Relationship between anticipatory grief and dyadic coping in advanced cancer patients and their spouses: An examination based on the actor-partner interdependence model.

Purpose: To evaluate the impact of pelvic floor physical therapy (PFPT) on urinary incontinence by assessing PFPT dosage on patient outcomes using the Urogenital Distress Inventory-6 (UDI-6) scores. Methods: Patient data were derived from a patient outcomes registry. All patients completed an initial and final UDI-6 patient-reported outcome measure. Urogenital Distress Inventory-6 change from initial to final was calculated and used as the dependent variable in a multiple linear regression. The primary independent variables were dosage, defined as frequency of visits per week and total visit count across an episode of care. Additional predictor variables were included, encompassing demographics, initial disability levels, and mental and physical health capacity. Results: A total of 3436 women were included in the cohort, age 48 ± 17, and largely used commercial insurance (75%). The regression revealed higher initial UDI-6 scores, higher visit dosage, and better initial mental and physical health as significant predictors of improvement in urinary stress symptoms as measured by the UDI-6 ( r = .45, P < .001). The regression model explained 20% of the variance in UDI-6 change ( P < .001). Discussion: Greater improvements occur in patients with more severe urinary symptoms and better baseline physical and mental health status. Additionally, greater UDI-6 change was observed in patients who received higher dosage of PFPT. The results highlight the importance of individualized treatment planning and adequate visit frequency to achieve clinically meaningful outcomes. From a policy perspective, the study supports early access to care and flexible visit coverage to ensure equitable care delivery.

Access to mental health care and its integration with primary care remain critical challenges worldwide. In France, these problems are compounded by fragmented provision, poor coordination, and limited reimbursement for psychotherapy, despite the country's high levels of health expenditure. This perspective examines how community health centers (centres de santé) can contribute to integrated care, understood as the systematic coordination of physical and mental health services across providers. We analyze the case of the Centre de Santé de Belleville in Paris as an illustration of how CDS can host significant mental health capacity for vulnerable populations, and explore why the model remains marginal in the French health system. We combine analysis of national policy reports, academic literature, and internal audit data from the Belleville center to situate CDS within French health system dynamics. A Strengths, Weaknesses, Opportunities, and Threats (SWOT) grid is used to summarize the model. The Belleville case illustrates that CDS can deliver integrated mental and primary care, with salaried teams of general practitioners, psychologists, and a psychiatrist serving a disproportionately vulnerable population. However, structural weaknesses - financial fragility, fragmented representation, reputational risks, and the enduring dominance of the self-employed, independent physician ("liberal medicine") - limit their wider diffusion. Policy windows linked to financing reform, workforce shortages, and broader frames such as sustainability occasionally elevate CDS on the agenda, but institutional path dependency keeps them peripheral. Community health centers in France illustrate how institutional legacies and professional power can constrain the adoption of organizational models aligned with policy goals. For international readers, the case underlines the importance of political economy and system values - in this case, liberal universalism - in shaping the possibilities for integrating mental and primary health care.

This meta-analytic study aims to comprehensively examine the relationship between mental health, learning capacity among health education students, and competencies in nosocomial disease risk management through cross-contextual empirical synthesis. An analysis of 47 studies involving 12,847 participants from 15 countries demonstrates a strong, statistically significant association between students' mental health and competencies in nosocomial infection prevention, as reflected by a correlation coefficient of r=0.68 (p<0.001) and a 95% confidence interval of 0.61-0.74. Students with high mental health scores (M=78.4; SD=8.2) exhibited substantially superior understanding of infection prevention protocols, namely 43% higher than the control group (M=54.7; SD=12.1; t(846)=18.42; p<0.001; d=2.31). Structural equation modeling confirmed learning capacity as a significant partial mediator (β=0.52; p<0.001), with an indirect effect reaching 35.4% and a 95% CI range of 28.6-42.1%. Mindfulness-based psychoeducational interventions were shown to enhance nosocomial risk identification abilities by 38.7% (F(2,564)=42.18; p<0.001; η²=0.41) while reducing clinical anxiety by 31.2% (t(382)=9.84; p<0.001). These findings extend the frameworks proposed by Song (2024) and Schutte et al. (2025), which primarily emphasize cognitive aspects, by demonstrating that the integration of psychological dimensions yields a multidimensional predictive model explaining 64.3% of the variance in risk management competence (R²=0.643; F(5,841)=304.76; p<0.001), surpassing conventional models that account for only 38-45% of the variance.

