There remains a widespread lack of knowledge regarding hidradenitis suppurativa (HS) among physicians in the United States, impeding timely diagnosis and implementation of comprehensive treatment interventions. Despite the presence of supporting communities for affected adolescents and their caretakers, the overall awareness of HS remains low, and a greater consensus on the treatment of HS is needed. Current research highlights the lack of standardized pediatric guidelines for treatment of HS largely due to the varied nature of the disease and limited efficacy of current therapies. Our study aims to explore the relationship between the chronic skin condition HS and social-emotional concerns, mental health, and physical health issues in US children and adolescents. Using the Arksey and O'Malley framework and PRISMA-ScR reporting, we searched PubMed/MEDLINE, Scopus, Web of Science, Cochrane Library, and Embase for U.S. studies (2015-2025) on pediatric HS (<18 years) and social-emotional, mental health, or quality-of-life outcomes. Recommendations were synthesized, and study quality was appraised with CASP checklist methods and rigor. Ten studies (2020-2025) met inclusion criteria. Pediatric HS was associated with depression, anxiety, social withdrawal, shame, low self-esteem, and reduced quality of life. Physical comorbidities increased psychosocial burden. Socioeconomic and racial disparities worsened outcomes and access to care. Studies emphasized early diagnosis, routine screening, multidisciplinary management, and disparity-focused interventions. Findings may inform clinical practice and guide research initiatives aimed at improving outcomes for children and adolescents with HS.

Background: Atopic dermatitis (AD) is a chronic inflammatory skin disease with a relapsing course and a substantial multidimensional burden. Conventional clinical and patient-reported outcome measures mainly provide cross-sectional evaluations and may not fully capture the long-term impact of the disease. The concept of cumulative life course impairment (CLCI) has been proposed to describe the progressive and lifelong consequences of chronic dermatologic conditions. Methods: This narrative review is based on a non-systematic literature search conducted in PubMed/MEDLINE and Embase up to July 2026. Relevant studies addressing quality of life, mental health, comorbidities, and economic burden in AD were identified and narratively synthesized, with particular focus on evidence supporting the CLCI framework. Results: AD exerts a cumulative burden across multiple domains. Pruritus and sleep disturbance emerge as key drivers, contributing to a self-reinforcing cycle involving psychological distress and impaired daily functioning. Increased rates of anxiety and depression, along with social stigmatization, negatively affect interpersonal relationships, educational attainment, and work productivity. Comorbidities and the chronic relapsing nature of AD further amplify long-term impairment. Economic burden, including both direct and indirect costs, acts as both a consequence and a driver of cumulative disadvantage. Recurrent disease flares play a central role in sustaining and amplifying this trajectory over time. Conclusions: AD should be considered a life-course disease in which interacting biological, psychological, and social factors shape long-term outcomes. A CLCI-oriented approach may improve patient stratification and support earlier, multidisciplinary, and proactive management strategies aimed at reducing long-term burden and improving overall outcomes.

Background/Objectives: Young people's mental health is increasingly discussed using diagnostic terms. However, limited knowledge exists about how young people describe distress and support needs. This study explored how young people with self-reported functional difficulties described challenges affecting their mental health and everyday lives. Methods: A qualitative study was conducted using 137 anonymized chat and text message contacts from BRIS (Children's Rights in Society), a Swedish youth helpline. Contacts registered within the category "Functional Impairments" were selected through predefined inclusion criteria. The material was analysed in Swedish using Framework Analysis. Results: One overarching theme, Trying to Survive in an Emotional Storm, was identified, comprising three subthemes: Social Environment-Between Norm Pressure and the Need for Support, A Constant Struggle in the Educational System and Insufficient Parental Support-Between Desire for Help and Barriers to Understanding. Young people described challenges related to social relationships, school demands, and limited support from adults. Self-reported diagnostic labels, particularly ADHD, were used to explain and communicate distress. Conclusions: The findings suggest that distress was closely linked to social and contextual circumstances. For nurses and other mental health professionals, the findings highlight the importance of listening to young people's narratives and supporting participation, autonomy, and meaning-making.

