The contemporary healthcare landscape dictates that pharmacists demonstrate comprehensive leadership competencies alongside advanced clinical expertise to navigate complex patient-care environments effectively. While academic curricula and extracurricular engagements are recognized as primary mechanisms for cultivating these professional proficiencies, the psychological impact of assuming such roles-particularly the manifestation of academic burnout and stress-remains critically underexplored within the literature. This study investigates undergraduate pharmacy students' perceptions of how curricular frameworks and extracurricular activities contribute to leadership development, concurrently evaluating the mental wellbeing of student leaders and exploring the mitigating influence of culturally integrated ethical frameworks on psychological resilience.

A cross-sectional study was conducted among undergraduate pharmacy students (Years 2 to 4) at the International Islamic University Malaysia (IIUM). The data collection instrument assessed leadership skills acquisition, perceptions of the pharmacy curriculum, the influence of extracurricular involvement, and elven core leadership competencies. Mental well-being was assessed using the Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS). Non-parametric statistical analyses, supplemented by the calculation of appropriate effect sizes, were employed to evaluate the data and determine practical significance.

A total of 183 students responded; mostly female (63.9%) and in their final academic year (42.1%). A substantial majority (80.3%) affirmed that the formal academic curriculum facilitated their leadership development, although 53.8% advocated for the integration of dedicated, leadership-focused coursework. More than half of students reported moderate mental wellbeing (54.6%). Substantive differences in mental wellbeing were observed relative to the year of study, academic performance, intrinsic motivation to pursue pharmacy, and the volume of extracurricular participation, with these associations supported by moderate effect sizes.

The findings elucidate the dual capacity of pharmacy curricula and extracurricular activities to foster essential leadership competencies while simultaneously highlighting the concurrent psychological demands placed on students. To optimize professional identity formation, pharmacy education programs must balance rigorous leadership training with robust, preemptive wellbeing support mechanisms. Furthermore, the integration of culturally specific paradigms, such as the Islamic concept of moderation (wasatiyyah), offers a valuable pedagogical framework for sustaining student resilience, preventing overcommitment, and navigating the complexities of modern pharmacy practice.

To evaluate the impact of long-term corticosteroid therapy on quality of life (QoL) in patients aged ≥65 years diagnosed with giant cell arteritis (GCA) and/or polymyalgia rheumatica (PMR).

A cross-sectional study included 50 patients aged ≥65 years with GCA and/or PMR receiving corticosteroid treatment for more than six months at the main hospital in Zaragoza, Spain. Recruitment and data collection took place between February and June 2025. Data on current and cumulative glucocorticoid doses, clinical characteristics, and medical history were collected. Participants completed the validated Short Form-36 (SF-36) questionnaire to assess QoL and the PREDIMED questionnaire to evaluate adherence to the Mediterranean diet.

Neither current nor cumulative glucocorticoid doses were associated with significant differences across the assessed QoL dimensions (Spearman's r = -0.172 to 0.199; p = 0.167-0.966). Similarly, adherence to the Mediterranean diet was not associated with improved QoL outcomes (all p > 0.05). Corticosteroid treatment was associated with the absence of worsening gastrointestinal symptoms (p = 0.035) but with an increased risk of high blood pressure (HBP) (p = 0.038). In addition, longer corticosteroid treatment was associated with better perceived mental health (p = 0.036).

In this cohort of older adults with GCA and/or PMR, prolonged corticosteroid therapy was not associated with poorer digestive health or overall QoL but was associated with an increased risk of HBP. Longer treatment duration was also linked to better perceived mental health, suggesting a favourable balance between disease control and patient-reported outcomes despite treatment-related risks.

