Primary care health services face workforce pressures internationally. Greater multidisciplinary working is seen as a solution. In Scotland, pharmacists are embedded within primary care teams. General Practice Clinical Pharmacists (GPCPs) deliver medicines-related services, including independent prescribing, medicines optimisation and medication review. However, GPCPs' clinical experience and training vary considerably. A structured preceptorship programme was developed to support role development.

To evaluate the impact of a preceptorship programme for GPCPs on self-assessed training needs, competence and confidence within routine primary care practice.

A prospective repeated-measures survey and medication review activity analysis were conducted with GPCPs in one health board between January 2024 and March 2025. Reported using the Checklist for Reporting of Survey Studies (CROSS). Preceptees, identified using eligibility criteria, completed a 32-item Hennessy-Hicks Training Needs Analysis questionnaire pre- and post a 12-week preceptorship programme, rating tasks for importance, self-perceived performance and confidence. Matched pre-post questionnaire responses were analysed using the Wilcoxon signed-rank test. Routinely recorded medication review activity was extracted from electronic clinical systems for six months pre- and post-programme and summarised descriptively.

Fifty-three GPCPs enrolled; 51 (96%) completed (median age 34 [range 24-57] years; 43 (84%) female. Median years qualified were 11 (range 1-33) and 3 years (0-10) primary care experience. Pre- to post-response rate was 76% (39/51). At baseline, the top five scoring self-reported priority training needs items (task importance minus perceived performance score) of the 32 items were: mental health and chronic pain reviews, conflict management, biopsychosocial assessment, and assessing patient decision-making capacity. At 12 weeks all scores had reduced, with larger reductions observed in the top five items (p < 0.001 for each item). Self-reported competence and confidence across all superordinate categories appeared to increase. Recorded medication review activity was summarised descriptively. Median monthly reviews increased from 2 (IQR 0-4) before preceptorship to 4 (IQR 1-10) during preceptorship, before returning to 2 (IQR 0-7) after programme completion.

Structured preceptorship was associated with improved self-reported competence and confidence and a short-term increase in recorded medication review activity. Further evaluation is required to determine whether these changes translate into sustained clinical activity for improved patient outcomes.

Urban green spaces provide vital restorative benefits for public mental health, yet traffic noise widely undermines these effects, with existing studies predominantly focused on sound pressure level rather than temporal and frequency characteristics of traffic noise. An outdoor experiment was conducted with 33 participants to investigate traffic noise impacts on urban green space restorative effects, assessing objective attentional restorative effects and subjective restorativeness (Perceived Restorative Soundscape Scale) under varied sound pressure levels, temporal discontinuity, and frequency conditions. Results showed that traffic noise consistently reduced subjective restorativeness, with negative effects intensifying as sound pressure level increased and weakening with greater temporal discontinuity. Medium-low frequency noise produced stronger detriments than medium-high frequency noise for both subjective and objective restoration. Objective restoration shifted from impairment to improvement as temporal discontinuity rose and showed a significant interaction between sound level and time-domain characteristics. Effect sizes further indicated that subjective restorativeness was more sensitive to sound pressure level, whereas objective restoration responded more to temporal characteristics. These findings clarify multi-dimensional traffic noise impacts on green space restorative effects, offering scientific support for urban noise management and green space soundscape optimization.

The United States is experiencing a youth mental health crisis, which is exacerbated for military-connected children because of frequent relocations and parental deployments. Despite universal healthcare, military-connected children report more mental health and special healthcare needs than their civilian peers, highlighting a gap that impacts family well-being and military readiness. To address this challenge, over 70 organizations formed the Military Child and Family Collaboratory (MCFC), a research Collaboratory operating within a collective impact framework. The MCFC developed guidance on collaboration, shared measurement and a common agenda to improve the mental, emotional, developmental, and behavioral (MEDB) health of military-connected youth. The collective impact framework requires diverse stakeholders to address distinct components of the issue. To assess the extent to which Collaboratory member organizations, and thus the collective impact framework, address the diversity of youth needs, researchers utilized a deductive content analysis of program descriptions, aligning them with 8 domains of youth well-being.

