Healthy aging has emerged as a global priority. However, older adults' participation in health promotion programs remains low, and traditional health promotion models have achieved limited success in fostering sustained engagement among this population. Mobile health (mHealth)-based gamification interventions offer a promising way to address these challenges. However, no published reviews support or oppose the use of mHealth-based gamification interventions as health promotion strategies in older adults.

The study aimed to identify mHealth interventions using gamification to promote health among older adults.

Our scoping review was conducted following the Joanna Briggs Institute recommendations for scoping reviews and Arksey and O'Malley's framework. The process followed PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) guidelines and PRISMA-S (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Literature Search Extension) checklist. A comprehensive literature search was conducted across 8 databases: PubMed, Scopus, Web of Science, Embase, Cochrane Library, CINAHL, PsycARTICLES, and IEEE Xplore Digital Library, from their inception to December 10, 2025. Two reviewers independently screened titles, abstracts, and full texts via Rayyan, with disagreements resolved by a third reviewer.

This scoping review identified 11 studies. Only 1 article was published before 2022. The interventions were found to improve enjoyment and motivation (n=5), cognitive function (n=3), physical activity (n=2), and digital literacy (n=2). Individual studies also reported improvements in mental health (n=1) and adherence (n=1), a reduction in suicidal ideation (n=1), improvements in physical function (n=1), the promotion of social engagement (n=1), and the identification of mild cognitive impairment (n=1). Game elements used were ranked by frequency as progress, challenges, goals, levels, reward, sensation, storytelling or narration, leaderboard, surprise, and avatar. No research was found to use the game element of "social sharing." mHealth types included augmented and virtual reality-based training systems, wearable devices, mobile phones, tablets, and Windows platforms and devices. Notably, only 4 studies applied theoretical frameworks, and 3 omitted the concrete approach to gamification.

As the first scoping review to identify and map mHealth-based gamification interventions for older adults, this study highlights their potential as an innovative approach to health promotion. By systematically synthesizing evidence regarding intervention designs, gamification strategies, and preliminary health outcomes, it establishes a foundation for future inquiry. However, this review is limited by the small number of included studies, precluding broad generalizations. Future research should assess long-term impacts, integrate theoretical frameworks, establish reporting guidelines, design personalized social-interactive interventions, and expand to broader health domains. Ultimately, these insights provide targeted guidance for developing age-appropriate digital health solutions, contributing to the realization of active aging.

Community-based informal reciprocal interactions (natural supports) enhance individual and community well-being. Like social connections, natural supports aim to establish supportive and healthy environments, but with a greater focus on local surroundings. This study explored natural support approaches within communities in an urban Canadian center. Employing grounded theory, purposive and theoretical sampling identified participants familiar with the community and its opportunities and activities, referred to as community champions. These champions were interviewed about their perceptions of resident connectivity and the key facilitators and barriers related to natural supports approaches in their communities. Themes and categories emerged, leading to the development of a theory. The overarching theory posited "building a community's capacity to transition from disconnected to naturally supportive: the need for connectors, assets, and action to empower residents". Community connectors and assets facilitate natural support approaches within urban community settings. Limited access to space and challenges in recruiting and retaining volunteers were identified as barriers. The findings empower knowledge users, such as community planners, to invest in and promote community natural supports approaches to enhance resident and community well-being. Future directions for this study include the implementation and evaluation of natural support approaches within communities.

