Midwifery work is both challenging and rewarding. Midwifery is emotionally demanding, and peer support is thought to help midwives process distressing experiences such as traumatic births, perinatal loss, or professional conflict. Whilst there is evidence of preceptorship, mentoring, and clinical supervision in midwifery, the ways in which midwives give and receive peer support are not well understood.

To examine the evidence regarding the use of peer support by midwives and to map the evidence, focusing on knowledge gaps, to inform further research on how to best support midwives.

A scoping review was undertaken through four databases that index midwifery-related research. Peer-reviewed papers in English were sourced. Two midwifery researchers independently screened all titles and abstracts, then selected full texts. This was undertaken in Covidence. A thematic synthesis was undertaken in the selected papers.

Thirty articles met the inclusion criteria. The acronym 'Strive' was developed to represent the key concepts of peer support for midwives, including Setting (context), Trauma, Relationships, Institutional support, Validation (emotional support), and Engagement (team/managerial).

'STRIVE' conveys an active, aspirational tone when the workplace setting or context is recognised, trauma may be minimised, positive relationships with the inter and intra professional team are built, institutional policies and practices support midwives, experiences perceived as stressful are validated through emotional support within the team, and the team and management are engaged in creating the positive environment and building social capital. Peer support may be enhanced if midwives are provided with education on mental health and well-being in the workplace.

Positive peer support is a necessity, not an indulgence, if we are to build a strong, resilient workforce and retain the midwifery workforce.

Pathogenic variants in TSPOAP1, encoding RIMBP1, cause ultra-rare autosomal recessive dystonia (DYT-TSPOAP1/DYT-22), with only two reports worldwide. Clinical features include upper-segment-predominant dystonia, intellectual disability, eye movement abnormalities, and cerebellar atrophy. We describe two unrelated patients with adolescent-onset generalized dystonia showing cranio-caudal progression due to novel truncating variants in the TSPOAP1 gene.

Cognitive impairment represents one of the core features of schizophrenia, with an important negative impact of psychosocial functioning and limited pharmacological treatment options. However, psychosocial interventions targeting cognitive performance appear to provide significant benefits.

The aims of the present randomized controlled trial were to compare two evidence-based approaches to treat cognitive impairment and a control condition.

A total of 132 individuals diagnosed with schizophrenia were allocated to three treatment arms: a Cognitive Remediation intervention (Integrated Neurocognitive Therapy - INT, n = 53), Physical Exercise (PE, n = 37), and Treatment As Usual (TAU, n = 42) and assessed at the beginning and at the conclusion of the treatment period (15 weeks) with measures of symptoms severity, cognitive performance, and psychosocial functioning.

Significant between-groups post-treatment effects were observed for Executive Functions, Social Cognition, and Global Cognitive Performance. Post-hoc analyses showed the superiority of INT over TAU on Executive Functions and Global Cognitive Performance. The superiority of INT over PE in Executive Functions and Social Cognition also emerged in the post-hoc analyses. No significant between-groups differences were observed regarding symptoms severity and functional outcomes.

The results of this study confirm the effectiveness of cognitive rehabilitation, and in particular of INT as an evidence-based treatment for outpatients diagnosed with schizophrenia. Even though the effects on the outcomes in this study observed for PE were not statistically significant, the PE intervention might represent a valid approach in rehabilitation settings.

This study evaluated the effectiveness of Adoption-Specific Therapy (ADAPT), in improving outcomes among adoptive families in Iran. Thirty adoptive families were initially recruited, and 25 families who completed both pre- and post-test assessments with children aged 7 to 12 were randomly assigned to either the ADAPT group (n = 12) or a control group (n = 13). The ADAPT intervention included 34 sessions over 20 weeks (14 for the child, 14 for the parents, and 6 joint sessions), focusing on adoption-related issues, attachment, identity development, and the parent-child relationship. Post-test assessments were conducted immediately after the 20-week intervention using the Child Behavior Checklist (CBCL; primary outcome), Kinship Center Attachment Questionnaire (KCAQ), and Parenting Stress Index (PSI). The ADAPT group showed significantly greater improvement than controls on the CBCL (F(1,22) = 6.09, p = .022, partial η² = 0.22) and KCAQ (F(1,22) = 5.45, p = .029, partial η² = 0.20). For the PSI, while ANCOVA showed significance (F(1,22) = 6.20, p = .021, partial η² = 0.22), this was not confirmed by non-parametric testing (U = 57.00, p = .347). These results provide preliminary evidence for the potential of ADAPT as a culturally responsive and trauma-informed intervention for Iranian adoptive families.

