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Adapting Health Services in Forced Displacement: Operationalizing Surge Capacity Framework in the EMT Barco San Raffaele, Colombia.1 week ago(1) Background: Colombia hosts one of the world's largest mixed-displacement crises, combining longstanding internal displacement with the influx of Venezuelan migrants. This case study examines how the Emergency Medical Team (EMT) Hospital Barco San Raffaele (HBSR) adapted its service-delivery model to respond simultaneously to internal displacement in the Colombian Pacific region and the Venezuelan refugee influx. Using the WHO EMT Surge Capacity Framework, the study analyses how health services were adapted across two concurrent displacement contexts. (2) Methods: A mixed-methods comparative case study was conducted using mission reports, epidemiological surveillance data, policy reports and institutional documents collected between November 2020 and May 2021. Data were analyzed through a thematic analysis structured around the four domains of the WHO EMT Surge Capacity Framework (Staff, Structure, Supplies and Systems), to examine how service adaptation was operationalized across different geographic, sociocultural and legal environments; (3) Results: EMT HBSR adapted staffing composition, supply chains, infrastructure, and operational systems across both settings. Its hybrid model, combining a hospital boat platform with mobile outreach teams, enabled continuity of primary care, mental, maternal and child health, and community-based services in geographically isolated and culturally diverse communities; (4) Conclusions: The findings illustrate how flexible EMT operational models can support the adaptation of health services, and reduce health access inequalities in displacement contexts characterized by high mobility, confinement and limited health system capacity. Mobile platforms, such as hospital boats, appear to be a viable strategy for ensuring continuity of care along migratory routes and in geographically isolated areas affected by protracted instability.Mental HealthAccess
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Mood Monitoring in Schools: A Promising Alternative to Single-Time-Point Screening.1 week agoSchool-based mental health screening typically relies on single-time-point assessments, which assume that students' emotional well-being is sufficiently stable for classification based on a single measurement. The present study examined this assumption by evaluating the stability of emotional well-being classifications under repeated mood monitoring. Students from two secondary schools (United Kingdom, n = 413; Australia, n = 354) completed the Brief Emotional Experience Scale weekly across six to seven weeks. Emotional well-being classifications were examined relative to a predefined low well-being threshold to assess stability across time, and a post-monitoring survey examined students' self-reported perceptions of the monitoring experience. Most students (78%) showed consistently above-threshold classifications across monitoring occasions, while a small proportion (5%) showed persistently low classifications. However, 17% of students fluctuated above and below the low well-being threshold across weeks, indicating that classification status for this group was sensitive to assessment timing. When monitoring data were aggregated using different decision rules, the proportion of students flagged as low well-being varied substantially, ranging from approximately 5% under a conservative stability-based criterion to around 12% when classifications were based on averaged monitoring scores. Classifications derived from averaged monitoring scores showed high agreement with single-time-point classifications, while identifying a partially different subset of students as low well-being, underscoring the sensitivity of threshold-based decisions to classification approach. Student feedback provided preliminary contextual insight into the acceptability of repeated monitoring under routine school conditions, with over half of respondents reporting that the process supported their emotional understanding. A substantial minority also reported greater inclination to talk with others about their well-being. Overall, the findings indicate that single-time-point screening may provide an incomplete basis for emotional well-being classification for some students, and that repeated assessment offers additional temporal context for interpreting threshold-based screening decisions.Mental HealthAccessCare/ManagementAdvocacy
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Integrating Well-Being in Living and Learning Through Occupational Therapy Fieldwork on a College Campus: The WILL Thrive Program.1 week agoPostsecondary institutions are seeing an increased prevalence of student mental health concerns and disabilities, highlighting the need for campus-based approaches that support student well-being. While college campuses provide many services to support students, occupational therapists are largely absent from these support systems, despite growing interest in this emerging field of practice. This program description and implementation case study examines preliminary indicators of feasibility for the WILL Thrive program, which delivered occupational therapy (OT) services on a college campus through a Level II fieldwork placement. Feasibility was examined across domains of acceptability, demand and implementation using an integrated approach combining a needs assessment, service development and process evaluation. Data sources included environmental observations, surveys, stakeholder