The Russian invasion of Ukraine in February 2022, following the conflict in 2014, resulted in indiscriminate shelling, systematic torture and conflict-related sexual violence (CRSV), suggesting possible war crimes and crimes against humanity (WCCAH). This study explores the experiences of Ukrainian veterans and former prisoners of war (POWs) since 2014 to systematically document reported abuses and inform accountability.

We conducted a series of semistructured key informant interviews (KIIs) of 40 Ukrainian veterans and former POWs (20 male, 20 female) from the 2014 and 2022 invasions between August and November 2025. The KII instrument contained 32 open-ended questions covering demographics, abuses, psychological impact and justice. Data analysis involved qualitative thematic analysis with quantitative descriptors from coded interviews.

Participants reported numerous abuses consistent with previously documented WCCAH including attacks on civilian infrastructure; systemic torture, beatings, electrocution, starvation, denied medical care, deliberate targeting of Ukrainian nationality, unlawful killings of civilians and hors de combat; and CRSV targeting both male and female captives and civilians. Internally, female veterans reported facing discrimination, restrictive roles and military sexual assault. Self-reported trauma symptoms consistent with post-traumatic stress disorder, anxiety, depression, sleep disturbances and moral injury were cited as major consequences of the wars.

Reported incidents appear deliberate and widespread and may constitute violations consistent with WCCAH. Psychosocial barriers undermine protection and prevention efforts for justice. Stigma, particularly for male survivors of CRSV, and fear of harming loved ones still in captivity obstruct evidence-gathering and truth-telling. Self-reporting of severe trauma symptomatology necessitates an immediate humanitarian response prioritising recovery of veterans and former POWs through structured, accessible, long-term psychological and psychiatric services. Restrictive roles, discrimination and military sexual assault reveal a need to establish mechanisms that combat internal sexual violence and reinforce professional military hierarchy.

This article reframes preparation for critically ill patients as a dynamic, compounding process that spans 3 temporal phases: strategic, operational, and reflective. Using concepts such as shared mental models, psychological safety, adaptive capacity, and the 3A's prebriefing framework (anticipate, align, and adapt), the article outlines how teams can better navigate uncertainty and complexity in real time. This article describes the consequences of preparation deficit and preparation debt, and provide practical tactics for rapid appraisal, decision-making in motion, and structured reflection. Together, these strategies create a preparation architecture that enhances performance, reduces error, and strengthens team and system resilience.

As recognized members of the mental healthcare team, pharmacists are uniquely positioned to support use of prescription digital therapeutics (DTx) for schizophrenia. However, their specific role in care is yet to be clarified.

To develop recommendations for how pharmacists can embed prescription DTx within healthcare systems, improve access to and engagement with these treatments.

A modified Delphi approach captured US pharmacists' perspectives on prescription DTx for schizophrenia. A 4-member expert steering committee developed a consensus framework on scale, access, and data to inform the creation of an online survey. Ten pharmacy experts with mental- and digital-health experience (average experience: 23.7 years) completed the survey and its results were used to formulate 24 Delphi panel questions (17 yes/no; 7 multiple-choice). Pharmacy experts and steering committee members (N=14) voted on the Delphi panel questions. Consensus was defined as ≥70% agreement. Questions failing to reach consensus statements in round 1 were discussed and subjected to a second vote. If consensus was not achieved after round 2, "no consensus achieved" was documented and the highest-voted category was noted.

Consensus statements were achieved on 20/24 (83%) questions (scale, n=8; access, n=10; data, n=2). Of these, 17/20 (85%) questions achieved consensus statements after one voting round; 3/20 (15%) required a second round. Four questions did not achieve consensus statements. The accepted statements informed recommendations regarding pharmacists' involvement in optimizing prescription DTx use for schizophrenia.

Recommendations included: Pharmacists can facilitate expanding scale by supporting integration of prescription DTx into pharmacy systems and addressing adoption barriers through prescriber education and partnerships; support access by being involved when a prescription DTx is introduced to a patient; and leverage clinical data that are a priority to stakeholders to drive awareness, usage, and adoption.

Multiply marginalized children with disabilities experience discrimination and inequity and consequently disparities in access to health care, health outcomes, and mortality. We gathered information about the health care experiences of multiply marginalized children with disabilities to describe lived experience-based solutions for improving health care and outcomes for this population.

A qualitative exploratory study using focus group and individual interviews with multiply marginalized young adults with disabilities and the caregivers of multiply marginalized children with disabilities in the United States and territories. We asked how services could be changed to better support their health and well-being using an initial deductive approach combined with ongoing inductive thematic analysis.

