Despite global commitments to universal health coverage and the Sustainable Development Goals (SDGs), particularly SDGs 3, 4, 5, and 10 by 2030, adolescents and young people with disabilities (AYPWD), including those with long-term physical, sensory, speech, intellectual, or mental impairments, face persistent barriers to accessing sexual and reproductive health (SRH) services (including antenatal care, contraception, family planning) in low- and middle-income countries. Evidence from Ghana remains limited. This study assessed accessibility and predictors of SRH service utilisation among AYPWD aged 15-24 years in Ghana's Bono Region.

A community-based analytic cross-sectional survey was conducted among 440 AYPWD selected using multi-stage random sampling across urban and rural districts. Data were collected using structured questionnaires capturing sociodemographic characteristics, disability profiles, SRH service utilisation, and structural and perceived accessibility indicators. Descriptive statistics summarised patterns of service use, while logistic regression models identified predictors of SRH service access and perceived ease of access. Statistical significance was set at p < 0.05.

Of the 440 respondents, most were female (62.0%), urban residents (80.7%), and aged 20-24 years (52.3%). Access to personal hygiene information was high (82.5%), whereas utilisation of contraceptive information (22.0%), sexually transmitted infection (STI) screening and treatment (32.0%), human immunodeficiency virus (HIV) testing (13.0%), safe abortion information (7.7%), and antenatal care (2.7%) was low. Females had significantly higher odds of accessing contraceptive information (AOR = 4.55; 95% CI: 2.43-8.50; p < 0.001) and menstrual health support (AOR = 13.42; 95% CI: 7.76-23.19; p < 0.001). Respondents with visual (OR = 0.15; 95% CI: 0.09-0.26; p < 0.001) and hearing disabilities (OR = 0.45; 95% CI: 0.25-0.81; p = 0.008) reported greater service-quality barriers, while visual disability was also associated with reduced perceived ease of access (OR = 0.50; 95% CI: 0.29-0.86; p = 0.013).

SRH service utilisation among AYPWD in the Bono Region remains low and is shaped by gender, disability type, and structural and socioeconomic factors. Strengthening disability-inclusive infrastructure, communication support, gender-responsive programming, and targeted financing mechanisms is essential to improve equitable access and advance progress toward universal health coverage in Ghana.

The aims of this study were to examine whether there are distinct biopsychosocial phenotypes among children with drug-resistant epilepsy (DRE) and to determine whether these phenotypes are related to the longitudinal trajectories of child, parent, and family outcomes after epilepsy surgery compared to medical treatment.

This prospective cohort study recruited children with DRE aged 4-18 years who were evaluated for epilepsy surgery and their parents. Baseline clinical variables, child characteristics, parent depressive and anxiety symptoms, and family factors (household income, family demands, family resources, and satisfaction with family relationships) were used to identify distinct phenotypes using hierarchical k-means clustering. The trajectories of child health-related quality of life (HRQOL), parent depressive and anxiety symptoms, family resources, and satisfaction with family relationships over 2 years in the surgical and medical treatment groups were compared across the phenotypes using linear mixed models.

There were 105 surgical and 197 medical patients. Three distinct biopsychosocial phenotypes were identified among children with DRE: the psychosocial vulnerability phenotype had the poorest psychological and social (family) functioning, the well functioning phenotype had substantially better clinical and psychosocial functioning, and the neurological burden phenotype demonstrated the highest seizure burden and intermediate psychosocial functioning. The most pronounced improvements in child HRQOL, parent emotional functioning, and family functioning over time were observed among those with psychosocial vulnerability, especially after epilepsy surgery. The well functioning and neurological burden phenotypes showed more limited change across most outcomes in both treatment groups.

Identifying biopsychosocial phenotypes may enhance prediction of child, parent, and family outcomes and identify children and families who could benefit from targeted interventions. Despite experiencing more psychosocial disadvantages, the psychosocial vulnerability phenotype demonstrated the largest improvement in outcomes following surgery, suggesting that surgical treatment has the potential to promote more equitable psychosocial outcomes, alongside clinical and HRQOL outcomes.

Immunosuppression of various origins is associated with an increased risk of infections and infection-triggered morbidity and mortality. Vaccination, therefore, plays a central role in the care of immunosuppressed individuals by protecting against vaccine-preventable diseases.Based on the available evidence as well as immunological and theoretical considerations, an expert statement on vaccination in immunocompromised individuals was first formulated in 2016. These recommendations have herewith been comprehensively updated and expanded. The aim is to provide a practice-oriented, indication- and therapy-specific guidance document for clinical care. A practical chart accompanying the present vaccination recommendation, which also functions as a decision tree for implementation, facilitates orientation within the document.The document includes an introductory section outlining fundamental aspects of immunosuppression and addressing immunological and organizational issues relevant to vaccination planning, application, and control of vaccination responsiveness. In addition, current developments regarding relevant vaccines are reviewed.Subsequently, a systematic overview of immunosuppressive agents commonly used across medical specialties is provided. These agents are categorized according to their degree of immunosuppression and the associated infection risks. Standardized vaccination schedules are provided and assigned to the respective drug classes to facilitate a structured approach in clinical practice. The decision on vaccination eligibility of these patients can only be made based on a comprehensive assessment of the underlying disease and the planned or ongoing immunosuppressive therapy.Special clinical situations-including circumstances in which vaccination cannot be performed, as well as travel-related vaccinations in the context of immunosuppression-are addressed in separate chapters. To ensure long-term relevance, the document refers to continuously updated external sources throughout, which are compiled at the end.This document acts as general recommendation without a claim of completeness. The specific procedure in clinical practice can be adapted to the clinical context, and the reader is referred to the respective professional societies.