interviews and process evaluation measures, including service delivery tracking, referral patterns, and resource utilization. Referrals and service utilization in this case were most frequently observed among students reporting neurodevelopmental and mental health-related functional challenges, providing preliminary indicators of potential service users, though a small, heterogeneous sample size limits generalizability. Referral patterns and engagement from the wellness center and accessibility staff highlight preliminary strengths of the program, including early indicators of acceptability and demand. In contrast, implementation barriers were also identified, including limited campus-wide understanding of the OT scope and role and constraints in on-campus OT supervision. Findings offer early, exploratory signals of feasibility for integrating OT services through an OT fieldwork II model and suggest that OT may complement existing campus supports by addressing participation-focused, functionally orientated needs. Results should be viewed as preliminary and inform future implementation studies that include systematic outcome measures, comparative analysis with existing services, and broader assessment across diverse higher education contexts.Mental HealthAccess
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Implementing Outpatient Therapeutic Playgroups for NICU Families: A Quality Improvement Project.1 week agoTherapeutic playgroups have shown promise in enhancing caregiver-infant mental health outcomes, yet tailored approaches for families following neonatal intensive care unit (NICU) admission remain limited. In this brief report on Quality Improvement, we evaluate key strategies and challenges in implementing an adapted therapeutic playgroup intervention designed for caregivers and infants with a history of NICU hospitalization at University of California, San Francisco and Zuckerberg San Francisco (UCSF) Zuckerberg San Francisco General Hospital (ZSFG) We conducted semi-structured interviews with NICU psychologists to assess local feasibility, barriers, and facilitators to implementation. Implementation science frameworks-the Consolidated Framework for Implementation Research (CFIR) and Proctor et al.'s implementation outcomes framework (acceptability, adoption, appropriateness, feasibility, and sustainability)-were used to guide data organization and interpretation. Qualitative reporting guidelines were followed to enhance transparency in describing interviews and analytic procedures. The psychologists emphasized the importance of embedding therapeutic playgroups within existing clinical workflows, providing flexible delivery models, and customizing curricula to meet cultural and family-specific needs. Multidisciplinary collaboration enhanced feasibility and parent engagement. Barriers included organizational constraints and variability in caregiver readiness. These findings inform local program development and highlight considerations for integrating dyadic mental health support into post-NICU care. Future work should incorporate caregiver perspectives and explore effective interventions across diverse settings.Mental HealthAccessCare/Management
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The Benefits of the Positive Parenting Program as Early Intervention for Mothers of Children Aged 1-3 Years Who May Have Neurodevelopmental Disorders.1 week agoBackground/Objectives: The Positive Parenting Program (Triple P) is an evidence-based intervention for families including young children with neurodevelopmental disorders. Because establishing a definitive diagnosis in early childhood takes time, especially for 1-3-year-olds who have only recently shown early signs, parents often experience substantial stress. This study examines the effectiveness of the Group Triple P (GTP) program for mothers of 1-3-year-old children without a confirmed diagnosis who spent time at a community parenting support center. Methods: The participants were 41 mothers of children aged 1-3 who did not confirmed neurodevelopmental diagnosis but showed behavioral, emotional, or developmental concerns, or whose mothers reported parenting difficulties. To reflect real community practices, a non-randomized pre-post test design without a control group was adopted. Assessments were conducted at baseline, postintervention, and at a 12 weeks follow-up using the Strengths and Difficulties Questionnaire, Parenting Scale, Parenting Experience Scale, and Depression Anxiety Stress Scale. Results: GTP improved the mothers' assessments of positive behaviors in children who may have neurodevelopmental disorders, with a medium effect size. GTP reduced dysfunctional parenting styles in mothers with a large effect size. It also enhanced mothers' confidence and fulfilling sense in parenting, and decreased depression and stress with a medium effect size. Perceived access to parenting support improved, contributing to better parenting adaptation with a medium effect size. Conclusions: GTP may serve as an early public health intervention for mothers of young children who may have neurodevelopmental disorders by supporting maternal mental health and promoting adaptive parenting.Mental HealthAccessCare/Management
