Preserving intrinsic capacity (IC) is central to healthy ageing. However, no consensus exists regarding validated multidimensional instruments suitable for assessing IC across the adult lifespan. This scoping review identified instruments used to assess IC and to evaluate their scientific validity, clinical relevance and usability.

An updated literature search was conducted following the PRISMA-ScR guidelines in five databases for studies published between January 2022 and May 2025. This scoping review updates and expands upon a previously published comprehensive review. Nine experts independently evaluated all identified tools using predefined criteria: scientific validity, clinical relevance, usability in clinical practice, usability for self-assessment and suitability for adults aged <60 years.

A total of 61 studies describing 61 distinct IC assessment instruments were included. All five IC domains were represented, although coverage across domains was uneven. Instruments assessing sensory capacity were scarce and generally received lower ratings than those targeting other domains. Only the Generalized Anxiety Disorder-7 and EUROQOL-5D achieved the maximum expert score. Importantly, very few instruments were considered appropriate for assessing IC in adults younger than 60 years, limiting their potential use for early identification of functional decline and preventive interventions.

Current IC assessment instruments show substantial heterogeneity in content, validity and usability, with important gaps in the assessment of sensory capacity and younger adults. The gaps identified in this scoping review suggest that the development and validation of a comprehensive, multidimensional IC assessment tool may be warranted.

Early Intervention in Psychosis services were established throughout England over two decades ago, yet despite aiming to optimise care, less than 40% of patients achieve full clinical recovery and notable inequities persist in accessing NICE-recommended treatments. Fragmented electronic health record systems and limited systematic data capture conceal how disparities in care delivery and effectiveness affect recovery and remission. The Early Psychosis Informatics into Care, EPICare, programme aims to develop a national, learning healthcare system incorporating a standardised core dataset and clinician dashboard to support equitable, data-driven care.

Our stakeholder co-design approach comprised three interlinked work packages delivered between 2021 and 2022. Using participatory co-design, we conducted four multi-stakeholder workshops and preparatory lived experience sessions with people with lived experience, clinicians, informaticians, academics, and policymakers. We identified essential data elements using adapted "MoSCoW" card sort methodology, refined content, and developed dashboard requirements. Parallel informatics and implementation research assessed technical feasibility, data maturity, and harmonisation requirements and evaluated anticipated barriers and facilitators to future adoption.

Consensus was achieved on core EPICare dataset "must haves" including sociodemographic variables, routine treatment interventions, Patient- and Clinician-Reported Outcome Measures, and longitudinal symptom data. Stakeholders defined key dashboard features, prioritising usability and alignment with clinical workflow. Substantial variation in Trust-level data infrastructure informed flexible technical architecture to mitigate implementation risk.

EPICare stakeholder engagement delivered the blueprint for a co-designed, technically feasible and nationally scalable specification for a psychosis learning healthcare system, enabling progression to platform development and piloting across five Early Intervention in Psychosis services in the NHS.

Dysglycemia, a common ailment in MDD patients, lacks research regarding its variance across the age of onset (AOO). Therefore, we investigated the correlation between fasting blood glucose (FBG) abnormalities and blood lipids in first-onset, untreated patients with MDD and to determine the factors that influence glycemic abnormalities in patients differentiated by age of onset.

The study enrolled 1718 Han Chinese outpatients with drug-naïve, first-episode MDD from a general hospital. Anxiety, depression, and psychotic symptoms were evaluated using the Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), Clinical Global Impression of Severity Scale (CGI-S), and Positive and Negative Syndrome Scale (PANSS) positive subscale, respectively. we divided patients into early age of onset (EAO, < 45 years) and middle age of onset (MAO, ≥ 45 years) groups.

MAO patients, compared to EAO patients, displayed higher scores on the HAMD, HAMA, CGI-S, and PANSS positive scales. Furthermore, they exhibited elevated serum levels of thyroid stimulating hormone (TSH), FBG, total cholesterol (TC), and low-density lipoprotein (LDL-C). In MAO patients, FBG correlated with TSH, triglycerides (TG), and TC, while only TSH correlated with FBG in EAO patients. Path analysis revealed a significant indirect effect of FBG on lipid levels through depressive symptoms, accounting for 35.46% of the total association in EAO patients and 16.22% in MAO patients.

Age-stratified analyses revealed that MDD-associated metabolic dysregulation in younger patients (< 45 years) was mediated by psychiatric symptoms, warranting depression-focused interventions, whereas older patients (≥ 45 years) demonstrated direct metabolic dysfunction, necessitating integrated psychiatric-metabolic management.

