Background/Objectives: Previous research has shown that mental disorders are common in the general population in Latvia, while access to specialised psychiatric services is limited, particularly in rural areas. General practitioners, therefore, have a crucial role in the early detection and management of these conditions. Previous studies and national initiatives have highlighted an unmet need for continuing education in psychiatry tailored to the Latvian primary care context. In response, the first Latvian telementoring programme, the "ECHO School of Psychiatry" (Extension for Community Healthcare Outcomes, ECHO), was launched in 2023 to enhance general practitioners' competencies and decision-making in mental healthcare. This study explored general practitioners' experiences and perceptions of participation in the programme and its perceived impact on their practice, using a qualitative approach. Methods: Thirteen women general practitioners who had participated in the programme between October 2023 and February 2025 were recruited using voluntary response sampling, via email invitations from programme coordinators. Individual semi-structured interviews were conducted remotely between May and September 2025, audio-recorded, transcribed verbatim, and the resulting transcripts were analysed thematically using an inductive approach, supported by NVivo software. Data collection continued until no new themes emerged. Results: Four main themes emerged from the thematic analysis: (1) participants' perceptions of the structure and educational value of the programme; (2) perceived impact of the programme on clinical practice and decision-making; (3) programme limitations in addressing professional isolation and fostering collaboration; (4) suggestions for programme improvement. Themes illustrate participants' perceptions of the programme's value, its impact on practice, and recommendations for further development. Conclusions: This study provides insights into the strengths and areas for improvement of the "ECHO School of Psychiatry" as perceived by general practitioners. It also acknowledges current challenges in primary care, such as limited access to specialists and professional isolation.

Background/Objectives: Japan's mental healthcare system is characterized by the world's highest number of psychiatric beds, widespread "social hospitalization," and a structurally entrenched managerial support model that frequently undermines patient autonomy. Joint Crisis Plans (JCPs)-collaboratively developed crisis management documents-have been increasingly adopted as a care coordination tool; however, their role in transforming professional practice towards recovery-oriented support remains underexplored. This study aimed to elucidate the experiences of professionals utilizing JCPs across diverse facility types and to develop a theoretical understanding of the process by which they redefine their role from 'manager' to 'recovery companion'. Methods: A qualitative design using the Modified Grounded Theory Approach (M-GTA), grounded in symbolic interactionism, was employed. Semi-structured interviews were conducted with 13 professionals (7 nurses, 6 mental health and welfare workers) across nine facilities (psychiatric hospitals, 24-h residential facilities, outpatient facilities) in the Kanto region of Japan. Theoretical sampling continued until saturation. Data were analyzed using the constant comparative method, with validity ensured through team checking. Results: Nine categories and 23 subcategories were extracted. A three-stage support transformation process emerged: (1) Initial Stage and Motivation, in which professionals confronted the limitations of managerial practice; (2) Role Redefinition and Practice through Collaboration, involving joint crisis management, strength-based support, and network building; and (3) Stage of Integration of Perspectives and Implementation of Recovery-Oriented Practice, in which professionals witnessed individual recovery and integrated new support values into their practice. Negative cases revealed that JCP effectiveness is contingent on the co-construction of shared meaning rather than procedural compliance. Conclusions: JCP was suggested to function as a potential tool to facilitate navigating and reframing structural managerial barriers in Japanese mental healthcare. The creation of a shared language through JCP was associated with supporting conditions for individual self-determination, alleviating professional conflicts, and contributing to shifts in organizational culture.

Overweight and obesity are prevalent among companion dogs and cats in the Western world. Affected animals are at risk of comorbidities and reduced longevity. This narrative review found that veterinary literature generally characterises overweight and obesity as nutritional disorders that are primarily addressed by reducing caloric intake. However, veterinary management of overweight and obesity has limited success outside research settings. The Five Domains model for animal welfare assessment is applied to explore impacts of overweight and obesity and their management in dogs and cats by focusing on nutrition, health, physical environment, behavioural interactions and mental state. A second focus is on the practical strategies for addressing non-diet-related barriers and client communication through the provision of management recommendations. This novel and integrative approach aims to inform veterinarians and improve the success of weight management protocols.

