Mental health, at the opposite end of the spectrum from mental illness, is an important yet understudied aspect of maternal well-being. We sought to characterize aspects of emotional, social, and functional well-being in the postpartum period and perceived facilitators and barriers to mental health following a high-risk pregnancy.

We conducted 28 in-depth interviews with people 3 to 6 months postpartum who experienced a pregnancy complicated by hypertension or diabetes in Atlanta, Georgia. We conducted a thematic analysis to examine dimensions of mental health and prevalent challenges to attaining it.

Participants described how social well-being (including interpersonal relationships, functional support, and social support) facilitated positive functioning and emotional well-being. Challenges to well-being included difficulties with infant feeding and care, housing and financial insecurity, and personal health. Facilitators of well-being included robust and positive relationships with female relatives and male partners. Participants described a limited role of the perinatal care team in supporting mental well-being.

Postpartum mental health is a distinct construct from mental illness that, when adequately supported through family networks and health care teams, can benefit both woman and infant.

Most rural Veterans with behavioral health concerns are not engaged in behavioral health care. Peer Support for Treatment Seeking (PS-TS) engages Veterans in care by leveraging Veteran peer specialists' unique skills to connect with other Veterans. PS-TS is a brief conversation about treatment-seeking beliefs that aims to connect Veterans to care. PS-TS was implemented in two rural Veterans Health Administration (VHA) regions in 2024.

Evidence-based implementation strategies were used to support uptake of PS-TS, including working with local stakeholders to identify site-specific implementation barriers, tailoring implementation materials for peer-delivery, tracking adaptations, and training peers to deliver PS-TS. We evaluated impact using the RE-AIM domains of reach, effectiveness, adoption, implementation, and maintenance.

Tailoring PS-TS and the implementation plan to fit the peers' scope of practice and the needs of rural Veterans enabled implementation, while peer discomfort with outreach calls and the complexity of delivering PS-TS were barriers. PS-TS content and training were adapted to provide peers with more support. Peers conducted 364 outreach calls and delivered PS-TS to 117 Veterans, of whom 43 (37%) initiated VHA behavioral health care and 17 (15%) sought community/other care. PS-TS fidelity was high overall, but quality of delivery was low moderate for more challenging components. PS-TS was not maintained after implementation support ended.

Evidence-based implementation strategies enabled PS-TS to reach many rural Veterans with unmet behavioral health needs and increase care engagement. Future implementation efforts should prioritize increasing the quality of PS-TS delivery and enabling PS-TS maintenance over time.

Psychiatric settings are high-risk environments for violence. Coercive measures (CMs) and security technologies (STs) can be used to ensure safety. However, limited evidence exists on how Italian mental health nurses (MHNs) perceive the appropriateness of such practices and the influencing factors. This study aimed to fill this gap.

Cross-sectional study.

An online survey collected sociodemographic data and validated measures of depression, anxiety, stress, stigma toward mental illness, and humanization of care. The perceived appropriateness of various CMs and STs was rated on a 5-point Likert scale using a validated item set. Data were analyzed using descriptive statistics, bivariate tests, and multilevel mixed-effects linear regression.

A total of 707 MHNs participated in the study. CMs were considered moderately appropriate (mean = 3.56 ± 0.92), with pharmacological restraint and locked-door policies rated as more appropriate than physical restraint. STs were evaluated better (mean = 3.74 ± 0.95), with alarms and closed-circuit television judged more appropriate than body-worn cameras and metal detectors. CMs were considered less appropriate by non-believers (p = 0.009), head nurses (p < 0.001), and those in non-acute settings (p = 0.004), and more appropriate by those in Central Italy (p = 0.036), on daytime shifts (p = 0.042), and with higher stigma (p = 0.012). STs were considered less appropriate by males (p = 0.004), head nurses (p = 0.040), and more experienced MHNs (p < 0.001), and more appropriate by those in Southern Italy (p < 0.001) and in non-acute settings (p < 0.001).

MHNs consider CMs and STs moderately appropriate. Perceptions are influenced by both individual and contextual factors. Targeted training, anti-stigma education, and inclusive policies are needed to ensure ethical and evidence-based safety practices in psychiatric care.

Targeted education and training in mental health nursing, both continuing and post-graduate, are essential to support cultural change among MHNs and ensure the appropriate use of CMs and STs. Integrating anti-stigma initiatives and involving MHNs in policy development can strengthen clinical decision-making and foster safer, more ethical, and person-centred psychiatric care.

