Despite the effectiveness of bariatric surgery in the treatment of severe obesity, a substantial proportion of patients experience insufficient weight loss or weight regain over time. Evidence indicates that behavioral factors and mental health conditions play a central role in these outcomes, representing strategic targets for educational and technology-based self-monitoring interventions.

This study aimed to develop and validate the content of a web-based application designed to support mental health self-monitoring and behavioral change among patients undergoing bariatric surgery.

This is a formative research study focused on the development and content validation of a digital health educational intervention, conducted in accordance with the Systematic Instructional Design (SID) model, encompassing the phases of analysis, design/development, and validation. Content validation was performed by a panel of 13 experts, based on Pasquali's criteria. Interrater agreement was quantitatively assessed using the Content Validity Index (CVI), considering the domains of clarity and relevance, with a minimum acceptable agreement threshold of ≥0.80.

The application was developed with 11 screens and integrates validated psychometric instruments for the self-monitoring of key mental health conditions, including the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7), the Modified Yale Food Addiction Scale 2.0 (mYFAS 2.0), and the Alcohol Use Disorders Identification Test (AUDIT). In addition, the platform includes body weight monitoring, physical activity tracking, and access to educational content on healthy eating and mental health. The application incorporates motivational strategies such as goal setting, automated alerts, and encouragement of multidisciplinary follow-up. All screens demonstrated content validity in terms of relevance (I-CVI=1.00; S-CVI=1.00). For the clarity domain, only one screen presented an index below the predefined cutoff in the initial evaluation. After revision and adjustments, this screen was re-evaluated and achieved satisfactory agreement (I-CVI=0.92).

The results indicate that the developed application demonstrates adequate content validity as a digital tool to support mental health care in the postoperative period of patients undergoing bariatric surgery. Although this study was limited to content validation, the findings support the formative development of Mcare as a tool for mental health self-monitoring and behavioral support in this population. Future studies should evaluate usability, acceptability, and clinical effectiveness in real-world settings.

Understanding the impact of menopause (M) and perimenopause (P) symptoms with female equestrians is crucial as it not only affects participation but their overall well-being. Yet, there is limited research in this area, thus this study explored the P and M symptoms on rider participation. n = 1,629 female participants from a range of equestrian disciplines aged between 21 and 73 years of age (x ± s; age = 51.86 ± 14.95 years) who were within or beyond P or M were recruited and completed an online questionnaire. Descriptive statistics and thematic coding were used for further analysis and interpretation. Key themes included: (1) Physical health changes, including joint pain (74%) and weight gain (66%). (2) Mental Health and emotional well-being, with sleeplessness (74%), anxiety (78%), and a loss of confidence (76%). (3) Riding confidence, with a decrease in riding confidence (75%). (4) Support and awareness suggested there was a lack of support within the female equestrian community. Finally, (5) Hormone Replacement Therapy alleviated symptoms that interfere with riding and daily life. The P and M experience for female equestrians is complex and can negatively impact participation, proactive awareness for riders and coaches can better support this life stage.

Dementia imposes a growing public health burden in Korea, with substantial implications for families living with affected members. Although prior Korean studies have suggested an association between dementia-related household context and depressive symptoms, population-based evidence on co-residence with a family member with dementia remains limited. This study examined the association between co-residence with a family member with dementia and depressive symptoms among Korean adults aged 50 years and older.

We conducted a cross-sectional analysis using data from the 2024 Korea Community Health Survey. Among 231,728 respondents, 120,029 adults aged ≥ 50 years living in non-single-person households were included. The exposure was co-residence with a family member reported to have dementia, rather than a direct measure of caregiving status, intensity, or duration. Depressive symptoms were assessed using the Patient Health Questionnaire-9 (PHQ-9), with a score ≥ 10 indicating clinically significant depressive symptoms. Survey-weighted multiple logistic regression was used to estimate odds ratios and 95% confidence intervals.

