Pediatric nurses carry heavy emotional and clinical demands that leave them vulnerable to burnout. Trauma-Informed Care (TIC) has helped ease burnout in the workplace, but psychological factors like Impostor Syndrome (IS) may weaken these benefits. Whether IS mediates the TIC-burnout link has not been well studied.

To examine the mediating effect of impostor syndrome on the association of trauma-informed care with burnout in pediatric nurses.

A descriptive cross-sectional study was conducted in six hospitals of Mansoura City, Egypt, between October 2024 and January 2025, with a sample size of 251 pediatric critical care nurses (96.5% response rate). Instruments included Trauma-Informed Care Scale, Maslach Burnout Inventory, and Clance Impostor Syndrome Scale. Data were analyzed by means of Pearson correlation, multiple linear regression, and mediation analysis through PROCESS macro with 5000 bootstrap samples.

Impostor syndrome was the strongest predictor of burnout (β = 0.383, p < .001), followed by attitude toward TIC (β = 0.234, p = .047). Female nurses reported lower burnout, though only IS acted as a mediator. IS partially mediated the association of TIC with burnout (indirect effect = 0.15, 95% CI (0.06, 0.24)), with the model explaining 50.3% of burnout variance.

Impostor syndrome has the potential to alter the work requirements of TIC into further vulnerability to burnout. Comprehensive support for pediatric nurses should incorporate trauma-informed practices alongside programs and strategies to ameliorate the experience of self-doubt, thus improving well-being and care quality.

Bipolar disorder (BD) follows a neuro-progressive trajectory, yet current clinical staging models lack robust biological markers. Based on recent evidence, we hypothesized that BD stages are associated with alterations in the functional architecture of the Triple Network Model. We analyzed resting-state fMRI data from 123 individuals spanning five clinically defined BD stages. Using a hierarchical approach, we investigated how functional connectivity features characterize these stages, transitioning from coarse- to fine-grained analyses in both clinical classification (binary early-versus-late grouping to five-stage discrimination) and connectivity metrics (mean and standard deviation of connectivity to topological dynamic features). First, low-level functional connectivity features, combined with gene expression data, discriminated early- from late-stage illness, reaching higher performance than unimodal approaches. Next, evaluating the full staging spectrum revealed a non-linear trajectory in whole-brain connection density, which was lower at each successive stage from 0 to 3 but unexpectedly higher at stage 4. Network topology analysis contextualized this finding, revealing a reorganization of functional hubs in the final stage. Specifically, three hubs within the Salience Network exhibited decreased centrality despite the overall increase in connection density. This shift corresponded to a loss of temporal synchronization between these hubs and default-mode hubs, an axis of communication mediated by the salience network that is known to be important in healthy subjects and disrupted in psychiatric disorders. Overall, our findings suggest that late-stage BD is characterized by a subtle but significant reorganization of brain architecture, accompanied by alterations in the dynamics of the salience network which loses its coordinating role.

The polytrauma clinical triad (PCT)-co-occurring posttraumatic stress disorder (PTSD), traumatic brain injury (TBI), and chronic pain-is common among U.S. service members and veterans. While known to result in worse clinical outcomes, the effect of the PCT on suicide in military populations remains unknown. The current study examined the effect of the PCT on suicidal ideation and attempts in U.S. veterans and service members.

In Study 1, veterans (N = 351) completed self-reports of PTSD symptoms and chronic pain and clinician interviews of TBI and suicidal ideation and attempts. In study 2, Army soldiers (N = 8558) completed self-reports of PTSD symptoms, chronic pain, TBI, and suicidal ideation and attempts across four assessments spanning from 1-month prior to deployment to 9-months post-deployment.

The PCT was more prevalent in veterans (30.09%) than service members (2.51%), and was associated with greater odds of suicidal ideation in veterans (OR = 4.11) when compared with only two conditions. When compared with one or no conditions, the PCT was associated with greater odds of suicidal ideation (ORs = 2.06-2.94) and attempts (ORs = 4.06-4.40) in service members. PTSD seemed to drive this effect.