Sex modulates both the clinical presentation of schizophrenia (SCZ) and treatment response, yet its impact on the neurobiology of antipsychotic (AP) action remains insufficiently understood. Clozapine (CLZ), the gold standard for treatment-resistant SCZ, shows sex-dependent effects in both clinical and preclinical settings. We recently reported that CLZ treatment is associated with changes in extracellular matrix (ECM) organization and inhibitory circuitry in a neurodevelopmental mouse model with SCZ-relevant phenotypes, but whether these effects differ by sex remained unknown. Here, we investigated sex-dependent effects of CLZ on parvalbumin (PV) interneurons, perineuronal nets (PNNs), ECM-related gene expression, and behavior in adult mice exposed to perinatal ketamine. CLZ restored global PNN density in ketamine-exposed males, whereas in females it selectively increased PV-associated PNNs. At the molecular level, CLZ was associated with shared and sex-dependent changes in the expression of ECM-related genes, including effects on Hapln2, Reelin, and Acan. Behaviorally, CLZ improved cognitive flexibility in both sexes, but rescued social memory only in males, while females showed greater vulnerability to CLZ-induced cognitive impairment in control animals. Together, these findings reveal coordinated sex-dependent changes in PV interneuron- and ECM-related phenotypes, together with distinct behavioral responses following CLZ treatment. These observations support the hypothesis that ECM-related alterations may contribute to sex-dependent variability in CLZ response and reinforce the importance of incorporating sex as a biological variable in preclinical AP research.

Research suggests a bi-directional relationship between physical and psychological health in seizure disorders. Intolerance of uncertainty (IU), anxiety sensitivity (AS), anxiety, and depression have been associated with poor outcomes across physical and mental health conditions. This cross-sectional study investigates relationships between these characteristics, somatic symptoms, and seizure frequency in people with epilepsy (PWE) or functional seizures (PWFS).

A convenience sample of 86 adults (41 PWE, 45 PWFS), with self-reported diagnoses was recruited online and through clinical services. Participants completed measures: IU (Intolerance of Uncertainty Scale-12), AS (Anxiety Sensitivity Index-3), depression (Patient Health Questionnaire-9), anxiety (Generalised Anxiety Disorder-7), somatic symptoms (Patient Health Questionnaire-15), in addition to questions regarding seizure condition and seizure frequency over the last four weeks. Regression analyses examined which variables were independently associated with (i) somatic symptoms and (ii) seizure frequency.

There were no significant between-group differences for measures, however, scores were elevated in both groups relative to published non-clinical benchmarks. In regression analyses only the condition composite (depression and anxiety) was independently associated with somatic symptoms; PHQ-15 was the only variable associated with seizure frequency, but this finding was not robust to extreme values. Key limitations were self-reported diagnoses and highly skewed seizure frequency data.

This study provides new insights into associations between IU, AS, anxiety, depression, and somatic symptoms in seizure conditions, finding elevated levels across measures in both PWE and PWFS. Results further establish the importance of assessing for and supporting with psychological factors affecting those living with seizure conditions.

Impaired insight is prevalent among individuals with psychosis spectrum disorders and is associated with treatment non-adherence, symptom relapse, and functional decline. Metacognition has been proposed as a mechanism underlying insight impairment, but it is defined and measured in different ways, ranging from experimental tasks assessing confidence in perceptual decisions to broader self-reflective capacities. Whether behavioral metacognitive tasks are associated with insight remains unclear. We therefore conducted a systematic review to examine the association between behavioral metacognitive task performance and insight in schizophrenia spectrum disorders. We searched the PsycINFO, PubMed, Embase, and Scopus databases in accordance with PRISMA guidelines. Studies were included if they assessed adults with psychosis spectrum disorders using a behavioral metacognitive task and a validated insight measure. A random-effects meta-analysis with subgroup analyses by task type was conducted on studies reporting extractable correlations. Seventeen studies were included; only 6 (35.3%) reported significant associations. Across the 12 studies eligible for pooling, the overall metacognition-insight correlation was small but significant (r = 0.18, 95% CI [0.05, 0.31]; I² = 60.2%). This effect varied substantially by task type: perceptual, probabilistic, metamemory, and social tasks showed no association with insight, whereas self-reflection paradigms (r = 0.46) and Meta-Wisconsin Card Sorting Test variants (r = 0.33) showed moderate associations. Task type accounted for approximately 89% of between-study heterogeneity. These results suggest that low-level, domain-specific metacognitive tasks do not capture processes relevant to insight, supporting hierarchical models of metacognition and the need for studies employing self-referential metacognitive tasks.