Background/Objectives: While there is an existing body of quantitative data on the psychological and mental burden of suicide-bereaved parents, further qualitative research is needed to explore suicide-bereaved mothers' living experiences in specific sociocultural contexts, especially in Southern Europe and the Eastern Mediterranean. Given the persistent stigma surrounding suicide in these societies, and the fact that previous research has often overlooked mothers' perspectives in favor of broader samples of bereaved parents, we explored the psychosocial needs of Greek-speaking suicide-bereaved mothers in the Republic of Cyprus, and their experiences in accessing formal mental healthcare support. Methods: An inductive, secondary content analysis of qualitative data collected through personal semi-structured interviews with ten suicide-bereaved mothers was employed. Results: Participants' psychosocial needs centered around a "persistent orientation towards protection," encompassing three interconnected domains: (1) self-protection and the need for acceptance by shielding themselves from stigma, social judgment, and emotional disintegration, (2) ensuring a safe and protective environment for the surviving family by safeguarding the psychological well-being and cohesion of surviving family members, and (3) protecting the posthumous dignity and memory of the deceased child. Rather than seeking formal support, participants overwhelmingly avoided mental health services, citing a lack of empathy, cultural misunderstanding, and fear of further stigmatization. Mental health professionals were often perceived as inadequate or even harmful, undermining participants' need for protective attitudes, self-reliance and self-respect during bereavement. These responses reflected how stigma and gendered social expectations surrounding suicide shaped participating bereaved mothers' disengagement from the healthcare system, despite their intense psychological needs. Conclusions: These findings underscored how gendered social expectations, combined with the stigma surrounding suicide, created significant psychosocial barriers to mental health care for women navigating traumatic grief, particularly in sociocultural contexts where suicide remains highly stigmatized.

Background/Objective: The Behavioral and Mental Wellness in Indigenous Communities (BMWIC) education program was created to address mental health (MH) resource gaps in the Fort Belknap Community (FBC). Designed to enhance MH literacy, task-shifting capacity, and MH care coordination skills, the FBC partnered with Johns Hopkins School of Nursing (JHSON) to co-develop a culturally aligned MH training program. This protocol outlines the development of the BMWIC curriculum. Methods: Steps 1-5 of the 6-step Collaborative Participatory Adaptation Model (CPAM) guided the development of the BMWIC, including collaboration, review of evidence-based models, cultural adaptation of materials, and the creation of a robust evaluation plan to be conducted. Four courses were ultimately developed on: historical trauma, culturally informed MH screening and care, risk and protective factors and health-related Tribal, state and federal legal jurisdiction in American Indian and Alaska Native (AI/AN) communities. Discussion: The BMWIC development process serves as a prime example of translating community priorities into an educational intervention through a combination of best practices in health science education with Indigenous ways of knowing (IWK). Targeted training and task shifting, such as through the BMWIC, may have the potential to expand MH-related knowledge and strengthen the capacity of community health systems to identify psychological and behavioral concerns early, coordinate care more effectively, and improve access to MH care and resources at the community level. Conclusions: This protocol may be useful for academic-community partnerships creating culturally informed educational programs across disciplines and specialties in service to Indigenous communities. The next steps will involve piloting and evaluating the curriculum and collaborating with healthcare organizations to determine sustainable pathways for scaling the BMWIC where it is most needed.

Non-suicidal self-injury (NSSI) imposes a significant burden on adolescents, making it essential to understand its underlying functions to develop effective interventions. This study aims to investigate the NSSI functional network and clarify the "psychosocial factors-personality-behavior" chain to inform the development of interventions for NSSI.

A total of 265 psychiatric inpatients aged 16-25 years with NSSI participated in this cross-sectional study. Network analysis was used to examine relationships among NSSI functions, and mediation analysis explored the pathways from psychosocial factors and personality to these functions.

Five stable NSSI functional communities were identified, including internal emotion regulation (IER), psychological pain avoidance (PPA), social influence (SI), suicide resistance (SR), and sensation seeking (SS). The core function of IER exhibited the highest centrality. Psychosocial factors, including health adjustment (β_IER = 0.450, β_PPA = 0.303, β_SI = 0.322, β_SS = 0.130), interpersonal stress (β_IER = 0.228, β_PPA = 0.196, β_SI = 0.301), neuroticism (β_IER = 0.205, β_PPA = 0.165), childhood emotional mistreatment (β_IER = 0.204, β_PPA = 0.195), openness to experience (β_SI = 0.146), conscientiousness (β_SR = 0.066), and extraversion (β_SR = -0.079) were significantly associated with various NSSI functions. Neuroticism mediated most of the pathways connecting psychosocial factors to NSSI functions such as IER, PPA, and SI.