Overall, 15.8% of individuals reported depressive symptoms. Living with a family member with dementia was highly associated with depressive symptoms (OR = 1.35; 95% CI: 1.29-1.42; p < 0.0001). Among men, significant lower associations showed with good health status (OR = 0.14; 95% CI: 0.13-0.16). Among women, similar patterns were observed, with high income (OR = 0.71; 95% CI: 0.63-0.80) and good health (OR = 0.14; 95% CI: 0.13-0.16) being strongly protective against depression.

Co-residence with a family member with dementia was associated with higher odds of depressive symptoms among Korean adults aged 50 years and older. These findings suggest the need to consider mental health screening and support strategies for families living with dementia, while acknowledging the cross-sectional and self-reported nature of the data.

Shift work is increasingly common in modern societies but is strongly associated with misalignments of natural circadian rhythms, which may negatively impact dietary behaviour and psychosocial well-being. Chronotype, an individual's natural sleep-wake preference, influences adaptation to shift work and its associated lifestyle challenges. This systematic review aimed to examine the relationship between chronotype on both eating behaviour and psychosocial well-being among shift workers. A systematic search was conducted in accordance with PRISMA 2020 guidelines. Literature searches were performed in Web of Science, Scopus, PubMed, and Cochrane from database inception until April 2026. Eligible studies included research involving adult shift workers reporting on chronotype in relation to eating behaviour and psychosocial aspects. Quality appraisal was performed using the Joanna Briggs Institute (JBI) Critical Appraisal Tools. Twenty-nine studies met the inclusion criteria, comprising primarily nurses and healthcare workers, with additional representation from manufacturing and services sectors. Evening chronotypes consistently exhibited less healthy dietary habits, including irregular meal timing, skipping breakfast, delayed food intake, greater consumption of energy-dense foods, lower fibre intake, and higher alcohol use. Additionally, psychosocial outcomes showed similar patterns, with evening types reported significantly higher levels of depression, anxiety, stress, emotional exhaustion, and burnout compared to morning and intermediate types. Misalignment between chronotype and shift schedule further amplifies these effects, whereas alignment improved job satisfaction and well-being. Sleep disturbances, a contributing factor that can exacerbate psychosocial issues, were observed to be more common in evening types as compared to morning and intermediate types. Evening chronotype is a key vulnerability factor for both unhealthy eating habits and impaired psychosocial well-being among shift workers. Organisational strategies such as chronotype-sensitive scheduling, access to healthier food options, and tailored psychosocial support may mitigate these risks. Future longitudinal and interventional research is needed to establish causal pathways and to evaluate the effectiveness of chronotype-based workplace interventions.

Mental health reform represents a sustained effort to improve the accessibility, quality and human rights orientation of mental health systems through changes to policy, legislation and service delivery. The scale and pace of growth in the lived and living experience workforce (LLEW) is unprecedented within mental health services, with a marked increase in roles representing a significant shift in the contemporary mental health landscape. In Australia, the state of Victoria is currently undergoing the most significant mental health reform in its history. This study aimed to explore mental health nurses' perceptions of the impacts of mental health reform on (1) their delivery of care in relation to consumer and carer safety and wellbeing and (2) their experiences of working alongside lived experience workers within reformed service contexts. This study employed a qualitative descriptive design, with secondary analysis of existing qualitative data (Szabo and Strang 1997), which were thematically analysed using Braun and Clarke and reported in accordance with CORE-Q guidelines. Semi-structured interviews were conducted with mental health nurses working in Victoria (N = 14), Australia, with three themes generated through reflexive thematic analysis: (1) Mind the gap: Reform impacts to safety and risk; (2) When care comes too late: reform impacts to care and treatment; and (3) Between sympathy and resistance: ambivalent attitudes towards LLEW roles. Persistent integration challenges related to LLEW influenced nurses' perceptions of usefulness. Nurses also described that an increased legislative emphasis on consumer choice, relative to clinical decision-making, contributed to uncertainty and hesitancy in intervention, which nurses perceived as negatively affecting care outcomes in some situations.

Adolescence drinking behavior is steadily increasing while the mean age of first- time drinkers has decreased. The aims of this study were to examine the potential effect of the "Teenagers Don't Drink" application on preventing alcohol use among Thai adolescents.