Community pharmacists play an increasingly important role in the care of transgender individuals receiving gender-affirming hormone therapy (GAHT). However, the content of structured pharmaceutical consultations tailored to this population has not yet been clearly defined. This systematic review aimed to identify therapeutic issues relevant to community pharmacy practice in order to inform the development of structured pharmaceutical consultations. A systematic literature review was conducted in accordance with the PRISMA 2020 Statement. The review question was structured using the PICo framework, with transgender individuals as the population, treatment-related issues associated with GAHT as the phenomenon of interest, and community pharmacy practice as the context. Electronic searches of Medline, Google Scholar, and APA PsycINFO were performed on 17 July 2024. Studies involving transgender adolescents or adults receiving GAHT and reporting therapeutic effects, adverse events, monitoring requirements, or medication-related issues were eligible. Two reviewers independently screened the studies and extracted data using a standardized form. Owing to the heterogeneity of study designs, the findings were synthesized narratively according to therapeutic domains relevant to community pharmacy practice. Among 755 screened records, 116 articles met the inclusion criteria. Seven therapeutic domains relevant to pharmacist-led consultations were identified: cardiovascular and cardiometabolic effects, dermatologic effects, gynecologic effects, musculoskeletal effects, biological and pharmacological effects, psychiatric effects, and other adverse effects or specific clinical situations. The evidence highlighted treatment-specific monitoring needs, medication-related risks, fertility and contraceptive considerations, laboratory monitoring requirements, drug-drug interactions, and mental health outcomes. Community pharmacists may contribute to the monitoring and optimization of GAHT, adverse effect management, patient education, fertility and contraceptive counseling, pharmacovigilance, and interdisciplinary collaboration within the scope of their professional practice. These findings provide an evidence-informed basis for the future development of structured pharmaceutical consultations tailored to transgender individuals.

Background: Chronic stress contributes to the development of cardiometabolic, malignant, and other chronic diseases through cumulative multisystem physiological dysregulation, conceptualized as allostatic load (AL). However, traditional AL relies on heterogeneous clinical biomarkers that are frequently unavailable or inconsistently collected in large cohorts, limiting reproducibility and translational utility. We developed and validated ProAL50, a proteomics-based measure of AL derived from 50 circulating proteins. Methods: Using high-dimensional plasma proteomic data from the UK Biobank, we constructed ProAL50 via penalized regression and stability selection and externally validated its construct in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Results: Among 37,089 UK Biobank participants, ProAL50 correlated strongly with traditional AL in the held-out test set (r = 0.72) and showed moderate external construct validity in CARDIA (r = 0.62). ProAL50 closely mirrored traditional AL in its associations with sociodemographic characteristics, lifestyle behaviors, physical and mental health, inflammation, and biological aging, supporting construct validity. In prospective analyses, ProAL50 showed associations with incident chronic disease, including type 2 diabetes, ischemic heart disease, chronic lung disease, chronic liver disease, chronic kidney disease, overall cancer, and all-cause and cause-specific mortality that were broadly comparable to traditional AL. Representative associations included incident type 2 diabetes (HR per SD = 2.72, 95% CI 2.61-2.84) and chronic liver disease (HR = 2.12, 95% CI 1.96-2.29). Conclusions: These findings support ProAL50 as a biologically informative, protein-based surrogate of AL for research use that complements traditional AL, pending further external validation and assay standardization.

Background/Objectives: Nurses may support offense-related self-reflection through practices that extend beyond formal group programs and dedicated offense-focused interviews; however, the scope of such support remains unclear. In this study, we described the range of nursing practices that nurses in Japanese forensic psychiatric inpatient settings perceived as supporting offense-related self-reflection beyond these formal interventions. Methods: A qualitative descriptive study was conducted using individual semi-structured interviews with 13 nurses from six hospitals between May and November 2025. Japanese-language transcripts were analyzed using inductive qualitative content analysis. Meaning units were coded and iteratively organized into subcategories and categories. Credibility and dependability were strengthened through co-researcher review, reflexive discussion, audit trail, and peer debriefing. Results: Five categories and 15 subcategories were identified: (1) examining offenses, victim impact, and responsibility; (2) clinical and relational readiness for self-reflection; (3) applying reflective insights to recidivism-prevention actions; (4) extending reflective learning into post-discharge life planning; and (5) integrating offense-related understanding into inpatient-community care planning. Conclusions: The categories describe functions that participants attributed to nursing practices surrounding formal interventions; therefore, they should not be interpreted as validated components of self-reflection or as evidence of effectiveness. The findings provide an initial, context-specific framework to guide nursing assessment, care planning, education, and further conceptual and empirical research that includes patients and community providers.

