Paediatric patient reported experience measures (pPREMs) can help children's voices be heard to evaluate and improve healthcare delivery. However, no standardised child-completed pPREM has been co-designed with children and validated in Australia. This research aimed to test the content validity of a co-created pPREM using an iterative, participatory approach with children.

21 children aged 6-11 years were recruited across four Australian hospitals. Children participated in online cognitive interviews to evaluate pPREM items and rating scales (using 'stars' or 'smiley faces') for their understandability, usability, relevance and importance related to their needs in hospital. Framework analysis was conducted iteratively, with items refined after the first round of interviews based on children's feedback.

Most (n=20; 95%) children understood the instructions. After nine interviews, two items were revised: 'Someone I knew could stay with me' changed to 'Family and friends could be with me' and 'I was able to talk to other patients', to 'I was able to talk to other kids in hospital'. Following these revisions, all children understood most (13 of 18=72%) items. In the remaining five items, some phrases, such as 'Care and treatment', were not easily understood, and items were edited according to children's feedback. Most children (n=14; 67%) preferred the 'smiley faces' rating system, and 83% (n=15) reported the number of questions as the right amount. Children generally found all items important, although some items did not apply to all and a 'Does not apply to me' response option was added.

Children aged 6-11 years can meaningfully engage with a co-designed pPREM. Cognitive interviews and an iterative approach helped identify and rectify comprehension issues. It is feasible to involve children in the design of pPREMs and doing so strengthens pPREMs' usability and understandability.

Psychiatric comorbidities impact one-third of dermatology patients, yet psychodermatologic conditions remain underrecognized and challenging to diagnose and manage. The 2023 EADV/ESDaP/APMNA consensus introduced a refined two-category classification that more accurately reflects the bidirectional mind-skin relationship and aligns diagnosis with treatment. This review reflects an evidence-based approach to the recognition, diagnosis, and management of psychodermatologic conditions. We ground our approach in the neuroimmune mechanisms underlying the mind-skin axis and present a stepwise diagnostic framework that incorporates validated screening instruments. Treatments are stratified by category 1 (primary psychiatric disorders with cutaneous manifestations) and category 2 (primary dermatoses with psychiatric impact). We also delineate the scope of psychotropic prescribing appropriate for dermatologists and identify clear thresholds for psychiatric involvement. Multilevel solutions to barriers impeding care are proposed. Dermatologists who integrate psychodermatologic assessment into routine practice are poised to improve outcomes for a substantial portion of patients.

Depression and anxiety are common mental health conditions associated with substantial morbidity and mortality. In psychiatric specialty clinics, standardized symptom monitoring improves outcomes and is recommended in practice guidelines, yet many patients remain unmonitored. This study examined factors associated with completion of standardized depression and anxiety symptom monitoring within a psychiatric specialty clinic network after implementing automated electronic health record workflows to support progress monitoring.

This retrospective cohort study used data from a large academic psychiatry clinic network (October 2023-September 2024). The cohort included adult patients with at least one return visit; data included patient demographics, visit characteristics, and standardized symptom measure completion. Symptom progress monitoring was defined as completion of at least one relevant standardized measure during a return visit. We found associations between care utilization factors and receipt of monitoring using univariable logistic regression, and multivariable models evaluated for joint effects.

Among 6700 patients, 83.6% completed depression monitoring and 81.4% completed anxiety monitoring at least once. Older adults, patients with a non-English language preference, and Black or African American patients were less likely to complete monitoring. Patients with more return visits and virtual visit use were more likely to complete both depression and anxiety monitoring.

This study is novel in identifying specific patient and care utilization factors associated with progress monitoring in a setting where certain implementation barriers have previously been addressed. Findings demonstrate patterns in who remains unmonitored and highlight the need for targeted strategies to support patients less likely to complete monitoring.

