Work-related rumination is associated with poor mental and physical health. This study aimed to develop and evaluate a personalized Bayesian optimization (pBO) algorithm, designed to tailor transcranial alternating current stimulation (tACS) parameters for UK schoolteachers experiencing elevated work-related rumination.

The algorithm adjusted tACS parameters based on individual head circumference and rumination levels. During the development phase, 80 burn-in and 319 personalized home-based sessions were conducted with 67 schoolteachers to model parameter-outcome relationships. In a preregistered, double-blind, within-participant follow-up study, 38 schoolteachers received both personalized and sham stimulation sessions in a counterbalanced order. Measures included work-related rumination, daytime sleepiness, actigraphy-based sleep fragmentation and efficiency, and side-effect ratings.

In the algorithm development phase, higher-amplitude stimulation was associated with reduced sleep fragmentation. In the follow-up study, both personalized and sham stimulation reduced rumination, but no significant differences were observed between conditions. Higher amplitudes were associated with greater reductions in daytime sleepiness. Post-stimulation changes in sleepiness and ruminations were associated only at higher amplitudes in the personalized condition and were not observed following sham stimulation. Side-effect severity did not differ significantly between conditions.

Home-based neurostimulation interventions are feasible and well tolerated. While personalized stimulation did not outperform sham, the findings identify current amplitude as a key factor influencing daytime sleepiness and highlight the need to further refine personalization algorithms and stimulation strategies to optimize effectiveness.

Mental illness remains a significant global public health concern, yet it is largely manageable through psychotropic medications and psychotherapy. However, non-adherence to prescribed psychotropic medications is a major barrier to effective treatment and long-term symptom control. This challenge compromises clinical outcomes, increases relapse rates, and places a burden on healthcare systems. Understanding the extent and contributing factors of medication non-adherence is essential for designing targeted interventions at both clinical and community levels. This study aims to assess the prevalence of psychotropic medication non-adherence and identify its determinants among adult psychiatric patients in Ethiopia.

An institution-based cross-sectional study was carried out between November 1 to November 30, 2024, among adult psychiatric outpatients who were diagnosed according to DSM-5-TR criteria and were receiving psychotropic treatment. Participants were selected using a consecutive sampling technique. Medication non-adherence was assessed using the 10-item Medication Adherence Rating Scale (MARS). Data were collected through face-to-face interviews and review of medical records. Bi-variable and multivariable binary logistic regression analyses were performed to identify associated factors, with statistical significance set at p-value < 0.05.

Out of a total of 418 participants, the prevalence of psychotropic medication non-adherence was 44.7% (95% CI: 40.0-50.0). Factors significantly associated with non-adherence included experiencing medication side effects (AOR = 4.67, 95% CI: 2.68-8.16), Lack of enrollment in the Community-Based Health Insurance scheme (AOR = 2.41, 95% CI: 1.06-5.5), current substance use (AOR = 6.71, 95% CI: 2.01-22.36), presence of comorbid medical illness (AOR = 5.42, 95% CI: 1.79-16.4), and perceived stigma (AOR = 3.63, 95% CI: 1.91-6.87).

Nearly half of the adult psychiatric outpatients in this study were non-adherent to psychotropic medications. Key factors associated with non-adherence included medication side effects, Lack of enrollment in the Community-Based Health Insurance scheme, current substance use, comorbid medical conditions, and perceived stigma. These findings highlight the need for integrated interventions addressing both clinical and psychosocial barriers to improve medication adherence and treatment outcomes among psychiatric patients in Ethiopia. Targeted strategies should be implemented at both healthcare facility and community levels.

To compare healthcare utilization and spending among women enrolled in an employer-sponsored, artificial intelligence (AI) structured pelvic care program with those receiving usual in-person care for pelvic floor dysfunction (PFD) in routine clinical settings.

This retrospective payor-perspective economic evaluation used exact and propensity score-matched cohorts derived from a third-party U.S. nationwide claims database from July 2022 to May 2025. Eligible participants were adult females with a pelvic-related condition, at least 24 months of continuous health-insurance coverage, and a minimum of one pelvic claim in the prior year. Intervention group (IG) comprised women who participated in the AI pelvic care program (consisting of biofeedback-mediated pelvic floor muscle training asynchronously monitored by a physical therapist specialized in pelvic health). Comparator group (CG) included women who sought a medical or physical therapy evaluation visit for PFD. Self-reported clinical outcomes available for the IG were assessed using latent-basis growth analysis.