The Biofluid Biomarkers Best Practices Workgroup of the National Alzheimer's Coordinating Center-Alzheimer's Disease Research Center (ADRC) Biomarker Core Steering Committee was convened to update pre-analytical handling guidelines for biofluid biomarkers, focusing on cerebrospinal fluid (CSF) and blood. We reviewed current literature pertinent to best practices for biomarker studies and surveyed the ADRCs for biomarker analytes, platforms, and protocols used at each center. Across 37 ADRCs, 16 CSF and 28 plasma/serum analytes were reported to be studied at multiple centers. The pre-analytical handling steps and concerns related to each, as supported by empirical studies and expert opinion, were integrated to generate a revised guideline document. The guideline aimed to standardize steps in biospecimen and biomarker analyte collection, storage, and pre-analytical handling across the ADRCs. The 2025 ADRC guidelines represent the current working knowledge on biomarker best practices, providing guidance and harmonized protocols, and promoting robust analysis and reporting of composite data.

This study aimed to examine treatment-related factors influencing antidepressant non-adherence among patients with Major depressive disorder in Pakistan.

An explanatory sequential mixed-methods cross-sectional design was employed. The study first conducted questionnaire-based quantitative research to assess non-adherence and its treatment-related predictors. This was followed by semi-structured interviews with a purposively selected subset of participants who were poorly adherent to explore their contextual experiences. Quantitative and qualitative findings were integrated using narrative synthesis and joint displays.

A total of 2,513 participants with recurrent major depressive disorder (MDD) were surveyed. Among them, 812 (32.3%) were classified as poorly adherent, 719 (28.6%) as moderately adherent, and 982 (39.1%) as highly adherent, based on the UMGLS-4. High ADR burden, low DAI-10 scores, unemployment, low income, and age above 55 years were significantly associated with non-adherence (p <0.05). Participants with high ADR burden were 1.42 times more likely to be non-adherent (AOR = 1.42, p < 0.001). Qualitative findings from 17 interviews supported and expanded these associations, revealing how sedation, weight gain, cultural interpretations of medication as "hot", lack of treatment timelines, and poor pharmacy support discouraged routine antidepressant use.

A combination of physiological, cognitive, and systemic treatment-related barriers drives antidepressant non-adherence among Pakistani MDD patients. Addressing these factors through culturally sensitive ADR counselling, consistent follow-up, and pharmacist-led support may improve adherence and treatment outcomes in low-resource mental health settings.

Older women experiencing homelessness (OWEH) have been a hidden or invisible population; however, with rising numbers globally, they are gaining attention. Our study examines what it means to be a woman in her 50s who is struggling financially and precariously housed in the United States. Although in their 50s, these women often experience accelerated aging and exhibit chronic health conditions comparable to those of housed women in their 70s and 80s. Lacking access to both public old-age benefits and family support, they often fall between the cracks of the nation's safety net system. While homelessness among women of reproductive age, including the role of gender-based violence in increasing their vulnerability, is now well documented, studies on the unique challenges faced by OWEH remain relatively limited.

This study explores how daily life on the streets and in emergency housing shelters, a system historically designed for men (particularly younger men), affects the well-being of OWEH and their journey toward stable housing. The aim was to describe, from the perspectives of OWEH, how shelter environment, policies, and practices (including continual displacement to the streets) shape their daily lives, well-being, and pathways to stable housing. Of particular interest was gaining a deeper understanding of how navigating the traumas of homelessness and shelter living affects individuals' sense of dignity, self-worth, adaptive resources, and resilience.

This qualitative study involved 15 semistructured, private individual interviews, each lasting about 60 min, conducted by an MSW social worker. Eligibility criteria included being homeless for at least 1 month, being in one's 50s, and being able to take part in an English-language interview. Using NVivo (qualitative research software), the interview audiotape transcripts were coded and analyzed using a multistep interpretative phenomenological approach to enable exploration of how OWEH make sense of what is happening to them (or the "lived experience') and their views (or "meaning making') of life and these experiences.

Trauma was a universal experience, and almost all participants were coping with significant physical and/or mental health issues. Overall, participants perceived that shelter management and staff failed to fully understand the challenges women faced in rebuilding their lives, especially the interconnectedness of health struggles, societal bias against older women, and the social prejudice of people experiencing homelessness. Five superordinate themes were identified, highlighting how shelter physical and social environments contribute to OWEH's daily struggles and sense of disempowerment: (a) dehumanizing and stigmatizing treatment; (b) unsafe surroundings and hypervigilance; (c) harsh living conditions and declining physical and emotional health; (d) disempowering situations and loss of control; and (e) an absence of normalcy and stability.