This quasi-experimental design with cluster-level allocation was conducted among adolescents aged 10-14 years in Chiang Mai, Thailand, between March and May 2022. A total of 50 adolescents were recruited based on the calculated sample size; 25 participants who met the inclusion criteria were selected by simple random sampling for each group. The intervention group received the mobile application "Teenagers don't drink". The control group received an adolescence drinking prevention manual. The data was gathered using Alcohol Use Disorders Identification Test (AUDIT), Alcohol Knowledge, Attitude towards Drinking, Drinking Refusal Self-efficacy, Parental control and support regarding alcohol consumption, and Intention to not Drink Alcohol Questionnaires before and one month after the intervention. Data were analyzed using descriptive statistics, Wilcoxon Matched Signed Rank Test, Paired T-test, Mann-Whitney U Test, and Independent t-test with STATA version 15. A significance level of less than 0.05 was considered.

Between groups score comparisons showed a statistically significant differences in terms of knowledge about alcoholic beverages (P=0.003), attitude towards drinking (P<0.001), drinking refusal self-efficacy (P=0.003), parental control and support regarding alcohol consumption (P=0.003), and intention to not drink alcohol (P<0.001) after the intervention.

The "Teenagers Don't Drink" application may improve adolescents' comprehension of alcoholic beverages, pertinent laws and regulations, and life skills associated with alcohol use prevention. The program seems capable of aiding initiatives to avoid or diminish alcohol intake among adolescents in communal environments.

While the association between atopic dermatitis (AD) and psychological comorbidities is established, whether this risk differs across developmental stages remains unclear. This study aimed to quantify and compare this risk and examine key methodological sources of heterogeneity.

We conducted a systematic search of PubMed, Embase, and Cochrane Library for studies published up to October 2025. Pooled effect estimates [hazard ratios (HRs) from cohort/case-control studies and odds ratios (ORs) from cross-sectional studies] were calculated using random-effects models. Ninety-five percent prediction intervals were calculated for all meta-analyses. The study protocol was registered with PROSPERO (CRD420251244849).

We included 28 studies of various observational designs (cohort, cross-sectional, and case-control) in the meta-analysis. The analysis revealed numerically higher risk estimates for depression, anxiety, and suicidality among pediatric and adolescent AD patients compared with adults. Specifically, for depression, the pooled HR from cohort studies in youth was 2.16 (95% CI: 1.56-2.98; I ²=99.1%, P < 0.001) versus 1.32 (95% CI: 1.23-1.41; I ² = 94.9%, P < 0.001) in adults; similarly, the pooled OR from cross-sectional studies in youth was 2.79 (95% CI: 1.52-5.12; I ² = 99.4%, P < 0.001) versus 1.61 (95% CI: 1.22-2.14; I ² = 92.4%, P < 0.001) in adults. A similar pattern was observed for anxiety. Additionally, younger patients exhibited an elevated risk of suicide relative to adults.

The psychological burden of AD appears most pronounced in children and adolescents, but the very high heterogeneity across studies limits the certainty of this finding. Therefore, the results should be interpreted cautiously.

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=1244849, identifier: CRD420251244849.

This study was conducted to assess the impacts of mind-body Health Qigong exercise performed regularly over a period of 11 weeks upon depression severity and cognitive function among older people.

A 2 × 2 two-factor structural design was incorporated into this research to carry out a randomized controlled trial. 35 participants underwent random allocation to the intervention arm (n = 17) and the control arm (n = 18). A regular mind-body Health Qigong exercise intervention carried out over 11 weeks was administered to the experimental group, with a 45-min session performed 3 times each week. The control group was instructed to retain their habitual lifestyle without any intervention. The depression severity and cognitive function of older adults in the experimental and control groups were assessed by means of the 15-item Geriatric Depression Scale and the Chinese version of the Mini-Mental State Examination before and after the exercise intervention.

