• Research to real-world impact: evidence-based knowledge mobilization to improve support for UK women veterans who have experienced military sexual trauma.
    1 week ago
    Background: Military sexual trauma (MST) disproportionately impacts women veterans globally. UK research highlights that these in-service experiences may contribute to unique mental and physical health needs. Yet, service providers are often perceived to be unaware of and unable to meet these needs.Objective: To evaluate a national training programme that synthesised evidence to support UK women veterans. Situated within a wider knowledge mobilization (KMb) initiative and guided by the Knowledge-to-Action (KTA) framework, a three-part programme was developed for different professional audiences to enhance understanding of and support for women veterans.Method: Co-produced and grounded in KMb theory. Course 1 aimed to enhance knowledge of women veterans' health needs. Course 2 targeted healthcare professionals and veteran specialist providers, exploring evidence-based considerations for promoting service engagement. Course 3 aimed to increase UK clinical capacity in the best-evidenced treatment for post-traumatic stress disorder associated with MST in women veterans, through training mental health professionals in cognitive processing therapy (CPT). Mixed-methods data were collected from all programme attendees. CPT attendees completed pre- and 3-month post-training measures; quantitative data were analysed using a Wilcoxon signed-rank test and qualitative data using manifest content analysis.Results: Course 1 was completed by 526 individuals, 363 completed Course 2, and 98 completed Course 3. Course 3 attendees were split across two cohorts (n = 57; n = 41). Compared with pre-training, 3-month post-training self-efficacy in delivering CPT across cohort one increased significantly (p < .001, r = 0.915). Content analysis identified three themes: (1) Clinician confidence delivering CPT; (2) Clinicians' perceptions of CPT; and (3) CPT in a service system.Conclusions: The education programme addressed gaps in UK service provider knowledge and increased CPT clinical capacity. The wider KMb initiative demonstrates how research can be translated into impact for military populations and highlights the value of co-produced KMb approaches.
    Mental Health
    Care/Management
  • Effect of Dialectical Behaviour Therapy on Deviant Eating Attitudes and Mental Health of Adolescents: A Case Report.
    1 week ago
    Eating attitude can be defined as beliefs, thoughts, feelings, behaviour and relationship with food. It can impact a person's food choices and health status. A deviant eating attitude is a maladaptive pattern of thoughts and behaviours related to food consumption, which can include periods of inconsistent eating, ranging from overeating to undereating, dietary restriction, emotional eating and preoccupation with food and body weight. These concerns may be visible in the form of emotional dysregulation, anxiety, depression, low self-esteem and interpersonal difficulties. The deviant eating attitude can lead to psychological distress, as individuals may use restrictive eating patterns to cope with overwhelming emotions and life stresses, further deteriorating their overall mental health. Dialectical behaviour therapy (DBT) plays a key role in addressing this vicious cycle by targeting the core emotional and behavioural patterns which maintain disturbed eating disorder. DBT reduces the shame and self-stigma that affect the eating cycle and fosters genuine engagement with the therapeutic process. Through DBT, an individual can learn about mindfulness, distress tolerance, emotion regulation and interpersonal effectiveness. It facilitates individuals to recognise and manage uncomfortable emotions without resorting to dysfunctional eating patterns.

    The study aimed to explore the therapeutic effect of DBT on deviant eating attitude, along with mental health in adolescents.

    A single case report method was used in the current study. The tools used in the study were case history, Mental Status Examination, Eating Attitudes Test-26, developed by David M. Garner, and Mental Health Inventory, developed by A. K. Srivastava. A total number of 14 sessions of DBT were given, and the pre- and post-therapy assessments were conducted. A case of a 15-year-old female presented with the chief complaints of concerns with her weight and physical looks, high consumption of junk food, disturbed sleep routine, disturbed interpersonal relationship, anger outburst, low self-esteem, irritability and reduced academic performance since the last 2 years, which increased significantly in the last 6 months.

    The pre- and post-assessments were conducted, and they indicated relief in the symptoms reported by the client. She reported improved focus and increased motivation for academic goals. She also reported improved social relationships with improved mood and regulated sleep than before. She reported a reduction in the consumption of junk food. Her interpersonal skills improved significantly, allowing her to express her thoughts and feelings more effectively.

