Lethal means safety counseling (LMSC) is recommended for children presenting to the emergency department (ED) for a mental health (MH) evaluation. Currently, no gold-standard guidelines exist for documenting LMSC in the ED.

This quality improvement project was conducted in the ED of a tertiary children's hospital. Baseline data were analyzed for access to any LMSC documentation (ALD) for "firearms/guns," "sharps," or "medication," and for complete LMSC documentation (CLD) if access to all 3 types was documented. The first intervention period added open-ended screening questions about access to lethal means to the MH-licensed clinical social worker note template. Intervention period 2 implemented an electronic health record "PowerForm" in Cerner PowerChart. We aimed to increase ALD and CLD to exceed 75% and 50%, respectively, during a 6-month period, with sustained success. Statistical process control p-charts with standardized special-cause rules were used to determine performance over time.

Baseline ALD and CLD rates were 3% and 1%, respectively. During intervention 1, the ALD and CLD rates increased to 81% and 68%, respectively, with special-cause variation noted for both rates. During intervention 2, ALD increased to 90%, but CLD rates did not change significantly (66%). For intervention 2, the documentation of firearm/gun access (90%) was higher than documentation of access to sharps (68%) or medication (69%).

We achieved a significant increase in ALD and CLD for MH evaluations in our ED. Lessons learned may generalize to other ED settings.

The demanding nature of modern healthcare systems is associated with substantial fatigue and stress among clinical nurses; however, the joint associations of mental health promotion and sleep concerns with fatigue and stress among nurses remain to be elucidated.

A multicenter cross-sectional survey was conducted among clinical nurses from three tertiary hospitals in Anhui Province, China. Mental health promotion, sleep concerns, fatigue, and perceived stress were assessed using the Mental Health Promotion Scale, the Anxiety and Preoccupation about Sleep Questionnaire, the Multidimensional Fatigue Inventory, and the Chinese version of the Perceived Stress Scale, respectively. The complex relationships among these variables, and characterizations of different subgroups, were studied using network analysis and latent profile analysis.

All 352 distributed questionnaires were returned, of which 338 valid questionnaires were included in the analysis. Network analysis showed that certain dimensions of mental health promotion (values, personal development, and friendship) were negatively correlated with both fatigue and stress, while sleep concerns, particularly sleep-related preoccupation, were positively correlated with fatigue and stress. Within the network, values showed the highest strength centrality. Physical fatigue, tension, and sleep-related preoccupation were key bridging nodes connecting different construct communities. Latent profile analysis identified three statistically derived fatigue/stress profiles: low fatigue/low stress (n = 33), moderate fatigue/high stress (n = 241), and high fatigue/high stress (n = 64).

Mental health promotion showed a negative association with fatigue and stress among clinical nurses, with values representing a core dimension of mental health resources. Furthermore, sleep-related preoccupation was observed as a bridging node between psychological and physical dimensions. These findings identify occupational values, physical fatigue, tension, and sleep-related preoccupation as candidate constructs for evaluation in future longitudinal and intervention studies.

Background Neuropsychiatric disorders, with their complexities, manifest with a blend of neurological and psychiatric symptoms that pose significant challenges within classification systems and their overall management. These intricate, perplexing disorders appear to contribute to increased readmission rates, illustrating the need for concrete evidence to facilitate the urgent and longstanding requisite for personalized care and research development within an interdisciplinary care framework. Methodology This retrospective cohort study analyzed a decade's worth of data from a 250-bed acute inpatient care facility in Abu Dhabi, United Arab Emirates. The dataset included a total of 334 patients: 75 with neuropsychiatric disorders and 259 with solely primary psychiatric disorders. Results As predicted, high readmission rates were observed in the neuropsychiatric disorder cohort in comparison to the primary psychiatric disorder cohort. Annual readmission rates averaged 0.37 for neuropsychiatric versus 0.16 for psychiatric cases alone. Furthermore, emerging trends of demographic disparities were identified, where the neuropsychiatric cohort demonstrated a high readmission frequency across various age, gender, and ethnic groups. Conclusion The readmission rates of neuropsychiatric disorders were substantially higher in the acute psychiatric care facility in Abu Dhabi, compared to primary psychiatric disorders. The results of this study in the acute, yet tertiary, inpatient psychiatric facility in Abu Dhabi highlight an urgent necessity for both specialized multidisciplinary care strategies in this vulnerable population and a specific focus on this population's perpetuating unmet needs to improve their overall prognosis and decrease hospital readmission rates.

