Workplace health coaching offers a promising approach to support behavior change and manage chronic diseases among working adults. This study evaluates the acceptability and preliminary outcomes of a pilot digitally supported health coaching program implemented in a maritime industry workforce in Singapore.

A pragmatic mixed-methods program evaluation was conducted to examine both clinical outcomes and participant experiences. Quantitative data were collected at baseline and 6 months from 32 participants and included body mass index (BMI), blood pressure, lipid profile, and glycated hemoglobin (HbA1c). Health-related quality of life was assessed using the SF-12. Open-ended survey responses explored participants' motivation, engagement, and perceptions of program components. Quantitative data were analyzed using Wilcoxon signed-rank tests, while participants' qualitative responses were analyzed thematically.

Participants had a median age of 55 years (IQR: 44-61), and 89.1% were male, with representation across port operations, engineering, and administrative roles. Statistically significant improvements were observed in BMI, systolic blood pressure, triglycerides, and HDL cholesterol. Mental health-related quality of life improved, while HbA1c showed a small but statistically significant increase. Participants highlighted the motivational support structure, personalized guidance and encouragement from health coaches as key facilitators of engagement. Barriers included time constraints, digital fatigue, and usability issues. Participants reported adopting healthier routines and increased self-awareness, but noted difficulties maintaining those changes after the program ended.

Findings suggest the feasibility and potential value of workplace health coaching in supporting employee well-being and chronic disease self-management. The results underscore the role of personalized and relational coaching approaches, and the importance of user-friendly digital tools and sustained support to maintain behavior change in workplace settings.

Adolescents in the United States face growing mental health challenges, with nearly one in three high school students reporting poor mental health in the past 30 days. Schools increasingly serve as key access points for mental health care. However, geographic disparities in access to school-based mental health services remain underexplored.

This study examines the spatial distribution of adolescent mental health resources in Travis County, Texas, and evaluates how school- and community-level factors are associated with the presence of on-site school social workers.

School locations, enrollment data, and the presence of on-site social workers were mapped and analyzed alongside ZIP Code Tabulation Area-level indicators of community vulnerability using ArcGIS Pro. Additionally, data from public high school districts, community mental health clinics, and social determinants of health indicators were incorporated for geospatial analysis through spatial regression modeling in R.

Many high schools were located more than two miles from a free or low-cost mental health clinic, especially in the eastern regions of the county. Among 24 Travis County high schools, only 29% had on-site social workers. Spatial regression results showed that schools located in communities with higher poverty, unemployment, and limited English proficiency were significantly less likely to have an on-site social worker (p < 0.05). In contrast, schools in areas with lower education levels, more residents with disabilities, and high housing cost burdens were more likely to have on-site social workers (p < 0.05).

Geospatial disparities in mental health service access represent an important challenge for high school students in Travis County. Public resources, primarily from local stakeholders, should be directed toward high school students in these communities. School-based social workers and telehealth partnerships help address some of these gaps. The findings emphasize the importance of equity-focused planning to provide accessible, school-centered mental health services.

Women's pathways into homelessness are gendered, shaped by family dysfunction, economic precarity, and high rates of violence. Despite the profound implications for women and their children, evidence from Ethiopia remains scarce. This study explored women's early-life experiences, trajectories into and through homelessness in Addis Ababa, and the challenges and resources related to community reintegration.

We conducted an exploratory qualitative study in Addis Ababa, Ethiopia, in December 2023 using semi-structured interviews. Women of reproductive age experiencing homelessness were purposively recruited through a local civil society organisation (n = 19). Data were analysed using reflexive thematic analysis, and the report was prepared in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ).

