Chronic Kidney Disease-associated Pruritus is a chronic itching condition experienced by patients during and between dialysis sessions. The individualised nature of the condition makes prevalence and severity difficult to measure.

The study aimed to identify the prevalence of Chronic Kidney Disease-associated Pruritus amongst patients receiving dialysis in Ireland, characterise symptom burden, severity, and frequency, factors associated with worsening symptoms, and to examine patient experiences of itching.

A quantitative study with a qualitative free-text element was employed.

689 patients undergoing dialysis completed a national survey.

Patients undergoing haemodialysis and peritoneal dialysis completed the 5-D itch scale and a qualitative assessment of itching experiences. Regression analyses examined associations between domains of the 5-D itch scale, patient clinical characteristics and the occurrence of moderate-severe itching. Content analysis was used to report qualitative findings.

Sixty-two percent (85% haemodialysis; 15% peritoneal dialysis) experienced Chronic Kidney Disease-associated Pruritus; 66% reported moderate-severe itching, with body/trunk region most affected (73%); however, the scalp/face region was most associated with moderate-severe itching (OR = 2.08, 95% CI 1.11-3.870). Four themes were identified: (1) the physical impact of Chronic Kidney Disease-associated Pruritus; (2) the psychological burden of itching; (3) variability in treatment success; (4) itch resolving over time.

Two-thirds of Irish patients experience moderate-severe Chronic Kidney Disease-associated Pruritus; a prevalence rate higher than international estimates. This condition is psychologically distressing - impacting sleep, overall quality of life, and risk of infection. Patients require improved clinical attention and greater pratitioner education on management of this condition.

Understanding when and who is at greater risk of dropping out can help therapists and mental health professionals develop strategies to keep clients engaged, thereby improving the overall effectiveness of therapy. In the present study, we aimed to explore the hazard of dropout, both early and late in treatment, and evaluate the predictive power of both static (i.e., baseline client characteristics) and dynamic predictors (i.e., treatment process variables), in a sample of 97 clients treated with the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders. Thirty-one clients (31.96%) discontinued treatment, with the highest dropout rate observed at the end of Session 4. Stratified Cox modelling showed a significant effect of younger age β 1 = - 1.706 , p = 0.031 , non-student status β 2 = - 1.715 , p = 0.031 and higher baseline anxiety severity β 3 = 1.806 , p = 0.022 , on the risk of dropping out until Session 4 (i.e., the early phase of treatment). Beyond Session 4, only lower depressive severity measured at intake began to significantly affect the risk of dropout β 8 = - 1.007 , p = 0.034 . Additionally, joint modelling (JM) of survival and longitudinal data for the early phase of treatment provided evidence of the predictive power of lower distress levels γ 01 = - 0.181 , p = 0.093 and lower therapeutic alliance quality γ 02 = - 0.137 , p = 0.05 on the clients' decision to discontinue treatment prematurely. After Session 4, no factor showed a significant association with dropout risk within the JM approach. The results suggest that early sessions are critical for the client's retention, and the JM approach is indispensable for studying psychotherapy dropout, especially in the context of endogenous time-varying predictors. Implications for clinical and research contexts are discussed.