Enhancing Mental Health Capacity in Ontario: AI Scribe Integration for Clinical Efficiency.

(1) Background: With the increasing complexity of public safety duties, police officers are frequently exposed to high-pressure, high-risk environments. They face multiple stressors, including workload demands, societal expectations, supervisory pressure, and emergencies. Such factors can impair their mental health and emotional suppression capacity. (2) Methods: This preliminary qualitative investigation examines police officers' perceptions of stress-related suppression processes through a literature review and semi-structured in-depth interviews with a small number of officers, employing qualitative content analysis. The research focuses on officers' reported coping strategies, experiences with psychological counseling systems, and views on institutional mechanisms such as officer screening and emotional support structures. (3) Results: The findings reveal that participants reported generally lacking adequate emotional expression channels, leading to emotional dysregulation, outbursts, and burnout. Social support, supervisor attitudes, and flexible duty arrangements were perceived as key stress-mitigating resources. However, the utilization of current psychological counseling services remains low, primarily due to concerns regarding stigmatization and confidentiality. (4) Conclusions: This preliminary study recommends the development of a responsive mental health support framework for police agencies, emphasizing improvements in officer selection processes, mental health training, counseling accessibility, and organizational flexibility.

Abstract Background In response to record-breaking wildfire seasons worldwide, wildfire researchers are increasingly called upon to conduct research to better understand the drivers and impacts of “megafires.” However, there is limited attention to the mental health risks and potentially traumatizing experiences of working in these disaster-affected social-ecological landscapes, or the implications of this on our ability to conduct collaborative and trauma-informed research. In this forum, we seek to raise awareness and catalyze action within the wildfire community to sustain the mental health and research capacity of wildfire researchers. Results We highlight the mental health risks of conducting wildfire research, in which both direct and secondary traumatic experiences can often be compounded by feelings of climate anxiety and ecological grief. We then reflect on our own experiences conducting interdisciplinary and community-engaged research in western North America during and after recent wildfire seasons, including the challenges of recognizing and addressing the psychological impacts of this work. Finally, we synthesize actionable recommendations, and share practical frameworks and tools, for individual researchers, supervisors, and institutions to support researcher mental health and wellbeing in wildfire-related research. Conclusions We present tangible actions that individual researchers, supervisors, and institutions can take to support the mental health and wellbeing of wildfire researchers, and call on the wildfire research community to advocate for and implement these within our respective institutions. We argue that concerted action, and cultivating communities of care, is necessary to ensure the quality and sustainability of wildfire research.

Introduction: Preeclampsia is one of the most common and serious complications during pregnancy, with significant maternal and fetal consequences. Physical exercise has been proposed as a preventive strategy, but evidence on the effects of high-intensity interval training (HIIT) during pregnancy remains limited. Objective: To evaluate the effectiveness of HIIT during pregnancy on preeclampsia and other outcomes related to maternal physical and mental health. Methods: A systematic review was conducted following the PRISMA guidelines. Randomized controlled trials evaluating HIIT interventions in pregnant women beyond 20 weeks of gestation were included. Searches were conducted in MEDLINE, Web of Science, and Scopus until April 2024. Risk of bias was assessed using the RoB 2 tool. Results: Four studies with a total of 185 participants were included. Findings suggest that HIIT may improve or maintain maximal oxygen consumption (VO2 max), mental health, and functional capacity without reported adverse effects. No negative impact on glycemic response or blood pressure was observed. Conclusion: HIIT during pregnancy appears to be a safe and potentially effective intervention to enhance cardiorespiratory and psychological health. However, current evidence is still limited and of moderate quality; more rigorous studies with larger sample sizes are needed.