We developed four themes: "Childhood trauma from abuse", "Sexual violence", "Barriers to leaving street life", and "Sources of hope". The analysis identified three distinct trajectories - Chaotic, Circuious, and Linear - which differentiated women's movement into and through homelessness. Women's accounts revealed trajectories in which early harm within families and households extended into street-based victimisation. This reinforced heightened insecurity and limited their options to exit homelessness. Across themes, cumulative violence was sustained by social and structural constraints, including substance use and limited access to formal protection and justice. Despite these constraints, women emphasised sources of hope, including faith, perseverance, and aspirations to care for and support their children.

Women's trajectories into and through homelessness in Addis Ababa were shaped by cumulative, gendered violence across the life course. These results suggest that reintegration pathways must be tailored to specific trajectories, providing trauma-informed care for chaotic routes and economic safety nets for circuitous ones. Such an approach highlights the need for locally grounded, trauma-informed, and gender-responsive interventions.

Health information-seeking is a central strategy used by patients and caregivers to cope with chronic illness. This study investigated the sources of disease-specific information utilized by adult patients with IF and caregivers of pediatric IF patients to identify existing information needs.

Using a community-driven research design, we developed a cross-sectional questionnaire to identify information sources and needs. The survey was disseminated via relevant patient support organizations, personal networks, and disease-specific social media support groups. Descriptive and univariate analyses were conducted to identify common information sources and needs and assess differences by respondent type.

A total of 283 respondents, consisting of adult patients with a history of IF (n = 167) and caregivers of pediatric patients with a history of IF (n = 116), completed the survey. Only half were receiving care via an intestinal rehabilitation program. The most frequently used sources of IF-specific information were specialist providers or teams (64%) and social media support groups (52%); a significantly larger share of patients than caregivers reported general practitioners as an information source (30% vs. 13%, p = 0.001). Top information needs pertained to 1) better understanding the current state of the field, 2) optimizing day-to-day life with IF and improving quality of life, and 3) supporting mental health and fostering a sense of connection.

Within this sample of engaged and resource-seeking participants, we found respondents utilized multiple information sources and expressed a range of information needs. We offer several suggestions for addressing these needs.

The relationship between headaches and psychiatric disorders among psychiatric outpatients remains insufficiently characterized. In this study, the prevalence of primary headaches was estimated, and the factors associated with headache occurrence and quality of life (QoL) in this population were examined. A total of 1,014 patients were evaluated. Psychiatric diagnoses were determined using the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), and primary headaches were classified according to the International Classification of Headache Disorders (ICHD-3). Key variables included psychopathology severity and functioning, assessed with the Clinical Global Impression (CGI) scale and the modified Global Assessment of Functioning (mGAF) scale; headache impact, measured by the Headache Impact Test (HIT-6); and QoL, assessed using the EUROHIS-QOL-8. The prevalence of primary headache was 60.4%. Tension-type headache (TTH) was the most frequent subtype, followed by migraine and comorbid migraine with TTH. Headache prevalence was lower among patients with psychotic disorders, and no significant differences in headache subtype distribution were observed across psychiatric diagnostic groups. Independent factors associated with headache occurrence included anxiety disorders, mood disorders, higher psychopathology severity, female sex, younger age, lower education, unemployment, and married status. Independent factors associated with QoL included lower functioning, HIT-6 severe headache impact, HIT-6 substantial headache impact, mood disorders, anxiety disorders, younger age, unemployment, ill-health retirement, married status, widowed status, age at headache onset, education, and female sex. The results of this study demonstrate that primary headaches are common among psychiatric outpatients and are associated with significant reductions in QoL. These findings emphasize the need to routinely assess headaches in psychiatric settings, given their clinical impact. Limitations of the study include its cross-sectional design, absence of a control group, and potential medication-related confounding.