Mental health disorders affect around one in seven adolescents globally. In India, home to one-fifth of the world's adolescent population, attention to adolescent mental health is increasing, but access to care remains limited, particularly for Adivasi (Indigenous) adolescents. Understanding how Adivasi adolescents conceptualise psychosocial distress and the kinds of support they value is essential to design supportive interventions. We conducted a qualitative study in rural West Singhbhum, Jharkhand. Using purposive sampling, we recruited 88 participants: 53 adolescents aged 10-19 years, 13 teachers, 11 parents, three community health workers, and eight mental health programme staff aged 18-25 years. Trained peer interviewers conducted semi-structured interviews and group discussions with adolescents in the Ho Adivasi language. A team including experienced Ho researchers and peer interviewers analysed data using the Framework approach. Adolescents, parents, and teachers used variations of the Ho root word "udu" to describe distress. "Udu" denoted thoughts or worries, depending on context. Sources of "udu" included family responsibilities and societal expectations that grew with age: girls were expected to do household work and received less support for school, while boys described income-earning pressures and a lack of emotional outlets. Other "udu" causes included violence at home, school, and public spaces, as well as family separation through migration, remarriage, or parental loss. Impacts of severe "udu" ranged from social withdrawal and strained relationships to early marriage, migration for work, and suicide attempts. Adolescents experiencing "udu" preferred informal support from friends, siblings, or teachers, while those with experience of help from respectful community health workers or trusted, trained older peers valued these. Group-based support was widely acceptable. Strengthening access to early care, alongside measures supporting family livelihoods and social protection, could improve Ho and broader Adivasi adolescent mental health.

Disability is increasingly experienced by women ageing with HIV and multimorbidity. The Episodic Disability Questionnaire (EDQ) measures the presence, severity, and episodic nature of disability across six domains. We evaluated EDQ properties among women living with HIV in the United Kingdom.

Participants in the Positive Transitions Through the Menopause (PRIME) study completed the EDQ at two timepoints (1 week apart), criterion measures (WHODAS 2.0, EQ-5D-5L, Work and Social Adjustment Scale), and a demographic questionnaire. We evaluated internal consistency, test-retest reliability, measurement precision (Minimum Detectable Change (MDC) 95%), and construct validity. We assessed disability prevalence using WHODAS 2.0 (moderate threshold) and Equality Act Disability Definition (severe threshold).

Of 104 participants (median age 56 years, 65% Black ethnicity), 93 (89%) completed the EDQ twice. Median duration since HIV diagnosis was 23 years; 98% had undetectable viral loads and 86% reported multimorbidity. Cronbach's alpha ranged from 0.83 (social domain) to 0.92 (daily activities domain). ICC ranged from 0.70 (physical domain) to 0.91 (daily activities domain). Precision varied, highest in daily activities (MDC95%: 6.10) and lowest in mental-emotional domains (MDC95%: 11.52). The EDQ met 80% (n = 47/59) of construct validity hypotheses. Disability prevalence was 79.81% (95%CI 70.57, 86.79) moderate and 41.75% (32.24, 51.88) severe.

The EDQ possesses internal consistency, test-retest reliability, and construct validity with varied precision among women living with HIV. Disability prevalence in this sample was higher than in the general population. The EDQ offers value for research, clinical practice, and national policy by enabling measurement and description of disability, supporting intervention evaluation, and informing priority-setting and healthcare service planning for women living with HIV in the UK.

Nursing is intrinsically demanding, exposing practitioners to substantial workloads, emotional labour, and systemic healthcare challenges that contribute to significant psychological distress. In Ghana, the compounding effects of structural deficiencies within the healthcare system make nurses particularly vulnerable. However, research on culturally informed coping strategies within this population remains limited. This study examined the association between psychological distress and Africentric coping strategies among 248 nurses in public healthcare facilities in the Central and Greater Accra regions of Ghana.

Data were collected using the Hospital Anxiety and Depression Scale (HADS) and the Africultural Coping Systems Inventory (ACSI). Psychological distress was operationalised as the summed HADS total score (range: 0-42). Descriptive statistics, Pearson correlation analysis, and multiple linear regression models were used to examine associations.

The mean HADS anxiety score was 12.22 (SD = 3.14) and mean depression score was 11.27 (SD = 3.06), indicating elevated anxiety and moderate depressive symptoms. Mean ACSI subscale scores were: Cognitive/Emotional Debriefing M = 2.11 (SD = 0.61), Spiritual-Centred Coping M = 2.18 (SD = 0.73), Collective Coping M = 1.96 (SD = 0.58), and Ritual-Centred Coping M = 0.75 (SD = 0.34). Spiritual (r = - .268, p < .05) and collective coping (r = - .587, p < .05) were significantly and negatively associated with psychological distress; cognitive and ritual coping were not. In regression models, only spiritual (β = -2.681) and collective (β = -0.811) coping demonstrated significant negative associations with distress. Demographic factors including gender, marital status, and professional rank were significant predictors of distress.

