Despite increased awareness of its multi-dimensional nature, pain remains often underestimated, and its management across different therapeutic areas remains complex. A patient-centred approach is needed to bridge the gap between clinical assessment and individual experience. This project aimed to explore the pain experience across different therapeutic areas through narrative medicine (NM). DIAMOND, the project name, is not an acronym but a symbol meant to shed light on physical and mental pain.

DIAMOND involved 19 Italian centres and collected narratives from patients experiencing chronic pain, epilepsy, Gram-positive infections or depression, as well as from their caregivers and treating clinicians. Narratives and socio-demographic data were collected anonymously via a dedicated platform. Narratives were analysed using MAXQDA (VERBI Software, Berlin, Germany), applying NM classifications and content analysis; metaphors used by participants to describe pain were also analysed.

Narratives were collected from 64 patients and 56 caregivers; 20 clinicians contributed 40 parallel charts, all of which were included in the analysis. Pain emerged as a deeply embodied and emotional experience, often described through metaphors of darkness, oppression and distortion. At diagnosis, fear, anxiety and disbelief predominated; however, over time, some participants reported acceptance and resilience. Caregivers described significant emotional, relational and economic burdens, often reporting feelings of helplessness and a sense of responsibility. Clinicians presented more progressive narratives, often focusing on technical aspects of care. The narratives revealed a perceptual gap between patients, caregivers and clinicians, especially regarding the emotional meaning of illness and treatment. The narrative process was seen as beneficial by most participants, supporting inner reflection.

This pioneering NM initiative mapped the lived experience of pain across multiple conditions, incorporating the perspectives of patients, caregivers and clinicians. NM proved essential in identifying unmet needs and emotional drivers of care, fostering more empathetic, patient-centred approaches in pain management.

Positive Youth Development (PYD) theory emphasizes strengths that emerge from person-context exchanges, yet item-level, time-ordered relations among PYD attributes (i.e., Competence, Confidence, Character, Caring, and Connection) remain unclear in high-pressure school systems. Using four-wave data from a cohort of grade 10 students in three public high schools in Shouguang, Shandong Province, China, we examined time-ordered relations among the 16-item Chinese Positive Youth Development-Very Short Form (PYD-VSF). At baseline, N = 2086 (Mage = 15.41, SD = 0.52; 53.74% girls); wave-level participation was T2 = 1522, T3 = 1860, and T4 = 1776, with lag-specific analytic samples of 1296-1550 across adjacent intervals. We estimated cross-lagged panel networks (CLPNs) for each successive wave pair using LASSO-regularized regression, summarized networks with out- and in-expected influence. Across intervals, connection-related indicators tended to occupy relatively upstream positions, showing stronger prospective associations with subsequent changes in other PYD indicators, whereas caring indicators more often appeared relatively downstream. Findings indicate that connection indicators were relatively more predictive within the observed system; stronger perceived relational support was prospectively associated with subsequent increases in caring. Clarifying these developmental dynamics can inform interventions to enhance adolescents' mental health and well-being in high-pressure contexts.

While challenges surrounding vaccine acceptance in pregnancy have long been prevalent in Canada, the COVID-19 pandemic introduced a new context for perinatal vaccine decision-making. Pregnant people had to weigh concerns about SARS-CoV-2 infection during pregnancy and the introduction of the new mRNA pandemic vaccines, with less access to in-person perinatal care and social support than usual. This qualitative analysis sought to understand how trust influenced the decision-making of pregnant people during the early COVID-19 pandemic regarding both routine and SARS-CoV-2 vaccinations.

This qualitative study, as part of a larger mixed-methods study, analyzed interviews with 73 participants who gave birth in Ontario or British Columbia, Canada from May 1st, 2020, to December 1st, 2021 via reflexive thematic analysis.

Three types of trust were influential to pandemic vaccination decisions during pregnancy: 1) trust in prenatal care providers, shaped by goals of alleviating mental load, cultural norms, and perceived transparency, 2) trust in institutions, focused on the government, healthcare system, and pharmaceutical industry, and 3) trust in networks, encompassing (dis)trust in social media, valuation of lived experiences, and views of vaccination as a reciprocal obligation to the broader community.

Several dimensions of trust played vital roles in the experiences of pregnant people navigating vaccine decisions amid high uncertainty. Trust in providers was composed of both honesty and transparency, with the latter enabling a new approach to the patient-provider relationship. Avenues to increase trust include social media moderation and discussion of original research by prenatal care providers.

Persons diagnosed with endometriosis report deleterious effects to their physical, psychological, and relational well-being. While some couples state that these challenges extend beyond the person in pain to also affect their partners, other couples have described positive changes to their lives associated with their ability to adapt to endometriosis. These differential experiences indicate that relational dynamics are involved when coping with a condition like endometriosis, yet there have been few investigations with concurrent inclusion of both members of the couple.

This study investigates the experiences of both partners' coping, addressing their individual perspectives and shared narrative around the management of endometriosis.