Background Psychiatric EDs manage high volumes of patients who often face barriers to medication access, limited understanding of discharge instructions, and difficulty securing timely outpatient follow-up. Structured early outreach has shown promise in improving these transitions. This quality improvement initiative evaluated a 72-hour nurse-led telephone follow-up program for patients discharged from a psychiatric service within an ED. Methods  All patients discharged over the study period were eligible for a structured telephone call within 72 hours. The call assessed medication pickup, medication adherence, follow-up appointment status, transportation needs, and satisfaction with both emergency care and the follow-up call. Diagnoses were extracted from clinician documentation. Demographic characteristics and patient-reported needs were summarized. Outcomes included call reach rate, patient-reported understanding of discharge instructions, medication-related behaviors, and follow-up completion. Results  A total of 69 patients met the inclusion criteria, with a mean age of 35.3 years. The most common diagnoses were major depressive disorder with suicidal ideation, schizophrenia, and bipolar disorder. The nurse navigator successfully contacted 37.7% of discharged patients. Among reached patients, half reported taking their medications, and over two-thirds had a scheduled follow-up appointment. Transportation barriers were uncommon. Patient satisfaction with psychiatric emergency care averaged 4.45 on a five-point scale, and satisfaction with the follow-up call averaged 4.95. Patients commonly sought clarification regarding medications, follow-up appointments, and transportation resources. Conclusion Early nurse navigator-led telephone follow-up after discharge from psychiatric emergency care demonstrated strong patient engagement and high satisfaction. The calls created opportunities to reinforce discharge instructions, support medication use, and assist with follow-up planning. These findings suggest that early nurse-led contact can highlight actionable barriers and support safer care transitions following psychiatric emergency discharge.

Yoga has been studied as an effective alternative therapy for substance use disorders, demonstrating its ability to reduce stress and addictive behaviors while improving self-control and self-esteem. However, not everyone may be willing or able to engage in yoga for various reasons. Furthermore, there is a lack of systematic reviews and meta-analyses of the existing research on this topic. The objective is to explore the nonparticipation rate in yoga intervention randomized controlled trials related to addictive disorders, and to explore the reasons for nonparticipation in yoga trials related to addictive disorders. We searched Google Scholar, CENTRAL, and PubMed for peer-reviewed published RCTs that incorporated yoga interventions in any format of at least one session. Data were extracted using standard procedures, and the risk of bias was evaluated. Pooled analysis and sensitivity analysis were done. About 54% of potential participants were not included. The pooled effect size was 0.544 (95% confidence interval: 0.301-0.787), with an I² = 99.797. Key barriers included failure to meet inclusion criteria, such as medical conditions, mental health issues, and specific health conditions such as posttraumatic stress disorder, depression, and heart disease. Participant refusals and lack of interest in randomization or the study itself were common reasons for nonparticipation. Scheduling conflicts were also frequently reported as a significant obstacle. Two broad categories for noninclusion were meeting exclusion criteria, and not interested/declined to participate. Understanding reasons for noninclusion can lead to more efficient and effective recruitment efforts in future trials and also possibly guide the design of future studies to minimize dropout rates and ensure a representative sample.

University is a pivotal life-course transition in which academic, social and geographic changes intersect with heightened risk for mental disorders and maladaptive behaviors. Health Mode On (HMO) and its longitudinal expansion Health Mode On Plus (HMO+), funded by the Italian Ministry of University and Research (MUR) competitive PRO-BEN 1 and PRO-BEN 2 calls, couple harmonized surveillance with a stepped, integrated model of prevention and care aligned with the World Mental Health-International College Student (WMH-ICS) framework to address fragmentation of campus provision and unmet need.

HMO implements a cross-sectional, census-style online survey paired with the implementation of an integrated counseling pathway and a Virtual Academy for staff and student mentors. HMO+ adds 12-month re-contact, objective lifestyle sub-studies, and a strengthened shared digital platform that supports first-contact intake, triage, and orientation to the most appropriate service. Within this framework, students with an anxiety risk profile may be offered participation in an embedded two-arm randomized evaluation of digital cognitive-behavioral therapy (e-CBT) versus counseling-as-usual. The consortium spans five universities, four higher artistic and musical education (AFAM) institutes and one Scuola Superiore Universitaria, in coordination with University Sports Centres (CUS). Primary outcomes are 12-month and lifetime DSM-5 disorder status derived from validated WMH-ICS/CIDI-based modules (mood; anxiety; trauma- and stressor-related; obsessive-compulsive and related; eating; attention-deficit/hyperactivity; and substance use disorders), and safety outcomes (suicidal ideation, planning and non-suicidal self-injury). Secondary outcomes include psychological distress, role impairment, days-out-of-role, sleep, physical activity (accelerometry in subsamples), dietary habits, nicotine and cannabis use, behavioral addictions (e.g., gaming, gambling, internet addiction), social connectedness, academic engagement and service access. Analyses will estimate weighted prevalence and impairment with multilevel models; longitudinal change with mixed-effects models and GEE; and naturalistic program effects using difference-in-differences with propensity-score methods.

