Telehealth has been proven to be an effective means of delivering psychotherapy, yet there is a lack of evidence in Vietnam where access to psychotherapy is limited. We conducted a study to evaluate the feasibility, acceptability, and preliminary efficacy of Tele-SSM-a mobile health-supported self-management intervention for depression in Vietnam.

This was a pre-post, mixed-methods study. Adults aged between 18 and 64 years old with symptoms of depression were recruited and participated in 10 individual weekly sessions delivered remotely by mental health para-professionals. Feasibility was assessed by recruitment capacity, retention, and participant compliance; acceptability by participant satisfaction ratings and in-depth interviews; and preliminary efficacy by changes in depression, anxiety, stress, suicidal ideation, self-esteem, and perceived social support scores from baseline to endline.

Seventy-five adults with depression were enrolled and 58 of those completed the intervention. Feasibility was adequate as recruitment, retention, and compliance all exceeded the predefined progression criteria. Recruitment reached 93.75% (progression criterion of ≥70%), retention was 77% (progression criterion of ≥75%), and compliance was high, with 93.1% of participants completing the intervention within the expected number of sessions (progression criterion of ≥80%). The intervention was well-accepted by participants with 96% of participants reporting satisfaction with the materials and coaching sessions. The average number of coaching calls required to deliver 10 sessions was 10.81, suggesting that the intervention may need to be implemented over 11 calls. Additional emphasis should be placed on realistic thinking and non-violent communications skills as participants reported more difficulties with these components. Exploratory pre-post analyses suggested potential improvements across depression, anxiety, stress, suicidal ideation, self-esteem, and perceived social support; however, these findings should be interpreted cautiously given that the study was not powered to assess efficacy.

These results provide promising evidence for the adequate feasibility, acceptability and preliminary efficacy of Tele-SSM on depression. The intervention also has the potential to address anxiety and stress. These preliminary insights can inform the design of a future randomized hybrid effectiveness-implementation study, particularly with regard to recruitment, retention, adherence, and potential outcome trends.

Clinicaltrials.gov, NCT06456775. Registered June 13, 2024 - Retrospectively registered, https://clinicaltrials.gov/study/NCT06456775?cond=depression&intr=Tele-SSM&rank=1.

Professional identity formation (PIF) is nurtured in medical school through the inculcation of the values, expectations and responsibilities of the profession-shaping belief systems that inform the professional identity and broader concepts of personhood. This developmental journey, however, places strain on mental health, with medical students facing higher rates of anxiety, depression and mental stress compared to non-medical peers. These experiences can impede effective PIF. Yet, studies that examine the intersection between PIF and mental health remain remiss, further compounded by the lack of research in localised, non-Western settings. To address these gaps, this study explores medical students' lived experiences with mental health challenges in Singapore, focusing on their impact on PIF.

Semi-structured interviews were conducted with 10 medical students on an oncology posting at the National Cancer Centre Singapore. Interviews were transcribed and analysed via deductive content analysis, guided by the Ring Theory of Personhood (RToP) that maps changes in belief systems across the Innate, Individual, Relational and Societal Rings.

Data analysis revealed three key domains: (1) stressors; (2) evolving self-concepts of personhood; and (3) adaptations. Medical students faced assessment-related, clinical, extracurricular and interpersonal stressors that introduced conflicts between emerging and existing belief systems. Personal adaptations to these conflicts were contingent upon the maturity of the internal compass and availability of personalised, enduring support systems. Students with a mature internal compass and rich peer, familial or collegial support engaged in healthy coping mechanisms that promoted adaptive growth in PIF. Conversely, an inexperienced internal compass and lack of support systems prompted maladaptive behaviour and placed further strain on the professional identity.

Beyond short-term well-being interventions to mitigate mental health challenges, this study highlights the importance of nurturing the internal compass through longitudinal, individualised and context-sensitive support that sustains students through their professional development. Future work can explore how such approaches may be effectively operationalised and evaluated in different cultures and clinical contexts.

Primary care physicians (PCPs) play a pivotal role in the Swiss healthcare system, serving as the first point of contact for diverse populations, including sexual and gender minorities (SGM). The collection and use of sexual orientation and gender identity (SOGI) information is increasingly recognized in public health as a tool to address health inequities. This study explores PCPs' perspectives, practices, and perceived relevance of collecting, documenting, and using SOGI information in Swiss primary care.