In this article, I explore how the mental health and mental capacity laws in England and Wales can be used for suicide prevention. I criticise the use of compulsion for persons diagnosed with a mental disorder who nonetheless retain decision-making capacity and argue for a greater reliance upon capacity as a distinguisher between autonomous decision-making about the end of life and the risk to life posed by symptoms of mental illness. The label of 'suicide' is also criticised as an outdated legal notion carrying pejorative meaning. Although focused on the law in England and Wales, the arguments apply much more broadly to all jurisdictions seeking to reconcile the demands of respect for life and respect for autonomy.

Clinical caseThis case is based on a multidisciplinary team (MDT) discussion about a 77-year-old lady with a background history of hypothyroidism and type-1 diabetes. This patient had a one year history of gradual memory loss, and rapid decline in the previous three weeks leading to hallucinations and forgetting meals and medications. A mental capacity assessment indicated lack of capacity, and the patient’s children had been appointed to be Lasting Power of Attorneys (LPAs). They wanted to arrange residential care for the patient against her will. The GPs referred the patient to Older Adult Mental Health (OAMH) Services for a formal dementia assessment and diagnosis.Diagnostic Evaluation and Mental Health AssessmentBlood tests were done at the GP practice as requested by the OAMH team. The only significant abnormal finding was elevated TSH at 57.3 mU/L (normal range 0.4 - 5). Part 1 of the MHA specifies the application of the act to patients with, “any disorders or disability of the mind”. The Community psychiatry nurse deemed that until TSH levels were back to normal the patient’s cognitive changes could not be deemed a mental health issue but instead physically treatable delirium secondary to hypothyroidism and levothyroxine non-compliance. The patient’s care was trapped in a self-reinforcing harmful cycle: forgetfulness contributed to her missing levothyroxine doses and a high TSH measurement, however she could not receive assessment and management for her memory issues due to the high TSH.ConclusionThe rejected OAMH referral led to a shift in focus towards the MCA. The patient had undergone a formal capacity assessment based on criteria outlined in Section 3 of the act. Her memory loss rendered her unable to retain information and weigh it up to make decisions, resulting in her being deemed incapable of making long term decisions about her own care. The patient's children, as LPAs wanted the patient to be admitted to full time residential care due to worries about deterioration of health. As outlined by Cheshire West and Chester Council v P [2014] UKSC 19, the case would meet the “acid-test” for DoLS, with the patient being both 1) under continuous supervision and 2) unable to leaveThe DoLS code of practice outlines six assessments for authorisation for a deprivation of liberty, the only one of which impending being the mental health assessment, declined due to TSH tests. The MDT members took a pre-emptive approach by again coordinating with the mental health team to repeat assessment, on the condition of a decrease in the patient’s TSH levels with help of care from district nurse home visits. This case outlined the interplay of endocrinology, mental health and mental capacity, highlighting importance of pre-planning, a holistic approach and multidisciplinary coordination to maximise quality of care and safe-practice.

To analyze the association between compliance Canadian 24 Hour Movement Guidelines (24hrMG) recommendations and QoL of school teachers. This obervational study with cross sectional design included total of 242 school teachers from 13 public schools were evaluated. QoL, sleep, sedentary behavior and physical activity were assessed using validated questionnaires. General Linear Model was employed to examine the association between QoL domains and 24hrMG, reporting unstandardized coefficients (β) along with 95% confidence intervals (CI). Full adherence to the guidelines was associated with better QoL in physical limitations (β = 0.34; 95%CI 0.16-0.52), general health (β = 0.31; 95%CI 0.16-0.46), social aspects (β = 0.17; 95%CI 0.05-0.29), emotional limitations (β = 0.17; 95%CI 0.10-0.24), mental health (β = 0.20; 95%CI 0.13-0.28), and functional capacity (β = 0.22; 95%CI 0.16-0.29). An association was observed between QoL and greater adherence to 24-hour MG among teachers.

