Work accommodations can facilitate return to work (RTW), but little is known about work accommodation needs and practices among employees with common mental disorders (CMDs). This study examines (1) needed work accommodations for RTW, (2) received work accommodations during RTW, and (3) the longitudinal relationships between received work accommodations and both depressive symptoms and work ability after RTW.

Data were collected in two German longitudinal studies among employees with CMDs on long-term sickness absence: (I) an observational cohort study (F2385; N = 286; 30-month follow-up); and (II) a randomized controlled trial (RTW-PIA; N = 424; 24-month follow-up). Needed and received work accommodations were described and compared. Multiple regression analyses were conducted to examine the longitudinal relationships between received work accommodations and both depressive symptoms and work ability after RTW.

Before RTW, 91-99% of the employees reported work accommodation needs, most frequently a gradual RTW (54-78%), workload reduction (35-45%), improvement of work organisation (31-55%), and regular feedback talks with supervisors (29-42%). During RTW, 64% of participants in both datasets received at least one work accommodation, most often a gradual RTW (48-49%), job change (28-29%), or workload reduction (11-19%). Only 13-16% had all work accommodation needs met. Receiving ≥ 1 work accommodation was related to reduced depressive symptoms and increased work ability after RTW.

More frequent and systematic provision of work accommodations, particularly regarding the improvement of working conditions, is essential to support recovery and RTW for employees with CMDs.

We examined the feasibility, acceptability and preliminary efficacy of Cognitive Behaviour Therapy for Perfectionism (CBT-P) for children delivered as an online 6-session guided parent-delivered intervention (GP-CBT-P). We conducted a two-arm randomised controlled trial comparing GP-CBT-P to waitlist for parents whose child was aged 7-12 and had elevated perfectionism. Primary outcomes were feasibility and acceptability; secondary outcomes were self-reported parental and child perfectionism, school satisfaction, happiness, stress, depressive symptoms, self-efficacy, and weight/shape concern. Assessment occurred at baseline (T1), 9- (T2, end of the intervention) and 18-weeks (T3) post-randomization. There were 89 enquiries over 14 months; 49 (54%) converted to randomisation (25 in GP-CBT-P, 24 in waitlist), and 60% of parents in the intervention group completed all 6 sessions. There were no differences between groups at baseline. Intent-to-treat analysis showed parents in GP-CBT-P had significantly lower levels of perfectionism at T2 and T3 than control (respective between groups effect sizes [ES] and 95% confidence intervals [CI] of 0.95 [0.37 to 1.53] and 0.65 [0.08 to 1.21]). Compared to control, children receiving GP-CBT-P reported significantly higher school satisfaction and academic self-efficacy, and lower stress, depression and weight/shape concerns; T3 ES ranged from 0.58 to 0.82. There were no significant differences between groups on child perfectionism. GP-CBT-P could benefit from strategies to enhance feasibility and acceptability given it promoted helpful change across parent and child self-reported outcomes. Reducing parental perfectionism may be a key driver of beneficial change in children. Further investigation with larger samples and longer-term follow-up is recommended.

Thermal ablation techniques, such as radiofrequency ablation (RFA) and microwave ablation (MWA), are used to treat hepatic malignancies. The 'oven effect,' where background cirrhotic tissue insulates and enhances heating, is well-documented in RFA but not in MWA. This study aims to explore whether the oven effect occurs in MWA.

A retrospective comparative study included all patients undergoing MWA for hepatic malignancies between 2014 and 2017. Patients were divided into two groups based on liver lesion characteristics: H group (hepatocellular carcinoma, likely cirrhotic liver) and M group (metastases, likely non-cirrhotic liver). Ablation volumes were calculated using CT scans performed 6 weeks post-ablation. Multivariate linear regression analysis was performed to assess the significance of differences in ablation volume.

94 patients (57 in H group, 37 in M group) were included. Groups were demographically matched, and ablation parameters (intensity and duration) were comparable. The mean ablation volume in the M group was 2.3cm³ smaller than in the H group, but this difference was not statistically significant (95% confidence interval -7.8, 3.3; p = 0.42).

This study found no evidence of the oven effect phenomenon in MWA. This may result from MWA's ability to achieve higher temperatures and larger ablation zones, reducing the impact of local tissue characteristics.

This study provides preliminary evidence that MWA produces consistent ablation volumes regardless of liver background, suggesting it is a reliable method for both cirrhotic and non-cirrhotic livers, advancing patient-specific treatment planning. However prospective validation is required before integration into clinical guidelines.