Background: Mobile health interventions offer a potential solution to adherence challenges, yet evidence regarding their collective efficacy in schizophrenia spectrum disorders has not been formally synthesized. This systematic review evaluates the impact of mobile health (mHealth) interventions on medication adherence as a primary outcome and on daily functioning and psychotic symptoms as secondary outcomes in individuals with schizophrenia spectrum disorders. Methods: Using the Population, Intervention, Comparison, Outcome (PICO) framework, a systematic search was conducted across multiple databases to identify relevant randomized controlled trials (RCTs) evaluating mHealth strategies for medication adherence in adults with schizophrenia spectrum disorders. The PubMed, CINAHL, PsycINFO, EMBASE, and JBI databases were searched from inception until 24 February 2026, using combinations of search terms such as "Schizo" OR "Psychos" AND "mHealth" OR "Digital Health" AND "Medication Adherence". Data extraction was conducted using a standardized data extraction table and narratively synthesized. This review adheres to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, ensuring structured and comprehensive reporting of the findings. Results: Fourteen randomized controlled trials (RCTs) with 1717 participants were included in this review. Four studies evaluated text messaging interventions, four employed phone call interventions, three used electronic medication monitoring systems, and three used mobile applications. Nine of the fourteen studies reported statistically significant improvements in medication adherence. For secondary outcomes, the results were highly inconsistent: only three studies demonstrated significant reductions in psychotic symptoms, and none showed benefits for daily functioning. While various theoretical frameworks, such as the Health Belief Model and Cognitive Behavioral Therapy and intervention modalities, were utilized, the overall evidence was limited by high clinical heterogeneity and a lack of robust long-term data. Conclusions: mHealth interventions, particularly text messaging and mobile applications, demonstrate clear potential to improve medication adherence in individuals with schizophrenia spectrum disorders. Given the high heterogeneity and lack of long-term evidence, future research should prioritize standardized outcome measurements, rigorous designs, and extended follow-up periods to confirm clinical utility.

Background/Objectives: Psychological distress, including symptoms of anxiety and depression, is common among individuals with inflammatory bowel disease (IBD) and may adversely affect well-being and disease management. However, routine assessment of mental health is not consistently integrated into clinical care. This study assessed the prevalence of anxiety and depression among patients newly diagnosed with IBD at diagnosis and after three months of treatment and explored associations between psychological symptoms, disease activity, and clinical characteristics. Methods: This prospective cohort study included 304 adults newly diagnosed with IBD and treated at Stavanger University Hospital between 2012 and 2019. Symptoms of anxiety and depression were assessed using the Hospital Anxiety and Depression Scale at baseline and after three months. Disease activity was evaluated using the Harvey-Bradshaw Index and Partial Mayo Score. Clinical variables included C-reactive protein, faecal calprotectin, folate, cobalamin, and body mass index. Multivariable regression analyses were conducted to identify factors associated with psychological symptoms. Results: The prevalence of anxiety decreased from 29.8% at diagnosis to 21.6% after three months, while the prevalence of combined anxiety and depression declined from 22.2% to 16.3%. The prevalence of depression alone remained stable over time. Higher disease activity, particularly as measured by the Harvey-Bradshaw Index, showed the strongest association with anxiety and depressive symptoms. However, after adjustment for potential confounders, no significant improvement in psychological symptoms was observed, suggesting that the association between time and HADS scores may be explained by changes in one or more measured covariates. Conclusions: Psychological symptoms remained common during the first months following an IBD diagnosis and were closely associated with disease activity. Medical treatment alone was insufficient to achieve meaningful improvements in mental health outcomes. These findings highlight the importance of systematic psychological assessment, early identification of emotional distress, and integrated multidisciplinary care, including nursing-led screening and supportive interventions, for individuals newly diagnosed with IBD.