Introduction: Psychological resilience is linked to the success of military operations. Resilient personnel seek social support, maintain high self-esteem, and adapt positively to adversity. Physical activity, integral to military duties, also fosters resilience by improving physical health, emotional regulation, and stress management. Objective: To adapt and validate the Resilience Scale in a sample of personnel from the Spanish Army and to examine the relationship between emotional intelligence and resilience. Methodology: To this end, the scale was adapted into Spanish and its psychometric properties were evaluated in a military sample from the Spanish Army (N = 739), consisting of officers, non-commissioned officers, and enlisted personnel, with an average age of 33.29 years (SD = 7.48). The measures used were the Resilience Scale and the Brief Emotional Intelligence Inventory for Senior Citizens. Results: From the confirmatory factor analysis revealed a unidimensional structure with twelve items, showing a good model fit. Discussion: The scale demonstrated reliability and structural validity in this context. Resilience was found to be positively related to emotional intelligence. Conclusions: In conclusion, the new Brief Resilience Scale for Spanish Military Personnel (EBRET-JG12) provides adequate evidence of validity and reliability for use within this institution. Since psychological resilience is closely associated with better mental health and greater coping capacity, having a valid and reliable tool for its assessment in the military context is essential to promote the overall well-being of personnel.

This study examines a holistic intervention that integrates social media awareness and spiritual well-being to support young adults facing life crises. The research aims to understand how digital engagement and spiritual values interact to influence identity development and psychological resilience. A quantitative approach was employed involving 31 participants, primarily female students (64.5%), who reported high social media usage, mainly for entertainment (41.9%) and maintaining social connections (38.7%). Descriptive and reliability analyses revealed strong internal consistency across key constructs, including Performance Expectancy (? = .730), Social Influence (? = .706), and Preservation of Religion (? = .932), while Hedonic Motivation showed moderate reliability (? = .607). Respondents strongly agreed on the positive impact of technology use (M = 3.43), social influence (M = 3.35), enjoyment (M = 4.00), and spiritual values such as religion (M = 4.16) and life preservation (M = 3.80). These findings highlight that social media, when approached with awareness and ethical guidance, can foster emotional balance and identity formation. The study concludes that integrating spiritual dimensions into digital literacy programs can enhance young adults’ mental health and coping capacities, promoting a more balanced and meaningful engagement with technology.

University students increasingly face mental health challenges, including anxiety, depression, and stress, yet most higher education environments lack proactive systems for emotional monitoring and support. This study aimed to design, implement, and evaluate a hybrid teaching management system that integrates narrative simulation with visual artificial intelligence (AI) to promote mental health literacy and emotional resilience among students. The system includes a narrative decision-making module simulating stress scenarios and an AI-powered emotion recognition tool (based on facial expression detection) embedded in classroom settings. A mixed-methods design was employed with 332 undergraduate students and 15 faculty members from multiple universities. Pre- and post-intervention surveys, usage logs, and real-time emotional data from visual AI were collected. Quantitative data were analyzed using descriptive statistics, paired t-tests, ANOVA, and multiple linear regression. Results indicated statistically significant improvements in students' mental health scores (p < 0.01), emotional awareness, and decision-making confidence. This integrated approach demonstrates both usability and scalability, offering instructors early emotional insight and students a reflective learning environment. The method is best suited for institutions equipped with AI-capable classrooms and trained ethical oversight.