Associate degree nurses constitute a substantial segment of the nursing workforce and play a crucial role in delivering frontline patient care across healthcare settings. Despite their importance, limited evidence exists regarding factors influencing their job satisfaction, particularly the quality of nursing work life (QNWL), within the Jordanian context. This study aimed to examine the relationship between QNWL and job satisfaction among associate degree nurses in Jordan. A cross-sectional study was conducted between March and April 2024 among 114 associate degree nurses working in 3 government hospitals in Jordan. Participants were recruited using purposive sampling. Eligible nurses held an associate degree in nursing, had at least one year of clinical experience, and were actively employed at the time of data collection. Nurses with less than one year of experience or those on extended leave were excluded. Data were collected using the Muller and McClosky Satisfaction Scale and Brooks' QNWL Scale. Descriptive statistics and Pearson correlation coefficient were applied for data analysis. The overall QNWL was low (mean (M) = 108.11, SD = 17.03). The lowest scores were observed in the work life/home life domain (M = 16.84, SD = 4.67) and the work design domain (M = 28.24, SD = 5.06), reflecting challenges related to workload and work-life balance. Job satisfaction levels were generally low, with mean scores ranging from 1.08 to 1.73 on a five-point scale, indicating dissatisfaction across multiple job dimensions. In contrast, relatively higher satisfaction was reported in interpersonal aspects, including satisfaction with coworkers (M = 2.67, SD = 0.42) and interpersonal interaction (M = 2.31, SD = 0.93). A strong and statistically significant positive correlation was identified between the work environment and job satisfaction (R = 0.746, P < .001). The findings reveal significant concerns regarding workload, work-life balance, and limited extrinsic rewards among associate degree nurses in Jordan. Implementing targeted organizational strategies and policy interventions aimed at improving the QNWL may enhance job satisfaction and ultimately contribute to improved quality of patient care.

Depression is a prevalent mental disorder that imposes a substantial global burden, and environmental exposure has been increasingly implicated in its etiology. However, the specific mechanisms linking urinary exposure to volatile organic compounds (VOCs) with depression remain poorly understood. A potential association of VOCs with depression prevalence was explored in this study, which also assessed the mediating effect of chronic inflammatory airway diseases (CIAD). This study analyzed data from the National Health and Nutrition Examination Survey from 2011 to 2020, involving 1696 participants. An ultra-high-performance liquid chromatography-tandem mass spectrometry assay was employed to quantify the levels of 16 VOCs in urine samples. We employed weighted multivariable logistic regression models, coupled with mediation analysis, to assess the potential association between urinary concentrations of VOCs and the risk of depression, while also investigating the intermediary pathway involving CIAD. The diagnostic potential of urinary VOCs as biomarkers for depression was further assessed through receiver operating characteristic curve analysis. Screening of the 1696 study subjects indicated a depression prevalence of 11.4%. Notably, 4 urinary VOC metabolites demonstrated a statistically significant positive association with the disorder (odds ratio > 1, P < .05). The dose-response relationship between them was also statistically significant. Mediation analysis indicated that CIAD mediated 7.3% of the total effect of VOC exposure on depression (P < .05). Contact with certain VOCs has been linked to an elevated incidence of depression disorder. CIAD plays a mediating role in the correlation between urinary VOCs and depression.