Erythema induratum of Bazin (EIB) is a rare form of cutaneous tuberculosis characterised by recurrent nodular lesions, predominantly affecting the lower extremities. It is considered a hypersensitivity reaction to Mycobacterium tuberculosis rather than a direct infection, hence the term "tuberculid". Due to its nonspecific clinical presentation, it often mimics other dermatological and systemic conditions, leading to diagnostic challenges. We report a case of a 40-year-old woman presenting with prolonged low-grade fever, weight loss, and multiple tender nodular lesions over the lower limbs and forearms. Laboratory evaluation revealed anaemia of chronic disease and elevated inflammatory markers, while autoimmune and infectious workup was negative. Histopathological examination demonstrated lobular panniculitis with lymphohistiocytic infiltrates and granulomatous inflammation along with vasculitis, consistent with EIB. The patient was initiated on anti-tubercular therapy, resulting in complete resolution of symptoms and lesions. This case highlights the importance of considering cutaneous tuberculosis in patients with persistent nodular lesions, particularly in endemic regions, and underscores the diagnostic value of histopathology.

Poor sleep and suboptimal diet are common during pregnancy and contribute to adverse maternal and infant outcomes. While sleep-diet associations are documented in general populations, evidence in pregnancy is scarce. This study investigated associations between sleep quality and duration and diet quality and dietary intake among Australian pregnant women. Data from two Australian pregnancy cohorts (Newcastle1000 and ORIGINS; n = 1070) were collected at 18-20 weeks gestation (2017-2024). Sleep was assessed using the Pittsburgh Sleep Quality Index (PSQI), and dietary intake and diet quality using the Australian Eating Survey and Australian Recommended Food Score (ARFS). Generalised linear models examined associations between sleep quality (continuous PSQI score) and sleep duration (< 7 h, 7-9 h, > 9 h) and dietary variables, adjusting for age, income, pre-pregnancy BMI, mental health, physical activity, and cohort. Participants were aged 32.3 ± 4.3 years; with a pre-pregnancy BMI of 25.9 ± 5.7 kg/m² and 95.3% were English-speaking. Most participants reported poor sleep quality (72.9%; PSQI global score 6.4 ± 2.8) and suboptimal diet quality (ARFS 35.5 ± 8.9). Poor sleep quality was associated with higher saturated fat intake (Exp(β) = 1.004, 95% CI: 1.000,1.008, p = 0.046). Short sleep duration (< 7 h) was associated with lower diet quality (β = -2.60, 95% CI: -3.95, -1.25, p < 0.001) and lower fibre intake (Exp(β) = 0.945, 95% CI: 0.900,0.992, p = 0.022). No other significant associations were observed in adjusted models. Poor sleep quality and short sleep duration were associated with less favourable dietary patterns during pregnancy. This highlights the need for further research to inform integrated interventions that consider sleep quality and duration alongside strategies to support healthier eating patterns and improve maternal and infant health outcomes.

The role of complement in Alzheimer's disease (AD) remains unclear, particularly regarding tau pathology and memory decline.

In 123 mild cognitive impairment (MCI) participants from Alzheimer's Disease Neuroimaging Initiative (ADNI), linear mixed‑effects models and Johnson-Neyman analysis examined associations of baseline cerebrospinal fluid (CSF) C3/FH ratio with longitudinal memory decline moderated by time‑varying plasma phosphorylated tau181 (p‑tau181).

The three‑way interaction was significant (p = 0.023). A region of statistical significance was identified: the conditional association of C3/FH with memory decline became significant when p‑tau181 exceeded 0.76 SD, with higher C3/FH associated with slower decline at elevated p‑tau181 levels. Cross-sectionally, no significant C3/FH-memory associations were observed in any diagnostic group (all p > 0.05).

These findings indicate that complement balance is associated with memory decline in MCI in a manner dependent on plasma p‑tau181 levels, suggesting that complement may interact with AD‑related pathophysiology during the prodromal phase. The identified statistical region provides a hypothesis‑generating benchmark for future studies.

Representation of pain areas offers a spatial dimension of pain perception, yet it has rarely been used in the context of visceral pain. This experimental study examined spatial patterns of acute visceral and somatic pain and their recall.

Healthy volunteers (N = 49, 30 females) underwent calibrated rectal distension (visceral pain) and cutaneous heat stimulation on the abdomen (somatic pain), and drew modality-specific pain areas on standardised body maps immediately after stimulation and one week later. Drawings were digitised and quantified, distinguishing local from referred pain, defined as pain area separated from local site. Pain intensity and unpleasantness were assessed with visual analogue scales, psychological traits and states via questionnaires.

Rectal distension induced larger and more diffuse areas than heat pain (p < 0.001). Pain areas were highly reproducible after one week (p < 0.001). Referred visceral pain was reported by 67% of participants, predominantly in the anterior abdomen, whereas somatic pain remained localised. Total pain areas were unrelated to pain intensity or unpleasantness. However, participants with referred visceral pain had higher trait anxiety (p = 0.011), while greater referred visceral pain extent was associated with higher pain intensity (p = 0.012). Bayesian analyses identified extraversion and behavioural inhibition as predictors of visceral pain area.