Ethics approvals will be obtained at the coordinating and partner institutions. GDPR-compliant governance and results' FAIR-oriented sharing are planned, alongside open-access publications, institutional dashboards and policy briefs.

To assess the risk of postpartum depression (PPD) in women with twin pregnancies using the Edinburgh Postnatal Depression Scale (EPDS), and to explore associations between maternal and neonatal complications and depressive symptoms during the postpartum period.

This prospective, mixed-methods study was conducted at the Multiple Pregnancy Outpatient Clinic. Fourteen women with twin pregnancies received psychodynamic psychological prenatal care throughout the pregnancy-puerperal cycle. Postpartum depressive symptoms were screened using the EPDS, with scores ≥13 indicating probable PPD. Associations between EPDS scores and obstetric or perinatal variables were analyzed using Pearson correlation and contingency tables.

A high prevalence of depressive symptoms was observed among participants, with 28.6% screening positive for probable PPD and an additional 21.4% at mild risk. Higher EPDS scores were associated with intrapartum hemorrhage, low APGAR scores (1st and 5th <7), cesarean delivery, and neonatal intensive care unit (NICU) admission. Breastfeeding was associated with lower depressive symptom scores. Despite the presence of depressive symptoms in part of the sample, improvements in emotional domains such as anxiety and sadness were noted, suggesting a potential benefit of continuous psychodynamic support.

Women with twin pregnancies are at increased risk of postpartum depression, particularly when compounded by obstetric and neonatal complications. Routine mental health screening and structured psychological support-such as psychodynamic prenatal care-should be considered integral components of care for women with multiple gestations. Further studies with larger samples and comparison groups are needed to refine preventive strategies.

Yoga has increasingly been recognized as a beneficial adjunctive therapy for mental health disorders in India. However, participation barriers persist. This study examines the factors influencing participation in yoga as an add-on treatment for Common Mental Disorders (CMDs) in India.

As the part of a larger open-label comparative study assessing in-person versus virtual yoga, 1147 patients with CMDs were screened at a tertiary care center in Southern India. Of these, 968 were eligible and 130 consented to participate (13.43%). Reasons for refusal were recorded and analyzed.

The overall refusal rate was 86.57%. The most common barriers were lack of time (30.78%), disinterest in yoga (21.12%), and distance to the yoga center (19.09%). Additional factors included ongoing psychotherapy (11.57%), preference for virtual sessions (10.26%), and unwillingness to randomization (7.04%). Participants who consented were significantly more educated and more females than males refused participation. The preference for virtual sessions reflected growing demand for accessible, technology-assisted interventions post-COVID-19.

Despite increased awareness of yoga, participation remains low because of logistical barriers. These findings underscore the need to develop and validate virtual yoga programs tailored to patient convenience and contemporary healthcare delivery models.

Musculoskeletal (MSK) disorders are a leading cause of disability and health care burden globally. While much research has focused on clinical outcomes, treatment efficacy, and system efficiency, less is known about how challenges in navigating the health care system affect patients' physical, psychological, and social well-being. Understanding these lived experiences is crucial to informing system-level care improvements.

To explore patients' experiences navigating the health care system and the associated impacts on their physical, psychological, and social well-being among individuals with musculoskeletal conditions in Alberta, Canada.

Qualitative study using the interpretive description approach.

Semi-structured interviews were conducted by telephone with a purposive sample of adult participants who received care for knee (soft tissue), low back (spine), and/or shoulder conditions. Data were analyzed using a framework analytic approach, with particular attention to themes derived from the data related to negative health impacts associated with system navigation.

