Chinese men who have sex with men living with HIV (MSMLWH) experience substantial psychological distress driven by minority stress and HIV-related challenges. However, culturally tailored digital mental health interventions that address HIV-specific maladaptive cognitive schemas and culturally specific psychosocial stressors remain scarce in China.

This study aimed to systematically adapt an evidence-based cognitive behavioral therapy (CBT) intervention Effective Skills to Empower Effective Men (ESTEEM) into a WeChat (Tencent) Mini-Program-based intervention (iESTEEM) specifically for Chinese MSMLWH and to evaluate its preliminary feasibility and usability.

We used a three-phase user-centered design approach guided by the Assessment, Decision, Adaptation, Production, Topical Experts, Integration, Training, and Testing (ADAPT-ITT) framework. The study proceeded in three phases: (1) a qualitative needs assessment using semistructured interviews with 20 MSMLWH (mean age 23.25, SD 3.08 years); (2) systematic intervention adaptation and platform development, including theater testing (n=5); and (3) a 2-week pilot study involving 10 MSMLWH and five counselors to evaluate feasibility, usability, and acceptability through focus groups and objective platform analytics.

Phase 1 identified 3 major themes of psychological distress: persistent health anxiety fueled by catastrophizing, intersectional stigma internalization, the disclosure dilemma, and intimacy barriers rooted in defectiveness and shame schemas. Participants also prioritized anonymity and bite-sized learning. Guided by these findings, iESTEEM was developed as a counselor-assisted, privacy-preserving WeChat Mini-Program incorporating HIV-specific scenarios, multimodal learning modules, and a back-end risk-alert system. During the 2-week pilot, participants logged into the platform 14.1 (SD 6.7) times per person and completed 134.3 (SD 103.1) minutes of learning activities; all participants accessed module 1, and 90% (9/10) accessed modules 2-5. Anxiety scores decreased from 8.9 (SD 2.3) to 7.2 (SD 3.0), whereas depression scores remained stable. All participants expressed a willingness to continue using the program and to recommend it to peers. Participants and counselors endorsed its contextual relevance, privacy protections, and clinical utility.

This study provides a theory- and evidence-informed model for culturally adapting digital mental health interventions for highly stigmatized populations. By integrating lesbian, gay, bisexual, transgender, and queer (LGBTQ)-affirmative CBT principles, HIV-specific adaptations, and a privacy-preserving, counselor-assisted WeChat Mini-Program, iESTEEM demonstrated promising preliminary feasibility, acceptability, and engagement among Chinese MSMLWH. These findings support the potential of culturally tailored digital interventions to expand access to psychological support for this stigmatized population in resource-constrained settings. Ongoing randomized controlled trials will further evaluate its efficacy, implementation outcomes, and mechanism of action.

To describe eight cases of necrosis and related skin changes following a once-monthly subcutaneous buprenorphine extended-release (Bup-XR) injection, identify potential risk factors, and increase clinician awareness of this adverse drug reaction.

A retrospective case series of all patients reported to have necrosis or related skin changes after subcutaneous Bup-XR injection in one psychiatric hospital between February 1, 2023, and September 30, 2024. We collected demographic data, clinical characteristics, psychiatric and medical comorbidities, substance use patterns, treatment details (dose and injection site location), and outcomes. Descriptive statistics were used to summarize data.

Eight individual cases were identified (six males, mean age 41.25 years). Common symptoms reported by patients with this adverse drug reaction included pain (5/8 cases), erythema (4/8 cases), induration (2/8 cases), and edema (2/8 cases). Common clinical features were cocaine/crack-cocaine use (5/8 cases), nicotine use (6/8 cases), and anxiety or mood disorders (5/8 cases). The most frequent medical comorbidity was gastroesophageal reflux disease (3/8 cases). Two cases occurred from the same lot of Bup-XR injections supplied by the manufacturer.

We identified eight cases of necrosis or related skin changes in people who received subcutaneous Bup-XR injections. Clinicians, nurses, and pharmacists should be aware of this rare but potentially important adverse reaction when Bup-XR is prescribed. Clinical attributes common to more than half of the cases included male sex, middle age, cocaine/crack-cocaine usage, nicotine usage, and comorbid mood or anxiety disorders. Further research is required to establish whether these attributes are risk factors for adverse reactions of this kind.

Substance use disorder is a chronic, relapsing disease for which all those living with this mental health condition deserve access to safe, ethical, appropriate care and treatment. Drug diversion, a possible consequence of substance use disorder, puts nurses, patients, organizations, and the public at significant risk. A review of the literature indicates that controlled substance diversion prevention programs are essential to drug diversion prevention efforts, education is key to promoting a culture of safety and encouraging staff to speak up, and alternative-to-discipline approaches should be considered when managing personnel involved in actual drug diversion cases. Additional nursing-focused articles are needed to guide nurses and nurse leaders on this complex and challenging issue. This article outlines a drug diversion prevention program's development and implementation at a large academic medical center in the Midwest. Nursing involvement, leadership, and expertise are paramount to this program's prevention, detection, and response efforts.