This single-center retrospective study explores the incidence of anxiety and depression in epilepsy patients and analyze their correlation with seizure control. A total of 201 epilepsy patients treated at our hospital between February 1, 2022, and February 1, 2024 were included. Based on the Hamilton anxiety rating scale (HAM-A) and self-rating depression scale (SDS) results, patients were divided into an AD group (73 cases) and a NAD group (128 cases). Among the AD group, 45 patients (61.6%) underwent anxiety/depression screening for the first time, highlighting the lack of routine psychological assessment in epilepsy management. Demographic characteristics, epilepsy history, seizure characteristics, medication usage, adherence, seizure control, auxiliary examinations, and psychological interventions were collected. Univariate analysis was performed to screen potential factors, and multivariate logistic regression was subsequently used to identify independent risk factors for anxiety/depression. Patients in the AD group had a younger average age (34.5 ± 12.6 years vs 39.1 ± 11.7 years, P = .047), shorter disease duration (P = .043), higher seizure frequency (P = .034), and poorer seizure control (seizure-free rate 24.7% vs 43.8%, P = .007). Additionally, a higher proportion of patients in this group used 3 or more antiepileptic drugs (17.8% vs 11.7%), and had lower medication adherence (19.2% vs 8.6%, P = .052). Anxiety/depression patients were more likely to receive cognitive behavioral therapy (47.9% vs 32.8%, P = .027), individual psychological counseling (39.7% vs 19.5%, P = .011), and emotional support (43.8% vs 36.7%, P = .039). Multivariate logistic regression analysis suggested that shorter disease duration (OR = 1.82, 95% CI: 1.07-3.11, P = .029), higher seizure frequency (OR = 2.17, 95% CI: 1.12-4.23, P = .021), and low adherence (OR = 2.53, 95% CI: 1.01-6.30, P = .048) were independent risk factors for anxiety/depression. Anxiety and depression are relatively common in epilepsy patients, affecting about 36.3% of them. Emotional disorders are closely related to poor seizure control, lower medication adherence, and complex medication regimens. There is a need to strengthen the assessment and intervention of emotional states in epilepsy patients, especially in those with shorter disease duration and frequent seizures, to promote early identification and management of mental health issues. This can help improve comprehensive treatment outcomes and quality of life.

Poor oral health is a common, but overlooked, issue among people with serious mental ill-health who experience higher rates of dental caries and periodontal disease, leading to increased hospital admissions. Despite its preventability, oral health remains largely absent from Australian mental healthcare policy and service delivery.

This two-phase study (1) systematically reviewed oral health integration within Australian oral and mental health policy and competitive funding mechanisms; and (2) qualitatively explored the experiences and prioritising of oral health care by individuals with serious mental ill-health, carers and healthcare professionals.

Findings indicated that oral health is rarely prioritised in mental health policy and that it receives only 0.22% of health research funding. Eighteen participants, including health practitioners and individuals with lived experience, were interviewed. Participants described oral health as being largely ignored, personal experiences of inadequate care, financial and psychological barriers to care and systemic neglect. Recommendations for change were identified, including a need for trauma-informed, holistic approaches to care that address social determinants and promote oral health within mental health services.

Poor oral health significantly, and negatively, impacts both quality of life and hospital admissions for people with serious mental ill-health, yet remains overlooked in mental health care. Holistic, interdisciplinary approaches - integrating oral health into psychiatric assessments, education and policy - are essential. Early intervention, public health messaging, trauma-informed training and personalised care may improve outcomes. Co-produced interventions and equitable access to services are critical to reducing oral health disparities and enhancing well-being for individuals living with serious mental ill-health.

To determine whether prompt genetic diagnosis in children with KCNQ2 neonatal epilepsy enabling targeted therapy is associated with improved outcomes, and identify early predictors of developmental outcomes.

Thirty-seven children with KCNQ2 neonatal epilepsy were recruited from five pediatric centers. We reviewed demographic, clinical, EEG, and genetic data. We determined differences in outcomes between individuals with prompt (greater than 30 days from seizure onset) and later genetic diagnosis, and we identified neonatal factors associated with developmental outcome.