To establish effective interventions, it is important to clarify the mental health characteristics of students visiting counseling centers. This study analyzed the Counseling Center Assessment of Psychological Symptoms (CCAPS) scores of Japanese university students. We examined 414 students on their first visit to the student counseling center at X University. The participants completed the CCAPS-Japanese immediately before meeting the clinical psychologists. We employed MANOVA and independent sample t-tests to explore the relationships between sex or grade level and CCAPS-Japanese scores. Male students reported higher levels of academic distress, alcohol use, and critical items, whereas, female students exhibited higher scores for eating concerns and family distress. Second- and fourth-year students reported high academic distress, whereas fourth-year students reported low levels of eating concerns. Second-year students had the highest hostility scores, and third-year students reported the highest alcohol use. First-year students scored higher on thoughts about hurting other people. These variations in psychological symptoms indicate the need for tailored mental health support strategies that consider the specific challenges faced by students at different academic stages and the distinct experiences of male and female students. By addressing these factors, university counseling services can enhance support strategies, contributing to improved student well-being and success.

Breastfeeding offers substantial positive health outcomes for both the mother and infant and has been identified as one of the most effective strategies for promoting infant health; however, the United States falls short in sustained breastfeeding rates. Additionally, with mental health conditions and substance use during pregnancy and the postpartum period affect nearly 1 in every 5 women in the U.S., more research is needed to better understand how these behavioral health factors, along with the co-occurrence of these factors, impact breastfeeding trends.

Cross-sectional data from the Virginia Pregnancy Risk Assessment Monitoring System (PRAMS) from 2016 to 2022 were analyzed to assess how maternal mental health and tobacco use before, during, and after pregnancy was associated with breastfeeding duration in Virginia mothers (n = 5,704).

The simultaneous presence of depression and anxiety symptoms was negatively associated with breastfeeding duration; those who reported both depression and anxiety breastfed their infants nearly three weeks less (M = 10.45, SD = 7.82) than those who reported neither (M = 13.34, SD = 7.76, p < .001). The more timepoints a mother reported depressive symptoms (before, during, and after pregnancy) was associated with statistically significant decreases in average breastfeeding duration (p < .001). Mothers who reported smoking at any timepoint breastfed their babies nearly six weeks less (M = 7.63, SD = 7.49) than mothers who did not smoke (M = 13.4, SD = 7.71, p < .001). However, among smokers, statistically significant improvements in breastfeeding duration were found in those who took initiatives to quit smoking during pregnancy (p < .001). Receiving breastfeeding support from a lactation specialist was protective, especially in smokers, as those who met with a lactation consultant had 3.53 times the odds (95% CI: 2.30, 5.43) of breastfeeding at least 12 weeks. Marital status was also protective, as married women breastfed their infants more than a month longer (M = 14.22, SD = 7.11) than non-married women (M = 9.82, SD = 8.49). Additionally, smoking was associated with shorter breastfeeding duration for those with high anxiety (p = .03), particularly among non-Hispanic Whites, Medicaid enrollees, and mothers with a high school diploma or less.

Enhanced smoking cessation, lactation support, and behavioral health services may be important for promoting breastfeeding among new mothers.

Social Anxiety Disorder (SAD) significantly impairs emotional regulation in adolescent girls, often manifesting as elevated levels of depression, anxiety, and stress. Given the limited efficacy of pharmacological treatments, this study aimed to evaluate the effectiveness of immersive virtual reality (VR)-based extreme sports as a non-pharmacological intervention for reducing depression, anxiety, and stress in this vulnerable population. A quasi-experimental design with pre-test and post-test assessments was employed, involving 130 adolescent girls diagnosed with SAD, who were randomly assigned to intervention and control groups (n = 65 each). Emotional states were measured using the Depression, Anxiety, and Stress Scale (DASS-21). Levene's test confirmed homogeneity of variance, and the Kolmogorov-Smirnov test indicated normal distribution. Between-group differences were analyzed using ANCOVA, controlling for baseline scores. Results demonstrated that the intervention group exhibited significantly greater reductions in depression (F = 42.18, p < .001, η² = 0.248), anxiety (F = 48.92, p < .001, η² = 0.277), and stress (F = 45.63, p < .001, η² = 0.263) compared to the control group. These findings suggest that immersive VR-based extreme sports represent a promising, non-pharmacological approach for alleviating depression, anxiety, and stress in adolescents with SAD. By offering a safe and engaging virtual environment, this intervention may enhance emotional resilience, mitigate psychological distress, and contribute to the development of accessible digital tools for youth mental health promotion programs.

