• First empirical study of climate adaptation justice in Aotearoa New Zealand. • Adaptation is a relational process connecting people, place, and ecosystems. • Multiple justice principles are interdependent for fair climate adaptation. • Māori and multispecies perspectives are central to demands for fair adaptation. • A new framework shows justice and resilience are prerequisites for effective policy. Climate adaptation raises profound questions of fairness: Who bears the greatest risks and costs, and who decides how to respond? This study explores how communities in Aotearoa New Zealand perceive “just” climate adaptation, grounding climate justice in lived experience. We draw on 64 in-depth interviews with people who have endured floods, storms, or droughts, alongside an analysis of public submissions to national adaptation policy processes. The findings reveal that climate adaptation is widely viewed as a deeply relational process connecting people, place, and more-than-human beings. Abstract justice principles – distributive, procedural, recognitional, intergenerational, corrective, epistemic, and multispecies justice – emerge as interdependent in participants’ accounts of fair adaptation. Communities actively audit adaptation fairness through expectations of collaboration, mutual care, and government accountability. Notably, Indigenous Māori perspectives (honouring Te Tiriti o Waitangi /the Treaty of Waitangi partnership obligations) and the rights of ecosystems (legal personhood for rivers and forests) are seen as integral to just outcomes. These insights challenge universal notions of climate justice by demonstrating that what constitutes “just adaptation” is context-specific and grounded in the relationships between individuals and communities. We propose a relational framework for just adaptation that bridges theory and practice, concluding that equitable climate resilience hinges on transforming the social and ecological relationships that underlie vulnerability. Our study highlights that climate justice is not a peripheral ideal, but a crucial prerequisite for effective adaptation policy and action.

The alternative model for personality disorders (AMPD) is approaching readiness for inclusion in the main section of the DSM, yet research informing its development has largely overlooked the perspectives of those who receive personality disorder diagnoses. This commentary argues that centering lived experience is essential for evaluating the AMPD's diagnostic language, given evidence that certain trait terminology (notably "manipulativeness") is perceived as highly stigmatizing. The AMPD's Criterion A, which emphasizes personality functioning rather than dispositional traits, may offer a less stigmatizing framework-a possibility supported by emerging lived experience accounts. Building on recent work by Sharp, Cano, Masland, Navarré, and colleagues, this commentary proposes research priorities for integrating lived experience perspectives into AMPD evaluation and considers whether the ICD-11‧s sub-diagnostic "personality difficulty" category could serve both clinical and destigmatizing functions if adopted within the AMPD.

Comparing service providers and youth advice on coordinated service delivery in Ontario's child welfare system.

Hustlers and tricksters: Colonialism, the war on drugs, and survival strategies of people who inject drugs.

The F-words for Child Development (Functioning, Family, Fitness, Fun, Friendships and Future) offer a holistic, strengths-based and family-centred approach to child development, rooted in the World Health Organization's International Classification of Functioning, Disability and Health. Interest in the F-words has grown significantly among families, health care providers, educators and researchers, creating the need for accessible and scalable training to support dissemination and implementation efforts. A self-paced online F-words Foundations Course was co-developed by families, health care providers, educators and researchers. The course consists of five 1-h modules covering the F-words approach, personal stories, goal-setting and practical strategies for integrating the F-words into daily life and practice. This study evaluated the acceptability, feasibility, usability and utility of the course through an online survey that included Likert-scaled and open-ended questions. Quantitative data were analysed using descriptive statistics, and qualitative data were analysed through content analysis. Fifty-five participants, including families, health care providers and educators from Ontario, completed an online survey assessing their experience. Findings were positive, with participants rating the course as useful in understanding the F-words (85%), accessible and easy to engage with (91%) and valuable in helping them achieve their learning goals (85%). Participants valued the multimedia components, particularly videos featuring individuals with lived experience, and appreciated the course's family-centred perspective. Suggested improvements included increasing interactivity (e.g., use of discussion boards and synchronous group sessions) and shortening the length or removing repetition in course content. The F-words Foundations Course is a free, accessible and online training tool that effectively supports increasing knowledge, awareness and use of the F-words in life and practice. Future directions include expanding course offerings for young individuals and exploring facilitated formats to enhance engagement.

The role of food-related strategies and social support: A qualitative study on the lived experiences with food among income-eligible food assistance beneficiaries.