In most parts of the world, people with disabilities are deprived of education, employment, health, and social and political rights. Moreover, women with disabilities can be subjected to double discrimination because of their gender and are more likely to experience physical, mental, and sexual abuse. Because of the nature of their disability, women with intellectual disability in particular face stigma and discrimination in accessing sexual and reproductive healthcare, which in turn affects their decision-making abilities regarding sexuality. In Ethiopia, due to a lack of resources and limited awareness, women with intellectual disabilities have difficulties accessing sexual and reproductive healthcare to meet their needs. We, therefore, aimed to explore the barriers and facilitators impacting access to sexual and reproductive health services in Gondar, Ethiopia.

The study employed a qualitative descriptive approach to explore the existing barriers and facilitators impacting access to sexual and reproductive health services, aiming to inform how to improve service provision for women with intellectual disabilities in Gondar, Ethiopia. Using a semi-structured interview guide, we conducted interviews in Amharic with 17 purposively selected women with intellectual disability, aged 15-49, in Gondar, Ethiopia. After the interviews were transcribed, we conducted a thematic analysis using both inductive and deductive approaches in NVivo 14.

The analysis of the study resulted in six themes reflecting on different barriers and facilitators impacting Sexual and reproductive healthcare access: sexual and reproductive health education, contraception, prevention of sexual abuse, prevention of sexually transmitted infections, pregnancy and parenthood, and the roles of community-based rehabilitation impacting access to Sexual and reproductive health services.

Study findings showed the barriers and facilitators impacting access to sexual and reproductive health services for women with intellectual disability, based on firsthand information and experiences of these women embedded in structural and sociocultural factors. The study's findings could guide future researchers, healthcare policymakers and healthcare practitioners to design culturally appropriate and disability inclusive interventions promoting sexual and reproductive healthcare access and improved outcomes among women and girls with intellectual disability.

Job burnout is a systemic challenge in healthcare, and dental nurses facing unique occupational stressors that linked to higher burnout symptom levels. Despite the growing recognition of burnout as a public health concern in health care workers, previous studies have paid relatively little attention to dental nurses.

This study aimed to investigate the current status of job burnout among dental nurses and identify its associated factors.

A cross-sectional study was conducted from September to October 2024, enrolling 261 dental nurses from a stomatological hospital in Yunnnan provinces of China. Data were collected using the Maslach Burnout Inventory-General Survey (MBI-GS), Nurse Job Stressor Scale (NJSS), Self-rating Depression Scale (SDS), Nurse's Career Identity Scale (NCIS), Social Support Rate Scale (SSRS), General Self-Efficacy Scale (GSES), and a self-designed general information sheet. A logistic regression model was constructed to analyse the associated factors correlated with job burnout.

The median score of job burnout was 38.67 (21.33-56.00), and the overall burnout prevalence was 33.7%. The results of logistic regression showed that depression [odds ratio (OR) = 1.117; 95% confidence interval (CI) (1.060, 1.177); P < 0.001], occupational stress [OR = 1.063; 95% CI (1.028, 1.098); P < 0.001] were associated factors of job burnout.

This study explores job burnout in dental nurses and confirms depression and occupational stress as its associated factors. Attention to dental nurses' mental health and targeted interventions are critical to alleviating burnout and improving nursing quality.

Nurses working in high-mortality clinical settings are frequently exposed to patient suffering and death. This might contribute to occupational stress and adverse psychological outcomes. However, the mechanisms linking this exposure to depressive symptoms remain unclear. This study examines the association between perceived mortality exposure and depressive symptoms and the mediating roles of life satisfaction and sleep quality.

A cross-sectional study was conducted among 200 nurses using an online survey. Data were analyzed using correlation, regression, and mediation analysis with Hayes' PROCESS macro.

Perceived mortality exposure was significantly associated with higher depressive symptoms and poorer sleep quality. Life satisfaction was inversely associated with depressive symptoms, whereas sleep quality was not. Nonetheless, the overall regression model, including perceived mortality exposure and life satisfaction, explained only a modest proportion of the variance in depressive symptoms. The mediation analysis showed no significant indirect effects through life satisfaction or sleep quality.

Perceived mortality exposure represents a potentially significant occupational stressor for nurses, but the lack of mediation indicates that factors beyond life satisfaction and sleep quality may better explain its impact on depressive symptoms.

Perinatal mood and anxiety disorders (PMADs) are among the most common complications of pregnancy. Yet, identification, access, and intervention lag behind need, particularly for those from historically marginalized backgrounds. Although couples-based, cognitive behavioral approaches show promise, few interventions integrate community-engaged, partner-inclusive, and in-home approaches that bolster accessibility.