Semi-structured interviews with 11 PCPs in German-speaking Switzerland were conducted. The data were analysed via a hybrid thematic analysis approach that combined inductive and deductive coding, guided by the minority stress model and a health equity perspective.

The PCPs generally acknowledged the relevance of SOGI information in specific clinical contexts, particularly mental and sexual health; however, they saw limited relevance in routine care. Documentation practices were inconsistent, often informal, and constrained by binary electronic systems. Open communication was described as a facilitator, although discomfort and fear of stigmatization limited proactive inquiry. SOGI is often framed in behavioural rather than identity terms. Most participants had received little to no formal training on SGM health and expressed ambivalence about the need for further education. Structural barriers, assumptions, and lack of visibility of SGM patients further contributed to the limited use of the SOGI in clinical decision-making.

Despite the growing awareness of the SOGI as a social determinant of health, it is still rarely addressed in Swiss primary care. Addressing documentation barriers, promoting inclusive communication, and embedding SOGI-related information in medical education are critical steps toward equitable, patient-centred care.

Social prescribing aims to provide holistic care to patients and meet needs that expand beyond the biomedical model. Holistic care includes spiritual health. However, the understanding of social prescribers' attitudes towards discussing spiritual health with their patients is limited. This study aimed to understand how spiritual health currently fits into social prescribing and explore barriers and facilitators to incorporating spiritual health within social prescribing practice.

Twelve social prescribers were interviewed online, using semi-structured interviews. These interviews were an hour long and covered aspects of spiritual health within social prescribing, as well as barriers and facilitators to the discussion of spiritual health within social prescribing. Thematic analysis was used to analyse the interviews by three researchers.

Currently, social prescribers use community faith-based organisations mainly for non-spiritual holistic support, especially around practical items. They identified an overlap and limited differentiation between spiritual health and mental health. When a patient discloses spiritual health needs, social prescribers felt they were open to helping patients access help. Barriers and facilitators to the discussion of spiritual health included: viewing religion as a sensitive topic and a subsequent fear of 'deep conversations'; concern about harm or offence to vulnerable patients; social prescribers' comfort and confidence with the topic being part of their role, as well as discordance/concordance with patient beliefs.

Social prescribers appeared very open to the topic of spiritual health; however many felt more confident with non-traditional-Western spiritual activities such as yoga or meditation, and using community faith-based organisations for non-spiritual support. Bespoke training for those in primary care could address barriers to the inclusion of spiritual health in primary care, but a systemic cultural approach is needed.

Kidney transplantation is the gold standard treatment for children and young people (CYP) with stage 5 chronic kidney disease (CKD). However, psychosocial and structural factors including race, socioeconomic status and family context can delay or limit access to transplantation. This systematic review explores the breadth of psychological, social and societal factors influencing transplant access, outcomes and quality of life. We included peer-reviewed quantitative, qualitative and mixed-method studies with primary data. Medline, PsychInfo, CINAHL and Web of Science were searched for papers published in English between January 1964 and November 2022. A total of 66 studies (52 quantitative, 10 qualitative and 4 mixed-methods) were identified and analysed. A wide breadth of psychosocial factors were identified: mental health, adjustment to CKD, non-adherence, beliefs, motivation, cognitive status, family structure, family relationships, trust in or relationship with healthcare professionals, health insurance, infrastructure, education, geography, socioeconomic status (SES), social support, housing, religion or culture, national or regional wealth, migrant status-driven or racialised health inequities and kidney allocation policies. Among these studies, 13 qualified for meta-analysis regarding SES and race. CYP experiencing lower SES as a potential stressor were more likely to access deceased donor transplantation, less likely to access pre-emptive transplantation and more likely to experience allograft failure. CYP from racially minoritised groups had reduced access to living donor and pre-emptive transplantation, and higher rates of allograft loss. These inequities were often mediated by structural racism, implicit bias, allocation policies and overlapping systems of disadvantage. There is a wide breadth of psychosocial factors that influence the lived experience of CKD and access to and outcomes after transplantation. Race, as a proxy for racism, interacts with SES, geography and other social determinants through an intersectional process that deepens inequities. Some factors are modifiable at the clinical or family level, while others require systemic change. Addressing these inequities will require multi-tiered strategies, from clinician education on bias to reforms in allocation policy and broader social structures. Further studies are needed to better understand the complex relationship between these psychosocial factors and kidney transplantation outcomes. Prospero Registration. number CRD42020210506.