Flooding can disrupt psychological well-being, social support networks, and everyday functioning, particularly in rural communities with limited access to psychosocial services. This study assessed the availability, utilization, and perceived effectiveness of psychosocial services among flood-affected communities in Kilosa District, Tanzania. A convergent mixed-methods design was employed, combined a household survey of 214 respondents with key informant interviews and structured observations. Quantitative data were analyzed using descriptive statistics and chi-square tests, while qualitative data were thematically analyzed and integrated during interpretation. Findings showed that 62.95% of respondents received at least one psychosocial service following flooding. Counselling was the most frequently reported service (47.66%), followed by therapy (30.84%) and public awareness or mental health education (21.03%). Village of residence was significantly associated with participation in public awareness and mental health education (χ² = 13.0572, p = 0.0015), therapy utilization (χ² = 16.6930, p = 0.0002), and perceived effectiveness (χ² = 24.5579, p < 0.0001). Duration of residence was also associated with perceived effectiveness (p = 0.0400). Education level was associated with counselling (p = 0.0205) and therapy utilization (p = 0.0425). Qualitative findings highlighted geographical disparities, shortages of trained personnel, limited continuity, and reliance on community-based support. Effectiveness reflects perceived usefulness, not measured psychological outcomes, and does not demonstrate improved coping, recovery, or resilience.

Supervised consumption sites (SCS) are interventions supported by decades of evidence and yet remain subject to considerable politicization. Recently, researchers from Alberta, Canada published a study in the journal Addiction that sought to assess the impacts of the closure of a SCS in Red Deer, Alberta. The study authors reported that the closure had no negative health impacts while increasing uptake of opioid agonist treatments among former clients. However, the study suffers from numerous methodological shortcomings that call the validity of the findings into question, including but not limited to issues pertaining to undisclosed service changes confounding the study findings, exposure misclassification, model assumptions, and problems related to comparator validity. Also evident are a range of undisclosed conflicts of interest involving the study authors, as well as misleading statements about the findings by the authors and organizations that produced the study. Over 25 Canadian researchers signed a retraction request letter that was rejected by the journal's editors, as were multiple letters to the editor outlining these concerns. This case sheds further light on the challenges related to communicating the scientific record and highlights the need for more effective and impartial retraction request processes, as well as efforts to minimize instances of potential research misconduct in the drug policy space.

People experiencing homelessness face profound health inequalities, including high rates of mental and physical illness, problematic substance use, injury and reduced life expectancy. While the therapeutic benefits of greenspace are established, research on nature-based interventions for this population remains limited. This study explores how a tailored green social prescribing programme delivered through a supervised community garden and nature-based activity project can improve wellbeing amongst people experiencing homelessness. The research was conducted at a primary care centre in Scotland. Semi-structured interviews with centre clients (n = 11) and programme staff (n = 3) captured experiences and perceived therapeutic processes. Data were analysed using reflexive thematic analysis and informed by an existing greenspace programme theory model. Five themes are presented in relation to nature, the individual-self, and the social-self. Findings suggest that greenspace interventions accessed through tailored green social prescribing have the potential to be therapeutic for people experiencing homelessness. To realise these benefits, interventions must accommodate individuals' capacities and circumstances, which may differ from other populations.

Although a complexity theory lens can help to understand national policy implementation at a local government level, application of this lens often remains at a metaphorical level. We illustrate how complexity concepts, such as adaptation, feedback, emergence and co-evolution can be used practically in research on policy implementation using a UK case study (Future in Mind; FiM), aimed at improving school children's access to mental health services in a metropolitan borough in the North England.

We re-analysed interview data with staff from local government, National Health Service/mental health, schools, and the voluntary and community sector (n = 31 semi-structured interviews) involved in the implementation of FiM and coded this data in NVivo12 using complexity concepts as sensitising constructs.

We identified 5 feedback loops: two positives (1. Flexing the training offer; 2. New skills, knowledge and behaviour by non-specialist staff) and three negatives (3. Short termism, 4. Free rider behaviour, 5. Professional boundaries). These loops energised local adaptations of FiM by school and NHS staff, leading to system-level change (emergence), with the school system becoming more responsive to mental wellbeing needs of children and young people, and shifts across systems (co-evolution), by developing joint values and language between schools and NHS.

We demonstrate the importance of positive and negative feedback loops for evidencing system-level change and shifts across systems. Our findings provide new insights into unintended consequences of policy implementation and starting positions for implementers to utilise feedback for generating impact. We argue for a blurring of boundaries between implementation and evaluation in policy research to optimise the use of feedback.

Student well-being is recognized as central to academic success, yet little is known about how extreme, isolated learning environments may shape this relationship.