Climate change is increasingly recognised as a significant threat to mental health, particularly among younger populations. Despite growing research attention, systematic syntheses of this emerging field still remain limited. This scoping review examined the prevalence of these emotional responses and their associations with mental health outcomes and related factors. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guidelines, we systematically searched APA PsycInfo, PubMed, and Web of Science for studies published before December 2025. Eligible studies reported quantitative data on climate anxiety, concern, distress, or worry in community samples of individuals under the age of 25. A total of 51 studies met inclusion criteria. Prevalence estimates for the four constructs varied widely, ranging from 18% to 90%, reflecting inconsistencies in definitions and measurement tools. The available evidence suggests that climate-related anxiety and worry may be positively associated with reduced mental wellbeing, as well as with symptoms of depression and generalised anxiety disorder. Age, gender, socioeconomic status, place of residence, education level, climate change knowledge and exposure, and participation in climate action emerged as potential influencing factors. Future research using standardised measures and longitudinal methods, particularly in younger children, is needed to clarify the direction of these relationships and distinguish between adaptive and maladaptive responses. As the climate crisis continues to unfold, addressing its psychological impacts, especially on vulnerable populations, must become a public health priority.

Occupational Takotsubo syndrome ("broken heart syndrome") has been reported very rarely, and only twice among healthcare personnel; the present case being, to our knowledge, the third documented occurrence. Here, we describe the case of a 57-year-old female neonatologist who developed the syndrome after 2 years of intense work-related stress, culminating in the management of a particularly delicate emergency. The diagnosis was made through cardiac imaging techniques that demonstrated the typical deformation ("ballooning") of the left ventricle that gives the syndrome its name (takotsubo in Japanese means "octopus trap"). The case draws attention to the risk of Takotsubo cardiomyopathy as a consequence of intense work-related psychophysical stress and to the need for hygiene and organizational measures to prevent both mental and cardiological disorders. Female emergency physicians should be considered a professional category at greater risk of developing the syndrome.

This systematic review examined two questions regarding youth mental health intervention research: (1) how is co-design practiced? (2) what clinical and implementation-related outcomes are reported? Eligible studies were primary research published from 2008 involving youth aged 15-24 years co-designing mental health interventions. Studies were excluded if they were descriptive only, focused on prevention/screening, involved only adult perspectives, or were grey literature, conference proceedings, dissertations, or protocols. We searched seven databases (Medline, PsycINFO, CINAHL, Scopus, Global Health, EMBASE, Cochrane) using terms mapped to youth, co-design, mental health, and interventions, and conducted a narrative synthesis. Study quality was independently assessed by two reviewers with discrepancies resolved through consultation. Fifty-eight studies were included, predominantly from high-income, English-speaking settings, with a majority of qualitative (57%) and mixed-methods (36%) designs. Co-design typically involved small-group workshops with youth in consultative roles focused on adapting content or design. Over half of the studies did not report an explicit theoretical framework, and few examined relational dynamics within co-design. Only 12 studies evaluated mental health outcomes, with most reporting moderate-to-large improvements. Implementation outcomes were reported in 38% of studies, with generally high usability, engagement and improved alignment with user needs. Co-design evidence remains limited by inconsistent reporting and lack of rigorous outcome evaluation.

This study reports the development of the 8-item NIMHANS-NMHS-2 Disability Scale-Short Version (NNDS-SV) from the 13-item NIMHANS-NMHS-2 Disability Scale (NNDS), aiming to reduce the administration time without compromising its psychometric properties.

An 8-item version was derived from the original 13-item NNDS via expert consensus and high response frequencies. Secondary analysis of the original validation data examined correlations between the NNDS-SV with the NNDS, WHO Disability Assessment Schedule (WHODAS 2.0), and the Brief Psychiatric Rating Scale (BPRS). Independent clinical validation of the NNDS-SV was then undertaken.

In secondary analysis, the NNDS-SV correlated strongly with the NNDS (rho = 0.988), WHO-DAS (rho = 0.918), and BPRS (rho = 0.792). Independent clinical validation (n-81) confirmed high concurrent validity with WHODAS (rho = 0.94) and discriminant validity with BPRS (rho = 0.80) with a reduced administration time of 4-6 minutes.

