Elder financial exploitation is an underrecognized form of elder abuse that can occur in medical and post-acute care settings. We present the case of a 74-year-old man with multiple comorbidities who was hospitalized following a mechanical fall with head trauma and concussion. During his inpatient stay, while experiencing residual altered mental status, he was approached by a representative of a concierge home health agency who presented discharge requirements inconsistent with those of his clinical team, resulting in the patient signing a costly contract for caregiver services that substantially exceeded his documented clinical needs both in scope and expense. The patient's family, despite repeated attempts to engage with discharge planning, was excluded from the decision. The contract was later identified as financially exploitative; a replacement agency provided equivalent care at approximately one-seventh the cost. This case illustrates a reproducible pattern of predatory conduct targeting cognitively vulnerable hospitalized elders and highlights systemic gaps in hospital discharge safeguards.

The rural and northern communities of British Columbia (BC) have their own barriers to accessing mental health and substance use services that lead to greater susceptibility to psychological disorders and substance abuse. Although there is increasing awareness about these inequalities, the research on mental health and substance use outcomes in these groups is still piecemeal. The proposed systematic review provided a synthesis of the current literature on mental health and substance use outcomes in rural and northern BC, the population-specific risk and protective factors, and the effectiveness of planned interventions to address the identified issues. Quantitative studies published in peer-reviewed journals, mixed-methods studies, and government and other health reports published in English were also considered. Predefined terms were used to search databases such as PubMed, PsycINFO, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus, and Web of Science, as well as grey literature sources, for mental health, substance use, rurality, and BC. Two independent reviewers performed title/abstract and full-text screening, and any discrepancies were settled by consensus. A standardized form was used to extract data, focusing on the characteristics of the studies, prevalence, and types of mental health and substance use outcomes, risk and protective factors, and intervention outcomes. Quality checking was conducted using the Newcastle-Ottawa Scale for observational studies, the Critical Appraisal Skills Programme (CASP) Qualitative Studies Checklist for the qualitative studies, and the National Institutes of Health (NIH) Quality Assessment Tool for before-after (pre-post) studies with no control group. Primary evidence suggests that depression, anxiety, and substance use disorders are higher in rural and northern BC due to the lack of socioeconomic and service access and geographic isolation. The available evidence of interventions is disparate and insufficient, and suggests gaps in specific mental health and substance use interventions. The combination of these results can be a basis for policy formulation and distribution of resources, as well as culturally sensitive interventions to decrease mental health and substance use disparities within underserved BC groups.

Lithium remains a cornerstone in the treatment of bipolar I disorder because of its well-established efficacy in reducing mood episode recurrence and suicide risk. However, its narrow therapeutic index makes patients particularly susceptible to clinically significant toxicity, especially following medication changes or drug-drug interactions. Nonsteroidal anti-inflammatory drugs (NSAIDs) are recognized to increase serum lithium concentrations by reducing renal lithium clearance, although reports involving nabumetone remain limited. We report the case of a 50-year-old woman with bipolar I disorder who had remained psychiatrically stable on chronic lithium therapy for approximately seven years before developing severe lithium toxicity following recent escalation of both lithium and nabumetone dosages. The patient presented with progressive confusion, lethargy, recurrent falls, tremor, myoclonic jerks, gait instability, generalized weakness, and altered mental status. Initial serum lithium concentration exceeded 2.9 mmol/L despite preserved renal function. Lithium and nabumetone were discontinued, aggressive intravenous fluid administration was initiated, and serial lithium concentrations were monitored. Given preserved renal function, declining serum lithium concentrations, and rapid neurologic improvement with supportive management, hemodialysis was deferred. The patient experienced progressive clinical recovery with normalization of lithium concentrations and resolution of neurologic symptoms. Lithium was cautiously reintroduced at a reduced dosage without recurrence of toxicity. Application of the Naranjo Adverse Drug Reaction Probability Scale yielded a score of 9, supporting a definite adverse drug reaction. This case highlights that severe lithium toxicity may occur despite preserved renal function following concurrent escalation of lithium and nabumetone therapy. The report emphasizes the importance of comprehensive medication reconciliation, recognition of clinically significant drug-drug interactions, close serum lithium monitoring following medication changes, and early recognition of neurologic manifestations suggestive of lithium toxicity.

Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder that may persist into adulthood. Adult ADHD remains understudied in India, particularly among professional groups.

The objectives of the study are to determine the proportion of participants showing probable adult ADHD screening positivity through an online questionnaire and to compare screening positivity across various professional groups.

This cross-sectional study used an online questionnaire consisting of demographic information, associated factors, and the validated Adult ADHD Self-Report Scale (ASRS) Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) screening tool. The questionnaire was distributed via WhatsApp (Meta Platforms, Inc., Menlo Park, CA, USA) to various professional groups across India. A cut-off score of 14 was used to identify probable ADHD.

Among 355 respondents, 115 (32.4%) showed probable adult ADHD screening positivity. Differences across professional groups were not statistically significant (p > 0.05). Screening positivity was significantly associated with marital status and work environment in unadjusted chi-squared analysis. Participants who screened positive reported higher screen time across professional categories than those who screened negative.

