This study examined Asian and Latino immigrants' recent exclusionary experiences with immigration policy, such as knowing someone deported, being racially profiled, or being denied health insurance, and their relationship with health care access and health status. The 2018-2020 Research on Immigrant Health and State Policy survey asked adult Asian and Latino immigrants (N = 2,010, Asian n = 1,004, Latino n = 1,006) if they had experienced any of sixteen immigration policy exclusions ever and in the last 12 months. Regression models tested relationships between the number of exclusionary experiences and mental and physical health outcomes for all respondents and only respondents with any lifetime exclusionary experience. Each additional recent exclusionary experience was associated with 40% higher odds of delaying care, 21% lower odds of better self-rated health, and 24% higher odds of mental illness. Results held when limiting the sample to only respondents with any lifetime exclusionary experience. Recent exclusionary experiences with immigration policy likely have immediate consequences for health care access and health status. Findings underscore the need for early intervention to reduce the impact of immigration policy exclusions.

This study aims to investigate the association between leukocyte telomere length (LTL) and the risk of incident NDDs using a large-scale cohort from the UK Biobank.

Data from 459,902 subjects were analyzed using Cox proportional hazards models and machine learning (ML) algorithms to assess LTL's association with NDD risk.

Shorter LTL was associated with an increased risk of NDDs, including Alzheimer's disease (HR: 0.52, 95% CI 0.40-0.67, P < 0.001), dementia in AD (HR: 0.53, 95% CI 0.39-0.73, P < 0.001), unspecified dementia (HR: 0.74, 95% CI 0.58-0.95, P < 0.05), degenerative diseases of the nervous system (including other specified degenerative diseases such as circumscribed brain atrophy and senile degeneration of the brain) (HR: 0.62, 95% CI 0.45-0.84, P < 0.01), extrapyramidal and movement disorders (including other specified extrapyramidal and movement disorders such as a range of tremors, chorea, tics, and other abnormal involuntary movements) (HR: 0.63, 95% CI 0.48-0.82, P < 0.01), and mental and behavioral disorders due to use of alcohol (HR: 0.46, 95% CI 0.38-0.55, P < 0.001). Conversely, longer LTL was associated with a 3.71-fold increased risk of multiple sclerosis (MS) (HR: 3.71, 95% CI 1.91-7.18, P < 0.001). ML models confirmed the predictive value of LTL for NDDs.

Shorter LTL increased the risk of several NDDs, while longer LTL paradoxically predisposed individuals to MS, especially in younger populations. ML models demonstrated strong potential for predicting NDD risks, enhancing our understanding of the role of telomeres in neurodegeneration.

Progression of multiple sclerosis (MS) remains incompletely understood. MS is characterized by demyelination, resulting in a wide variety of symptoms. Conventional magnetic resonance imaging (MRI) is the current standard for diagnosing and monitoring patients. However, conventional MRI has its limitations in visualizing the myelin dynamics. In contrast, advanced myelin-specific MRI techniques enable non-invasive, in vivo quantification of myelin content. Such approaches hold promises for the early detection of pathology and for improving the understanding of disease mechanisms and their relationship to clinical outcomes, particularly since many patients with MS experience progression of symptoms that cannot be fully explained by conventional imaging measures. This narrative literature review aims to summarize recent advances in longitudinal myelin-specific MRI studies in MS and their clinical applications. Overall, longitudinal studies demonstrated that myelin-specific MRI techniques can capture dynamic changes in myelin, possibly aiding in understanding the progression of MS, although inconsistencies persist both between and within techniques. Even though more myelin-sensitive than myelin-specific methods, such as diffusion MRI or multi-contrast methods, are not specific to demyelination, they could aid clinical follow-up by predicting lesion formation, as changes are visualized before being present on conventional MRI. These findings underscore the need for future research that integrates MRI-derived metrics with detailed assessment of disease courses.