Justice-involved individuals with opioid use history face significant social determinants of health challenges that may influence recovery outcomes. This cross-sectional study examined the association between 24 demographic and social determinants of health variables and two outcomes: self-reported opioid use within 1 month and previous overdose. Participants (N = 255) were recently released from incarceration and enrolled in a peer-based recovery program. Bivariate analyses and exploratory logistic regression models were used to examine patterns of association. Peer meeting attendance was associated with a significantly lower likelihood of recent opioid use, suggesting a protective influence of social connection. In contrast, transportation insecurity and co-occurring mental health diagnoses were associated with increased odds of both opioid use and overdose, underscoring potential barriers to recovery. Other observed associations included younger age, race, health care access challenges, and parental status. Medications for opioid use disorder (MOUD) enrollment was also associated with prior overdose history, potentially reflecting more severe use patterns among individuals identified for treatment. Notably, financial insecurity was linked to reduced opioid use, and having children was associated with lower overdose risk, though these relationships may reflect short-term or contextual elements. These findings highlight the complex amalgam of social, health, and economic factors that may shape opioid use and overdose patterns in this population. For nurses in corrections and community health, understanding the cumulative effects of transportation, health care access, mental health, and social support is essential for improving engagement and promoting recovery outcomes.

The purpose of this research was to explore how trauma resulting from earthquakes, individuals' perceptions of risk, and the use of alcohol, tobacco, and illegal substances are interconnected in the southeastern region of Turkey.

This cross-sectional research was carried out between October and December 2023 in 11 provinces affected by in the Southeastern Anatolia Region of Turkey. Earthquake risk perception by participants' characteristics related to addictive substance use were compared.

Significant differences were found between participants' reasons for substance use and their earthquake risk perception and post-traumatic stress levels. Those who used substances due to sadness and distress had higher emotional earthquake risk perception (p <.05, η² = 0.018), post-traumatic stress total scores, and behavioral problems (p <.05, η² = 0.019), emotion limitation (p <.05, η² = 0.022), and sleep disturbance (p <.05, η² = 0.019). A significant difference was also observed between the type of substance first used and post-traumatic stress, with amphetamine users scoring higher than marijuana users (p <.05, η² = 0.013). Furthermore, participants who increased their substance use after the earthquake had increased levels of excitement restriction (p <.05, η² = 0.012) and sleep disturbance (p <.05, η² = 0.011).

These findings highlight the role of addiction and mental health nurses in identifying at-risk individuals and providing trauma-sensitive care after disasters. Incorporating addiction nursing approaches into disaster protocols can improve health outcomes and reduce maladaptive coping.

Wilson's disease (WD) is a rare autosomal-recessive disorder of copper metabolism that can cause hepatic and/or neuropsychiatric manifestations, most often presents in young people. Lifelong treatment adherence is essential to prevent neurological deterioration, hepatic decompensation and death, yet non-adherence is frequent. Centres of the French national WD network evaluated the feasibility and the perceived utility of SPUR, a behavioural diagnostic tool, in the management of people living with WD.

In this non-interventional, prospective, multicentre, non-comparative study, 100 adults with WD from four French centres completed the self-administered digital SPUR questionnaire, which estimates a non-adherence risk (NAR, 0-100) and identifies the individual behavioural drivers of that risk. Healthcare professionals (HCPs) then reported whether the SPUR results changed their perception of the patient, changed their support, and were useful overall.

The mean NAR was low (15.8/100). The predominant behavioural drivers were social (societal and immediate) and financial. Perceived health condition and perceived mental well-being were both inversely associated with the NAR. HCPs considered SPUR useful in 82% of cases, although the tool changed their perception of the patient in only 26.3% and their support in only 27.4% of cases. These findings are exploratory given the subjective clinician-reported endpoint and the selected cohort.

Clinicians perceived SPUR as useful in a selected, hepatology-recruited WD cohort. Because the study had no comparator group, no objective adherence measure and no outcome follow-up, its effect on adherence behaviour and clinical outcomes remains to be established in prospective, controlled studies using objective adherence markers.

To prevent tuberculosis (TB) transmission, individuals with presumed or confirmed respiratory TB are isolated until they are no longer considered infectious. Minimal research exists on the impact of prolonged isolation on persons with TB (PWTB). We surveyed PWTB following hospital discharge when hospital-based isolation (HBI) occurred.

From September 2023 to June 2024, adult PWTB who had experienced HBI were invited to participate in a survey at a New York City Health Department Chest-clinic. The survey was administered by project coordinators or self-administered by patients. Survey questions were adapted from validated instruments, and assessed mental adjustments to TB, access to tangible support, and incurred economic costs during HBI.