Women experiencing mental health disorders (MHD) have shown lower preventive mammography screening rates. Studies in veterans have shown inconsistent results and been limited to single facilities, failed to separate substance use and MHD into individual categories, and have had limited analyses on systems level covariates.

The study examined the individual associations between MHD in univariate and multivariate analyses and included adjustments for factors previously shown to impact on the rate of receipt of recommended preventive breast cancer screening.

Women veterans ages 50 through 54 receiving primary care in the Veterans Health Administration (VHA) in 2021 and 2022.

The design was an observational cohort study using health data including patient level factors and system factors. Women veterans were studied over a 2-year period and generalized liner mixed regression models examined for the association between MHD (e.g., depression, PTSD, anxiety, opioid, cannabis) on mammography.

A total of 36,720 eligible women veterans were identified in the 2-year evaluation period, of which 79.2% received preventive breast cancer screening. Depression was the most common MHD (17,798; 48.5%). In univariate analyses, depression, PTSD, and anxiety disorders were not associated with mammography receipt. For individual substance use disorders, univariate analyses revealed opioid, cocaine, cannabis, and alcohol were all significantly associated with lower mammogram rates. In multivariate models including any significant univariate person or system factors, decreased rates of mammography were associated with bipolar (OR 0.76, p < .001), schizophrenia (OR 0.62, p < .001), opioid use (OR 0.50, p < .001), and cannabis use (OR 0.77, p < .001).

Multivariate regression revealed that bipolar disorder, schizophrenia, opioid and cannabis use disorders are significantly associated with lower mammography rates while depression, anxiety, PTSD and alcohol use disorder are not.

Osteoporotic vertebral compression fractures (OVCFs) have a high incidence and seriously affect the physical and mental health of the elderly. Percutaneous curved kyphoplasty (PCKP) has been proved to be one of the safe and effective treatment methods, but its efficacy in OVCFs with different compression degrees needs to be further clarified, Especially in the treatment of moderate and severe OVCFs. To evaluate the differential early outcomes and cement characteristics of Percutaneous Curved Kyphoplasty (PCKP) in treating osteoporotic vertebral compression fractures (OVCF) stratified by Genant severity grades. In this retrospective study, 114 patients with single-level OVCF treated with PCKP were categorized into mild (Genant grade 0-1, n = 30), moderate (grade 2, n = 48), and severe (grade 3, n = 36) compression groups. Primary outcomes included Visual Analogue Scale (VAS) scores and Oswestry Disability Index (ODI) assessed preoperatively and at 2 days, 3 months, and 12 months postoperatively. Secondary outcomes encompassed cement dosage, distribution quality, leakage, and refracture rates. All groups demonstrated significant improvement in VAS and ODI postoperatively (P < 0.05). At 2 days, the moderate and severe groups exhibited superior pain relief compared to the mild group (P < 0.05), though this difference equilibrated at 3 and 12 months. Cement dosage inversely correlated with compression severity (mild: 4.63 ± 0.90 ml, moderate: 4.09 ± 0.63 ml, severe: 3.21 ± 0.49 ml; P < 0.05), while the cement leakage rate exhibited a positive correlation (mild: 13.33%, moderate: 16.67%, severe: 22.22%; P > 0.05). No significant intergroup differences were observed in excellent cement distribution (P = 0.92) or refracture rates (P = 0.90). PCKP provides significant and rapid early pain relief, particularly in moderate to severe OVCFs. While the technique achieves excellent cement distribution across all severity levels, the risk of cement leakage escalates with increasing vertebral compression, necessitating meticulous surgical technique.

Epilepsy affects 22.2% of people with intellectual disability compared with 1% of the general population. This study aims to identify characteristics associated with epilepsy-caused deaths in adults with intellectual disability and epilepsy in England.

We conducted a retrospective population-based analysis of all deaths of adults with intellectual disability and epilepsy reviewed by the English Learning from Lives and Deaths programme (2016-2021). Deaths were classified by whether epilepsy was the primary cause or not. Demographic, clinical and care-related variables were analysed using multivariable Cox regression for associations with age at death and factors linked to epilepsy-related mortality.