The matched cohort included 602 women (301 per group). Relative to CG, IG patients had substantially lower healthcare spending over 12 months, with mean gross per-person pelvic-related savings of $3,082.4 (95% CI $1,270.2 to $4,894.7, p<.001). Savings were primarily associated with fewer surgical procedures (per-person difference of $2,534.2; 95% CI $831.2 to $4,237.2, p=.004), with differences also noted in medical office visits and imaging utilization. IG participants demonstrated significant improvements in pelvic floor symptom burden, work productivity, and mental health.

Claims-based analyses cannot exclude unmeasured confounding, misclassification, or selection bias. The one-year follow-up limits assessment of long-term economic impact.

Participation in this AI pelvic care program was associated with markedly lower healthcare utilization and spending compared with usual care, largely linked to fewer surgical interventions. These findings highlight the potential of accessible, guideline-concordant AI pelvic care to lessen healthcare spending associated with PFD and inform payor-oriented care delivery models.

Ulcerative colitis (UC) is a type of chronic, relapsing inflammatory bowel disease (IBD) characterized by mucosal inflammation of the colon and rectum. Symptoms such as bloody diarrhea, abdominal pain, and fecal urgency significantly affect patient quality of life. Early recognition of UC is critical to facilitate specialist referral and initiate management. Recent advances in the therapeutic landscape include the introduction of novel biologic agents, small molecules, and biosimilars, which have expanded access to effective and affordable treatment options. Clinicians must remain informed of updates and indications for both pharmacologic and nonpharmacologic interventions, as treatment selection is based on disease severity, location, and individualized patient needs. Adjunctive therapies also play a role in comprehensive care and health maintenance. Optimizing therapy is essential for inducing and maintaining remission, promoting mucosal healing, and preventing disease progression. A multidisciplinary approach, involving primary care clinicians, gastroenterologists, colorectal surgeons, dietitians, and mental health professionals, is essential for delivering individualized care and improving long-term outcomes.

The harmful effects of alcohol are well known but a variable proportion of hospital admissions are due to alcohol related problems. The aim of the current study was to examine the number of alcohol-related admissions to Landspitali University Hospital 2005-2022 and to investigate whether there has been an increase during the period.

A search was undertaken for alcohol related ICD-10 diagnostic codes at the Landspítali University Hospital and information was collected on all those who had received one or more of these diagnoses upon discharge from 2005 to 2022. Relevant clinical data was obtained.

A total of 2925 alcohol-related admissions were found during the study period, 1779 patients were admitted, 1168 men (66%) and 611 women (34%), with a median age of 54 years. Alcohol-related admissions increased from 34 per 100,000 population in 2005 to 64 per 100,000 in 2022. At the beginning of the study period, the proportion of alcohol-related admissions of all admissions to Landspítali was 0.32% whereas at the end of the period, the proportion had increased to 0.95%. The median length of stay was 6 days. The dominating diagnoses were related to mental and behavioural disorders (n=1878), alcohol-related liver disease (n=923), alcohol-related pancreatitis (n=457), and diseases of the nervous system (n=210), of whom 144 had Wernicke's disease.

Alcohol-related hospitalizations increased by 88% between 2005 and 2022. The most common diagnoses were mental and behavioral disorders and liver and pancreatic diseases. This has led to a significant cost increase for the healthcare system and society as a whole.

Adequate and stable housing has implications for the health and wellbeing of older people. However, affordable housing options are becoming elusive and dominant models of home ownership are in decline with uncertain health consequences for older populations. Supporting older adults to age safely in their community has many health benefits such as improved quality of life and increased social connectedness and reduces dependency and healthcare costs.

This qualitative evidence synthesis examines 15 international studies to assess impact of housing insecurity on the health and wellbeing of older people. A reflexive thematic analysis (Braun & Clarke, 2021) identified five interlinked themes building upon each other to create contextual depth of understanding of how health is impacted by housing insecurity in older age.

To summarise findings, psychosocial health and wellbeing benefit from safe, secure housing which promotes autonomy, dignity and social engagement. Poor housing conditions and inability to install modifications negatively impact health and the ability to live independently for longer. Increasing housing costs and lifecourse financial uncertainty both precipitate deteriorating health and wellbeing, potential relocation and constitute barriers to ageing in place and were most evident for marginalised social groups. Housing insecurity was mitigated by strong social attachments or attempting to be an ideal tenant/neighbour but there is some evidence that smoking or alcohol are used as coping mechanisms.

In conclusion, housing insecurity negatively impacts mental health whereas adequate housing supports older adults to live independently and promotes positive mental health and wellbeing.