Probable adult ADHD screening positivity was observed across multiple professional groups and was not confined to a single occupation. The observed associations with relationship status and work environment should be interpreted as exploratory and non-causal. These findings support the need for workplace awareness, structured screening pathways, and further studies with clinical confirmation and multivariable analysis.

Due to their high inter-tissue contrast, Magnetic resonance images (MRIs) can reflect neuroanatomical changes related to healthy aging and pathological processes. However, standard brain MRI acquisition resolutions hinder the ability to measure the more subtle changes that occur in early disease stages. Increasing the resolution during acquisition poses multiple challenges, including increased noise, higher acquisition times and cost, and discomfort of the scanned individual. In this work, we propose a robust, generalizable single-image super-resolution network for brain MRIs named Resolution Augmentation with Variational auto-Encoder Networks (RAVEN) with generative adversarial networks (GANs). We show RAVEN is capable of upsampling in-vivo and ex-vivo MRIs of diverse modalities (e.g. T1-weighted, T2-weighted, and T2*) and varying field strengths (3T to 7T) to target voxel sizes as small as 0.5 mm isotropic using arbitrary upsampling factors. RAVEN achieved state-of-the-art performance against deep learning and non-deep learning methods, best preserving true anatomical information. We have also made RAVEN open access, with the source code as well as training and evaluation scripts available and ready to use at: https://github.com/waadgo/raven.

Many dietary interventions have been conducted in rheumatoid arthritis (RA) with quantitative outcomes the key focus; qualitative research exploring participant experiences remains limited. The autoimmune protocol (AIP) diet is an elimination reintroduction approach designed for autoimmune conditions. This study explored the experiences of nine adults with RA who completed an eight-week AIP dietary intervention, with semi-structured interviews conducted immediately post-intervention and again one year later. Interviews explored participants' motivations, challenges, enablers, and perceived effects of the intervention, their experiences with food reintroduction, and the degree to which dietary changes were sustained. Thematic analysis identified three themes related to initial intervention experiences. Open to change, captured initial motivations, trust in the protocol and willingness to attempt substantial dietary change. Navigating dietary transition described the mental, practical, and social strategies used to manage challenges and support adherence. Reflections on benefits and looking ahead, captured perceived health changes and intentions for future dietary practices. At one-year follow-up, three further themes were identified. Personalised reintroductions and responses highlighted how participants observed the effects of foods on RA and health. Finding and sustaining balance reflected the ongoing process of negotiating dietary structure with flexibility, particularly in social contexts. Reflections on wellbeing and future intentions encompassed perceived benefits, persistent challenges, and plans for ongoing dietary management. High initial adherence was facilitated by participant motivation and structured study support. The reintroduction protocol was perceived as burdensome, however, most participants sustained meaningful dietary change, even without ongoing formal guidance.

Against the backdrop of China's accelerating population aging, the geographic separation of older adult parents from their adult children has become increasingly common. While intergenerational proximity is widely assumed to benefit older adults' well‑being, empirical evidence on the optimal distance and its underlying mechanisms remains inconclusive. This study investigates the direct and indirect effects of intergenerational residential distance on the mental health of Chinese older adults, with a particular focus on the mediating roles of financial support and contact‑based emotional support.

We utilized data from the 2023 China Longitudinal Study of Aging Social Survey, a nationally representative sample of community‑dwelling older adults. Intergenerational residential distance was categorized into four levels: cohabitation, same village/neighborhood committee, same city (different neighborhood), and different cities/provinces. Mental health was measured using a validated composite scale of depressive symptoms and life satisfaction. Mediation analyses were conducted via structural equation modeling, controlling for sociodemographic characteristics, health status, and social network variables.

Contrary to the conventional proximity assumption, older adults whose children lived in the same city (but not in the same household or immediate neighborhood) reported significantly better mental health than those in cohabitation or very close proximity. The mediation analysis revealed that children's financial support exerted a robust positive mediating effect, whereas contact‑based emotional support showed a negative mediating effect. Notably, the negative indirect effect through emotional support was substantially larger in magnitude than the positive indirect effect through financial support, offsetting the total benefit of proximity.

These findings suggest that a moderate degree of intergenerational separation-sufficient to reduce daily frictions and role conflicts, yet close enough for practical assistance-may be more conducive to older adult mental health than over‑closeness. The stronger negative mediation via emotional support implies that frequent in‑person interactions, when accompanied by intergenerational disagreements or excessive caregiving demands, can undermine psychological well‑being. For older adults with adequate self‑care capacity, maintaining a moderate residential distance appears to preserve emotional bonding while minimizing daily conflict. Policy implications include the need for differentiated community‑based services that cater to diverse living arrangements, alongside targeted financial subsidy programs to offset the costs of separate residence, thereby supporting healthy and active aging in China's rapidly changing demographic landscape.

Social prescribing has gained international attention as an approach that connects individuals with community-based, non-clinical resources to address social determinants of health and support well-being. Despite growing use across health and community systems, the evidence remains fragmented, with variation in intervention models, settings, target populations, mechanisms, and implementation conditions.