Despite three decades of research, costing methodology in health professions education (HPE) remains fragmented, limiting the production of consistent, interpretable, and decision-relevant cost evidence. As HPE institutions face increasing pressure to allocate limited resources effectively, robust cost evidence is needed to support cost-conscious decision-making. This study synthesizes persistent methodological challenges in HPE costing and proposes a research agenda to support more transparent, interpretable, and contextually responsive methodology.

A state-of-the-art review was conducted to 1) chart key developments in HPE costing methodology, 2) synthesize recurring methodological challenges across contemporary cost literature, and 3) develop a research agenda. All publication types addressing costs of designing, developing, implementing, and evaluating HPE were eligible if they reflected methodological challenges in cost research. Challenges were synthesized across nine established phases of economic research: study design, perspective, time horizon, identification, measurement, valuation, reporting, comparability, and quality appraisal. Insights from the historical overview and synthesized challenges informed a research agenda.

Development of HPE costing methodology has progressed through two parallel streams: domain-specific frameworks and broader conceptual guidance. Limited integration across these approaches contributes to persistent fragmentation. Challenges were identified across all nine phases of cost research, including inconsistent cost definitions, difficulty separating educational and clinical costs, limited data sources, and limited operational guidance for identifying, measuring, valuing, and reporting costs. These findings informed a research agenda outlining priorities to support more transparent, interpretable, and contextually responsive costing methodology.

Methodological fragmentation in HPE cost research reflects not only uneven methodological development, but also the conceptual, structural, and operational complexities of examining costs across diverse HPE contexts. The resulting research agenda identifies priorities to strengthen methodological foundations through improved transparency, shared methodological resources, and context-sensitive application. Addressing these gaps may support production of rigorous, interpretable, and decision-relevant cost evidence in HPE.

The occupancy-driven pharmacology model in psychopharmacology has guided drug discovery and development for decades, whereby the goal is stable receptor occupancy over an extended period with a direct relationship of drug exposure to pharmacodynamic and therapeutic response. Event-driven pharmacology (EDP) is a concept where the acute pharmacodynamic actions of a plastogen, a transient binding event, drive changes resulting in sustained pharmacodynamic effects that greatly outlast the time frame of drug exposure. Such plastogens may be neuroplastogens producing a measurable change in neuroplasticity without inducing subjective mental states or psychoplastogens exerting neuroplastic effects in addition to causing dissociation, hallucinations, or psychotomimetic symptoms. Within neuropsychiatry, plastogens have been shown to induce long-lasting neural plasticity and persistently activate synaptic machinery that primes synapses to respond to subsequent stimuli (metaplasticity), often following either a single dose or repeated administration of intermittent doses. Developing rapid-acting plastogens to adhere to a traditional target occupancy dose optimization model that achieves consistent drug target occupancy over an extended period of time may paradoxically exert few or no durable benefits while increasing side effect burden. We review evidence supporting the concept that plastogens, including the rapid-acting antidepressant ketamine and classical psychedelics, operate within the EDP model. With the emergence of EDP, new methods for drug development, clinical dosing, and biomarker adoption will need to be developed to account for distinctive pharmacological actions. Rapid-onset plastogens, rationally administered, have profound potential in the treatment of depression and many other neurological and psychiatric diseases characterized by synaptic dysfunction.

Interprofessional education (IPE) in healthcare remains insufficiently studied, despite the World Health Organization's strong emphasis. Research on attitudes toward IPE among medical students (MS) from private medical schools is particularly limited.

To study the attitudes toward IPE among MS from German private medical schools.

Using an online survey, positive and negative predictors of IPE attitudes, as measured by the validated German version of the Interprofessional Learning Scale of the University of the West of England Interprofessional Questionnaire (UWE-IP-D ILS), were identified from 256 MS at four private German medical schools. Additionally, MS selected preferred preclinical / clinical curriculum subjects for IPE.

The overall UWE-IP-D ILS mean (standard error) score was 20.27 (± 8.16). Multiple regression analysis identified female sex as a significant positive predictor of positive IPE attitudes, even after Bonferroni correction (p = 0.006). However, IPE attitudes tended to decrease over the study years (non-statistically significant trend). Basic sciences, mental health disciplines, and family medicine were most frequently identified as most appropriate subjects for IPE. More than 80% of participants expressed willingness to allocate teaching activities to IPE within and outside the regular curriculum.

The survey results support the implementation of structured IPE programs and guide IPE embedding in the German medical curriculum.

The online version contains supplementary material available at 10.1007/s40670-026-02712-9.