    Findings support DBT as an effective mode of intervention that targets deviant eating attitudes and improves mental health by strengthening emotion regulation, increasing distress tolerance, and improves interpersonal skills.
    Mental Health
    Care/Management
    Policy
  • Effects of continuous traumatic stress and coping efficacy on mental health outcomes during an ongoing war in Ukraine.
    1 week ago
    War profoundly affects the well-being of civilian populations and shapes subsequent mental health outcomes. This study aimed to investigate the effects of continuous traumatic stress (CTS) and coping efficacy on mental health outcomes among adults in Ukraine amid ongoing warfare over time. We examined how changes in CTS responses, coping efficacy, and stressful life events predicted posttraumatic stress disorder (PTSD) symptoms and broad mental health outcomes (depression, anxiety, insomnia, well-being). Participants were 157 adults who experienced war-related stress and completed two online surveys approximately 12 months apart. Moderately small but significant symptom reductions were observed, ds = 0.18-0.32, ps = .005-.026. Structural equation models analyzing the associations between initial status and changes in CTS, coping efficacy, and stressful life events and Time 2 PTSD symptoms and broad mental health outcomes explained most of the variance in PTSD symptoms and broad mental health outcomes, R2 = .84‒.85. Higher initial severity and worsening CTS responses over time predicted higher PTSD symptom severity, standardized estimate (Eststd) = 0.29‒0.32, ps = .001‒.006, and poorer broad mental health outcomes, Eststd = 0.25‒0.28, ps = .001‒.016. Increased stressful life event exposure was linked to worse broad mental health outcomes, Eststd = 0.16, p = .001. Improvements in coping efficacy predicted superior broad mental health outcomes, Eststd = -0.43, p < .001. Assessing and addressing the impact of CTS, considering the toll of stressful life events, and enhancing coping efficacy may help to optimize service delivery in ongoing war environments.
    Mental Health
    Care/Management
  • A Dyadic Study on the Relationships Among Health Literacy, Psychological Resilience, and Fear of Disease Progression in Patients with Chronic Heart Failure and Their Caregivers.
    1 week ago
    This study examined the interactive relationships among health literacy, psychological resilience, and fear of progression (FoP) in patients with chronic heart failure and their caregivers.

    A total of 300 dyads were recruited. The Actor - Partner Interdependence Mediation Model was used to analyze actor, partner, and mediation effects.

    For both patients and caregivers, health literacy and psychological resilience negatively predicted individual FoP. Caregivers' health literacy positively predicted their psychological resilience, while no such association was found in patients. Psychological resilience mediated the health literacy-FoP association in both groups. Patients' health literacy could indirectly alleviate caregivers' FoP via caregivers' psychological resilience.

    FoP in chronic heart failure is a dyadic psychological phenomenon. Interventions should target both patients and their caregivers to reduce fear of disease progression and improve family mental health.Clinical Implications: Dyad-based interventions that enhance health literacy and psychological resilience in both patients and caregivers may effectively alleviate FoP and promote overall family well-being.
    Mental Health
    Care/Management
  • Astrocyte reactivity modifies the effects of locus coeruleus norepinephrine-related dysfunction on tau and its impact on cognition.
    1 week ago
    Animal models demonstrated that pharmacologically-induced lesioning of the locus coeruleus (LC), the brain's primary source of norepinephrine, triggered astrocyte reactivity, exacerbating Alzheimer's disease (AD) pathology and cognitive deficits. We examined whether astrocyte reactivity modulates the relationship between LC dysfunction, tau pathology, and cognitive decline in humans.

    We combined ultra-high-field LC functional imaging during an affective task with plasma biomarkers of glial fibrillary acidic protein (GFAP) and hyperphosphorylated tau (p-tau), and longitudinal cognitive data from 78 asymptomatic individuals. Associations between LC activity and norepinephrine transporter-enriched LC functional connectivity (LCFC) with p-tau, GFAP, and cognitive decline were examined.

    Lower LC activity and LCFC were related to elevated plasma p-tau217, particularly at elevated GFAP. Lower LC FC was also associated with cognitive decline in individuals with elevated plasma p-tau217 and GFAP.