This scoping review aimed to map the characteristics of social prescribing interventions, including models, initiation and coordination settings, referred community assets, target populations, reported mechanisms, outcomes, implementation facilitators and barriers, and evidence gaps.

A scoping review was conducted following the frameworks of Arksey and O'Malley (22), Levac et al. (23) and Joanna Briggs Institute guidance. Reporting followed PRISMA-ScR and PRISMA-S. MEDLINE, Scopus, Web of Science Core Collection, APA PsycINFO, CINAHL, and Embase were searched from inception, with the final search conducted on June 13, 2026. Eligibility criteria followed the Population-Concept-Context framework. Two reviewers independently screened records and charted data using a standardized extraction form. Findings were synthesized descriptively and thematically.

Of 7,602 records identified, 115 peer-reviewed empirical studies met the inclusion criteria after deduplication and screening. Included studies used qualitative (n = 51), mixed-methods (n = 34), and quantitative (n = 30) designs and were conducted across primary care, community, cultural, nature-based, mental health, and hospital settings in 16 countries, including one cross-national Italy-Portugal study. Most studies originated from the United Kingdom (approximately 64%). Reported outcomes included improved mental well-being, reduced loneliness, increased confidence, stronger social connectedness, and improved everyday functioning, whereas clinical and system-level outcomes were more variable. Common mechanisms included relational continuity, personalized support, identity development, and engagement in meaningful community-based activities. Barriers included socioeconomic disadvantage, unstable funding, limited community-sector capacity, workforce pressures, and limited integration of social determinants into routine care pathways. Evidence gaps were notable for migrants, minoritized populations, young people, and economic evaluation.

This review integrates evidence on link worker models, arts and cultural prescribing, nature-based approaches, and condition-focused programs within a single analytical framework. Social prescribing appears to operate through relational processes, community capacity, and local implementation conditions, not referral pathways alone. These findings may inform future research, policy, and practice.

This study aims to assess the prevalence and severity of burnout, depression, suicidal ideation, and anxiety among Obstetrics and Gynaecology (OB-GYN) doctors in Hong Kong and identify their contributing factors. All OB-GYN trainees and specialists in Hong Kong were invited to complete a voluntary online cross-sectional survey. This survey used standardized questionnaires including Copenhagen Burnout Inventory (CBI) for burnout, Patient Health Questionnaire-9 (PHQ-9) for depression, and Generalized Anxiety Disorder-7 (GAD-7) for anxiety. A total of 218 doctors completed the survey. Overall, 43.1% of respondents perceived the well-being status of OB-GYN doctors as "poor"; 36.1% as "average" and 20.8% as "excellent." Using a CBI subscale cut-off score of ≥50 (moderate and higher), 56.4% reported personal burnout; 52.8% reported work-related burnout; and 45.4% reported client-related burnout. The prevalence of depression was 21.1% with 13.3% reported presence of suicidal ideation. The prevalence of anxiety was 20.2%. The most cited sources of stress were work demands, followed by working hours and on-call duties. Residents-in-training and those worked more than 50 h a week had higher prevalence of burnout, suicidal ideation and anxiety while having children had protective effect on doctors' well-being. Possible interventions including limiting excessive work hours and on-call duties, promoting flexible work arrangements, protected training activities, reviewing training curriculum and streamlining the logbook, dedicated mental health and wellness programs and comprehensive mentorship programs would help to improve the well-being of doctors. This study identified a considerable level of burnout, depression, suicidal ideation and anxiety among OB-GYN doctors especially in residents-in-training and doctors working for more than 50 h a week. Addressing this critical issue will require a collaborative effort involving healthcare organizations, policymakers and mental health professionals.

Social anxiety disorder (SAD) is a common and often persistent mental health condition that typically emerges during adolescence and is associated with marked functional impairment. Although cognitive-behavioral therapy and selective serotonin reuptake inhibitors remain first-line treatments, many individuals experience incomplete response, poor tolerability, stigma-related concerns, or limited access to care. Against this background, exercise has attracted increasing interest as a low-cost, accessible, and scalable adjunctive intervention, although adherence and accessibility may vary across populations. In this mini-review, we synthesize current evidence on the role of physical activity and structured exercise in the management of SAD. Available findings suggest that higher levels of physical activity are generally associated with lower social anxiety symptoms, while emerging intervention studies indicate that aerobic exercise, climbing, and group-based exercise programs may confer psychological benefit. Exercise may complement mainstream therapies through partially overlapping yet distinct pathways, including enhancement of self-efficacy, resilience, body image, and social engagement, as well as modulation of cognitive bias, neuroplasticity, and stress-related physiological processes. Potential applications in adolescents, individuals with autism spectrum disorder and comorbid social anxiety, and performance-related anxiety contexts also warrant attention. However, the current evidence base remains limited by small samples, heterogeneous interventions, insufficient long-term follow-up, and a lack of large randomized controlled trials in clinically diagnosed SAD, and much of the available evidence derives from non-clinical or subclinical populations. Overall, exercise should be considered a promising adjunct rather than a replacement for established treatments, and future research should prioritize mechanism-informed, precision-based, and implementation-oriented intervention models.