This study contributes to our understanding of how emergency housing shelters create or exacerbate the challenges faced by OWEH and often result in disempowering. The findings suggest the importance of transforming both the physical and social environments of shelters, using trauma- and aging-informed approaches, to better support this growing population of OWEH in their pathway to stable housing.

To understand the impact of COVID-19-related closures of community-based exercise programmes (CBEPs) on exercise participation, physical activity, and health of older adults with balance and mobility limitations; facilitators, and barriers to exercise and physical activity; and preferred support from recreation centres and health care providers.

This qualitative descriptive study involved semi-structured interviews with seven older adults (aged 50-76 years) with balance and mobility limitations, enrolled in CBEPs at a recreation centre in a suburban area in Canada prior to the COVID-19 pandemic. We conducted a thematic analysis.

One major theme, losing ground in the absence of structured exercise, was identified. Despite engaging in alternative at-home or outdoor activities, participants perceived a worsening of their balance and mobility, dissatisfaction with the extent of exercises and physical activity, and loss of social connectedness. Participants desired structured, individualized exercise resources, and frequent check-ins from exercise instructors to stay physically active during programme suspension.

Following CBEP closures, older adults with balance and mobility limitations from a single recreation centre perceived declines in physical and mental health, exercise participation and social interaction, and desired personalized exercises and communication from exercise instructors. The small sample size may have limited achievement of saturation.

Alopecia areata (AA) is a chronic autoimmune-mediated disorder characterized by hair loss from the scalp and/or body. AA patients frequently present with comorbid chronic inflammatory disorders (CIDs), particularly atopic and autoimmune diseases. Genome-wide association (GWA) studies have suggested a genetic link. However, no studies to date have examined genetic factors that are associated with the comorbid development of CIDs directly in individuals affected by AA.

We performed an exploratory GWA study in Central European AA patients stratified by self-reported comorbidity status (110 to 1,302 cases with- and 1,030 controls without comorbid CIDs). Comorbidities were analyzed first as broad atopic and autoimmune categories and subsequently as individual conditions, including asthma, atopic dermatitis, rhinitis, vitiligo, and Hashimoto's thyroiditis.

No genome-wide significant signals were identified at either the variant or gene level. At exploratory thresholds (p_variant<1x10^-5, p_gene<0.001), more loci showed potential association with comorbid autoimmunity than with atopy, although the number of implicated genes was comparable. Several identified genes were previously implicated in CID pathogenesis and many loci contained variants with known regulatory effects on gene expression in skin and immune cells. For comorbid atopy/autoimmunity overall, PHF11 was the most frequently implicated gene, consistent with its previously described role in T- and B-cell biology. Network analyses highlighted cytokine, hormone, and transcription factor signaling pathways as potential mechanisms underlying comorbid CID development in AA.

Our study provides initial mechanistic insights for comorbid CID development in AA, and a foundation for larger-scale studies.

Health disparities in the United States are not produced by single risk factors but by interacting social and biological conditions that cluster within structurally marginalized communities. Poverty, violence, and poor physical and mental health form a reinforcing system of disadvantage that traditional healthcare models-organized around isolated diseases-are poorly equipped to address. This perspective examines these dynamics through a syndemic framework, which conceptualizes co-occurring conditions as mutually interacting epidemics intensified by social inequality. Drawing on interdisciplinary evidence from public health, medicine, and social science, we describe how poverty-related stressors such as housing instability, food insecurity, and barriers to healthcare intersect with exposure to interpersonal and structural violence to amplify risks for depression, posttraumatic stress disorder, chronic disease, and premature mortality. These interactions produce compounded health burdens that are disproportionately experienced by marginalized populations. Despite increasing attention to social determinants of health, current healthcare responses remain fragmented. Health systems frequently identify risks through screening for social needs or trauma exposure but lack the institutional infrastructure, reimbursement mechanisms, and cross-sector partnerships required to address them effectively. We argue that advancing health equity requires moving beyond additive models of care coordination toward syndemic-informed healthcare systems that intervene simultaneously on clustered conditions and their shared upstream drivers. We outline key priorities for practice, policy, and research, including linking screening to actionable care pathways, strengthening partnerships between healthcare and social service systems, and expanding workforce training to include structural and syndemic competency.

[This corrects the article DOI: 10.3389/fpsyt.2025.1623358.].