Couples coping with endometriosis were recruited as part of a larger, mixed-methods study focused on understanding their lived experience. Persons diagnosed with endometriosis and their partner (N=49 couples) participated together in semi-structured interviews probing challenges, successes, and strategies used to cope with endometriosis. Following an inductive approach to thematic analysis, data underwent iterative comparison of codes by two independent coders.

Distinct themes were developed within two domains: Shared Challenges and Coping Together. Under Shared Challenges, the themes of Compounded Illness Burden, Psychological Barriers, and Undermined Agency are described. Within Coping Together, couples described Mutual Support and Psychological Resilience, encompassing the importance of learning new physical and psychological and coping strategies, including lifestyle changes, acceptance, and emotional support.

Findings highlight the potential benefits of a relational framework and how partnered coping processes provide support and impact both the person with endometriosis and their partner. Recommendations for clinicians and efforts to develop psychosocial support programs for endometriosis include collaborative, multidisciplinary care models that provide support to patients and partners.

Substance use during pregnancy poses significant risks to maternal and neonatal health, yet less than half of pregnant women with substance use disorders (SUDs) receive appropriate treatment. State-level prenatal substance use policies may influence treatment outcomes, but their impact on treatment completion remain understudied. This study examines how criminal justice, provider reporting, and treatment support policies are associated with substance use treatment completion among pregnant women.

We analyzed data from the Treatment Episode Data Set-Discharge (TEDS-D) for pregnant women aged 12 or older who were admitted to publicly funded substance use treatment facilities between 2020 and 2022 in the United States (n = 38,410). Multivariable-adjusted logistic regression models were used to assess associations between state-level prenatal substance use policies and treatment completion, adjusting for other covariates.

About 29.5% of pregnant women completed treatment. Women in states with criminal justice policies had a higher likelihood of treatment completion (adjusted odds ratio [AOR], 1.23; 95% confidence interval [CI], 1.13-1.34; p < 0.001), as did those in states with treatment support services (AOR, 1.14; 95% CI, 1.03-1.28; p = 0.014). Conversely, those in states with provider reporting mandates had a lower likelihood of treatment completion (AOR, 0.49; 95% CI, 0.36-0.67; p < 0.001).

State-level prenatal substance use policies are associated with treatment completion among pregnant women. While criminal justice and supportive treatment policies may enhance treatment completion, mandatory provider reporting requirements may deter retention. These findings underscore the importance of designing policies that foster trust, reduce stigma, and prioritize access and engagement for pregnant women.

Activity-dependent trafficking of AMPA receptors (AMPARs) and subsequent long-term synaptic strengthening underlie different forms of learning and memory. The AMPAR subunit GluA1 amino-terminal domain (ATD, a. k. a. NTD) plays a critical role in synaptic AMPAR trafficking and LTP. The GluA1 ATD accounts for almost half the proteins' size and protrudes significantly into the synaptic cleft, hence it is ideally localized for interactions with synaptic cleft proteins. Using unbiased proteomics, we identified the epilepsy and intellectual disability-associated voltage-gated calcium channel (VGCC) auxiliary subunit α2δ-1 as a GluA1 ATD-interacting protein. At CA1 synapses, postsynaptic deletion of α2δ-1 selectively enhanced basal synaptic AMPAR, but not NMDAR currents. Conversely, presynaptic α2δ-1 deletion did not affect basal synaptic transmission but decreased LTP. α2δ-1 deletion in hippocampal field CA3 impaired performance in an object location memory task, but not other forms of memory. Collectively, our work identifies α2δ-1 as an extracellular AMPAR regulatory protein with distinct pre- and postsynaptic functions: in cis, limiting AMPAR access to synapses; in trans, facilitating LTP. Furthermore, it expands our understanding of the mechanisms underlying α2δ-1's regulation of hippocampal function and raise the possibility that α2δ-1-dependent AMPAR regulation may contribute to the effects of gabapentinoid drugs.

Effectively preventing child sexual exploitation and abuse (CSEA) requires understanding the barriers that hinder program success.

This study examines barriers to program implementation (hindering set-up and maintenance), access (hindering groups of individuals from access), and utilization (hindering individuals from engaging with or benefiting from programs), to identify barriers with high and low levels of endorsement across European Union (EU) Member States.

Participants were experts in CSEA prevention. A modified two-round Delphi technique was used. Round 1 was a qualitative online survey analyzed using reflexive thematic analysis, capturing diverse perspectives to inform the development of the Round 2 survey. Round 2 was a quantitative online survey analyzed using a three-step strategy: (1) retaining only items rated by experts from at least two-thirds of EU Member States, (2) calculating country-level mean ratings for each item, and (3) calculating the proportion of Member States endorsing each item, categorizing them as barriers with low, medium, or high levels of endorsement.

Negative public perception, lack of funding, concern for practitioner wellbeing, and a preference for punitive policies were identified as barriers with high levels of endorsement, mainly concerning the implementation of prevention initiatives. Specific legal regulations and a lack of certain prevention initiatives were identified as having low levels of endorsement across Member States but still requiring country-specific targeting.