Fifty PWTB completed the survey. Participants were in HBI for a median of 23 [IQR: 13-38] days. Survey items assessing cognitive adjustment indicate fighting spirit was the most reported (91% average, range 80%-96%) cognitive strategy used. However, patients also reported feeling hopeless and helpless (28% average, range 20%-44%) and using cognitive avoidance strategies (69% average, range 62%-82%) while in HBI. Sixty-two percent of participants reported lacking at least one form of tangible support (e.g., inability to easily find someone to stay with during an emergency). Thirty-seven (74%) participants reported a loss of employment income and thirty-nine (78%) reported difficulties paying for usual expenses.

Participants reported financial, social, and cognitive adjustment challenges during HBI for TB. Pathways to reduce HBI duration and approaches to provide or direct patients to sources of support are needed.

Emergency and trauma care increasingly involves patients with overlapping acute pathology, chronic disease, frailty, infection risk, functional limitation, and modifiable cardiometabolic factors. Although research published between 2020 and 2026 shows important advances in resuscitation, surgery, critical care, rehabilitation, and chronic disease prevention, these domains are often evaluated separately, limiting their translation into coordinated patient-centred care. This narrative review aimed to synthesise recent evidence from 2020 to 2026 on general medicine and trauma emergency care through an integrated framework combining surgery, internal medicine, rehabilitation, and lifestyle medicine. Studies were reviewed across trauma triage, prehospital and emergency resuscitation, operative and non-operative surgical decision-making, perioperative medical optimisation, sepsis management, organ support, analgesia, rehabilitation, lifestyle intervention, and digital follow-up. The evidence suggests that outcomes depend on accurate triage, timely stabilisation, appropriate use of resuscitative adjuncts, individualised surgical decisions, frailty assessment, comorbidity control, antimicrobial stewardship, physiologically guided critical care, multimodal analgesia, graded rehabilitation, and secondary prevention targeting nutrition, physical activity, glycaemic control, and cardiovascular risk. The literature also highlights uncertainties, including variable benefit from prehospital tranexamic acid and blood products, mixed findings on fluid restriction and sedation strategies, implementation barriers, and the need for longer-term functional outcome measures. Integrating emergency medicine, surgery, internal medicine, critical care, geriatrics, rehabilitation, digital health, and lifestyle medicine may improve survival, reduce complications, preserve function, and strengthen continuity of care.

Chronic musculoskeletal pain (CMP) is a heterogeneous condition in which overall treatment effects may obscure differences across patient subgroups.

To identify distinct baseline symptom profiles and examine their association with baseline-adjusted post-treatment outcomes, responder status, exploratory multidomain negative change, and response trajectories following a structured active pain coping program in primary care.

This was a prospective observational cohort study (n = 169). Participants were enrolled in a 12-week physical therapy program combining pain neuroscience education (PNE) and therapeutic exercise. Two-step cluster analysis identified baseline profiles from pain catastrophizing (PCS), kinesiophobia (TSK-11), disability (RMDQ), and central sensitization (CSI). Pre-post changes, ANCOVA-adjusted endpoints, responder rates, and K-means response trajectories were examined.

Two profiles emerged: Moderate (57.4%) and Severe (42.6%). Participants in both profiles improved significantly, with larger absolute reductions in the Severe profile (PCS responders: 77.6% vs 47.8%). After adjusting for baseline values, between-group differences were non-significant (p ≥ 0.05) across all domains, with similar adjusted endpoint levels in both profiles. The exploratory multidomain negative-change criterion was met by 21.6% of participants and was concentrated in the Moderate profile (88%; OR = 3.99, 95% CI: 1.36-11.70). Response-pattern analysis identified three trajectories: Global Responders (broad improvement across domains; 7.1%), Limited Responders (modest symptom change with worsening mental health; 45.9%), and Moderate Responders (intermediate improvements; 46.9%); the distribution of these trajectories was significantly associated with baseline profile. Only 31.0% of participants met the prespecified ideal responder criterion (simultaneous improvement in symptoms and quality of life).

Both profiles converged toward comparable functional endpoints, making baseline severity a poor gatekeeping criterion for access to this care. Nonetheless, exploratory multidomain negative change was more frequent in the Moderate profile, and concurrent symptom and quality-of-life recovery was uncommon, underscoring the need for systematic mid-treatment monitoring and outcome definitions that extend beyond symptom scores.

The United States continues to experience an opioid epidemic, which has been described by three waves: prescription opioid use, heroin use, and use of synthetic fentanyl analogs. Currently, a new "fourth wave" has emerged, which includes the use of stimulants (methamphetamine and cocaine) and synthetic opioids. Combining stimulants with high-potency synthetic opioids, such as fentanyl and fentanyl analogs, is associated with an increased mortality. Recent changes in methamphetamine production have led to a surge in supply, purity, and potency, thereby exacerbating the crisis. Nurses must understand the physical and mental health impacts of these substances and recognize overdose signs, ensuring patient and staff safety during care. Evidence-based guidelines and Food and Drug Administration-approved treatments for stimulant use disorder are essential, with current emphasis on behavioral therapies. Nurses play a crucial role in implementing these strategies and must stay abreast of evolving best practices in managing this complex epidemic.