Compared with baseline, the total scores of C-MMSE in the experimental group were significantly higher at post-intervention (p < 0.001), and the scores of its subdomains (orientation and immediate memory) were also significantly elevated (p < 0.05); meanwhile, the post-test total scores of GDS-15 in the experimental group was significantly reduced (p < 0.01). In contrast, the pretest and posttest total scores of C-MMSE in the control group did not differ notably (p > 0.05), but the scores of its subdomain (delayed recall) were significantly decreased (p < 0.05); furthermore, the control group exhibited a notable rise in the post-test total scores of GDS-15 (p < 0.01).

The results indicated that engaging in mind-body Health Qigong Taiji Stick exercise for 11 weeks yielded statistically significant improvements in cognitive subdomains, including orientation and immediate memory, as well as a statistically significant reduction in depression severity among older adults. The clinical significance of these beneficial effects remains uncertain and should be confirmed by future studies with larger sample sizes.

This study was approved for registration by the Chinese Clinical Trial Registry on April 24, 2024 (ChiCTR2400083424).

Creative and arts-based techniques are increasingly integrated into child and adolescent psychotherapy, yet little is known about how they are applied in routine practice and whether their use differs when working with racially minoritized youth. This study examined the prevalence, clinical functions, and contextual positioning of art-based techniques among therapists in Germany, with a focus on identity-informed applications in work with clients of Color and clients from Black ethnic groups.

This study reports data from the German arm of the CREATE project, an online cross-sectional mixed-methods research initiative conducted in Germany and the United Kingdom. Therapists working with children and adolescents (N = 98; Mean age = 36.60, SD = 9.84) completed quantitative items on use, goals, and perceived preparedness across client contexts (general vs. PoC vs. Black), and provided open-ended responses on strengths, challenges, and barriers. Quantitative analyses used descriptive statistics and non-parametric within-therapist comparisons; qualitative data were analyzed via framework analysis.

Overall, 62.2% of therapists reported using art-based techniques (51.0% exclusively; 11.2% combined with music-based methods). Use was most frequent in individual settings and was primarily described as transdiagnostic, targeting emotional access, engagement, nonverbal communication, and experiential processing; diagnosis-specific mentions were less common (most often anxiety, ADHD, depression, and trauma-related symptoms). Therapists with experience working with BIPoC clients and with non-binary clients were more likely to use art-based techniques. Within-therapist comparisons showed significantly lower perceived preparedness in PoC contexts, alongside reduced endorsement of art-based techniques for relationship-building and for supporting nonverbal communication of difficult-to-express experiences. Qualitative findings highlighted benefits for communication, emotional expression, access to avoided topics, and self-efficacy, while barriers centered on limited training, institutional constraints, and uncertainty about structuring and integrating techniques. Only 17.3% reported racism-informed training and 4.1% training on racial trauma.

Art-based techniques are widely valued and used flexibly in German routine child and adolescent psychotherapy, predominantly as transdiagnostic, process-oriented tools. However, their positioning in minoritized contexts appears shaped by lower therapist preparedness and limited racism-informed training. Integrating structured training in creative techniques alongside culturally responsive and racism-informed psychotherapy may support more confident, relational, and identity-informed application in diverse youth populations.

This study aimed to contextualize structural barriers to the implementation of Individual Placement and Support (IPS) in Japan.

We examined the position of Japan's employment service policies for individuals with mental illness within the OECD framework for IPS implementation and identified key challenges. A mixed-methods approach was employed, combining a narrative search of Japanese policy documents with systematic searches of Japanese IPS research. According to the OECD framework, Japan's IPS implementation was positioned between the stages of "Building the foundations for integrated mental health, skills, and work policy" and "Shifting from trials to a scaled-up integrated approach." A major barrier was the absence of a comprehensive vocational service system for individuals with a diagnosis of severe mental illness.

Advancing IPS dissemination in Japan requires multifaceted strategies, including grassroots efforts by service providers, strengthened advocacy, incorporation of employer and client perspectives, and consideration of resource allocation across populations with varying levels of needs.

While macro-level research on IPS implementation remains scarce in Japan, the practical and feasible policy considerations identified in this study could be beneficial in Japan as well as other non-Western contexts encountering similar implementation challenges.