Using Krippendorff's guidelines, researchers purposively sampled publicly available programs from the websites of 72 member organizations for a final sample of 252, which were coded into 8 domains of youth well-being. Two raters independently coded the units with an interrater reliability of 95.6%. Researchers calculated the frequency of programs within each domain, and coded the program beneficiaries as either direct-for military families-or systemic-for clinical care. To assess alignment with Collaboratory initiatives, researchers coded the function of the program as research (i.e., research dissemination), training (i.e., provider training), or implementation (i.e., resource dissemination).

The content analysis revealed a strong alignment between the activities of Collaboratory member programs and youth well-being; all 8 domains were addressed. There was a concentration of programs in Mental and Behavioral Health (n = 90, 35.7%) and Community and Belonging (n = 89, 35.3%), followed by Social Networks and Relationships (n = 22, 8.7%), Education and Learning (n = 22, 8.7%), Economic Stability (n = 16, 6.3%), Physical Health (n = 8, 3.2%), Physical and Psychological Safety (n = 4, 1.6%), and Sense of Purpose (n = 1, 0.4%). Additionally, 46.4% (n = 117) of programs were direct and 53.6% (n = 135) of programs were systemic, with a statistically significant difference between beneficiary types across domains X2 (7, n = 252) = 43.14, P < .001. Further, 62.7% (n = 158) of programs were implementation-focused, 19.1% (n = 48) of programs were research-focused, and 18.5% (n = 46) of programs were training-focused.

Findings illustrate alignment between Collaboratory program activities and the common agenda, with a focus on Mental and Behavioral Health, as well as the diversity of programs supporting all 8 domains of youth well-being. This study highlights the importance of the Collaboratory's collective impact model, which creates space for innovative solutions and ensures they are strategically coordinated for optimal resource allocation and program reach. Future studies may directly measure youth well-being outcomes associated with the programs and evaluate strategies to build partner capacity and mutual engagement.

Magnetic seizure therapy (MST), as a novel physical therapy technique, has demonstrated significant efficacy in the treatment of depression. Previous systematic reviews and meta-analyses have preliminarily confirmed its clinical value. This study conducts a meta-analysis based on updated randomized controlled trials to evaluate the differences in efficacy between MST and electroconvulsive therapy (ECT) in patients with major depressive disorder (MDD), as well as their effects on cognitive function.

We conducted a systematic search of PubMed, Embase, the Cochrane Library, Web of Science, Ovid, ProQuest, and CNKI databases for randomized controlled trials published up to March 1, 2026. The selection of studies strictly followed the Cochrane Risk of Bias in Randomized Trials tool, and the meta-analysis was conducted in accordance with the Cochrane Systematic Reviewer's Manual. Data from 429 patients across 6 studies were included in the quantitative synthesis.

The results showed that post-treatment depression scale scores in the MST group were 0.329 higher than those in the ECT group (95% CI: 0.119-0.539, I² = 9.4%, P = 0.0021), suggesting that the antidepressant efficacy of MST was inferior to that of ECT. In the neurocognitive subgroup analysis, MST performed significantly better than ECT in verbal fluency (SMD = 0.75, 95% CI: 0.19-1.31, P = 0.0088), immediate memory (SMD = 0.68, 95% CI: 0.35-1.01, P < 0.0001), delayed memory (SMD = 0.61, 95% CI: 0.28-0.94, P = 0.0003), and verbal learning (SMD = 0.57, 95% CI: 0.18-0.95, P = 0.0037).

Our evidence-based study conducted a meta-analysis of the antidepressant efficacy of MST and its effects on cognitive function. The evidence from this study suggests that MST may be slightly less effective than ECT in treating depression but may offer advantages in terms of cognitive preservation; further research is needed to confirm these findings.