Theoretical perspectives suggest that pre-sleep cognitive processes, including cognitive arousal, rumination, and stress can impair sleep. However, previous studies have relied on cross-sectional designs, limiting insight into how these cognitive processes relate to sleep on a night-to-night basis. In addition, anticipatory stress has received little empirical attention, despite its relevance for poor sleep. To address these gaps, the present study examined the associations of pre-sleep cognitive arousal, pre-sleep rumination, and anticipatory stress with sleep quality, sleep duration, and sleep onset latency both when averaged across 7 days (between-person level) and on a day-to-day basis (within-person level).

A total of 166 emerging adults (M_age  = 20.36 years, 80.1% female) completed smartphone-based surveys during 7 consecutive days, reporting on pre-sleep cognitive processes (cognitive arousal, rumination, anticipatory stress) each evening and sleep outcomes each morning.

Linear mixed-effects models showed that, at the between-person level, higher average levels of all three pre-sleep cognitive processes across the week were associated with poorer sleep quality and shorter sleep duration. No significant associations were found for sleep onset latency. At the within-person level, all three pre-sleep cognitive processes were not related to next-morning sleep outcomes.

Overall, the findings suggest that stable individual differences in pre-sleep cognitive processes, rather than short-term changes, are linked to sleep quality and duration in emerging adults.

Understanding trauma-related psychopathology increasingly requires tools capable of capturing how symptoms and underlying mechanisms unfold across real-world contexts. Traditional assessments, which depend on retrospective recall and intermittent clinical contact, are limited in their ability to reflect the dynamic and context-sensitive processes that shape trauma-related mental health outcomes. Emerging digital health technologies and computational approaches address this gap by enabling the continuous measurement of behavior and physiology, whereas biological markers provide mechanistic insights into processes such as stress-related neuroendocrine, autonomic, immune, and sleep-wake functioning that reflect the biological embedding of trauma over time. This review integrates recent advances in digital and biological measurement in posttraumatic stress disorder (PTSD) and outlines principles for combining these approaches within computational frameworks. We emphasize the importance of grounding digital proxies in established biological theory; modeling intraindividual dynamics rather than relying solely on cross-sectional group differences; and integrating multimodal behavioral, physiological, and contextual data. We further highlight essential considerations for ethical, inclusive, and methodologically rigorous implementation, including privacy-by-design, data quality, and clinical interpretability. Together, these approaches support a more mechanistic, dynamic, and personalized understanding of trauma-related risk and recovery, with the potential to enhance early risk stratification and guide preventive and individualized models of care.

Medication nonadherence is common among patients diagnosed with schizophrenia and is associated with poor clinical outcomes. The effectiveness of adherence therapy (AT) in improving adherence remains debated, particularly in community settings. This systematic review evaluated the impact of AT on medication adherence among individuals with schizophrenia. Following PRISMA guidelines, eight databases were searched for randomized controlled trials (RCTs) published in English between 2010 and 2023. Study quality was assessed using CONSORT criteria, and risk of bias was evaluated independently by two reviewers using the Cochrane RoB 2 tool. Ten RCTs met the inclusion criteria. Findings indicate that AT is significantly associated with improved medication adherence and positive patient outcomes. Despite these promising results, further high-quality, double-masked RCTs involving diverse populations across different geographic and ethnic backgrounds are required to strengthen the evidence base and support the generalizability of AT in community-based mental health care settings.Study Registration: PROSPERO Protocol registration ID: CRD420261416466.

ObjectiveTo evaluate changes in mental health symptoms, wellbeing, recovery, and emotion regulation among young people receiving care in a recovery-oriented inpatient unit and day programme.MethodsThis is a prospective observational longitudinal cohort study of young adults aged 16-25 years assessed at baseline, 3 months, and 6 months. Measures included the Depression Anxiety Stress Scales-21 item version, Difficulties in Emotion Regulation Scale, Interpersonal Emotion Regulation Questionnaire, Recovery Assessment Scale-20 item version, and WHO-5 Wellbeing Index. Lifestyle and psychosocial factors were assessed.ResultsSeventy participants were enrolled; 71.4% were female and 52.9% aged 17-19 years. Significant reductions in depressive symptoms were observed, with DASS-21 Depression scores decreasing from 26.3 at baseline to 20.5 at 6 months (p = .04). Emotion regulation difficulties improved significantly, with DERS-16 scores decreasing from 58.9 to 53.5 (p = .02). Recovery scores and wellbeing showed positive but non-significant trends. Positive changes were observed in outdoor activity, physical activity, diet quality, and perceived social support.ConclusionsThis study provides preliminary evidence that a tailored, recovery-oriented inpatient and day programme model is associated with reduced depressive symptoms and improved emotion regulation among young adults with mental health concerns. These findings support further evaluation of youth-specific, recovery-oriented mental health services.