These findings highlight the importance of culturally and contextually tailored mental health support that incorporates spiritual resources and peer support networks. The study provides empirical evidence to guide healthcare policy, workplace mental health programming, and culturally responsive nursing practice in sub-Saharan Africa.

Not applicable.

Intimate partner violence (IPV) is a serious public health concern linked with adverse health consequences such as posttraumatic stress disorder, depression, and anxiety. Although substance use disorders (SUDs) have been associated with IPV, there is limited research on IPV screening and disclosure among health care patients with SUDs, particularly veterans.

To examine the rates of IPV screening and disclosure among veterans with alcohol use disorder (AUD) and opioid use disorder (OUD) and to identify IPV subtypes and lethality risks, disaggregated by sex and SUD type.

This study analyzed IPV screening and disclosure rates among veterans in the Veterans Health Administration (VHA) diagnosed with AUD and/or OUD from January 2016 to December 2021.

790,384 veterans diagnosed with AUD, OUD, or both in VHA electronic health records.

Data included rates of IPV screening, rates of positive IPV screens (IPV+), IPV subtypes (psychological, physical, sexual), and risk of IPV-related lethality (escalation, strangulation, belief of being killed).

In our sample, 22.36% (n = 176,739) were screened for IPV, with 12.24% (n = 16,086) of those with a valid administration, screening positive. Female veterans had higher rates of being screened for IPV and positive IPV disclosures than males. Veterans with co-occurring AUD and OUD were more likely to screen positive for IPV than those with only AUD or OUD. Female veterans, particularly those with co-occurring AUD and OUD, were more likely to report high-lethality IPV compared to male veterans with AUD only.

Approximately 1 in 5 veterans in the cohort were screened for IPV. Female veterans with co-occurring AUD and OUD had the highest screen positive rate and severity of IPV. These findings highlight the need for routine IPV screening in VHA, tailored interventions, and integrated treatments addressing both SUD and IPV to improve health outcomes.

Growing evidence reveals relative stability in long-term clinical and functional outcomes of schizophrenia spectrum disorders (SSD), and links poor premorbid adjustment (PA) to worse prognoses. This study investigated associations between PA across developmental stages and long-term outcomes. Data on 496 participants (age 26.8 ± 6.5, male 58.5%) from the Danish randomised OPUS I trial were used (January 1998-December 2000; NCT00157313). Participants, with a first diagnosis within SSD, were recruited from outpatient and inpatient mental health services in Denmark and followed up for twenty years (retention = 29.0%). PA was assessed retrospectively at baseline using the Premorbid Adjustment Scale. Academic and social domain scores in childhood, and their subsequent changes in early and late adolescence, were used. Mixed models examined their effects on social functioning (Global Assessment of Functioning) and negative symptoms (Scales for the Assessment of Negative Symptoms). Low social functioning was associated with worse Social (β[95%CI] = 6.46 [0.54, 12.38], P ≤ 0.033) and Academic (9.40 [3.35, 15.44]; P ≤ 0.002) PA in childhood. Severe negative symptoms were associated with impaired Social PA in childhood (1.23 [0.73, 1.73], P ≤ 0.001), deterioration of Social PA in early adolescence (1.64 [0.93, 2.35], P ≤ 0.001), and declined Academic PA in late adolescence (0.77 [0.14, 1.39], P ≤ 0.016). Poor PA in childhood and PA decline during adolescence are related to Severer negative symptoms and lower social functioning 20 years after SSD onset. Our findings suggest that early signs may emerge in childhood, alongside age-dependent vulnerability-accumulation processes, when developing SSD. Support for maladjusting individuals during development is necessary to mitigate long-term impairments.