Fibromyalgia is a common and debilitating chronic pain syndrome of poorly understood etiology. Here we conduct a multi-ancestry genome-wide association study meta-analysis across 2,563,755 individuals (54,629 cases and 2,509,126 controls) from 11 cohorts, identifying 26 risk loci for fibromyalgia. The strongest association was with a coding variant in HTT, the causal gene for Huntington's disease. Gene prioritization implicated the HTT regulator GPR52, as well as diverse genes with neural roles, including DCC, DRD2/NCAM1, MDGA2 and CELF4. Fibromyalgia heritability was exclusively enriched within brain tissues and neural cell types. Fibromyalgia showed strong, positive genetic correlation with a wide range of chronic pain, psychiatric and somatic disorders, including genetic correlations above 0.7 with low back pain, post-traumatic stress disorder and irritable bowel syndrome. Despite large sex differences in fibromyalgia prevalence, the genetic architecture of fibromyalgia was nearly identical between males and females. This study provides robust genetic evidence defining fibromyalgia as a central nervous system disorder, thereby establishing a biological framework for its complex pathophysiology and extensive clinical comorbidities.

Despite distinct receptor targets, both ketamine and serotonergic psychedelics produce a rapid clinical response and share biological signatures that suggest convergence on common downstream molecular mediators. To identify shared biomarkers of rapid antidepressant response, this study integrated CSF proteomics from healthy volunteers (HVs) who received intravenous ketamine with transcriptomic analyses from induced pluripotent stem cells (iPSCs) derived from participants with treatment-resistant depression (TRD) and HVs; iPSCs were treated with ketamine, its metabolite (2 R,6 R)-hydroxynorketamine, lysergic acid diethylamide (LSD), or psilocybin. Multimodal clinical characterization (transcriptomics (n = 16 TRD; 11 HV), magnetoencephalography (MEG) (n = 30 TRD; 25 HV), and plasma cytokines (n = 39 TRD; 25 HV) were also performed on TRD and HV participants who received a single dose of intravenous ketamine (0.5 mg/kg) or placebo. Conserved immune pathways were identified across CSF and iPSC neurons with interleukin-15 (IL)-15 and monocyte chemoattractant protein-1 (MCP-1) emerging as key regulatory hubs. Transcriptomically, in whole blood, ketamine responders exhibited decreased IL-15 and elevated B-cell signaling pathways at baseline that were reversed post-treatment. At the protein level, plasma IL-7 levels (primary B-cell driver) correlated with baseline MEG gamma power, reaching brain-wide significance across all participants (main effect p_FDR < 0.05). The association was most pronounced in the TRD participants across subcortical regions (diagnosis x IL-7 p_FDR < 10^-14). Post-ketamine, the TRD IL-7-gamma relationship inverted, paralleling widespread gamma power reductions throughout default-mode network regions (session x IL-7 p_clc < 0.05). In mixed-effects models, cytokine ratios linked to IL-7/IL-15 signaling predicted antidepressant response (IL-4/interferon gamma (IFN-γ) p_FDR < 0.041) and non-response (MCP-1/IL-7 p_FDR < 0.009), suggesting that rebalancing within the IL-7/IL-15 axis may contribute to therapeutic efficacy. Clinicaltrials.gov identifier: NCT00088699; NCT02484456.

Pre-Descemet's endothelial keratoplasty (PDEK) is an evolving endothelial keratoplasty (EK) procedure that merges the advantages of Descemet membrane endothelial keratoplasty (DMEK) and ultrathin EK methods. This review reports the latest anatomical, surgical, and clinical research on PDEK and discusses its potential future role in current EK practices. Anatomical data show that the Pre-Descemet/Dua's Layer (PDL/DL) acts as a biomechanical support, or "splint," for Descemet's Membrane (DM). This support facilitates the creation of grafts that are less tight and easier to handle compared to DMEK tissue. Notably, PDEK leads to rapid visual recovery and improvements in best-corrected visual acuity after surgery. Since PDEK results in an acceptable level of endothelial cell loss and has demonstrated reasonable detachment and rebubbling rates in published series, particularly in experienced hands, it is regarded as a reliable method for effectively utilising young and paediatric corneas, thereby optimising tissue use in eye bank procedures. Furthermore, advancements in surgical techniques, such as specialised PDEK clamps, an air-pump-assisted method, consistent 360-degree scoring, and the integration of optical coherence tomography into the surgical microscope, have resulted in higher success rates in creating Type 1 big-bubble, decreased overall tissue loss, and enhanced procedural consistency. Finally, PDEK merges the optical advantages of DMEK with enhanced intraoperative control and expanded donor options with the inclusion of young donor eyes, and is likely to gain wider adoption when integrated into training programs and eye bank protocols.