Integrating mental health and wellbeing services in schools has the potential to improve students' socio-emotional wellbeing, engagement in learning and education outcomes. This scoping review aimed to establish and synthesize the current evidence base in relation to the junction of education and mental health and wellbeing practice. A systematic search and screening of peer-reviewed and gray research literature was conducted and resulted in the identification of 56 relevant sources. Extracted data was analyzed using descriptive and qualitative synthesis via content analysis. The largely exploratory and qualitative studies examined a range of influences on interdisciplinary collaborations. Enablers and barriers were interconnected and related to interprofessional relationships, the role of teachers and administrators in collaborations, territorialism, or the perceived practice divide between education and mental health, resourcing issues and the need for role clarity, appropriate training and structures and processes which support joint working. Insights gained may inform practice, policy, and research at the evolving intersection of education and mental health and wellbeing practice.

Many antipsychotic users at some point want to stop. They mention side effects, functioning and experiencing no benefits.

To explore questions antipsychotic users and their relatives have about stopping or tapering antipsychotics.

Data were used from a publicly available anonymous Q&amp;A in which experts answered questions about mental health. Questions about stopping or tapering antipsychotics asked by antipsychotics users and their relatives were analysed using an inductive content analysis.

In total 3000 questions were screened, where 426 were about antipsychotics and 194 were about stopping or tapering. The most common question was whether it was sensible to stop. Questions focused on how fast to taper, about the minimum dose, where to find support and when withdrawal symptoms or side effects would subside. Motivations were side effects, difficulties in functioning and experiencing no benefits. Barriers were lack of support and return of symptoms. Facilitators were support from others and experiencing a relief from side effects and/or symptoms.

Antipsychotic users and their relatives are left with many questions about stopping. These questions reveal attitudes, preferences and concerns that are important to address when discussing antipsychotic treatment.

Previous research has indicated an association between hypermobility and autism. This study examined whether being autistic affects diagnosis, symptoms, and health experiences of people with hypermobility, including hypermobile Ehlers-Danlos syndrome (hEDS) and hypermobility spectrum disorders (HSD). We compare three groups: autistic adults, non-autistic adults, and adults who are not autistic but have a high level of autistic traits. Additionally, we examined which health and social factors predicted self-reported physical and mental health outcomes for autistic and non-autistic people with hEDS/HSD.

A total of 1754 participants completed an online questionnaire about their diagnostic experience, hypermobile symptoms, co-occurring health conditions, self-rated physical and mental health, engagement with health services, and employment and benefits status. Around 25% of respondents were autistic; a further 25% had high levels of autistic traits.

Autistic participants had more symptoms of hEDS/HSD and were more likely to have co-occurring physical and mental health conditions, compared with non-autistic and high autistic trait respondents. Autistic and high autistic trait participants self-reported poorer physical and mental health compared with non-autistic participants. Autistic participants' mental health was impacted by limitations to everyday activities, whereas non-autistic participants were more impacted by difficulties with self-care.

Autistic and non-autistic people may experience hEDS/HSD differently, which may impact the type of supports that are most beneficial to them.

The quality of mental disorder treatment varies widely, with many patients not receiving treatments based on evidence-based guidelines. We examine data from the World Mental Health (WMH) surveys to investigate prevalence and correlates of receiving effective treatment coverage (ETC) among patients receiving minimally adequate treatment (MAT) in the 12 months before interview.

Data come from 25 WMH surveys carried out in 21 countries that included n = 1,119 participants who met the criteria for at least one of nine 12-month disorders considered here who received MAT for n = 2,313 disorders. MAT was defined as either (i) medication with 4 + healthcare visits or (ii) 8 + counseling sessions. ETC was defined as a subset of MAT that additionally required (i) medication appropriate for the disorder (e.g., mood stabilizers, anticonvulsant, or antipsychotic for bipolar disorder) taken with adequate control and adherence; and/or (ii) 8 + counseling sessions with a mental healthcare provider. Multivariable regression analysis with person-disorder treated as the case was used to examine associations of socio-demographic, disorder-related, and treatment-related factors with receiving ETC given MAT.

Fewer than half (47.1%) the cases with MAT received treatment qualifying as ETC. The strongest predictors of ETC given MAT were high patient education, mild/moderate disorder severity, treatment by a mental health specialist rather than primary care provider, and receipt of combined treatment with both medication and counseling rather than only one of these types of treatment. Importantly, combined treatment was associated with a significantly higher relative-risk of ETC if it was provided by a psychiatrist rather than a combination of a general medical provider and a non-psychiatrist mental health provider.

Noteworthy limitations include the data being cross-sectional, the predictor set being restricted, and the outcome being defined in terms of structural characteristics rather than fidelity of implementation. Within the context of these limitations, results suggest that fewer than half of cases with minimally adequate treatment receive treatment meeting published guidelines for effective treatment coverage. This finding underscores the importance of improving treatment. Future research should focus on targets to improve each stage of the help-seeking process beginning with entry into treatment through receipt of ETC.