This article presents the development and protocol for the New Family Wellness Project (NFWP). The six-session NFWP focuses on shared family values and communication supplemented with between-session provider check-ins, support groups, homework, and tailored case management. Twenty-two participants (8 couples; 6 mothers alone) provided quantitative and qualitative feedback on the NFWP feasibility and acceptability.

Participants reported very high engagement (M = 96/100) and identified the in-home and partner-inclusive format as vital. Qualitative feedback highlighted that the NFWP improved communication and enhanced reflection on family values and actionable steps to support effective co-parenting. Nearly half of the participants said they would not have participated without the in-home and couples-based format.

Preliminary findings support the feasibility and acceptability of this community-engaged, cognitive behavioral therapy, couples-based intervention for PMADs. Future directions explore scalability on a larger scale to enhance equitable, perinatal mental health interventions for family systems.

Doula support is increasingly recognized as a promising strategy to address racial inequities in maternal health. The New York City Health Department launched the Citywide Doula Initiative (CDI) in March 2022 to expand access to free, community-based doula support in disinvested neighborhoods.

To evaluate the program's first year of implementation, we conducted semi-structured interviews with 44 clients, doulas, doula-organization staff, and Health Department staff between November 2022 and April 2023. We coded interview notes using template analysis (a thematic analysis approach) and grouped barriers and facilitators according to the Practical Robust Implementation and Sustainability Model.

Facilitators included high perceived value of the CDI, a shared commitment to community, open communication, and policymaker support for doula work. Barriers included insufficient time for planning, cumbersome bureaucratic processes, and cultural and capacity differences between the Health Department and community partners. Additional factors, such as-variation in hospital treatment of doulas, doula-organization capacity, doula skills and experiences, and client needs and circumstances-had mixed effects on program implementation.

Findings indicate that community-based doula models, which have been shown to improve birth outcomes in disinvested communities, can be successfully scaled in an urban setting. Programs seeking to expand access to doula support should prioritize time for planning, allocate sufficient resources for administrative support, and work to establish efficient and responsive payment and contracting processes. Having mission-driven staff at all levels of the program and prioritizing relationships with community-based organizations and doulas are vital for success.

Recreational activities are considered vital for emotional and cognitive health of youth, yet empirical research examining the specific associations between recreational activities and youth behavioral and cognitive outcomes is limited.

In this cohort study, interpretable machine learning methods, specifically random forest paired with SHapley Additive exPlanations (SHAP) analysis, were applied to quantify the contribution of each activity to behavioral and cognitive outcomes in the Adolescent Brain Cognitive Development℠ (ABCD) Study baseline data (ages 9-10). Data-driven activity groups were defined by SHAP contribution patterns for behavioral and cognitive outcomes. Engagement in these groups was then tested for association with the corresponding outcomes using linear mixed-effects models in the hold-out sample, both cross-sectionally and longitudinally.

Of activities, 14 were identified with more favorable and 8 with less favorable behavioral patterns, and 13 were identified with more favorable and 2 with less favorable cognitive patterns. Activities with more favorable behavioral patterns (eg, skiing/snowboarding) were linked to fewer problems (β = -1.12, p < .001), whereas activities with less favorable patterns (eg, martial arts) were linked to more problems (β = 1.75, p < .001). For cognition, activities with less favorable patterns (eg, football) were associated with lower cognitive scores (β = -1.34, p < .001), whereas activities with more favorable patterns (eg, musical instruments) were associated with higher scores (β = .98, p < .001), and family income moderated this association (p < .001).

Recreational activities exhibit distinct patterns of association with cognitive and mental health outcomes. These data-driven findings highlight the importance of considering individual differences and contextual factors when investigating youth engagement in recreational activities.

Despite men demonstrating high levels of grief and mental health difficulties after baby loss, support services predominantly focus on women. There is little known about the role of sport, football and targeted peer support for men who have experienced baby loss.

To examine men's experiences of accessing football-based baby loss bereavement support and the self-reported impact of the sessions on men's grief and mental health. This project was designed with three men who have experienced baby loss.

The study used a sequential QUAL-qual multimethod exploratory design. An online anonymous qualitative survey was distributed to all men who had attended a football session. A group discussion then considered the findings from the survey to add further depth to our understanding. Data were analysed using qualitative content analysis. Consent was obtained from all participants. Staff with mental health training were present during the discussion.

Twenty-one survey responses were received, and 11 men participated in the group discussion. Participants reported the limited targeted support available for men after baby loss, and that the football sessions provided a safe space to talk with other men who had a shared journey and experiences and that the football focus helped break down barriers and challenge the myths surrounding men and grief. The football-based sessions were described as life-changing and life-saving.

The study highlights the need to dispel myths surrounding men's grief after baby loss and emphasises the importance of football-based bereavement support in addressing men's mental health.