Joint statement by the World Psychiatric Association, the American Psychiatric Association, the European Psychiatric Association, and the Global Expert Task Force on ECT on the portrayal of electroconvulsive therapy in the WHO Guidance on Mental Health Policy and Strategic Action Plans.

This qualitative study explored the impact of comorbidities on multiple sclerosis (MS) management, integrating perspectives from individuals with lived MS experience and healthcare professionals who have direct experience in treating and managing MS. Semi-structured interviews were conducted with five individuals living with MS and five clinicians recruited through professional networks and advocacy groups. Interviews were conducted online between February 26th to March 15th, 2024. A thematic analysis was used to identify the main themes emerging from the interviews, focusing on the influence of comorbidities on MS progression, treatment decisions, and daily experiences. Comorbidities were found to significantly complicate MS management by exacerbating symptoms and influencing clinical decision-making. Individuals with lived MS experience and clinicians emphasized the need for enhanced coordination between healthcare providers and more comprehensive, interdisciplinary care models. Additionally, participants highlighted gaps in existing research on the relationship between comorbidities such as insomnia and substance use and their effects on MS outcomes. Comorbidities add a significant layer of complexity to MS management, both for individuals living with the disease and for clinicians providing care. Our findings suggest a need for integrated care models that address the unique needs of individuals with MS and comorbidities. Enhanced communication between specialists, comprehensive education for the individuals living with MS, and research that further explores the links between MS and comorbidities are critical steps toward improving outcomes. Not applicable.

International guidelines for treatment of children with severe acute malnutrition advise against giving standard oral rehydration solutions (ORS) for dehydration secondary to diarrhoea. Instead, they recommend exclusive use of low-sodium rehydration solution for malnutrition (ReSoMal), due to concerns about both sodium and fluid overload. Supportive evidence is lacking, warranting reappraisal of this guidance. We aimed to assess the safety and superiority of standard WHO-ORS versus ReSoMal. GASTROSAM was a phase 2, factorial, open-label, superiority randomised controlled trial conducted at six hospitals in four African countries (Kenya, Niger, Nigeria, and Uganda). Children aged 6 months to 12 years with severe acute malnutrition who were admitted to hospital with severe (stratum A) or moderate (stratum B) dehydration and diarrhoea were randomly assigned in a 1:1 ratio to receive ReSoMal or low-osmolarity WHO-ORS. A simultaneous randomisation in stratum A compared two intravenous strategies versus an oral control rehydration strategy (results reported elsewhere). Children with severe dehydration (stratum A) received their allocated ORS as soon as possible. The primary endpoint was change in sodium concentration at 24 h from baseline in all randomised participants and analysed on an intention-to-treat basis. Children with lived experience were not involved in the study design. The trial is registered on the ISRCTN registry (ISRCTN76149273) and the Pan-African Clinical Trials Registry (PACTR202103852542919). Between Sept 2, 2019, and Oct 27, 2024, 415 eligible children were enrolled (218 [53%] male; 197 [47%] female); 272 were enrolled into stratum A (137 to ReSoMal and 135 to WHO-ORS) and 143 were enrolled into stratum B (69 to ReSoMal and 74 to WHO-ORS). Children were followed up for 28 days; 11 (3%) were lost to follow-up or withdrew. The primary endpoint was assessed in 387 (93%) of 415 participants. The increase in sodium concentration was similar in both groups (5·3 mmol/L [SD 8·1] with ReSoMal vs 5·0 mmol/L [7·6] with WHO-ORS; mean difference for WHO-ORS vs ReSoMal -0·6 [95% CI -1·9 to 0·7], p=0·37). There was no difference in day 28 mortality between the WHO-ORS and ReSoMal groups (19 [9%] vs 24 [12%]; adjusted hazard ratio 0·76 [95% CI 0·41 to 1·41], p=0·39). Fluid overload events (pulmonary oedema and cardiac overload) were actively monitored: none was observed. WHO-ORS resulted in similar outcomes to ReSoMal, and neither strategy led to fluid overload. This finding informs the simplification of guidelines supporting the use of WHO-ORS for the management of dehydration in children regardless of nutritional status. Joint Global Health Trials Scheme of the UK Medical Research Council, UK Department for International Development, Wellcome, and Médecins Sans Frontières.