Visceral and somatic pain showed distinct, reliably recalled spatial representations. Visceral pain was more extensive and diffuse. Its association with personality traits suggests that spatial pain representations reflect stable, trait-like characteristics, highlighting the value of body maps as complementary tool for characterising interoceptive pain in experimental and clinical research.

Visceral pain evokes a broader and more diffuse spatial representation than somatic pain, which is reliably recalled and shaped by psychological traits. Body maps capture features such as referred pain that are not reflected by intensity ratings alone. Visceral pain was predicted by personality trait factors, while referred pain extent was linked to pain intensity. These findings support modality-specific body maps as a mechanism-informed tool for stratifying visceral interoceptive pain in research and clinical contexts.

To articulate the politicisation of recovery as a conceptual and clinical framework for early intervention in psychosis and to argue why the field must move beyond the imperative of functioning.

Early intervention for ultra-high-risk states and first-episode psychosis has improved symptomatic outcomes, yet a persistent gap remains between remission and functional recovery, while social and environmental determinants shape both onset and course. This gap partly reflects an implicitly autoplastic model of recovery, helping young people adjust to social conditions that remain unexamined, a drift intelligible within cognitive capitalism, where functioning itself becomes the imperative.

Conceptual and narrative analysis drawing on critical and survivor-led accounts of the recovery movement, Langer's autoplastic/alloplastic dialectic, Pichon-Rivière's grupo operativo and eco-phenomenological accounts of selfhood.

We define the politicisation of recovery as the expansion of clinical and institutional practices that support the young person's capacity to act within, interpret and sometimes transform the conditions shaping their lived world; the restoration of agency, not collective social change, is the criterion. We describe three levels at which early intervention, a field born as a reform movement, already enacts this politics without naming it: the therapeutic relationship and case management, the group as a small-scale world and the institution through peer involvement and reflexivity.

We discuss three tensions the framework must navigate, responsibility, stratification and dependency and their implications for outcome measurement and research, where instruments sensitive to perceived control, empowerment and meaningful participation should complement functional indicators such as NEET status.

In recent decades, the widespread adoption of digital devices has led to a dramatic increase in screen time among children, raising significant public health concerns. This narrative review synthesizes current evidence on the relationship between daily screen exposure and the rising prevalence of childhood overweight and obesity. Childhood overweight and obesity are established risk factors for children's mental health problems in the short term and for the occurrence and development of various chronic diseases in adulthood. We searched PubMed, Web of Science, and Scopus for observational and intervention studies published in English between 2005 and 2026, using combinations of the terms "screen time", "television", "video games", "social media", "children", "adolescents", "overweight", and "obesity". Mounting evidence suggests that prolonged engagement with screens whether through television, smartphones, tablets, or computers is associated with to an elevated risk of weight-related health issues in children. However, the strength and consistency of this association vary across age groups, screen modalities, and study designs, with much of the evidence deriving from observational research that precludes definitive causal inference. Our review evaluates existing literature, encompassing recent empirical findings, theoretical perspectives, and proposed mechanistic pathways underlying this association. Key factors under examination include sedentary behavior displacing physical activity, exposure to unhealthy food marketing, disrupted sleep patterns, and the potential metabolic effects of prolonged screen use. Notably, these pathways are presented as proposed rather than definitively established mechanisms, given the predominance of cross-sectional and longitudinal observational data. Furthermore, this review explores evidence-based intervention strategies aimed at mitigating screen-related health risks, emphasizing the role of parental guidance, school-based policies, and public health initiatives in fostering healthier developmental trajectories for children. By integrating multidisciplinary insights, this review aims to inform future research directions and practical interventions to address this pressing global health challenge.

Cosmeticorexia is a provisional descriptive label, not a DSM-5-TR or ICD-11 diagnosis, for impairing skin-focused preoccupation and excessive cosmetic routines. It overlaps with body dysmorphic disorder (BDD); its proposed emphasis is a culturally sanctioned product ritual that may cause objective skin damage. The psychodynamic formulation offered here is interpretive and hypothesis-generating.

The patient was a 14-year-old girl referred after recurrent periocular dermatitis, burning, and acneiform eruptions associated with cosmetic overuse. She applied 10-12 products before school, avoided school when use was restricted, repeatedly checked and sought reassurance about skin flaws, and spent 4-5 hours daily viewing and comparing skincare content.

Dermatological assessment identified irritant contact dermatitis and acne medicamentosa. The BDDQ-DV screen was positive; clinician-derived BABS (19/24) and BDD-YBOCS-A (38/48) ratings reconstructed from routine interviews descriptively suggested marked preoccupation, repetitive behavior, avoidance, and poor insight. They were non-diagnostic, and no structured psychiatric interview was conducted. Care combined skin-barrier repair and routine simplification with psychological formulation.

This case illustrates an impairing BDD-like presentation in which cosmetic behavior and skin injury reinforced one another. It does not validate cosmeticorexia as a distinct diagnosis or establish a psychodynamic mechanism. The findings support integrated dermatological and mental health assessment while avoiding pathologization of normative adolescent grooming.