Posttraumatic stress (PTSD) and substance use disorder (SUD) treatment research has been hampered by heterogeneous measures, inconsistent reporting, and sensitive data governance constraints that limit data synthesis and clinical translation. This manuscript describes how integrating FAIR (Findable, Accessible, Interoperable, Reusable) principles and FACT (Fairness, Accuracy, Confidentiality, Transparency) concepts can strengthen PTSD-SUD data science, with Project Harmony as an applied example.

We identify key barriers to evidence accumulation in PTSD-SUD clinical trials and map FAIR+FACT-aligned practices across the research lifecycle (data acquisition, harmonization, analysis, sharing, and dissemination). We then illustrate implementation strategies using procedures from Project Harmony's (PH) individual participant data meta-analysis (IPD-MA), including common data element (CDE) labeling, interoperable harmonization pipelines, documentation of analytic decisions, and governance-informed access controls.

We identify priority points where FAIR+FACT alignment improves reproducibility and validity while reducing participant risk, particularly for populations vulnerable to confidentiality harms and stigma. The PH case example demonstrates feasibility of rigorous harmonization and measurement-equivalence approaches at scale and shows how transparent, provenance-preserving workflows can support comparative effectiveness analyses across diverse trials.

FAIR+FACT integration offers a practical framework for advancing trustworthy PTSD-SUD treatment evidence. We provide specific recommendations for investigators, clinical trial networks, and funders/policymakers to institutionalize FAIR+FACT requirements and resource the personnel and infrastructure needed for ethical, reusable PTSD-SUD datasets. Routine adoption of interoperable metadata standards, rigorous documentation and code sharing, and trauma-informed governance can accelerate guideline development, strengthen policy relevance, and improve clinical decision-making for individuals with comorbid PTSD and SUD.

The transition from military-to-civilian life is associated with challenges including shifts in identity and employment, reestablishment of family and personal relationships, and financial hardship. To better support transition, it is important to explore the perspectives of those who have transitioned from the Australian Defence Force (ADF) into civilian life. Thus, the study aims to explore how occupational participation during military service influences the experience of transitioning to civilian life.

A narrative inquiry methodology with two phases of interviews was used to collect data from 12 former serving Australian Defence Force members. Thematic analysis was used to interpret the data.

The first author is a former ADF member. The second interview was intended to check and enhance participant participation in the study. There was no further consumer and community involvement.

Two themes were developed. (1) Being in the 'bubble' described how occupational participation is experienced in military service. The military bubble created occupational imbalance and was heavily reliant on work and devoid of leisure. (2) 'The bubble pops and the real-world begins' describes how the loss of the military occupations including peers and the collective culture, challenged their occupational participation in civilian life. Most participants sought to establish occupational balance, to varying degrees of success.

Imbalanced occupational participation during military service can hinder the transition to civilian life. Supporting this shift requires strategies that promote engagement in community and leisure activities. Future research should focus on how to support occupational participation in civilian roles and activities to facilitate smoother transitions.

Adherence to treatment guidelines for agitation in dementia is suboptimal and inconsistent. We designed and evaluated an Integrated Care Pathway (ICP) for the management of agitation in dementia.

This was a double-blind randomized controlled trial at 12 inpatient units and long-term-care homes (LTCHs) across Canada. Participants were randomized 1:1 to the ICP or treatment-as-usual (TAU). Primary outcomes were Cohen Mansfield Agitation Inventory (CMAI) and psychotropic polypharmacy at 12 weeks.

We randomized 185 participants (93 inpatients, 92 in LTCHs). For CMAI, there were no significant time-by-treatment-group interactions among inpatients (F_{4, 299.3} = 1.7, p = 0.14) or LTCH residents (F_{4, 296.0} = 0.87, p = 0.48). For polypharmacy, there were significant time-by-treatmentgroup interactions among both inpatients ( χ 7 2 = 15.3, p = 0.032) and LTCH residents ( χ 7 2 = 30.0, p < 0.001), with lower rates of polypharmacy in the ICP group at certain time points, but not at week 12.

Standardizing care for agitation in dementia may result in lesser polypharmacy without affecting efficacy. Future studies should assess the ICP in the broader community and outpatients.

Abortion is a common reproductive healthcare process that is often stigmatised. Research on abortion stigma has grown significantly since the last major review over a decade ago, and there is a pressing need for an updated, comprehensive systematic review. The purpose of this review is to examine the extent and subjective experiences of abortion stigma among those seeking an abortion in high-income countries. We aim to explore the theoretical conceptualisations of abortion stigma in relevant studies. We conducted a mixed-method systematic review following the JBI and PRISMA guidelines. PubMed, CINHAL, PsychINFO, LIVIVO, and the Cochrane Library were searched for peer-reviewed articles. Quantitative studies were summarised narratively. Qualitative studies were synthesised using the JBI meta-aggregative approach. We included 41 qualitative, nine quantitative, and three mixed methods studies. Most studies lacked a substantial theoretical conceptualisation of abortion stigma. Quantitative studies reported prevalence rates of perceived abortion stigma ranging from 37% to 60%, suggesting that stigma remains a common experience among abortion seekers. Findings also indicate associations between abortion stigma and various sociodemographic factors (e.g., religion, race, age), as well as adverse mental health outcomes. In the qualitative studies, people seeking abortion care reported experiencing and anticipating judgment from healthcare professionals, anti-abortion activists, and their close social circle. Their experiences also centered on the internalisation of shame and guilt. Some studies highlighted the mitigating effect of social support. Longitudinal and mixed methods approaches with consistent assessment would be useful to better understand the developmental pathways of abortion stigma. This understanding is necessary to provide individual and structural support for people seeking abortion care.

