective, 21 of 32 projects (66%) reported secondary health and wellbeing outcomes. Projects involving direct nature contact showed the strongest co-benefits: nine of ten high-nature-contact projects reported health benefits, compared to two of eight low-nature-contact projects. Notable outcomes included 94% of participants reporting increased willingness to engage in future community activities and 76% reporting mental wellbeing improvement following community garden workshops. Blue space engagement demonstrated particular significance for mental health and social cohesion.

Green and blue space engagement in climate action projects consistently produces secondary health outcomes. We propose the Community-Environment-Health Nexus (CEHN) framework to understand how community-led environmental action generates synergistic health co-benefits.

The relationships between superficial white matter (SWM) and cognition, and its interaction with gray matter (GM), remain unclear in community-based populations.

We analyzed data from 459 older adults in the Harmonized Diagnostic Assessment of Dementia for the Longitudinal Aging Study in India. SWM microstructures were estimated by multi-shell diffusion magnetic resonance imaging (MRI). We examined cross-sectional associations between SWM with memory, language, executive, visuospatial function, and cognitive impairment (CI); and tested SWM interactions with GM atrophy and modification by socioeconomic status.

Higher SWM neurite density index (NDI) related to better language, whereas higher fraction of isotropic water (FISO) related to greater odds of CI. While GM metrics remained strongest predictors of cognition, these associations were attenuated by better SWM integrity (high NDI and low FISO). No formal education, low literacy, and rural residence worsened SWM-related language deficits.

Neurite-level SWM health may drive resistance to neurodegeneration and cognitive decline.

The present pilot study aimed to (1) Characterize neural markers of reward sensitivity during periods of social stress; (2) Evaluate clinical relations between neural reward markers and anhedonia; and (3) Investigate if peer victimization was associated with ventral striatum (VS) suppression and anhedonia symptoms during social stress.

A total of 28 adolescents between the ages of 13 and 17 (M_age = 15.31; SD = 1.51; 55.2% cisgender girls) were included in analyses and completed a semi-structured interview, self-report questionnaires regarding social anxiety, stress, depression, and anhedonia, and a magnetic resonance imaging (MRI) scan while engaging in the Island Getaway task. VS BOLD signal activation estimates were then extracted during discrete phases of the task (e.g., anticipation of social feedback and outcome of social feedback) and statistically compared within-subjects.

Results revealed that when in the presence of social stress (defined as the potential for negative feedback), socially anxious adolescents demonstrated significantly suppressed VS activation relative to feedback anticipation. Additionally, the reduced VS activation during the outcome phase was significantly correlated with anhedonia. Moreover, relational peer victimization was associated with suppressed VS activation.

Findings identify novel mechanisms associated with anhedonia and blunted reward processing in socially anxious youth that could be improved via interventions that target positive-valence systems.

Metacognitive interventions have emerged as promising therapeutic approaches for individuals experiencing a first episode of psychosis (FEP), given the relationship between metacognitive deficits, reduced cognitive insight, and symptom persistence. This systematic review synthesizes the available evidence on the effectiveness of metacognitive therapies in adults with FEP, focusing on their impact on cognitive insight, psychotic symptoms, and global functioning.

A systematic search was conducted in PubMed, PsycINFO, Web of Science, and Scopus following PRISMA guidelines, with prior registration in PROSPERO (CRD420261281443). Studies published between 2014 and 2025 were included if they applied metacognitive interventions to adult FEP samples and evaluated changes in psychotic symptomatology and/or cognitive insight using validated instruments. Methodological quality was assessed using the Mixed Methods Appraisal Tool.

A total of 15 studies met the inclusion criteria. Overall, metacognitive interventions demonstrated consistent improvements in cognitive insight, notably increased self-reflectivity, and reduced overconfidence. Findings regarding psychotic symptom reduction were heterogeneous, although several studies reported significant improvements. Additional benefits were observed in neurocognitive domains, whereas results concerning social cognition were mixed. Interventions varied substantially in duration, format, and intensity, with most being delivered individually.

The available evidence suggests that metacognitive therapies constitute a promising treatment option for individuals with FEP, showing robust effects on cognitive insight and potential benefits for clinical and functional outcomes. Nonetheless, further high-quality research, particularly comparative trials and long-term follow-up studies, is needed to consolidate these findings and clarify their applicability across diverse clinical settings.