Findings support the PCT as a potentially important risk factor for suicide in both current and former military members. Future research should attempt to understand the impact of the PCT on mechanisms of suicide risk and suicide risk screening should be prioritized in polytrauma clinics where patients with the PCT are likely to be seen.

Child maltreatment is strongly associated with adverse physical and mental health outcomes. Yet, when authorities become aware of violence against children, addressing health needs has proven difficult, even within the Barnahus model, which explicitly aims to facilitate legal processes while providing care and support to children. The reasons for this imbalance remain unclear, particularly from the justice system's perspective. A clinical feasibility study at Barnahus Stockholm, Europe's largest facility, examined routine voluntary health examinations through collaboration with police investigators. In practice, however, investigators rarely offered these examinations despite explicit instructions to invite every child. This study explored investigators' experiences of informing children and caregivers about health examinations and their organizational, professional, and personal reasons for refraining from doing so. Ten forensic child abuse investigators were interviewed. Reflexive thematic analysis, informed by institutional logics theory, showed that legal processes consistently outweighed health priorities. Children were regarded primarily as evidence-bearers rather than rights-holders, their health needs filtered through investigative priorities. Organizational agendas shaped interpretations of children's best interests, encouraging medical examinations when serving prosecutorial aims but dismissing them when focused solely on health. Concerns for suspects' integrity and anticipated reactions from adult stakeholders further constrained health-oriented responses. Findings suggest that despite multidisciplinary intentions, criminal law logic dominates Barnahus practice, systematically subordinating children's health needs to investigative requirements. This institutional prioritization undermines the model's stated child-centered approach, highlighting the need for structural and legislative reforms to better integrate health and welfare considerations into child protection responses.

Anxiety disorders form one the most common type of mental illness and comprises of separation anxiety, specific phobias, social anxiety disorder, and generalized anxiety disorder. These disorders offer considerable comorbidity with other mental disorders like depression, memory and learning deficit which all shows considerable seasonal variance. Seasonal changes have major impact on health of individuals' especially mental health. N-Acetylcysteine (NAC) is an acetylated derivative of cysteine, and is considered as an antioxidant precursor to glutathione. It has been shown to ameliorate various types of mental disorders. This study investigated changes in anxiety-like behaviours in albino mice across different seasons in Nigeria and the modulatory role of NAC. The study was conducted across two seasons (cold dry and hot humid seasons) Nigeria. Forty (40) mice of both sexes (20/season) were used, divided into control (normal saline) and NAC (500mg/kg body weight) groups, respectively. All administration was done orally for one week and the rectal temperatures were measured. Behavioural test was conducted using Elevated Plus Maze (EPM) and Open Field Test under standard protocols for each season for a period of one week. The parameters for seasonal changes were also recorded. All analyses were done using Mixed ANOVA followed by Tukey's and Bonferroni's test, respectively and (P-values <0.05) were considered significant using SPSS version 22. The results of the study revealed a significant (P < 0.05) increase in anxiety-like behaviours in hot humid season and increased locomotive activity in cold dry season in male mice. Female mice were more susceptibility to anxiety in cold dry season, which was ameliorated by NAC. In conclusion, the study revealed that hot humid season have anxiogenic like effects, while cold dry season increased locomotive activities in male mice, demonstrating increase exploratory activity and decrease in level of anxiety. The study establishes the occurrence of anxiogenic-like behaviours in female mice in the cold dry season which was ameliorated by NAC administration. Key Words: Anxiety, Seasonal Variation, N-Acetyl Cysteine, Neurobehaviour Running Title: Seasonal variation and Anxiety-like behaviour.

US Navy sailors experience a range of personal and interpersonal stressors due to challenging operational tempos that can contribute to psychological distress and increased suicide risk. Digital mental fitness tools offer scalable, stigma-reducing solutions to support psychological readiness. However, many existing digital mental health interventions use top-down designs that lack input from the target population and focus on treating psychological symptoms rather than improving overall mental fitness.