The study team conducted 5 focus groups and 4 individual interviews with 33 young adults and caregivers in English, Spanish, and ASL. Negative health care experiences include biased and discriminatory professional behavior, barriers to access, and the necessity and burden of advocacy. Proposed solutions focused on professional growth, mental health, disability-centered design, and lived experience leadership. An underlying sentiment was the desire for equitable treatment.

Advancing health equity for multiply marginalized children with disabilities is within reach. Starting points for health care professionals and system leaders include addressing biases and developing reflective and empathic practices and systems, including child and family mental health in care, and using disability-centered design to proactively and flexibly support access. Implementation should be done with lived experience leadership and the centering of human dignity for multiply marginalized children with disabilities and their families.

The revised McDonald criteria (2024) introduced new imaging and laboratory biomarkers, allowing earlier and more accurate diagnosis of Multiple Sclerosis (MS).

To assess the applicability of the new criteria in Portugal and identify diagnostic tool availability and implementation barriers.

We conducted a national survey of neurologists from public hospitals involved in MS diagnosis and follow-up. Descriptive statistics and Pearson's chi-square tests identified factors associated with systematic implementation.

24 of 30 centres responded (80.0%). MRI protocols are routinely implemented in 58.3% of centres, with active Neuroradiology collaboration in 41.7%. CVS and PRLs were not routinely analyzed in 37.5%. OCBs are mostly performed locally (58.3%), while κFLC index is routinely measured in 41.7%. VEPs were timely in 75.0%, while OCT had inadequate response times in 54.2%. Systematic application was reported by 70.8% and associated with higher patient volume (p=0.035), Neuroradiology collaboration (p=0.022), and shorter CSF biomarkers turnaround times (OCB/κFLC index, p=0.003). Main barriers were limited technical resources (78.9%) and time constraints (42.1%).

Access to advanced biomarkers remains heterogeneous. Systematic implementation is associated with higher volume centres, Neuroradiology collaboration, and faster access to CSF biomarkers, highlighting priorities for equitable and timely adoption of the revised criteria.

Obsessive-compulsive disorder (OCD) is clinically heterogeneous, and traditional threat-based models do not fully explain this diversity. Intolerance of uncertainty (IU) and not-just-right experiences (NJREs) have emerged as clinically relevant features of OCD, but their associations with spontaneous brain activity remain unclear.

Fifty-seven patients with OCD and 38 healthy controls (HCs) underwent resting-state functional magnetic resonance imaging. Regional spontaneous activity was assessed using the amplitude of low-frequency fluctuations (ALFF). Clinical measures included the Intolerance of Uncertainty Scale, the Not-Just-Right Experiences Questionnaire-Revised, the Yale-Brown Obsessive Compulsive Scale, and the State Anxiety Inventory. Group differences in ALFF were examined, and partial correlations were performed within the OCD group after controlling for age, sex, education, mean framewise displacement, state anxiety, and medication status.

Compared with HCs, patients with OCD showed increased ALFF in the bilateral orbital middle frontal gyrus and decreased ALFF in the left precuneus and right superior parietal gyrus. They also exhibited significantly higher IU scores. Within the OCD group, greater IU was associated with more severe NJREs and obsessive-compulsive symptoms (both Bonferroni-corrected p < 0.0125). Although IU was not associated with regional ALFF, greater NJRE severity was associated with both higher symptom severity and increased ALFF in the right orbital middle frontal gyrus (r = 0.380, p = 0.006).

OCD is characterized by altered frontoparietal spontaneous activity and elevated IU. The observed associations among IU, NJREs, symptom severity, and orbitofrontal ALFF suggest that uncertainty-related vulnerability, incompleteness-related experiences, and altered intrinsic brain activity are interconnected clinical features of OCD.

Rest intolerance, the experience of negative emotions when attempting to rest, is an emerging public health concern, yet its population-based epidemiology remains poorly understood.

This study systematically investigated the prevalence, distribution, and health correlates of rest intolerance among adults in China, with particular focus on its manifestation in highly educated and younger populations.

We analyzed cross-sectional data from 24,405 adults in the 2024 Psychology and Behavior Investigation of Chinese Residents (PBICR) survey. Rest intolerance (Rest Intolerance Scale-8 [RIS-8]), mental health (Patient Health Questionnaire-9 [PHQ-9], Generalized Anxiety Disorder-R3 [GAD-R3], and Perceived Stress Scale-4 [PSS-4]), and quality of life (EQ-5D-5L or EuroQol visual analog scale [EQ-VAS]) were assessed. Cutoffs were derived via cluster analysis and latent profile analysis, followed by regression and moderation analyses.