To explore student's and staff's perception of student well-being and learning at the University Centre in Svalbard (UNIS), focusing on the Arctic context.

We used a qualitative, exploratory design, conducting semi structured interviews and focus groups with students and staff at UNIS.

We identified four themes: Arctic isolation, nature as the learning environment, belonging and identity, and extended roles. Participants emphasized strong field‑based pedagogy, high motivation, and close student-staff bonds that foster learning and belonging. Simultaneously, geographic isolation, seasonal variability, logistical constraints , and limited local mental‑health services amplifies challenges. Staff frequently adopt extended caregiving roles without formal training, blurring boundaries and increasing workload. Participants expressed a need for on‑site psychological services, targeted staff training, clearer role definitions, and a focus on mental health promotion.

UNIS has engaged staff and motivated students, and the environment foster valuable learning opportunities. Simultaneously, there are some important psychosocial vulnerabilities. A whole‑university approach combining on-site support services, staff development, and embedded mental health promotion would better safeguard student well-being and sustain learning outcomes.

To investigate the clinical, psychological, and functional determinants of kinesiophobia and to examine their interrelationships in patients with systemic lupus erythematosus (SLE). This cross-sectional study included 60 patients with SLE. Demographic characteristics, disease-related variables, laboratory parameters [e.g., C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR)] and disease activity were recorded. Kinesiophobia was assessed with the Tampa Scale for Kinesiophobia (TSK). Central sensitization, personality, mental health, quality of life, and sleep were evaluated by the Central Sensitization Inventory (CSI), Type D Scale-14 (DS14), Hospital Anxiety and Depression Scale (HADS), Short Form-12 (SF-12), and Jenkins Sleep Evaluation Scale (JSS), respectively. Serial multiple mediation analysis were performed to examine factors associated with kinesiophobia. A mean age of patients with SLE was 39.7 ± 13.8 years. Kinesiophobia was present in 70% of the study population. Patients with kinesiophobia had significantly higher ESR and CRP, DS14 total and negative affectivity scores, and greater psychological distress across all HADS subscales (p < 0.05, for all). TSK scores correlated positively with CRP, ESR, pain, CSI, DS14, and HADS subscales (correlation coefficients ranged between 307 and 522) and negatively with SF-12 Physical Component Summary score (correlation coefficient=-0.414). Serial mediation analysis explained 40% of TSK score variance (R²=0.40). CRP had a significant direct effect on kinesiophobia (B = 0.87, p = 0.002), independent of age and sex. Neither DS14 nor CSI significantly mediated this association. Kinesiophobia is highly prevalent in patients with SLE and associated with inflammatory, psychological, and functional parameters. Systemic inflammation, reflected by CRP, appears to be independently associated with fear of movement in SLE. These findings underscore the importance of monitoring inflammatory markers in SLE management and integrating personality and central sensitization assessments into a comprehensive biopsychosocial approach.

BACKGROUND This study aimed to evaluate whether a multi-modal training that combined Baduanjin, computerized cognitive training, and reminiscence therapy is associated with improved cognitive function in older adults with mild cognitive impairment (MCI) in a pilot randomized controlled trial. MATERIAL AND METHODS Sixty-five patients with MCI were randomly assigned into an intervention group (a 24-week multi-modal training) and a control group (health education). Cognitive function was assessed at baseline, week 12, and week 24 using the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). A repeated-measures ANOVA was conducted across 3 time points to examine the group effects, time effects, and interactions. RESULTS Significant group × time interactions were observed for MMSE and MoCA (both P<0.001). At 24 weeks, the intervention group showed greater improvement than the control group in MMSE score, with a between-group difference of 1.88 points (P<0.001), and in MoCA score, with a between-group difference of 1.62 points (P<0.001). Exploratory MoCA subdomain analyses suggested possible domain-specific benefits in the intervention group, with nominal declines in naming, memory, and attention in controls. CONCLUSIONS This pilot randomized controlled trial provides preliminary evidence that a 24-week multi-modal program combining Baduanjin, computerized cognitive training, and reminiscence therapy was associated with improved global cognitive performance in community-dwelling older adults with MCI compared with health education alone. Given the pilot nature of the study and the modest between-group differences, these findings should be interpreted with caution and confirmed in larger, adequately powered trials.