Marriage and family therapy emphasizes systemic responsiveness, yet integrating advocacy into clinical training remains limited. This pilot study examines a trauma-informed service-learning partnership with a community-based organization, where graduate students conducted supervised forensic evaluations for asylum seekers. Using a phenomenological case study design with mixed-methods follow-up, we explored how direct engagement with survivors of politically motivated persecution shaped students' professional development, cultural humility, and advocacy skills. Upon the 1-year follow-up participants reported lasting empathy, systemic awareness, trauma-informed competence, and confidence applying clinical skills beyond the therapy room. Students described the experience as transformative, expanding their professional roles to include advocacy and systemic responsibility. Challenges with interviewing, reporting, and contextualizing mental health in sociopolitical frameworks highlighted the need for stronger academic support and advocacy training. Embedding experiential, community-based learning into MFT curricula may bridge the gap between ethics and practice, equipping therapists to serve as both clinicians and systemic advocates.

To analyze association between prevalence of diagnosis of depression in adults and health service coverage in Brazil's Federative Units.

This was a cross-sectional study using data from the 2019 National Health Survey. Adjusted odds ratios (OR) and 95% confidence intervals (95%CI) were calculated from multilevel logistic regression models to analyze association between diagnosis of depression and health service coverage.

88,531 adults residing in the 27 Brazilian Federative Units were analyzed in 2019. Higher odds of depression diagnosis were found among adults residing in Federative Units with greater Family Health Strategy coverage (OR 1.35; 95%CI 1.29; 1.42), with a greater number of family health support centers (OR 1.17; 95%CI 1.13; 1.21) and psychosocial care centers (OR 1.31; 95%CI 1.23; 1.41).

The results of this study indicated that greater health service coverage was associated with higher prevalence of diagnosis of depression. These findings emphasized the importance of expanding and strengthening the psychosocial care network to improve diagnosis and care of individuals with mental disorders in Brazil.

Cognitive impairment in individuals attending treatment for substance use disorders is common. However, multiple aetiologies contribute to the presentation of cognitive issues in this population, and key risk factors for significant impairment are unclear. This limits effective screening, including identifying which clients are most appropriate for comprehensive neuropsychological assessment. The aims of the current study were to: (i) examine clinical characteristics and risk factors for cognitive impairment in individuals engaged with community-based substance use treatment services; and (ii) explore which risk factors predicted objective cognitive impairment based on a cognitive screening measure.

The current study retrospectively analysed clinical data collected from individuals who participated in cognitive screening programs (n = 559) in two community drug and alcohol services in New South Wales, Australia between 2015 and 2020. This included collation and analysis of: (i) risk factors for cognitive impairment; (ii) objective cognitive screening and questionnaire data.

On cognitive screening, 72% of clients met criteria for suspected cognitive impairment, with high rates of non-modifiable and modifiable risk factors reported by clients. A history of neurodevelopmental conditions, education level, and self-rated cognitive and functional ability significantly predicted score on the Montreal Cognitive Assessment.

This study highlights the high rates of risk factors for cognitive impairment in individuals attending community substance use treatment, and the complexity of determining who requires more comprehensive cognitive assessment. A history of neurodevelopmental conditions or self-reported functional or cognitive difficulties may indicate the need for objective cognitive screening.

Global functioning is a common clinician-rated measure of treatment changes in inpatient psychiatric care, but its broad scope may limit its sensitivity to specific mental health changes. This study aimed to research interplay and improvements of global functioning and several mental health parameters.

At admission and discharge 561 inpatients at a psychiatric clinic received assessments for global functioning, depression severity (clinician- and self-rated), sleep quality, quality of life, life satisfaction, and mood level. ANCOVAs assessed mean changes, while multiple linear regressions explored predictors of global functioning at both time points and over time.

Global functioning and most mental health parameters significantly improved (p < 0.001-0.019, partial η² = 0.02-0.14), except for sleep quality. Clinician-rated depression severity was consistently the strongest predictor of global functioning at admission, discharge, and over time (β = -0.56 to -0.47, p < 0.001). At admission, life satisfaction predicted global functioning improvement (β = 0.27, p = 0.038), while lower sleep quality indicated higher global functioning (β = 0.16, p = 0.041).

The strong association between clinician-rated measures suggests a halo effect. A diagnostic and visualized integration of clinician- and self-rated measures is proposed for more reliability.

Eating disorders are associated with high morbidity and mortality, requiring timely treatment by a competent workforce. Dietitians are important members of the eating disorders health care team. This study aimed to explore the perceived and changing eating disorders education and training needs of practising dietitians in Australia and New Zealand across two time points.