The overall prevalence of high rest intolerance was 14.94% (3645/24,405). Notably, rates were significantly elevated among younger adults and those with higher educational levels. Rest intolerance was significantly associated with adverse mental health outcomes (anxiety: β=0.406; depression: β=0.402; and perceived stress: β=0.440; all P<.001) and reduced quality of life (EQ-5D: β=-0.115 and EQ-VAS: β=-0.117; both P<.001). Moderation analyses further revealed that these adverse associations were stronger among highly educated and younger individuals.

Rest intolerance affects 14.94% of adults in China, with highly educated and younger populations constituting particularly high-risk groups. The condition demonstrates robust associations with adverse mental health outcomes and diminished quality of life, especially among these populations. These findings underscore the need for targeted psychological interventions and workplace health policies addressing rest-related distress in contemporary performance-oriented societies.

Emergency medical services (EMS) clinicians operate in environments characterized by repeated trauma exposure, operational unpredictability, shift work, moral distress, and cumulative occupational stress. A substantial body of evidence demonstrates elevated rates of post-traumatic stress symptoms, depression, anxiety, substance use, sleep disturbance, burnout, and suicide among EMS clinicians and other public safety professionals compared to the general public. The implications extend beyond individual well-being, affecting workforce sustainability, clinical performance, and high quality patient care. Mental health in EMS is therefore not solely an individual concern, but a systems issue. Therefore, the National Association of EMS Physicians (NAEMSP) recommends that:Organizational leadership should recognize EMS clinician mental health as foundational to workforce sustainability and safe patient care.EMS clinician mental health awareness, management, and treatment options should be a core part of EMS education.EMS systems should take a multi-faceted approach to mental health, with an emphasis on ensuring access to confidential and culturally competent resources for EMS clinicians and other public safety professionals including telecommunicators, law enforcement officers and firefighters.EMS systems should engage in quality improvement to identify and improve practices affecting EMS clinician mental health.EMS systems should achieve meaningful and sustainable improvements in EMS clinician mental health through legislative advocacy and building strong partnerships with local, regional and national agencies including public health and research institutions.

Menopause is an important biological transition with up to 72 symptoms that shapes aging trajectories across organs and encompasses ~40% of the female lifespan. Although menopause awareness is increasing, research on strategies for menopause symptom management and optimizing health in the postmenopausal period is lacking. This Review highlights that menopause characteristics, such as type, timing, and symptom burden, influence health outcomes and later-life disease risk. Similarly, menopause hormone therapy comes in >200 varieties that differ by dose, formulation of estrogens and progestogens, and timing, each with their own distinct risk-benefit profiles. These distinctions are often missed in the literature but have considerable repercussions for outcomes. Optimized menopause care necessitates a precision medicine approach that considers menopause symptoms, genetics, and previous hormone exposures.

U.S.-based Latino older adult populations face disproportionate barriers to accessing behavioral health services. We examined associations between multifaceted mental illness stigma and help-seeking from different sources of behavioral health supports among understudied Latino older adults with behavioral health problems.

Data come from a cross-sectional survey that included U.S.-based Latino residents ages 50-86 (N=274; 2021). The survey measured mental illness biopsychosocial causal beliefs, treatment efficacy beliefs, and social rejection beliefs as multiple facets of mental illness stigma that may influence mental and physical health help-seeking behaviors from four sources: traditional media, online/digital media, family/friends, and healthcare providers. Linear regression models examined associations between each stigma component and each help-seeking outcome, adjusting for personal/family factors in the full sample of Latino older adults and among a subsample reporting a self/familial behavioral health problem (n=173).

Among Latino older adults with self/familial behavioral health problems, higher biopsychosocial causal beliefs were associated with increased mental and physical health help-seeking from healthcare providers (p<0.05), while social rejection beliefs were associated with decreased mental/physical health help-seeking from healthcare providers (p<0.05). Similarly, higher biopsychosocial causal beliefs were associated with increased mental health help-seeking from traditional media (p<0.05) among those with self/familial behavioral health problems. No associations were observed between stigma components and mental/physical health help-seeking from online media or family/friends. Similar results, though attenuated, were found in the full sample.

Multifaceted anti-stigma interventions for multi-generational Latino families may be an opportune strategy for increasing help-seeking for behavioral health problems among Latino older adults.