Internal emotion regulation was the central driver among five functions of NSSI. Neuroticism played a key mediating role in the link between psychosocial factors and NSSI functions. Tailored interventions targeting emotion regulation are essential.

This is an update of an existing review. The main clinical intervention for mild to moderate hearing loss is the provision of hearing aids, which amplify speech in addition to environmental sounds. Hearing aids are routinely offered and fitted to those who seek help for hearing difficulties. Since the previous 2017 review, further randomised-controlled trials (RCTs) have been published. This review updates the certainty of the evidence and assesses two additional outcomes: mental health and cognition.

To evaluate the benefits and harms of hearing aids in adults with mild to moderate hearing loss.

Cochrane Information Specialists searched CENTRAL, Cochrane ENT registry, MEDLINE, Embase, Web of Science, ClinicalTrials.gov, ICTRP and additional sources for published and unpublished trials. The date of the final search was 2 August 2024. We have also included published existing and ongoing studies up to 18 May 2026.

We included RCTs and cross-over trials that investigated the effect of acoustic hearing aids on adults with mild to moderate hearing loss. We did not include cluster-RCTs. We included studies where the control comparison was passive (waiting list, no intervention) or active (e.g. placebo hearing aids, education programmes, assistive listening devices, auditory training). We excluded studies with interventions delivered in a group setting.

The critical outcomes were hearing-specific health-related quality of life (participation as the key domain) and the adverse effect, pain. Important outcomes were health-related quality of life, listening ability, mental health (loneliness as the prioritised subdomain; other subdomains were depression, anxiety, and social isolation), cognition (working memory as the prioritised subdomain; other subdomains were memory, immediate attention span, set shifting, inhibition, language, processing speed, visuospatial function, and brief measures of global cognitive performance), and the adverse effect, noise-induced hearing loss. We show only prioritised outcomes in the synthesis of results section below and in the summary of findings.

We used the Cochrane tool for assessing risk of bias (RoB 1), and assigned a judgement about the risk of bias for each included study.

We synthesised results for each outcome using random-effects meta-analyses of the standardised mean differences (SMDs). Where this was not possible, we synthesised results using a narrative approach. We used GRADE to assess the certainty of evidence.

We included 16 RCTs involving 2261 participants; we added 11 new studies to this update. The studies were conducted in the USA, Europe, Brazil, Hong Kong, and Australia, and were published between 1987 and 2025. Participants had mild to moderate hearing loss. The average age ranged from 58 to 83 years. Study duration was 4 weeks to 3 years.

All studies except one had high or unclear risk for performance and detection bias because blinding was inadequate or absent. Most studies had low risk for selection, attrition, and reporting bias. For hearing-specific health-related quality of life (participation), there is likely to be a large difference favouring those wearing hearing aids over the control comparison (SMD -1.25, 95% confidence interval (CI) -1.63 to -0.87; 8 studies, 1683 participants; moderate-certainty evidence, downgraded for risk of bias). The evidence for pain is very uncertain. Six studies (1186 participants) monitored adverse effects. Of these, one study reported two instances of pain or discomfort (one participant stopped using hearing aids due to pain while wearing them; one stopped using hearing aids due to ear dryness requiring treatment). Certainty of evidence was very low, downgraded for risk of bias and extreme imprecision. For health-related quality of life, there may be a small difference favouring those wearing hearing aids over the control comparison (SMD -0.27, 95% CI -0.46 to -0.09; 4 studies, 1558 participants; low-certainty evidence, downgraded for risk of bias and indirectness). For listening ability, there is likely to be a large difference favouring those wearing hearing aids over the control comparison (SMD -1.28, 95% CI -2.41 to -0.15; 5 studies, 622 participants; moderate-certainty evidence, downgraded for risk of bias). For loneliness, there may be little to no difference between those wearing hearing aids and the control comparison (SMD -0.12, 95% CI -0.25 to 0.01; 2 studies, 907 participants; low-certainty evidence, downgraded for risk of bias and indirectness). For working memory, the evidence is very uncertain about the effect of hearing aids compared to the control (SMD 0.51, 95% CI -0.21 to 1.23; 3 studies, 910 participants; very low-certainty evidence, downgraded for risk of bias, indirectness and inconsistency). Of the six studies that monitored for adverse effects, none reported noise-induced hearing loss (1186 participants; evidence certainty not graded).