The case of mental health disorders has been a main topic in the clinical and psychological field. The advancement of computing studies, especially in Natural Language Processing (NLP)-a subset of Machine Learning, created a system of detection that can detect the mental health state of a person in early stage to prevent the eventuality of the worst case. This is crucial since there has been a lot of case of mental health disorder-such as depression and suicide, remains undetected and untreated-especially when the internet usage is more prevalent than ever even among the most vulnerable users, which are the preadolescent users. This study explores the models that can accurately predict mental health disorder with the provided six labels the model can predict. The labels are anxiety, depression, personality disorder, stress, bipolar, and normal. The dataset is gathered from a Kaggle repository which is then processed and refined further for the training process. From multiple evaluations across diverse amount of texts from different users, our Bi-LSTM-XGBoost model outperforms the other models with an accuracy of 0.9035 and 0.4320 loss, while other models fall short within 50-84% accuracy. Further improvement can be made with our model, whether from improving the model's parameters further or by improving the quantity and quality of the dataset gathered.

To synthesise existing qualitative and conceptual literature on the implementation, ethical considerations and policy implications of Medical Assistance in Dying for Mental Disorder as a Sole Underlying Medical Condition (MAiD MD-SUMC) in Canada and internationally.

A qualitative evidence synthesis using a thematic analysis approach. Empirical, conceptual and policy papers addressing MAiD for mental disorders were identified through major databases and grey literature. Studies were thematically analysed to identify recurring ethical, clinical and policy themes related to eligibility, assessment and implementation.

Data was extracted from a systematic search of Medline and Embase for peer-reviewed studies published from 1974 onwards, supplemented by relevant policy documents and legal cases.

Studies were included if they examined MAiD MD-SUMC and explored ethical, legal or clinical considerations or provided stakeholder perspectives. Exclusion criteria included studies focusing solely on non-psychiatric conditions or not published in English.

Two independent reviewers screened, extracted and analysed data using an iterative thematic synthesis approach. Key themes were identified through consensus discussions.

The synthesis identified four major themes: (1) Irremediability and treatment resistance-persistent uncertainty regarding when mental disorders can be considered irremediable. (2) Capacity and vulnerability-ongoing debate about assessing capacity amid fluctuating symptoms and social influences. (3) Ethical and policy considerations-divergent interpretations of autonomy, justice and safeguards highlighting the need for standardised criteria. (4) Public and professional perspectives-public and family support for inclusion, although clinician hesitancy exists.

The evidence supports a thoughtful, structured approach to potential implementation of MAiD MD-SUMC in Canada. Future priorities include refining criteria for irremediability, standardising capacity assessments, addressing disorder-specific complexities and strengthening mental health infrastructure. Continued research, engagement and transparent policy dialogue will be essential to ensure that any expansion of MAiD upholds ethical integrity, protects vulnerable persons and maintains public trust.

To evaluate changes in health-related quality of life (HRQoL) three years after laparoscopic hysterectomy (LH) for benign, prophylactic, and malignant indications, and to identify baseline factors associated with these changes.

Registry-based observational cohort study with longitudinal patient-reported outcomes.

Women undergoing LH at five Norwegian hospitals between 2019 and 2020.

LH for benign, prophylactic, or malignant indications.

HRQoL was assessed preoperatively and at three years using the RAND-36 across eight domains (0-100; higher scores indicating better health).

Of 939 eligible women, 575 (61%) responded at three years. Indications were benign disease (n=445, 77.4%), prophylactic surgery (n=71, 12.3%), and malignancy (n=59, 10.3%). Women with benign conditions showed significant improvements in bodily pain (mean difference (MD): 12.1, 95% confidence interval (CI): 9.3, 14.9) and physical role limitations (MD: 10.9, CI: 6.3, 15.5) (both p ≤ 0.001), with consistent effects across subgroups. Prophylactic surgery showed no significant changes. Malignant indications had mixed outcomes: physical functioning declined (MD: 9.5, CI -14.9, -4.1, p ≤ 0.001), while mental health improved (MD: 7.2, CI: 1.8, 12.5, p = 0.009). Among benign cases, higher baseline HRQoL predicted less improvement (regression coefficient β = -8.0 to -4.6, p < 0.001).

Three years after LH, changes in HRQoL outcomes varied by indication. Women with benign conditions showed significant improvements, while prophylactic surgery showed no significant change and malignant indications yielded mixed effects. Baseline HRQoL was the strongest predictor of long-term change, highlighting its importance in preoperative counseling.