Seventy-three participants completed an interview. The majority of participants described negative health impacts, which they attributed to challenges navigating the MSK health care system. Patient accounts reveal a spectrum of negative health impacts, including physical health deterioration over and above the MSK condition, a range of mental health challenges, and a decline in social well-being. Participants linked these experiences to specific system-level factors such as delays in receiving care, inconsistency in communications and treatment recommendations, care fragmentation, and affordability barriers.

These findings underscore the challenges of navigating the health system with an MSK condition, which can hinder recovery, exacerbate suffering, and add additional health burdens. Greater attention to the lived experience of system navigation is needed, alongside integrated, timely, person-centred and holistic approaches to MSK care.

Pregnant people in rural communities experience constrained social services and economic supports, increased social complexities, and limited access to maternal health care. Within this environment, crisis pregnancy centers (CPCs) have proliferated to serve rural perinatal populations in the United States. CPCs provide wraparound services to pregnant and postpartum people and their families, but little is known about the services provided for pregnant people with social complexities that increase maternal morbidity risk. We examine CPC leaders' perceived function in providing care to perinatal clients living in low-resource rural communities experiencing intimate partner violence (IPV), substance use, and mental health conditions.

We interviewed 17 leaders of CPCs serving communities with health professional shortage areas in a state with a large rural population. We ask about their perceived role, assessment, and care for clients who may be experiencing substance use, mental health concerns or conditions, or IPV.

We find that CPC leaders in this sample did not describe the capacity to appropriately address some of the primary drivers of maternal morbidity. CPC leaders' descriptions of delivery of medical, mental, and social care screenings, and that their policies and procedures are inconsistent with evidence-based medical care delivery, despite some CPC's use of medical technology. CPC leaders describe a lack of standardized, validated health and social risk screening, reliance on relationship-based risk identification, non-systematic referral processes, unclear anticipatory guidance for medical conditions, and sometimes employ stigmatizing language.

In this study, CPC efforts were found to be inconsistent and unsupported by current clinical care guidelines endorsed by medical professional societies.

Violence against women is a major human rights violation and public health concern with serious physical, mental, sexual, and reproductive consequences. Intrapartum obstetric violence can damage trust in healthcare providers and discourage women from using facility-based maternity services, sometimes more than geographic or financial barriers. However, evidence on intrapartum obstetric violence in Ethiopia remains limited.

This study aimed to assess the prevalence of Intrapartum Obstetric violence and its associated factors among women attending delivery care at public hospitals in Addis Ababa, Ethiopia.

An institution-based cross-sectional study was conducted among 316 postpartum women at six public hospitals in Gondar city from June 11 to July 31, 2023. Study participants were selected using systematic random sampling. Data were collected using an interviewer-administered, pretested questionnaire conducted in a face-to-face setting. Interviews were carried out at a consistent postpartum time point prior to discharge from the health facility. Collected data were checked for completeness, entered into EpiData version 3.1, and exported to SPSS version 25 for analysis. Descriptive statistics were presented using narration, tables, and figures. Bivariate and multivariate logistic regression analyses were performed to identify factors associated with intrapartum obstetric violence. Odds ratios with corresponding 95% confidence intervals were used to assess the strength of associations.

The magnitude of intrapartum obstetric violence was 27.3%. Age of mothers (AOR: 1.24, 95% CI (1.23, 13.95), educational level of mothers AOR: 24, 95% CI (0.02, 0.37), number of delivery (AOR: 1.35, 95% CI (1.20, 1.53), mode of delivery AOR: 0.27, 95% CI (0.18, 0.44) and occurrence of complication AOR; 0.16, 95% CI (0.03, 0.90) were factors that had association with the intrapartum obstetric violence.

More than one-fourth of participants experienced intrapartum obstetric violence. Maternal age, education, parity, mode of delivery, and complications were significantly associated. Hospitals should implement context-specific interventions targeting these risk factors to reduce obstetric violence.