This study aimed to design a mobile app version of the Rational Thinking, Emotion Regulation, and Problem Solving (REPS) program and evaluate usability and user experience. REPS is grounded in cognitive-behavioral and rational emotive behavior therapy principles. We examined sailor feedback across two evaluation phases to make iterative improvements to the app.

Two rounds of usability testing were conducted with 13 first-term Navy sailors over a 2-month period in spring of 2024. Sailors on duty at a naval ship were recruited by their commanding officer. Evaluation phase 1 (n=8) included exploratory interviews and concept testing using an initial prototype that covered a learning objective of the first module. Sailor feedback from phase 1 informed iterative refinements, including a gamified badge feature and dedicated skill practice session. Evaluation phase 2 (n=5) included a think-aloud protocol using an updated, fully functioning prototype of the first module, with three structured learning objectives. Both phases assessed sailor feedback through qualitative interviews and the System Usability Scale (SUS). Thematic analysis identified core themes related to user needs and app characteristics, and SUS scores were summarized to describe usability.

Sailors found the REPS app prototype to be culturally relevant and relatable to their daily life within the Navy. Sailors also commented that the app had an intuitive, user-friendly design and praised the modern and visually appealing interface. Sailors reported liking the scenario-based situations and clear explanation of how thoughts, feelings, and actions are intertwined. Sailors also identified ways to enhance user engagement, including clearly defining psychological terminology, introducing gamified rewards, outlining learning objectives, and incorporating more prominent visual cues to enhance the discoverability of interactive content. Quantitatively, SUS scores for both evaluation phases were in the excellent range (phase 1: median 92.50, range 72.5-95.0; phase 2: median 85.00, range 80.0-92.5).

The REPS mobile app was rated as highly relevant and usable by newly enlisted Navy sailors. Scenario-based activities, intuitive design, and relatability with lived military experiences were identified as core strengths. Iterative feedback emphasized the importance of human-centered design in refining app functionality, esthetics, and information. These findings support REPS as a promising, scalable digital tool to enhance mental fitness and contribute to universal suicide prevention in the Navy.

The paper presents a clinical case of psoriasis that developed in a 23-year-old Ukrainian service member after a combat-related through-and-through gunshot wound to the lower leg sustained in 2022. The patient had no previous dermatological diseases or family history of psoriasis. Two weeks after the injury, irregular pink plaques appeared around the damaged skin areas and gradually spread to the lower limbs, trunk, and upper extremities, becoming generalised within two months. The disease subsequently progressed to severe plaque psoriasis, complicated by nail dystrophy and psoriatic arthritis. By 2026, skin lesions involved more than 50% of the body surface area (Psoriasis Area and Severity Index (PASI) 25,9) and were associated with a significant impairment in quality of life (Dermatology Life Quality Index (DLQI) 16). Persistent psycho-emotional stress related to military service, sleep disturbances, smoking, and poor adherence to therapy contributed to recurrent exacerbations. Screening revealed clinically significant anxiety, and the patient was referred for psychological evaluation and support. After referral to a mental health centre and implementation of comprehensive management that included psychological support and improved adherence to dermatological therapy, gradual improvement in skin condition and quality of life was observed.

Aim: The aim of the study is to define the values typical for medical students by analysing the career choice motivations in wartime in Ukraine.

Materials and Methods: Overview, Data Retrieval and Thematic Analysis (Braun&Clarke) methods were used. The total of 45 students' essays were analysed in the study.

Results: The professional values of future healthcare specialists in Ukraine in wartime have been defined: restoring health, believing in recovery, recovering the joy of life, helping the military (rehabilitation students); alleviating suffering, respecting dignity, giving people hope, helping them overcome illness (medical students); supporting people who have experienced trauma, providing psychological support in life hardships (clinical psychology students); health and beauty care, volunteer dental care for the military (dentist students). It is established that the frequency of mentions in student essays about the war as a factor in the development of medicine in present Ukraine and the military who need assistance in restoring health/rehabilitation is quite the same as the frequency of mentions of the concept of "compassion" as an important professional value of future healthcare specialists.