Long COVID, or post-COVID-19 syndrome, is characterized by persistent symptoms following SARS-CoV-2 infection, including cognitive impairments such as "brain fog" that adversely affect quality of life. The aim of this study was to evaluate the impact of long COVID on working memory using a single, rapid, anonymous online survey and visual working memory quiz.

We analyzed working memory scores in relation to reported long COVID status (clinically diagnosed, self-reported, and non-long COVID), age, number of COVID-19 infections, long COVID duration, and subjective ratings of brain fog severity and the overall life impact of symptoms. The study utilized the Rapid Objective Working Memory Assessment (ROWMA), a brief, gamified visual recognition task designed to maximize compliance and minimize fatigue.

A total of 1,064 participants aged 16 to over 85 years were recruited, with 39% reporting long COVID. Categorical regression revealed that long COVID status was the strongest predictor of working memory performance, followed by age and number of infections. Participants with long COVID performed significantly worse on the working memory quiz than non-long COVID controls, with the lowest scores observed in the clinically diagnosed group. Furthermore, working memory scores declined with age, particularly among those aged 35 and older, and decreased with multiple COVID-19 infections within the diagnosed group. Individuals in the diagnosed group reported the most severe brain fog and the greatest life impact, both of which strongly correlated with lower memory scores. Although longer long COVID duration was associated with lower memory performance, an exploratory analysis indicated this trend may have been influenced by the SARS-CoV-2 variant.

Our results support the hypothesis that long COVID is associated with objective working memory impairment, particularly among individuals with a clinical diagnosis. These findings add to the growing body of evidence linking long COVID to objective cognitive difficulties. Moreover, the study advocates the use of rapid, single-task online cognitive assessments as a practical, scalable, and low-burden approach for evaluating working memory function in this population.

Cancer stigma, both underaddressed and understudied, remains a pervasive challenge in sub-Saharan Africa. Currently, the region is experiencing rising cancer incidence alongside some of the lowest cancer survival rates worldwide. With complex and multifaceted sociocultural factors contributing to this stigma and subsequent lack of screening, low treatment adherence and poorer health outcomes, it is critical to implement effective interventions in the region, at both the clinical and policy levels. To achieve a path forward, it is necessary to create targeted efforts that incorporate existing infrastructure and key cultural contexts.

The apolipoprotein E (APOE) +4 allele is a major genetic risk factor for mild cognitive impairment (MCI) and is associated with hippocampal dysfunction. However, its effects on hippocampal subregional functional connectivity (FC) and clinical manifestations in MCI patients with subsyndromal depression (MCID) remain unclear.

In this study, 88 patients with MCID were stratified into APOE+4 homozygotes (n = 12), heterozygotes (n = 31), and non-carriers (n = 45). Resting-state FC of the dorsal (dHIP) and ventral hippocampus (vHIP) was examined. Mediation analyses were conducted to investigate the effect of neurological biomarkers on APOE +4 gene dose, depressive symptoms with cognitive function in MCID.

Compared with non-carriers, APOE +4 homozygotes showed decreased FC between the left vHIP and the left inferior temporal gyrus and right precentral gyrus, while heterozygotes showed decreased FC between the left vHIP and the right middle frontal gyrus and left cerebellum. In addition, APOE +4 homozygotes exhibited a gene dose-dependent reduction in FC between the vHIP and the left postcentral gyrus (PoCG) compared with heterozygotes. Importantly, vHIP-PoCG FC mediated the relationship between depressive symptoms and cognitive impairment, and between APOE +4 gene dose and cognitive impairment in MCID patients.

These findings suggest that reduced vHIP-PoCG FC may represent a candidate neuroimaging correlate in MCID and may underlie APOE +4-related vulnerability to depressive and cognitive symptoms. Moreover, the mediating effect of vHIP-PoCG FC may partly account for the association among APOE +4 gene dose, depressive symptoms, and cognitive impairment in MCID.