A cross-sectional survey was administered to Australian and New Zealand dietitian members of professional associations in 2009 and 2022. The 2022 survey was administered online via Microsoft Forms and contained 51 items, including Likert scale, tick-box and open-ended responses. Descriptive analysis and logistic regression models were used to identify predictors of perceived knowledge, skill, comfort, confidence and educational need. Qualitative data was analyzed using reflexive thematic analysis.

286 dietitians completed the 2009 survey and 147 the 2022 survey. In 2022 98% were female and 74% aged 20-40 years. Compared with 2009, dietitians in 2022 undertook more eating disorders education and training, reported greater knowledge and skill, and were more likely to express a need for education and training. Across both surveys, prior training, clinical experience and workplace setting predicted knowledge, skill, comfort or confidence. Prevention, detection, referral and a broad range of treatment aspects were identified as important educational areas.

Improvements over time in access to eating disorders training and perceived knowledge and skill were evident. Key educational areas of prevention, detection, referral and treatment require action as a priority to ensure dietitians are well equipped to practice in eating disorders.

This manuscript explores the silent yet urgent crisis of suicidal ideation and suicide within the nursing profession. Despite being one of the most trusted and essential health care roles, nurses face disproportionately high risks for psychological distress, moral injury, and suicide.

The paper aims to synthesize existing evidence on prevalence, risk factors, and theoretical frameworks to guide prevention and intervention efforts, while emphasizing the critical need for trauma-informed, organizational, and policy-level responses.

Using Joiner's Interpersonal Theory of Suicide, the Job Demand-Control-Support (JDCS) model, and trauma-informed care (TIC) principles, the manuscript illustrates how feelings of burdensomeness, thwarted belonging, and exposure to trauma converge to elevate suicide risk.

Key contributing factors to nurse suicide include chronic occupational stress, compassion fatigue, workplace bullying, moral distress, and limited autonomy, all compounded by a pervasive stigma around mental health help-seeking. A poignant case study underscores how institutional silence and lack of systemic support following medical errors can lead to devastating outcomes. Barriers such as fear of licensure consequences and lack of confidential services further discourage early intervention.

The suicide crisis among nurses necessitates a comprehensive, multi-level response. Nurse leaders must foster psychologically safe environments, promote peer support, and integrate mental health education into all levels of practice. System-level changes-such as confidential reporting systems, national suicide surveillance, licensure reform, and culturally competent outreach-are essential to prevent further loss. Future research must examine longitudinal risk trajectories, intervention efficacy, and artificial intelligence (AI)-driven early warning tools tailored to the nursing workforce.

Valproic acid is a broad-spectrum anticonvulsant medication that is used to treat multiple neurologic and psychiatric disorders such as epilepsy, bipolar disorder, schizophrenia, and migraine prophylaxis. Famotidine is an antacid used for various gastrointestinal conditions, including gastric and duodenal ulcers and gastroesophageal acid reflux disease (GERD). Acute ingestion of famotidine was found to inhibit anticonvulsant action and increase brain concentrations relative to free plasma levels in a mouse model. While they are not known to interact with one another, one of their proposed metabolisms is through the same CYP450 enzyme. However, a drug-drug interaction between valproic acid and famotidine, or this interaction causing toxicity in a child, is extremely rare. A 10-year-old male with a past medical history of bipolar disorder, posttraumatic stress disorder, and anxiety presented to a community emergency department (ED) with acute altered mental status and increasing somnolence. Routinely taking valproic acid, he had started prescription famotidine two days prior. In the ED, his valproic acid levels were six times the upper limit of normal with associated elevated creatinine and hypocalcemia. Later, hyperammonemia developed. He was ultimately treated with L-carnitine, lactulose, and meropenem as well as admitted to the pediatric intensive care unit (PICU) with normalization of lab values and complete resolution of his neurologic symptoms after 29 hours. This case describes an extremely rare drug-to-drug interaction of valproic acid and famotidine leading to acute altered mental status in a pediatric patient. While causality cannot be established from a single case, clinicians should consider this potential interaction when new medications are added to a stable valproic acid regimen, as these two medications are commonly prescribed in both adults and children.