    LC-norepinephrine system dysfunction may contribute to emerging tau pathology and cognitive decline, with astrocytes playing a critical gating role.
    Mental Health
    Care/Management
  • The influence of histamine and antihistamines on microglial regulation and neuroinflammation.
    1 week ago
    Despite extensive characterisation of immune responses across peripheral organs, the immunological landscape of the central nervous system (CNS) remains incompletely defined. Among the resident immune cell populations in the brain, mast cells and microglia have emerged as key modulators not only of neuroinflammatory processes but also of fundamental homeostatic functions, including regulation of sleep, affective states, and energy balance. These cells engage in complex bidirectional communication, mediated in part by the biogenic amine histamine. Although histamine was first identified over a century ago, its multifaceted roles in CNS homeostasis, immune surveillance, and neuropathophysiology remain poorly delineated. This review examines the biosynthesis, receptor-mediated signalling, and functional consequences of histaminergic activity within the brain, with a particular focus on microglial dynamics. We discuss crosstalk between mast cells and microglia via histamine signalling pathways, and the potential implications of this interaction in the etiology of neurodevelopmental disorders. Furthermore, we evaluate the emerging evidence on the capacity of centrally acting antihistamines, especially those capable of penetrating the blood-brain barrier, to modulate microglial phenotypes. Collectively, these insights underscore the urgent need for deeper mechanistic studies to elucidate histamine's role in CNS immunophysiology.
    Mental Health
    Policy
  • Older adults' beliefs about anxiety: a multicultural qualitative study informed by Leventhal's Common-Sense Model of self-regulation.
    1 week ago
    Anxiety disorders in older adults are commonly underdiagnosed and undertreated, especially among minority ethnic groups. This UK-based multicultural qualitative study explored beliefs about anxiety among White British, South Asian, African and Caribbean older adults who self-reported anxiety, and examined the applicability of Leventhal's Common-Sense Model.

    Individual interviews were conducted with 52 older adults self-reporting current or past anxiety. Data were managed and analysed using the Framework Method. Professional interpreters facilitated interviews with non-English speakers.

    The study included 27 participants with distressing anxiety and 25 with non-distressing anxiety. Participants' accounts revealed a fragmented understanding of anxiety. Beliefs varied within and across cultural groups, shaped by the interaction between culture, participants' salient identities, degree of distress and prior contact with mental health services. Despite this variability, participants' beliefs broadly mapped onto Leventhal's Model, supporting its applicability. Inductive analysis identified two new dimensions: aggravating factors and protective factors.

    Older adults' understanding of anxiety is often fragmented. Broad cultural classifications risk obscuring within-group diversity. Cross-cultural research should adopt nuanced approaches to provide meaningful, person-centred insights into people's perceptions of illness. While applying Leventhal's Model provided new insights, further theoretical refinement may be needed to capture dimensions extending beyond the model.
    Mental Health
    Policy
  • ORAL AND GENERAL HEALTH-RELATED QUALITY OF LIFE IN ADULTS: AN UPDATED SYSTEMATIC REVIEW AND META-ANALYSIS INCLUDING PHYSICAL AND MENTAL HEALTH COMPONENTS.
    1 week ago
    Oral health and general health are closely linked, but the association between the two is still under discussion. This study aimed to update and expand a previously published systematic review and meta-analysis to include new data on the correlation between overall Oral Health-Related Quality of Life (OHRQoL) and Health-Related Quality of Life (HRQoL), and to examine how OHRQoL relates to the physical and mental components of HRQoL.

    A comprehensive search of online databases (Ovid MEDLINE(R), Embase, CINAHL, PsycInfo, Scopus, and Web of Science) was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligible studies reported correlations between validated OHRQoL and HRQoL instrument summary scores, and/or physical and mental component scores in adult populations. Correlation coefficients were pooled using the random-effects model. Subgroup analyses were performed by population setting (dental, medical, and nonpatient). A sensitivity analysis was conducted to compare pooled correlations for OHRQoL with the physical and mental components of HRQoL. Heterogeneity and publication bias were evaluated using Q, I², τ², funnel plots, and the trim-and-fill method.

    Nine studies covering 12 populations from 6 countries were included in this update. The pooled correlation between OHRQoL and HRQoL summary scores was r = 0.42 (95% confidence interval [CI]: 0.33-0.49), indicating a medium relationship with improved precision (narrower CI) compared to prior results. Subgroup analyses showed similar associations across dental, medical, and nonpatient populations with no significant subgroup differences (QM = 1.80, P = .41). The pooled correlation between OHRQoL and Physical Component Score (PCS) was r = 0.35 (95% CI: 0.26-0.43), and for Mental Component Score (MCS) it was r = 0.38 (95% CI: 0.30-0.46). Both correlations were moderate in magnitude, meaning that oral health contributes similarly to physical and mental dimensions of overall well-being.