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Children's Drawings as a Tool to Explore the Emotional Experience of Migrant Children in Dental Care: A Qualitative Study in Italy.1 week agoBackground: In multicultural healthcare systems such as the Italian one, migrant children may experience dental care as particularly stressful because linguistic and cultural barriers can limit communication, emotional expression, and understanding of the clinical setting. Aim: Understanding the emotional experience of migrant children during dental visits is essential for improving clinical management in pediatric dentistry and orthodontics within multicultural contexts. Because linguistic barriers often limit verbal communication, this study aimed to explore children's mental representations, emotional states, and perceptions of the dental environment through drawing and to evaluate the clinical implications for communication and therapeutic collaboration. Methods: This qualitative study was conducted in Italy between 2016 and 2025 and analyzed 50 drawings produced by 50 foreign-born migrant children aged 6-13 years, recruited through an educational cooperative in Piacenza. Most participants originated from developing countries and had limited proficiency in Italian, frequently showing a marked "experience gap" in drawing ability that interfered with normative developmental stages described by Lowenfeld. The analysis focused on spatial organization, line quality, color use, posture, interpersonal distance, and representation of the clinical environment, integrating graphic competence assessment with emotional interpretation. Results: Younger children commonly depicted rigid lines, essential settings, and oversized dental unit lamps, whereas older children increasingly represented threatening or disproportionate instruments, aggressive dentists, and omission of the patient figure. Around age 10, drawings became more detailed and colorful, although symbols of closure, such as locked doors, persisted. In adolescents, representations polarized between rich, coherent scenes and extremely essential drawings dominated by fear, rigidity, minimal environments, and symbols of constraint. The findings suggest that drawing may represent a valuable non-verbal clinical and communicative resource for exploring migrant children's emotional experience of dental care and for identifying signs of anxiety and vulnerability that may not emerge through verbal interaction alone. Conclusions: These findings support the value of a culturally sensitive dental approach integrating drawing, visual aids, multilingual educational materials, and play-based strategies to reduce communication barriers and improve cooperation in migrant children receiving pediatric dental and orthodontic care.Mental HealthAccessCare/Management
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School-Based Alcohol and Tobacco Prevention Strategies: A Scoping Review and the Missing Role of School Nurses.1 week agoBackground/Objectives: Alcohol and tobacco use in adolescence are major public health concerns that shape long-term health trajectories and undermine healthy behaviour development. Schools are key settings for health promotion, offering structured environments to foster self-regulation, social skills, and protective behaviours. This scoping review mapped recent school-based educational strategies designed to prevent alcohol and tobacco use among adolescents and to examine whether the included studies reported any involvement of school nurses. Methods: Review followed Arksey and O'Malley's framework and adhered to JBI guidance and PRISMA-ScR. Searches were conducted in PubMed and Web of Science (2019-2024) to identify school-based educational interventions targeting alcohol and/or tobacco use among primary or secondary school children. The primary search targeted prevention strategies, complemented by nursing-related terms to identify nurse involvement. A standardised charting form captured study characteristics, intervention formats, theoretical foundations, implementation factors, and any reported participation of health professionals. Data extraction was performed independently by two reviewers. Results: Eleven studies met the inclusion criteria. Most were randomised controlled trials (81.8%). Educational strategies included online (45.5%), hybrid (27.3%), and face-to-face (27.3%) formats. Programs focused on social skills, self-regulation, harm reduction, or resilience. Digital formats were cost-effective but showed challenges in engagement and sustained participation, while face-to-face or hybrid approaches offered relational support but were vulnerable to implementation drift. No study reported nurse involvement. Conclusions: School-based prevention strategies can contribute to healthier behaviours related to substance use by reinforcing socioemotional competencies and reducing early exposure to substances. However, persistent barriers such as low engagement, inconsistent delivery, and the absence of health professionals limit their impact. The role of school nurses could be considered in future school-based prevention programmes.Mental HealthAccessPolicy