Rheumatoid arthritis (RA) is a chronic autoimmune disease causing joint inflammation, pain, and deformity, significantly impacting physical and mental well-being. Sleep disturbances and obesity exacerbate symptoms, increasing disease severity. Oxidative stress plays a key role in RA progression, and diet may influence inflammation. The Dietary Antioxidant Index (DAI) reflects dietary antioxidant intake, but its link to RA symptoms is unclear. This study explores DAI associations with RA outcomes, sleep quality, anthropometric indices, and quality of life (QoL).

This cross-sectional study included 246 RA patients attending a rheumatology clinic in Ahvaz, Iran. Dietary intake was assessed using a validated food frequency questionnaire, and DAI was calculated via the Wright method. To analyze the data, we employed various statistical methods, including analysis of variance, chi-square tests, t-tests, linear and Poisson regression, as well as logistic regression, as appropriate.

In this study, patients with RA (163 females and 83 males; mean age 50.40 ± 6.33 years) were evaluated. Poor sleep quality affected 54.9% of participants. Higher DAI scores were significantly associated with lower poor sleep quality across all models (OR = 0.66, 95% CI: 0.51-0.85). Most QoL domains showed no significant link with the DAI score, except for emotional limitations and total mental health, which improved with higher scores. Central obesity, defined by waist circumference (WC), exhibited a borderline association with DAI (OR = 0.75, 95% CI: 0.56-1.00).

Our study suggests that among RA patients, higher adherence to DAI is linked with a lower likelihood of sleep deprivation, reduced central obesity as measured by WC, and a decreased rate of tender joints. However, no significant impact on overall QoL was observed. Further research involving larger populations is needed to confirm these findings.

Literature has shown that memory can be influenced by sensorimotor simulations at encoding as those involved in motor imagery (MI), action observation (AO), or affordances elicited by visual object presentation (OBJ). Such simulations can improve memory by creating multimodal and thus, more accessible memory traces. However, no research has yet compared all these simulations within a single study and investigated their relationship with participants' imagery ability. The current study aimed to fill this gap by assessing the effects of different simulations on episodic memory for objects that initially were encoded as part of a sentence in which the action was 'grasping' (e.g., You are grasping a fork). By applying a between-subject design, 163 participants were assigned to different sensorimotor encoding conditions, and their memory was tested in a free recall task 15 min after encoding. Our results showed a main effect of AO, indicating an overall AO benefit to memory enhancement. Moreover, a three-way interaction between AO, MI and OBJ showed how the facilitating role of AO can be dampened by MI and OBJ. Finally, we found that the individual trait of kinesthetic imagery (KI) interacts with AO in recall performance, as higher levels of KI interfere with AO encoding, suggesting potential different mechanisms underlying the mental simulations involved in motor imagery and action observation.

Psychotropic medications are often associated with significant and rapid weight gain in pediatric populations, especially second-generation antipsychotics and mood stabilizers. This was a retrospective study assessing weight gain, and tolerability of adjunctive topiramate in hospitalized child and adolescent psychiatric patients.

A total of 285 inpatients were included in the study: an intervention group (n = 45) receiving adjunctive topiramate and a control group (n = 240) receiving standard care. Net weight, polypharmacy burden (chlorpromazine [CPZ] equivalent doses and other mood stabilizers) and psychiatric recovery (Global Assessment of Functioning [GAF] and Clinical Global Impression-Severity [CGI-S] scores) were measured. Hierarchical ANCOVA models were employed to disentangle the independent metabolic effects of topiramate from the confounding effects of polypharmacy.

The mean weight gain in the control group was significantly greater than in the topiramate group (3.3 kg vs -0.1 kg, p < 0.001). This protective metabolic effect persisted with high statistical significance even after controlling for the concurrent CPZ equivalent dose (3.1 kg advantage). Clinical recovery, measured by equivalent improvement in GAF scores and reduction in CGI-S scores, was similar for both groups.

Adjunctive topiramate is a highly effective and safe metabolic shield in acute pediatric inpatient settings. It reduces the risk of psychotropic weight gain and can substantially reduce the need for obesogenic polypharmacy, without impeding the course of psychiatric recovery.