This scoping review explores the school and school-related experiences of children and adolescents with Inflammatory Bowel Disease (IBD), drawing on 10 studies identified from an initial pool of 2676 records published between 2014 and 2022 across eight countries. The review identifies the following four key themes: school attendance/absenteeism; educational outcomes; general school experience; and school functioning and school-related quality of life outcomes. This scoping review included studies that were predominantly quantitative in design, with findings synthesised thematically across study types, alongside a narrative summary of quantitative indicators such as absenteeism, school functioning, and school-related quality of life. The findings reveal that, while educational outcomes for children with IBD were generally not significantly different from their peers (although some studies noted lower academic performance in children with IBD), children with IBD often felt that teachers and peers lacked understanding of their condition, which led to increased stress and sometimes bullying. Furthermore, children with IBD had lower quality-of-life scores related to school functioning compared with healthy peers. Despite these challenges, participation in school activities varied, with some children missing out on physical education and extracurricular activities. Overall, the review highlights the need for more research directly exploring children's perspectives on the emotional and embodied impact of IBD on their everyday lived school experiences. Furthermore, it emphasises the importance of improving school accommodations and understanding for children with IBD among peers, teachers and wider school staff. Future studies should consider qualitative approaches, including use of creative methods, to deepen the understanding of the complex lived experiences of schoolchildren with IBD.

"I've never had anyone listen to my story like that": Understanding the social validity of biographical mapping as an intake process in the context of personalized exercise programming.

Clozapine rechallenge after neutropenia: a retrospective cohort study in the UK.

Parents of children with autism spectrum disorder (ASD) face emotional and practical challenges that affect their well-being and family dynamics. Given parents' crucial role in guiding their children, interventions focused on parental support have been developed. Although group-based programs are shown to be beneficial for stress management, reductions in mental health symptoms, and parental self-efficacy, existing programs do not integrate the various essential resilience-building components (e.g., Cognitive Behavioral Therapy, Applied Behavioral Approaches, self-compassion, emotion regulation, self and stress management, and mentalization), and have rarely been evaluated qualitatively from the parents' perspective. This Immersion/Crystallization qualitative thematic approach explores the experiences of parents participating in the P-PEARL program (Parent Psychological-Educational program for Autism: Resilience and Learning) and its perceived outcomes for themselves, their children, and families. We conducted semi-structured interviews with 20 parents who participated in the intervention, and analyzed them in an iterative process of reading and re-reading the interview transcripts, followed by vertical and horizontal analysis. The analysis revealed that through the intervention, parents learned the importance of self-compassion and of integrating stress-management practices into their lives. They enhanced their understanding of their child's perspective and needs, through mentalization, allowing them to better predict triggers and stressors and manage them better. They felt that the group process fostered a sense of community, emotional support from peers with the same lived experience, and reduced feelings of isolation. The study findings suggest that the P-PEARL program holds significant potential to enhance parental resilience, emotional regulation, and reflective functioning, contributing to the growing evidence base on parent-focused interventions that support family well-being in autism. • Qualitative study of a novel parent intervention for families of young children with ASD. • The P-PEARL program combines ACT, ABA, mentalization, and self-compassion practices. • Parents reported increased emotional regulation and understanding of their child’s needs. • Group format reduced parental isolation and fostered reflective, compassionate parenting. • Findings support resilience-building frameworks in autism-focused parental interventions.