Housing is a critical social determinant of health for migrant and refugee populations, with housing inequalities leading to significant health disparities. This study aimed to explore the perspectives of recently arrived migrants and refugees on potential solutions to address housing and related health inequities.

This qualitative study recruited thirty recently arrived migrants and refugees residing in Greater Western Sydney, Australia, using purposive and snowball sampling primarily through community organisations, settlement and migrant support services, and social media platforms. Participants completed semi-structured interviews, and an inductive approach to thematic analysis was employed to identify contextual patterns and themes.

Three major themes were identified: (1) Structural and policy reforms to address housing inequities, including simplifying rental processes, regulating rent control and tenant protections, and increasing affordable housing supply; (2) Integrated housing and health support systems for equitable outcomes, encompassing emergency housing support, financial subsidies, health-focused housing improvements, and integrated housing and mental health services; and (3) Community-based housing and social integration initiatives for health equity, involving settlement and housing literacy programs, and culturally tailored support and community engagement initiatives.

These findings highlight the importance of multisectoral solutions that combine systemic policy reforms, cross-sectoral service coordination, and community-driven initiatives to address the housing and health inequities experienced by recently arrived migrants and refugees. SO WHAT?: Embedding the lived experiences and priorities of these communities within housing and health strategies is essential for advancing health equity and improving outcomes for migrant and refugee populations.

We aimed to quantify inequalities in mental health service use in Australia and identify the sociodemographic, economic, and geographic factors associated with access.

We conducted a secondary analysis of the National Study of Mental Health and Wellbeing (NSMHWB, 2020-2022). We evaluated 12-month mental health service use before the survey among people who reported a mental disorder. We fitted multivariable logistic regression models adjusted for sociodemographic covariates and tested the joint (intersectional) effects of remoteness and socioeconomic area disadvantage on service use. Jackknife replicate weights accounted for the complex survey design.

The study included 15,893 respondents (weighted population: 19,828,348). Lifetime prevalence of any mental health disorder was 42.9% (95% CI = [42.5, 43.3]), and 21.5% (95% CI = [20.7, 22.3]) reported symptoms in the past 12 months. Among those with a 12-month disorder, 45.2% (95% CI = [39.9, 50.5]) had accessed care, and 16.5% (95% CI = [15.8, 17.2]) reported using digital or telephone services. Service use was higher in university graduates and residents of advantaged areas and lower in remote/outer regional residents and the most disadvantaged quintiles. Intersectional analysis revealed compounded inequities, with the lowest service use observed among socioeconomically disadvantaged populations in remote areas and the highest among advantaged major-city residents.

Substantial and intersecting inequalities exist in access to mental health services, with the lowest coverage among remote, socioeconomically disadvantaged, older, and male populations. Targeted, place-based strategies - including expanded outreach and tailored digital and community-based models - are needed to reduce unmet need and improve equity.

To achieve expert consensus on quality indicators for evaluating discharge planning processes in inpatient mental healthcare settings. This study is part of a larger multiphase project to develop an instrument to measure and evaluate the quality of discharge planning in mental healthcare.

A modified two-round Delphi study.

A province-wide multidisciplinary expert panel comprising nurses, social workers, occupational therapists and psychiatrists across Ontario, Canada completed two online survey rounds. Panel members assessed 79 preliminary indicators identified from a prior concept analysis and focus groups, rated the importance of each indicator and provided narrative feedback to support indicator refinement.

In Round 1, 37 panellists evaluated 79 quality indicators. Seventy-four indicators achieved the predefined consensus threshold; however, further review of panel feedback resulted in the removal, consolidation and refinement of indicators due to conceptual overlap, redundancy, or feasibility concerns. Thus, fifty-three indicators were retained following Round 1. In Round 2, 36 panellists reviewed the revised indicator set and evaluated three new candidate indicators. Two additional indicators achieved consensus and one indicator was reinstated, resulting in a final set of 56 indicators across seven domains: Comprehensive Needs Assessment (n = 14), Information Gathering and Synthesis (n = 3), Patient Capacity Assessment (n = 4), Collaborative, Patient-Centred Care (n = 14), Resource Availability Management (n = 5), Care and Service Coordination (n = 7) and Discharge Plan (n = 9).

A multidisciplinary expert panel reached consensus on 56 quality indicators evaluating discharge planning processes in inpatient mental healthcare settings. The findings provide an evidence-informed foundation for future development and testing of measurement approaches to evaluate discharge planning quality in mental healthcare.