Socioeconomic inequalities in children's emotional and behavioural problems are already present at school entry. We examined associations between early-life socioeconomic conditions and children's externalising and internalising problems and assessed whether early-life risk factors mediated these associations.

We analysed harmonised individual participant data from eight birth cohorts within the EU Child Cohort Network. Maternal educational level during pregnancy was used as an indicator of early-life socioeconomic conditions (SECs). Scores of children's externalising and internalising problems around school entry age were used as the outcome variables. Inequalities were quantified using the Slope Index of Inequality which captures the difference in prevalence of problems between children from highest and lowest SECs. Mediation analysis was used to assess the mediating role of five early-life risk factors: maternal smoking during pregnancy, gestational age, small for gestational age, postpartum depression and breastfeeding.

Inequalities in externalising and internalising problems by SECs were consistent across cohorts: Children of mothers with low educational level had on average a 12 and 11 percentage point increased prevalence of externalising and internalising problems respectively. Early-life factors explained around 8% (DNBC, Denmark) to 54% (INMA, Spain) of the inequality in externalising problems and 7% (ELFE, France) to 25% (ALSPAC, UK) in internalising problems.

Children from lower SECs consistently had a higher prevalence of both externalising and internalising problems around school entry age. These inequalities were partly mediated by early-life factors. Public health interventions in pregnancy and the preschool period are critical to address the early emergence of inequalities in children's mental health.

Cognitive decline is a common concern in aging populations, and mild cognitive impairment (MCI) often precedes dementia. Mind-body exercise (e.g., tai chi and baduanjin) combines mental focus and physical movement, potentially improving both cognitive and physical function. This study aimed to evaluate whether a 12-week mind-body exercise intervention could enhance cognitive function, physical function, and body composition in older adults with MCI.

A randomized controlled trial was conducted with community-dwelling older adults (≥60 years) in Nanjing, China. Participants were assigned to either a mind-body exercise group (tai chi and baduanjin, three sessions/week, 60 min/session) or a control group (standard health education and light stretching). Cognitive outcomes included the Montreal Cognitive Assessment, memory, and executive function. Physical function was assessed via the 30-s chair stand, 30-s arm curl, 2.44-m up and go, and single-leg stand, and body composition measures encompassed waist and hip circumference, body fat percentage, and body mass index.

After 12 weeks, the mind-body exercise group showed significantly greater improvements in Montreal Cognitive Assessment score (Δ = 2.04, p < .01), memory (Δ = 0.72 points), and executive function (Δ = 0.37 points) compared with the control group. Participants also improved physical function, evidenced by increased repetition counts in the 30-s chair stand (Δ = 5.93) and arm curl tests (Δ = 5.17) and reduced up-and-go times (Δ = -0.73 s). Although modest reductions in waist and hip circumference were observed, there were no statistically significant group differences in body mass index or overall body fat percentage.

A 12-week mind-body exercise program (tai chi and baduanjin) significantly enhances cognitive and physical function in older adults with MCI. These findings suggest that integrating mind-body exercises may be beneficial as a nonpharmacological intervention to address cognitive decline.

The observed improvements in cognition and physical performance highlight the potential for mind-body exercises to serve as a practical, low-cost strategy for delaying or mitigating MCI-related declines in aging populations. Incorporating such interventions into community-based programs or clinical recommendations could promote healthy aging and reduce the burden of cognitive impairment on health care systems.