The available evidence suggests that hearing aids likely improve hearing-specific health-related quality of life and listening ability in adults with mild to moderate hearing loss, with a large beneficial effect. Hearing aids may also improve general health-related quality of life. This evidence is compatible with the widespread provision of hearing aids as first-line clinical management in those who seek help for hearing difficulties. The review did not provide evidence that hearing aids were effective at improving loneliness or working memory, nor that hearing aids resulted in adverse effects. To improve the certainty of evidence and ascertain whether the effects of hearing aids vary according to demographics (e.g. age, sex, degree of hearing loss, socioeconomic environment, race and ethnicity), greater consistency is needed in outcome measures used. Longer-term, placebo-controlled studies may be more sensitive to potential effects on mental health and cognition, but it may not be ethically justifiable to withhold hearing aids long term.

The review had no dedicated funding.

Registration (2015) PROSPERO: CRD42016043834 Protocol (2015) DOI: 10.1002/14651858.CD012023 Original review (2017) DOI: 10.1002/14651858.CD012023.pub2.

Integrated behavioral health care has advanced from simple service colocation to a coordinated, system-wide approach that connects behavioral health, primary care, emergency medicine, social services, and community support. Health systems increasingly rely on partnerships to address the complex medical and social needs driving population health outcomes. The Harris Center for Mental Health and IDD (The Harris Center) illustrates this evolution, operating as a comprehensive population health partner that serves nearly 90,000 individuals annually across Harris County. Through deep integration with hospitals and providers, The Harris Center embeds behavioral health within broader care systems. Its Psychiatric Emergency Services partnership with the Harris Health healthcare system bridges emergency medicine and community care, enabling rapid stabilization and coordinated follow-up. Similarly, its Integrated Behavioral Health Home (IBHH) model combines primary care, behavioral health, and care coordination to manage chronic conditions common among individuals with serious mental illness.The Harris Center also addresses social determinants of health through food-as-medicine initiatives, housing partnerships, and outreach strategies. Integration extends into criminal justice systems, where teams inside jails provide stabilization, continuity of care, and reentry planning. Mobile wellness clinics, homelessness outreach, and crisis diversion programs further expand access beyond traditional settings. Key outcomes of this integrated model include: Reduced emergency department and inpatient utilizationImproved management of chronic diseasesIncreased engagement in preventive care and medication adherenceEnhanced diversion from incarceration and reduced recidivismBetter coordination of care across health, social service, and justice systemsTogether, these outcomes demonstrate how integrated, cross-sector partnerships can reduce fragmentation, improve health outcomes, and advance whole-person care for complex, high-risk populations.

Colombia is undergoing rapid population aging, yet its infrastructure to support healthy aging is limited. This study examines the associations between environmental conditions-home, neighborhood, and community infrastructure-and depression among older adults, separately for urban and rural settings. Using data from the 2015 SABE-Colombia survey, a nationally representative study of adults aged 60 and older, we analyzed the association between depressive symptoms (GDS-15) and home disorder, housing materials, neighborhood disorder, neighborhood amenities, and community infrastructure. We found that for older adults living in urban areas with poorer housing materials had higher depression scores, while those living in neighborhoods with more amenities and community infrastructure had significantly lower higher depression scores. In rural areas, greater access to neighborhood amenities was associated to lower depression. Home and neighborhood disorder were not significantly associated with depression in either setting. Our findings highlight the importance of examining environmental conditions both independently and jointly, and of accounting for rural-urban differences when studying environmental determinants of mental health. The results highlight how contextual variation in infrastructure and housing quality can shape depression in later life in Colombia and may have broader relevance for other Latin American countries.