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The Evolution of the Mental Health-Acute Coronary Syndrome Intersection: A 50-Year Bibliometric Mapping and Changepoint Analysis (1975-2025).1 week agoBackground/Objectives: The intersection of mental health and acute coronary syndromes has become an increasingly prominent area of cardiovascular and psychosomatic research, yet its temporal dynamics and intellectual structure remain incompletely characterized. Methods: This study analyzed 13,646 peer-reviewed documents spanning five decades, employing advanced changepoint detection (PELT) algorithms, network visualization (VOSviewer), and bibliometric performance metrics (Bibliometrix) to quantify the evolution of the mental health-ACS intersection. Results: Statistical analysis identified two robust inflection points at 1990 and 2005 that demarcate distinct developmental periods. The 1990 breakpoint marked an important transition, although additional metadata-completeness analysis indicated that part of the increase from 72 to 142 publications may reflect improved availability of non-title Topic-field metadata in WoSCC around 1990-1991. The 2005 breakpoint represented the most critical transition (Cohen's d = 4.05, p < 0.000001), initiating exponential growth from 349 to over 600 annual publications by 2022 and coinciding with growing research attention to psychiatric comorbidity within ACS literature. Keyword co-occurrence networks revealed a shift in research focus: early publications predominantly addressed mental health as a psychological reaction to cardiac events, whereas more recent publications increasingly frame depression, anxiety, and PTSD alongside mechanistic constructs such as inflammatory pathways, autonomic dysfunction, and platelet reactivity. Although seminal intervention trials (i.e., ENRICHD, SADHART) established pharmacological safety and symptom improvement, keyword analyses indicate that following these trials, research attention increasingly shifted toward precision psychiatry concepts and mechanistic pathway elucidation. Conclusions: These findings provide a quantitative map of how publication activity at the mental health-ACS intersection has evolved, offering a structured basis for identifying under-researched areas and informing future research agendas.Mental HealthAccess
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Healthcare Experiences of Older Adults with an LGBT+ Identity: An Integrative Review.1 week agoBackground/Objectives: Older adults with an LGBT+ identity represent an under-researched population within healthcare systems. Existing evidence suggests that they experience distinct health challenges compared to their heterosexual counterparts, partly shaped by lifelong experiences of stigma and discrimination. Such experiences may contribute to minority stress, which is associated with adverse mental health outcomes and lifestyle-related health issues. This review aims to synthesise the existing literature on how older adults with an LGBT+ identity experience encounters with healthcare. Methods: An integrative literature review was conducted following PRISMA guidelines. A systematic search of multiple databases was performed, and studies were screened using predefined inclusion and exclusion criteria. Data were analysed using systematic text condensation. Results: A total of 18 studies were included, comprising approximately 450 participants. All studies contained a qualitative component. Three overarching themes were identified: (1) double-edged discrimination-experiences of stigma and anticipated fear in healthcare; (2) relational networks as essential yet fragile sources of support in later life; and (3) healthcare practices as shaping inclusion or invisibility-the need for competence and recognition. Conclusions: The findings highlight significant barriers faced by older adults with an LGBT+ identity in healthcare, including fear of discrimination and challenges related to disclosure. Social networks play a crucial role as sources of support, while healthcare professionals' competencies and practices are central to ensuring inclusive and equitable care.Mental HealthAccess
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Help-Seeking Intentions and Preferred Sources for Mental Health Problems Among University Students in Saudi Arabia.1 week agoBackground: Mental health problems are highly prevalent among university students in Saudi Arabia; however, help-seeking behaviors remain low despite the availability of mental health services. There is limited evidence regarding students' intentions to seek help and preferred sources of support, especially formal or informal sources. This study examined help-seeking intentions for mental health problems among university students. Methods: This cross-sectional descriptive study was conducted using an online self-administered questionnaire. Participants were 248 undergraduate students from various Riyadh universities. Help-seeking intentions were assessed using the General Help-Seeking Questionnaire. SPSS software was used to perform independent t-tests to assess differences in preferred sources across demographic groups, and Pearson's correlation analyses were conducted to examine relationships between preferred sources and demographic variables. Multiple linear regression analyses were conducted to examine demographic and academic predictors of intentions to seek help from formal and informal sources. Results: Students demonstrated a low overall propensity to seek help. Online sources were the most preferred help-seeking option, followed by mothers, friends, and general physicians, whereas faculty, relatives, and religious persons were the least preferred. Preferred help-seeking sources differed by gender. Seeking help from mental health specialists was positively correlated with age and grade point average. Additionally, the regression analysis for formal help-seeking was significant, explaining 8.4% of the variance, with gender as the only significant predictor. Conclusions: These findings suggest the need for targeted interventions to improve students' help-seeking behaviors. Universities should prioritize mental health literacy initiatives, stigma reduction strategies, and accessible support pathways, particularly by integrating digital and hybrid services and enhancing the role of faculty and institutional support systems in promoting timely and appropriate help-seeking.Mental HealthAccess