To enhance CSEA prevention, improved public perceptions, sustainable funding, and practitioner support should be prioritized across the EU. Targeted strategies are needed to address country-specific barriers with low levels of endorsement.

To determine the association between intimate partner violence and alexithymia in pregnant women treated at two hospitals in Cusco, 2025.

A cross-sectional analytical study was conducted, which included 286 pregnant women treated in the outpatient clinics of Gynecology and Obstetrics at Hospital Antonio Lorena and Hospital Regional del Cusco between February and April 2025. Direct interviews were applied using the Toronto Alexithymia Scale (TAS-20) and the Woman Abuse Screening Tool (WAST). Statistical analysis was performed using the generalized linear model (GLM) with Poisson distribution, logarithmic link function, and robust variance, calculating adjusted prevalence ratios (aPR).

286 pregnant women were included. 71.7% presented alexithymia and 55.6% reported intimate partner violence (IPV). The study reveals that the prevalence of alexithymia was 50% higher in pregnant women with IPV (aPR: 1.50; 95% CI: 1.26-1.79; p<0.001), adjusted for origin, educational level, employment status, economic situation, number of gestations, and pregnancy planning.

Intimate partner violence was significantly associated with a higher prevalence of alexithymia in pregnant women treated at two hospitals in Cusco. Pregnant women exposed to violence showed a 50% higher prevalence of alexithymia, even after adjusting for sociodemographic and obstetric variables.

Sleep is essential for health, yet a large proportion of the population reports sleep complaints. The ASLEEP (Preventing and Treating Insomnia Symptoms in Mid-Life and Older Adults) intervention is conceptualized as an eCBT-I (digitally delivered cognitive behavioral therapy for insomnia) intervention aiming to prevent and treat insomnia in individuals aged 50 years and over through a novel, tiered approach. The first step, a basic course delivered via iPad through a dedicated app, includes educational videos grounded in sleep education and sleep hygiene advice, a 7-day digital sleep diary, and a postcourse digital sleep report providing personalized feedback on sleep efficiency via email.

The objective of this study was to assess the feasibility and acceptability of the ASLEEP basic course among adults aged 50 years and over, including participant engagement, acceptability of the course content, and delivery of study activities, through PROTECT Norge (Platform for Research Online to Investigate Genetics and Cognition in Ageing Norge), an online research infrastructure.

A single-arm multimethod feasibility and acceptability study was conducted as a nested study within PROTECT Norge. Data comprised preintervention questionnaires on sleep and mental health, intervention compliance tracking, and 2 postintervention focus group interviews. Questionnaire and compliance data were analyzed descriptively, and focus group data were analyzed using systematic text condensation.

Of 150 invited individuals, 18 expressed interest. Ten participants were included in the study, all of whom completed the intervention and subsequently took part in 2 focus group interviews, with 5 participants in each group. Participants included 6 women and 4 men aged 54 to 78 years. Preintervention data showed that 7 participants reported subthreshold insomnia and 3 reported no insomnia. Sleep diary compliance during the ASLEEP basic course was 99.3%. The systematic text condensation analysis revealed three main categories: (1) motivation for participation in the ASLEEP study, (2) benefits of the ASLEEP intervention, and (3) promoting and hindering factors of delivering a fully digitalized intervention.

The ASLEEP basic course was well-received and provided participants with a new understanding of sleep through increased knowledge and awareness. Technological insecurity was experienced by some of the participants, but it was mitigated by technical support. Improving app stability and expanding device compatibility could enhance accessibility and optimize ASLEEP's future delivery. The PROTECT Norge platform demonstrated good feasibility in recruitment, participant management, and compliance monitoring, supporting the successful delivery of the study.

Negative interpretation bias, the tendency to interpret ambiguous situations as negative or threatening, is associated with reports of intense and more frequent negative affect. However, there is a relative paucity of work seeking to determine whether this cognitive bias might account for individual differences in affective responses to positive content. Given the wealth of benefits associated with positive emotional experiences, such as greater psychological wellbeing and better physical health, this investigation tested the influence of negative interpretation bias on emotion responses to evocative positive film clips as positive emotion-eliciting contexts. Negative interpretation bias was indexed using a novel word matching task. In each investigation, careful consideration of dispositional or trait-level influence on interpretation bias (i.e., dispositional negativity) was considered. Investigations conducted across three samples of college students at a large, Midwestern public university reveal complexity to this question: in one study, a small significant indirect effect of negative interpretation bias on the association between dispositional negativity and self-reported affect following positive emotionally-evocative films was found, while in the two subsequent studies, no significant mediation was found. Certain contextual factors, such as the explicit or discrete nature of the clip presentation as well as more stable tendencies toward positive emotional responsivity and the capacity to self-report emotional experiences, appear to be important. Finally, the novel task was found to be reliable and demonstrated convergent validity with established indicators. Future work should continue to clarify the conditions under which negative interpretation bias may influence responses to positive emotional contexts, given the importance of positive emotionality for lifelong physical and mental health.