Artificial intelligence (AI) is rapidly reshaping critical care through predictive analytics, intelligent monitoring and decision-support tools. While these innovations may enhance early detection and workflow efficiency, they also raise professional questions about transparency, explainability, data bias, accountability and the preservation of compassionate, human-centred care. Critical care nurses, positioned at the bedside where AI outputs are interpreted and enacted, experience these tensions directly, yet their lived experiences remain underexplored. To explore critical care nurses' lived experiences of clinical judgement in AI-supported care, focusing on how innovation influences professional integrity, ethical accountability and human-centred practice. A qualitative phenomenological study was conducted at King Faisal University Health Care settings in Saudi Arabia. Semi-structured, in-depth interviews were undertaken with critical care nurses who routinely interacted with AI-supported clinical systems. Data were analysed using reflexive thematic analysis informed by Braun and Clarke's six-phase framework. The study followed the Standards for Reporting Qualitative Research (SRQR). Sixteen nurses participated. Four interconnected themes were identified: (1) Balancing algorithmic input and professional judgement, where AI was valued as a prompt for vigilance but required contextual interpretation rather than automatic compliance; (2) Instinct informed by experience, describing embodied and situational knowing that nurses perceived as essential when AI outputs did not capture patient complexity; (3) Ethical weight and accountability, reflecting heightened responsibility and concern about scrutiny when following or overriding AI recommendations; and (4) Preserving human-centred care, highlighting deliberate efforts to protect relational nursing roles, patient-family communication and professional identity amid technology-dense workflows. Nurses experienced AI as transforming the conditions of clinical judgement rather than replacing it. Innovation was welcomed when it supported early recognition and prioritisation, but nurses emphasised that integrity in AI-supported care depends on maintaining professional discretion, ethical accountability and human-centred values. Implementing AI in critical care should include governance and education that strengthen nurses' critical appraisal of AI outputs, clarify accountability and support transparent, explainable systems. These steps can help ensure AI's impact enhances safety and efficiency without eroding human-centred critical care nursing.

"You don't know how to live like me" - Survivors' experiences of burn care in New South Wales (NSW).

Ixekizumab in children with active psoriatic and enthesitis-related juvenile idiopathic arthritis (COSPIRIT-JIA): a multicentre, open-label, 16-week, Bayesian trial including a randomised reference group to adalimumab.

This study aimed to explore the impact of cystic fibrosis (CF) on the transition to motherhood using a strength-based narrative approach. It sought to elevate the voices of women with CF and examine how they navigate pregnancy and early motherhood in the context of chronic illness. A qualitative narrative study was conducted, led by a researcher with lived experience of CF and motherhood. The study adopted a co-constructed, interpretive epistemology to centre participant perspectives and challenge deficit-based clinical narratives. Ten Australian women with CF who had given birth within the past 5 years participated in in-depth, semi-structured interviews. Narratives were analysed using holistic and categorical methods, including thematic coding and story mapping. Reflexive collaboration and participant validation were used to enhance trustworthiness. Narratives consistently followed the 'Hero's Journey' archetype, with participants portraying themselves as resilient protagonists. Key strengths included hope, leadership, discernment, child-focus and optimism. While healthcare providers were often described as supportive allies, antagonistic interactions-particularly during pre-pregnancy counselling-undermined trust and joy. Postpartum, women struggled to balance CF treatment with mothering roles, often prioritising their child over medical compliance. Breastfeeding emerged as a specific area of conflict between maternal values and clinical expectations. Women with CF demonstrate significant strengths in navigating motherhood, yet face systemic challenges in receiving holistic, collaborative care. This study highlights the value of lived experience-led research and calls for healthcare teams to offer more tailored postpartum support and nuanced guidance around treatment, parenting and breastfeeding.

While physiotherapy, occupational therapy and Cesar/Mensendieck exercise therapy are considered essential in the management of multiple sclerosis (MS), little is known about how people with MS (PwMS) value these therapies across the disease course. This study explores the lived experiences and values of PwMS regarding these therapies during the lifespan with MS. In-depth interviews were conducted with a purposive sample of 23 PwMS (15 females, 8 males; median age 50 years, range 32-79; median disease duration 13 years, range 2-32). The sample size ensured a broad range of experiences with the therapies, so that in-depth and detailed meanings could be obtained for interpretative phenomenological analysis, coloured by contextual factors. PwMS highly value continuous physiotherapy and occupational therapy, especially when tailored to personal needs and disease progression. Only 7 PwMS had experiences with Cesar/Mensendieck therapy. Five key themes emerged: values related to the patient, the therapist, the patient-therapist relationship, the therapy itself, and collaboration among healthcare providers. These values are dynamic, multifaceted and interwoven, underpinning positive therapy experiences. Personal needs, goals, and the role of the therapist evolve over time, and therapies shift from general orientation to tailored interventions, empowering PwMS to make increasingly autonomous and confident decisions. Continuous, individualized physiotherapy and occupational therapy are highly valued by PwMS. Adapting therapy to their interwoven values, evolving needs and circumstances, is considered essential for optimal MS care.

Between crises and care: Childhood realities with sickle cell Anemia: A qualitative study.

Experiences of parents of children with congenital nevi: A qualitative study.