Conclusions: To support and develop professional values of medical students (empathy, compassion), implementing courses that help improve awareness of the role of healthcare specialists in wartime into medical school curricula is recommended; as well as to cooperate with institutions that take care for socially vulnerable groups of the population and persons affected by war; and to expand the system of mental health support for students.

AI has become increasingly used in mental health care for applications such as diagnosis, monitoring, and treatment support. These include tools like clinician support systems, large language models, and conversational agents used to augment psychotherapy and clinical decision-making. While prior research suggests potential benefits of and concerns with AI, little is known within the domain of obsessive-compulsive disorder (OCD). Given the expanding role of AI in psychiatry, understanding these perspectives is essential to ensuring AI implementation aligns with patient priorities and values.

This study aims to explore the perspectives of individuals with OCD on the use of AI in health care, including perceived benefits, risks, and its role in relation to human clinicians.

We conducted semistructured interviews with 24 adults self-reporting OCD, recruited through online communities and advocacy networks. Eligible individuals (≥18 y with self-reported OCD) completed screening, provided informed consent, and participated in remote Health Insurance Portability and Accountability Act (HIPAA)-compliant Zoom (Zoom Communications, Inc) interviews (May-December 2024). Transcripts were deidentified, open-coded, and used to develop a codebook. Focused codes were applied using a thematic analysis framework in Dedoose (v9.2.22; Sociocultural Research Consultants, LLC). Each transcript was independently coded by 2 reviewers, with discrepancies resolved through consensus. Themes were developed through iterative interpretive analysis of code clusters.

Participants' perspectives encompassed concerns and benefits of AI in mental health care. Participants expressed concerns about the accuracy and efficacy of information provided by AI, as well as a limited ability for clinical judgment in psychiatric care. Additionally, participants emphasized the importance of human connection, particularly therapeutic alliance, empathy, and reassurance provided by clinicians, which they felt AI could not replicate. Concerns about data privacy, security, and downstream use of information were also highlighted. Despite concerns, many endorsed the use of AI as an adjunct rather than a replacement for clinicians, noting potential benefits in symptom monitoring, preliminary information gathering, and support for administrative tasks, provided that human oversight is maintained.

Individuals with OCD expressed nuanced views on AI in mental health care, balancing cautious optimism with several concerns. While AI may improve efficiency, standardization, and symptom monitoring, participants highlighted risks related to deindividualization, accuracy, and erosion of human connection. These findings underscore the importance of patient-centered, ethically guided AI integration that preserves the therapeutic alliance while leveraging technological benefits.

Physical inactivity increases with age, yet evidence on physical activity (PA) among older adults affected by forced displacement remains scarce, particularly in refugee camp settings. We aimed to assess PA levels and identify associated factors among Rohingya older adults aged ≥60 years living in refugee camps in Southern Bangladesh. A cross-sectional survey was conducted between May and August 2024. PA was assessed using the Physical Activity Vital Sign (PAVS), alongside socio-demographic, health, and lifestyle variables collected via a pre-tested semi-structured questionnaire. in line with WHO guidelines, participants were classified as active (≥150 minutes of moderate to vigorous PA per week) or low active (<150 minutes of moderate to vigorous PA per week). Multivariable Firth penalised logistic regression was used to examine factors associated with meeting PA guidelines. The sample comprised 943 participants (mean age 67.5 years), of whom 70% were aged 60-69 years and 66% were male. Overall, 95% were classified as low active. In adjusted analyses, only older age (≥70 years) was significantly associated with lower odds of meeting PA guidelines (OR 0.31, 95% CI 0.11-0.70). Fewer than one in twenty Rohingya older adults met recommended PA levels. These findings highlight the need for tailored, culturally appropriate PA interventions, with particular attention to adults aged 70 years and older.