The NNDS-SV demonstrates robust psychometric properties and is optimized for large-scale epidemiological studies and has been used in NMHS-2.

The global research has actively investigated the post-COVID neuropsychiatric symptoms (PCNS). There is a paucity of studies from India that explore long-term PCNS.

This study aims to estimate prevalence, types of PCNS, associated factors (sociodemographic factors, life events, COVID-19-related variables, and vaccination status) and persistence of PCNS after two years.

A cross-sectional study was conducted from October 2022 to October 2023 in a tertiary care hospital. A total of 2,281 randomly selected individuals with reverse transcription polymerase chain reaction-positive for COVID-19 were screened for PCNS. Among 927 participants consented to and completed the telephonic screening for PCNS. Structured clinical interviews for DSM-5-Research Version and World Health Organization-Post-COVID Case Report Form were applied. Descriptive statistics and binary logistic regression analysis were used for data analysis.

Median age of individuals was 34 years, and 51.3% being female. Only 21.6% had lifetime PCNS, and 7.3% had persistent PCNS at two years of COVID-19. The common lifetime PCNS were persistent fatigue (15.6%), reduced smell (5.9%), reduced taste (4.8%), anxiety (4.3%), insomnia (3.6%), depressed mood (2.6%), cognitive symptoms (2.6%), and persistent muscle pain (2.6%). The logistic regression analysis revealed a positive association of lifetime PCNS with female gender, preexisting medical comorbidities, symptomatic COVID-19, oxygen supplementation, repeated infections, and life events. Full or partially vaccinated against COVID-19 appeared to be protective against PCNS.

About one in five individuals developed lifetime PCNS following COVID. Among them, one in three had persistent PCNS after two years of COVID. Female gender, life events, severity of COVID-19, repeated infection, and Vaccine-naïve status were associated with the development of PCNS.

Parents of children with intellectual disability (ID) are concerned about the care of their wards after their death or incapacitation. Most literature originates in high-income countries, which have greater resources and distinct cultural and socioeconomic contexts. There is a need for Indian literature.

To explore the concerns and plans of parents regarding the future of their wards with mild ID when they can no longer care for them.

The study was conducted in a tertiary care hospital in Bengaluru, India. Both parents of four men and four women with mild ID (referred to as 'ward' from here on) who had future caregiving concerns were interviewed using a semi-structured interview schedule. All 16 interviews were translated and transcribed. Thematic analysis was done using the Braun and Clarke approach. Atlas-Ti software, version 9, was used.

Parents were concerned about identifying a prospective guardian, the ward's safety, and future care. Parental concerns are influenced by individual factors (including the degree of supervision required for daily activities, behavioral problems, and physical health of the ward), parental factors (such as age, physical health of the parents, coping strategies, and awareness about ID), family factors (including sibling relationship and attitude of father), and environmental factors (such as attitude toward the ward with ID and COVID-19). Most parents had a financial plan, preferred to keep guardianship a family affair, and considered residence and occupation/employment after their lifetimes.

Caregiving concerns and plans did not differ between parents. They were influenced by the parents' financial position, how society perceived the ward, independence, and behavioral issues. Parents preferred a family member, usually the neurotypical sibling, as the guardian, but many hadn't explicitly discussed guardianship with them or initiated legal procedures.

Suicidal ideation during pregnancy constitutes a significant public health concern due to its serious consequences for both the mother and the fetus. Despite its relevance, the accurate assessment of this construct in pregnant women remains limited, particularly in Latin American contexts. In this regard, having psychometrically sound and culturally appropriate instruments is essential for early detection and timely intervention.

To analyze the psychometric properties of the Frequency of Suicidal Ideation Inventory (FSII) in pregnant women.

A total of 962 Peruvian pregnant women participated, completing a sociodemographic questionnaire, the Frequency of Suicidal Ideation Inventory (FSII), the Athens Insomnia Scale (AIS), the Patient Health Questionnaire-2 (PHQ-2), and the Generalized Anxiety Disorder-2 (GAD-2). Structural equation modeling, Bayesian reliability, and item response theory were applied for statistical analysis.

The FSII demonstrated adequate content validity (V > 0.70), a unidimensional structure [CFI = 0.99, TLI = 0.99, RMSEA = 0.07 (90% CI: 0.050, 0.099), SRMR = 0.01], and high reliability (ω = 0.94, H = 0.98). Additionally, factorial invariance was supported according to pregnancy planning status, and significant positive associations were found with depressive symptoms, generalized anxiety, and insomnia. Item 4 showed the highest discrimination and information, and the scale proved to be most precise at higher levels of suicidal ideation.

The FSII shows adequate psychometric properties that support its factorial structure and reliability for interpreting scores in Peruvian pregnant women. Evidence of factorial invariance by pregnancy planning and its utility at higher levels of suicidal ideation further support its use in this population. Therefore, its application is recommended in both clinical practice and research, contributing to the detection and prevention of suicidal risk during pregnancy.