Baseline characteristics were similar between children with prompt (n = 6, median age at genetic diagnosis 15 days) and later (n = 31, median age 309 days, p < .05) diagnosis. All with prompt diagnosis received sodium channel blocking (SCB) anti-seizure medication (ASM) in the neonatal period compared with 15/31 (48%) in the later diagnosis group. Children with prompt diagnosis had higher rates of seizure freedom at age 12 months than those with later diagnosis (6/6 [100%] vs. 17/31 [54%]; p .049], and lower number of emergency department representations (median 0 vs. 2), and hospital readmissions (median 0 vs. 1). Factors in the neonatal period associated with abnormal developmental outcome included neurological abnormalities (e.g., abnormal tone) and markedly abnormal neonatal EEG background (11/11 [100%] with markedly abnormal EEG vs. 11/24 [46%] with normal to moderately abnormal EEG).

Prompt genetic diagnosis was associated with targeted therapy, resulting in improved seizure control and reduced hospital representation. Clinical features present in the neonate assist in predicting outcome severity, which is critically important in counselling families receiving a KCNQ2 diagnosis soon after seizure onset.

In KCNQ2 neonatal epilepsy, sodium channel blocking antiseizure medicines are recommended, but the benefits of starting treatment early have been uncertain. Our findings show that prompt genetic diagnosis enabled early targeted treatment, with potential to improve outcomes. Specifically, prompt genetic diagnosis was associated with improved seizure control and reduced hospital visits compared with delayed diagnosis. However, a prospective, long-term study is needed to determine whether early treatment also improves developmental outcomes. Predicting outcome severity in newborns remains challenging, although abnormal neurological examination and markedly abnormal EEG in the newborn period were linked to abnormal developmental outcomes.

Female genital mutilation/cutting (FGM/C) is harmful to physical, mental, and reproductive health, though the effect of this practice on a woman's HIV susceptibility is poorly understood. Despite the known associations of FGM/C with short-term vaginal epithelial damage, neither genital inflammation nor the genital microbiome have been explored in women who have undergone FGM/C. In this study we compare the genital immune milieu and microbiome among female sex workers (FSWs) by FGM/C status, hypothesizing that these biological factors are dysregulated in women who have undergone FGM/C, heightening their risk of HIV acquisition.

1003 FSWs in Nairobi, Kenya, were enrolled in the Maisha Fiti study and visited a study clinic up to three times from June 2019 to March 2021. Participants self-reported any previous exposure to FGM/C as well as other relevant sociodemographic factors. Levels of proinflammatory cytokines and soluble E-cadherin (sE-cad), a biomarker of epithelial barrier disruption, were measured by multiplex immunoassay using self-collected cervicovaginal secretion samples provided by HIV-uninfected participants. Genital inflammation was defined using a composite score of inflammatory cytokines previously associated with HIV acquisition. The presence of inflammation was compared longitudinally between groups using mixed models to control for potential confounders including age, bacterial vaginosis (BV) status as defined by Nugent score, and others. Vaginal bacterial abundance, Shannon diversity, and total levels of key vaginal bacteria were measured by qPCR and compared by FGM/C status in an exploratory analysis.

44 of 1003 (4%) participants had undergone Type I or II FGM/C. These participants were older (p < 0.001) and more likely to test positive for herpes simplex virus-2 (HSV-2; p = 0.04), and less likely to have completed primary education (p = 0.03). Among HIV-uninfected participants, there was no evidence that genital inflammation was associated with FGM/C status after controlling for potential confounders (aOR = 0.70; 95% CI: 0.31-1.59; p = 0.40). There was no evidence of a difference in BV prevalence (p > 0.99), total bacterial abundance (p = 0.96), or Shannon diversity (p = 0.15) by FGM/C status.

Type I or II FGM/C was not associated with genital inflammation or microbial dysregulation in the long-term among HIV-negative FSWs in this cohort. This may be due to the duration elapsed since FGM/C occurred or the lowered mucosal immune activation previously observed in FSWs.