    This updated analysis confirms a medium-strength relationship between oral and general health. In addition, oral health connects similarly with both the physical and mental components of HRQoL. These results support the idea that oral and general health influence each other and reinforce the importance of interprofessional collaborative approaches to improve patient health and well-being.
    Mental Health
    Advocacy
  • Improvement in Outcomes of Childhood Acute Myeloid Leukemia Treatment: A Survival Analysis at a Reference University Hospital in Rio de Janeiro, Brazil.
    1 week ago
    Acute myeloid leukemia (AML) represents 15% to 20% of all pediatric acute leukemias and is responsible for nearly 30% of deaths in this population. While high-income countries report overall survival (OS) rates near 75%, survival in Brazil remains significantly lower, ranging between 30% and 40%.

    The objective of this study is to analyze the probability of OS and event-free survival (EFS) in pediatric patients with AML treated at a Brazilian university hospital, evaluate prognostic factors, and compare outcomes with international data.

    This retrospective study included 51 patients (under 14 years old) diagnosed between 2004 and 2023 and treated with BFM-based protocols. The median age was 4.6 years. Patients with acute promyelocytic leukemia (APL) achieved an OS of 100% and EFS of 90%. For other AML subtypes, the 5-year OS and EFS were 53.7% and 43.7%, respectively. Implementation of improved supportive care (ISC) after 2008-including the opening of a pediatric ICU and better infection management-was a pivotal prognostic factor (p < 0.001). Following ISC implementation, OS increased dramatically from 8.3% to 74.5%, and the early death rate dropped to 5.7%, reaching levels comparable to high-income countries.

    Pediatric AML outcomes in developing regions can achieve international standards when intensive chemotherapy is combined with optimized supportive care. The establishment of specialized pediatric intensive care and advanced management of infectious complications are essential pillars for bridging the survival gap in these populations.
    Cancer
    Access
    Care/Management
    Advocacy
  • Factors Associated With Cervical Cancer Awareness Among Women of Reproductive Age in the Democratic Republic of the Congo: Evidence From a Nationwide DHS Analysis.
    1 week ago
    Cervical cancer (CC) is a major public health concern, ranked as the fourth leading cause of cancer. Evidence shows that CC is preventable if detected and treated at the early stages. In the Democratic Republic of the Congo (DRC), national-level evidence on women's awareness of CC and its associated factors remains limited.

    This study aimed to assess the level of cervical cancer awareness and identify factors associated with awareness among women of reproductive age in the DRC.

    Cervical cancer (CC) is a major public health concern, ranked as the fourth leading cause of death. Evidence shows that CC is preventable if diagnosed at the early stages. In the Democratic Republic of the Congo (DRC), there is limited evidence at the national level and on factors associated with CC awareness among women of reproductive age. This study aimed to address this gap.

    The study analysed secondary data from a total weighted sample of 27 583 women aged 15-49, drawn from the 2023-2024 DRC Demographic and Health Survey (DRCDHS). The dependent variable was CC awareness, and the independent variables were the sociodemographic characteristics of a woman. Descriptive, bivariable and multivariable analyses were conducted. A significant factor was determined at p-value < 0.05 at 95% confidence intervals (CIs).

    The overall CC awareness among women of reproductive age in DRC was 21.3% (95% CI = 19.5-23.2). Logistic regression results revealed that women aged 25-34 (AOR = 1.36; 95% CI = 1.12-1.66) and 35-49 (AOR = 1.60; 95% CI = 1.27-2.02), women who were residing in urban areas (AOR = 1.53; 95% CI = 1.06-2.20), women with primary education (AOR = 1.45; 95% CI = 1.03-2.04), secondary education and above (AOR = 1.73; 95% CI = 1.22-2.45), employed women (AOR = 1.48; 95% CI = 1.20-1.84), women who had been examined for breast cancer (AOR = 4.72; 95% CI = 2.91-7.67), women who had been listening to radio (AOR = 1.60; 95% CI = 1.28-1.99), women who had visited health facility last 12 months (AOR = 1.63; 95% CI = 1.35-1.97), Christian (AOR = 2.35; 95% CI = 1.06-5.21), use internet (AOR = 1.67; 95% CI = 1.23, 2.28), reading newspaper/magazine (AOR = 1.33; 95% CI = 1.01-1.76) and delivered at health facility (AOR = 1.53; 95% CI = 1.18-1.98) were statistically significant associated with having CC awareness compared to their counterparts.

    The study revealed overall suboptimal CC awareness among women of reproductive age in DRC. Although health education interventions should target all women of reproductive age, special attention should be given to younger women aged 15-24 years, those with no formal education and those living in rural areas, as these subgroups demonstrated particularly lower awareness levels. Strengthening tailored interventions for these vulnerable groups may therefore improve awareness within the broader reproductive-age population and the community at large.
    Cancer
    Access
    Advocacy