The discharge planning domains and quality indicators identified in this study may support future efforts to evaluate discharge planning processes, identify gaps in care and inform quality improvement initiatives aimed at supporting continuity of care and transitions from hospital to community settings.

This study addresses the lack of standardized quality indicators for evaluating discharge planning processes in inpatient mental healthcare settings. Through a two-round Delphi process, a multidisciplinary expert panel reached consensus on 56 indicators reflecting core components of discharge planning, including comprehensive needs assessment, patient capacity evaluation, coordination of community services and supports, housing-related planning and follow-up care. The study findings provide a foundation for future development and psychometric evaluation of a standardized measurement instrument to assess discharge planning quality.

This study is reported in accordance with the Guidance on Conducting and Reporting Delphi Studies (CREDES) recommendations.

No patient or public contribution.

Workplace health promotion (WHP) plays an important role in improving employees' health and well-being and promoting health communication in the industry. However, current health promotion activities for miners achieve limited outcomes, owing to the overlook of the cultivation of miners' autonomy, and the role of the supportive work environment. This study addressed this research gap following a multistep method. First, a comprehensive qualitative method based on intervention mapping was applied to determine the stakeholders, barriers, and facilitators in promoting miners' internal health locus of control. Second, social network analysis was employed to analyze the connectivity between stakeholders' behavioral strategies and identify the key strategies which have the most significant influencing effect in the network. Last, combined with system dynamics modeling, a four-party dynamic evolutionary game model was constructed and simulated to analyze the asymptotic stability conditions of stakeholders' behavioral strategies and explore the impact of the changes in the key strategies on miners' strategic choices. As a result, among 47 items of stakeholders' behavioral strategies, strategies such as mine managers' commitment to safety and health, team leaders' tangible and intangible support, and health managers' organization of mental intervention programs, were identified as the key to WHP solutions' successful implementation. Sufficient enforcement of these significant strategies could increase the probability of miners actively participating in WHP programs. Overall, this study developed health promotion solutions aimed at promoting miners' health self-management, with the perspectives of all stakeholders involved, which contributes to improved workplace health practices in mines.

In South Africa, which has the world's highest prevalence of HIV, intimate partner violence (IPV) and common mental health conditions are barriers to retention in HIV treatment and achieving viral suppression. The Common Elements Treatment Approach (CETA), a cognitive-behavioural-therapy-based intervention designed for lay healthcare worker delivery, is effective in reducing mental and behavioural health problems but has not been trialled for effectiveness in improving HIV outcomes. We conducted a randomized control trial to evaluate the effectiveness of CETA in improving HIV treatment outcomes among women experiencing IPV in South Africa.

This was a single-blind trial conducted among women living with HIV on antiretroviral therapy (ART) who experienced sexual and/or physical IPV in the last 12 months and had either an unsuppressed viral load or were at risk for poor medication adherence in the past year (e.g. defaulted on treatment, late or missed clinic visit). Women were randomized 1:1 to receive either 8-12 CETA counselling sessions or weekly safety text messages. The primary outcome was viral suppression (≤50 copies/mL) (which requires retention) at 12 months after baseline, which was evaluated using routinely collected medical records. A linear regression model was estimated to calculate risk differences and 95% confidence intervals (CI).

Participants were enrolled from 11 November 2021 to 19 July 2023, with 202 women randomized to CETA and 197 randomized to the control arm. Median age was 41.0 years (interquartile range [IQR]: 34.0, 47.0) with a median time on ART of 8.2 years (IQR: 4.3, 12.5). Receiving CETA was associated with a 1-percentage point (95% CI: -0.11, 0.09) decrease in retention and viral suppression compared to the control. When restricted to individuals who completed CETA (N = 144) compared to all controls, we observed a 7-percentage point (95% CI: -0.03, 0.18) increase in retention and viral suppression.

Our estimates suggest overall there was no meaningful difference in retention and viral suppression at 12 months between individuals who received CETA compared to individuals who received the active safety control. Future work should seek to determine if CETA can be effective among those who complete the intervention.

Fibrodysplasia ossificans progressiva (FOP) is a rare genetic disorder characterised by progressive heterotopic ossification of soft tissues due to mutations in the ACVR1 gene, leading to dysregulated bone morphogenetic protein signalling. Over time, recurrent episodes of painful inflammatory soft tissue swellings (flare-ups) lead to progressive ossification and eventual ankylosis of joints, resulting in severe restriction of mobility. Most patients become wheelchair-bound by the third decade and may succumb to complications such as thoracic insufficiency syndrome and cardiorespiratory compromise. Due to its rarity and lack of awareness, FOP is often misdiagnosed, and patients may undergo unnecessary invasive procedures such as biopsies or surgical excisions, which can precipitate rapid disease progression. Early recognition based on clinical and radiological findings is therefore critical to prevent iatrogenic harm. We present a rare case of a six-year-old girl with this condition, emphasising the diagnostic challenges and key imaging findings.