Adoptive immunotherapy with third-party virus-specific T lymphocytes (VSTs) is effective against refractory viral infections. However, its long-term efficacy and persistence must be enhanced. T memory stem cells (TSCMs) with superior self-renewal and multilineage differentiation potential may enhance VSTs durability, although their antiviral capacity is underexplored. Cytomegalovirus (CMV)-and Epstein-Barr virus (EBV)-specific T cells are enriched with CD8⁺ TSCM through cytokine and peptide stimulation. Comprehensive preclinical evaluations show that purified TSCM-VSTs exhibit reduced exhaustion, enhanced expansion, and stronger antiviral activity than central or effector memory VSTs (TCM or TEM). Transcriptomic and epigenetic analyses show significant enrichment of the MAPK and Wnt signaling pathways, consistent with stem-like characteristics. In a murine model, CD8⁺ TSCM VSTs provide more effective protection against Raji-pp65 tumors than TCM or TEM VSTs. In a phase I clinical trial, 10 patients with refractory CMV or EBV infections post-transplant who received third-party, off-the-shelf TSCM-enriched VSTs show a 100% overall response rate and 70% complete response, with persistence up to 12 weeks and no severe adverse events. These findings support TSCM-enriched VSTs as a potent, scalable antiviral immunotherapy and highlight TSCM proportion as a critical determinant of VSTs efficacy.

Heart failure (HF) imposes a growing public health and macroeconomic burden in low- and middle-income countries (LMICs), yet its long-term economic impact remains unquantified. China, characterized by rapid ageing and escalating cardiovascular risks, provides a critical setting to model HF economic implications.

Using data from the Global Burden of Disease Study 2021, China Cardiovascular Association Registry, and national insurance databases, HF macroeconomic burden (2025-35) was projected via a health-augmented macroeconomic model. Three interventions were evaluated: B-type natriuretic peptide (BNP) screening (adults ≥40 years), intensive blood pressure (BP) control (hypertensive patients), and guideline-directed medical therapy (GDMT) optimization for HF with reduced ejection fraction. Costs are reported in 2017 international dollars (INT$).

By 2035, HF cases in China will reach 22.7 million [95% uncertainty interval (UI): 9.5-36.9 million], with an age-standardized prevalence of 760.65/100 000 (95% UI: 283.2-1340.8/100 000). The cumulative economic burden (2025-35) is INT$1001.1 billion (95% UI: 733.4-1365.6 billion), representing 0.26% of gross domestic product (95% UI: 0.19%-0.34%), driven by labour force attrition (72.1%; 95% UI: 64.4%-74.8%). Interventions reduced the total burden by 12.5% (95% UI: 10.4%-14.5%): BNP screening (25% coverage) saved INT$78.5 billion (95% UI: 62.8-94.1 billion; 8.10% reduction; cost-benefit ratio 0.49), Intensive BP control saved INT$27.5 billion (95% UI: 25.1-29.9 billion; 2.74% reduction; ratio 0.22), GDMT optimization saved INT$17.0 billion (95% UI: 12.8-22.4 billion; 1.70% reduction; ratio 0.48).

HF imposes a substantial and increasing macroeconomic burden in China, largely through workforce productivity losses. Scalable, cost-effective strategies, including primary care-based BNP screening, subsidized hypertension control, and enhanced GDMT adherence, are essential to curb economic losses. These findings inform policy priorities for China and other LMICs confronting demographic transitions.

We investigated the perception and attitudes of health care providers who manage patients with diabetes mellitus on the routine employment of an oral health assessment tool (OHAT) in diabetes management. A survey was conducted among health care providers practicing in underserved areas (N=54). Most providers acknowledged that oral health has an impact on diabetes, with participants identifying poor periodontal health as a contributing factor, and that untreated periodontitis influences patients' response to diabetes therapy. Conversely, health care professionals responded in the affirmative that blood glucose levels affect oral health, and the status of periodontal health and maintenance differs between patients with diabetes and other patients. Most providers also acknowledged that their institution currently has no OHAT for patients with diabetes. Despite this, most health care professionals are willing to incorporate an OHAT in their current diabetes self-management education curricula.