Epilepsy was the primary cause of death in 1584 (16.2%) of 9756 deaths of people with intellectual disability and epilepsy. These individuals died at a significantly younger median age than those who died of other causes (56 vs 62 years; p<0.001). Epilepsy and non-epilepsy-related deaths in this population were more common among people with moderate-to-profound intellectual disability (p<0.001) and those of African or Asian ethnicity (p<0.001). Risk factors included poor quality of care, service gaps and lack of annual health checks (p<0.001). Psychiatry and speech and language therapy (SALT) input was protective.

Epilepsy-related deaths in intellectual disability may cause earlier mortality because of pervasive health inequalities and missed prevention opportunities. Targeted interventions, including annual health checks, improved multidisciplinary care access, improved inclusion of ethnic minorities, and integration of specialist psychiatric and SALT support may increase length of life. Systemic service redesign is required to reduce avoidable epilepsy-related mortality.

As of 2021, Ohio Community pharmacists can enter into collaborative practice agreements to solve drug-related problems related to medication access, drug safety, and improve workflow for both community pharmacists and healthcare providers.

The primary objective is to describe and quantify the usage of the Community Collaborative Practice Agreement (CPA) at 5 community pharmacies within an integrated clinic. The secondary objective is to evaluate the impact of the Community CPA on pharmacists and other providers at the practice.

This study was conducted at 5 community pharmacies within a clinic throughout Ohio that provides primary care, pharmacy, dental, mental health, and social services.

A Community CPA covering 8 conditions under which pharmacists may prescribe medications and durable medical equipment to solve drug-related problems was implemented at 5 community pharmacies in Ohio.

A retrospective review of prescriptions written by pharmacists was conducted to assess the primary objective. A survey was created and completed by pharmacists and healthcare providers at the practice sites to assess the secondary objective.

A total of 954 prescriptions were written by the pharmacists. The conditions most frequently written for include gender affirming care (629, 65.9%), diabetes (219, 23%), and asthma/chronic obstructive pulmonary disease (87, 9.1%). The average number of prescriptions written per month was 80 in the first year. Overall, a majority of pharmacists and providers agreed or strongly agreed that the Community CPA improved access to medications and patient safety. Workflow impact varied depending on the pharmacist or provider.

The Community CPA allows pharmacists to take a more active role in providing access to medications and improving patient safety while minimally impacting workflow. This type of innovative practice may help other pharmacists improve medication access and patient safety while maintaining workflow efficiency.

Substance use and substance use disorders (SUD) disproportionately affect people with disabilities (PWD), yet PWD remain under-represented in addiction treatment literature. While recent work has begun to address SUD prevalence and recovery service gaps, little is known about how disability status shapes substance use outcomes. The present study is the first to our knowledge to investigate how recovery, mental health comorbidities, and barriers to care differ across disability status using structured survey data from people who use substances.

333 participants who use substances and provided information about their disability status in the baseline survey for a digital intervention study were included in the analysis (Mean_Age: 41.1 (10.6); 58.0 % female; 68.2 % White). Bivariate analyses-independent sample t-tests and Chi-Square tests-were conducted to examine differences across disability status in recent substance use patterns, mental health comorbidities, recovery history, and barriers to treatment. Multivariable regression models were used to assess associations between disability status and variables of interest, adjusting for socio-demographic covariates.

Of the participants, 34.2 % reported having a disability (n = 114). PWD were more likely to be of color, unemployed, insured, and older, compared to those without disabilities (n = 219; ps ≤0.001). Regression analyses indicated that PWD had significantly higher odds of using cannabis, alcohol, stimulants, and other drugs over past 30-day (aORs ranged 2.22-2.30). PWD also had higher odds of endorsing depression, anxiety, and lifetime suicide attempts (aORs ranged from 2.39 (anxiety) to 3.38 (depression)). Additionally, PWD perceived more barriers to substance use treatment (β: 0.55 (0.24)) and reported more overdoses (aOR (95 % CI): 2.60 (1.49, 4.54)) and prior recovery attempts (aOR: 2.69 (1.55, 4.68)), compared to those without disabilities.

This study is among the first to use quantitative survey data to assess and compare substance use and treatment engagement among PWD and their non-disabled peers. Findings underscore urgent equity gaps in SUD treatment systems and the importance of incorporating disability-informed frameworks in clinical assessments and recovery services. These insights complement recent qualitative findings and emphasize the need for inclusive, accessible, and person-centered care approaches in substance use health services and research.