BackgroundGlobal crises, humanitarian emergencies, and forced migration continue to challenge the mental health and well-being of individuals and communities. Frontline healthcare professionals, particularly those in primary care, play a pivotal role in managing psychological trauma and fostering resilience among both patients and themselves. This round table explores diverse strategies and experiences from around the world that highlight how health systems and practitioners can respond effectively to trauma, protect mental health, and promote self-care during and after crises.ObjectivesTo highlight the critical role of primary healthcare teams in managing stress and trauma in both patients and providers. To present international initiatives aimed at supporting healthcare professionals’ mental health, with a focus on humanitarian settings. To share practical approaches to delivering compassionate, culturally sensitive, and person-centered care for refugees and migrants in early reception phases. To foster dialogue on capacity building and system-level resilience in primary care under stressful conditions.MethodologyThis interactive round table brings together three expert-led presentations followed by a moderated discussion. The talks will draw on evidence-based practices, case studies, and project experiences from Brazil and Greece, including the work of the WONCA Working Party on Mental Health and the EUR-HUMAN project. Audience participation will be encouraged to promote knowledge exchange and contextual learning.Target AudiencePrimary care and mental health professionals, humanitarian responders, policymakers, medical educators, and researchers with an interest in trauma-informed care, migration health, and mental health system resilience.Expected OutcomesIncreased awareness of the psychosocial challenges faced by both patients and providers in crisis and migration contexts. Improved understanding of scalable mental health support strategies in primary care. Enhanced capacity to deliver empathetic, effective care to vulnerable populations, particularly refugees and migrants. Strengthened networks for international collaboration and knowledge sharing.Main MessagesPrimary care teams are essential to addressing trauma and promoting mental well-being in times of crisis. Tailored mental health support for healthcare workers is crucial, especially during prolonged humanitarian emergencies. Compassionate, culturally appropriate care for refugees and migrants must be prioritized from the earliest stages of arrival. Collaborative global initiatives offer valuable frameworks for building resilience and mental health capacity in diverse healthcare settings.Managing stress and trauma: the role of primary healthcare team \\ Heather RogersSupporting mental health and advancing skills of healthcare professionals during humanitarian crises:MHT projects: a WONCA Working Party on Mental Health initiative \\ Marilena AnastasakiExperiences from Brazil \\ Flavio Dias SilvaMeeting the needs of early arriving refugees and migrantsProviding compassionate and tailored care: the EURHUMAN project \\ Christos LionisExperiences from Greece \\ Foteini Anastasiou

With the escalating issue of population aging, the health of older adults has gained increasing attention. While prior research has predominantly examined the impact of resource flows between generations on older adults’ health, the roles of intergenerational relationship quality and cohabitation have been relatively overlooked. Using data from CHARLS 2020, this study investigated how intergenerational relationship quality influenced older adults’ mental health and functional capacity. Additionally, it incorporated intergenerational cohabitation as a potential moderating factor within the research framework. The results showed that the intergenerational relationship quality served as a protective factor against disability and depressive symptoms in older adults, significantly reducing these risks. Moreover, intergenerational cohabitation moderated the association between intergenerational relationship quality and disability but did not exhibit a significant effect on depressive symptoms. This study provides deeper insights into the association between intergenerational relationships and the health of older adults.

Background: Nurses play a crucial role in health emergencies, such as pandemics, bioterrorism, and natural disasters, but many gaps exist in the biosecurity and emergency preparedness training for nurses around the world - especially for vulnerable communities in low-resourced settings. Aim: This integrative review evaluates the efficacy of nurse education on biosecurity and health emergency preparedness, examining their nature in nurse education, what they measure, what they assess, what issues exist, and how the findings can be used to make evidence-based, relevant changes. Methods: 27 studies from 2015-2025 were synthesized from PubMed, CINAHL, Scopus, Web of Science, and EMBASE with a focus on education modalities, competency domains, and evaluation. Data were analyzed thematically and descriptively using descriptive and inferential statistics, and quality was appraised using the Mixed Methods Appraisal Tool. Results: Simulation-based education improved knowledge (10% to 30% improvement), skills (p=0.027), and confidence (70% reported a higher perceived preparedness). Simulation training was a better educational modality than a lecture. Low baseline levels of knowledge were noted (78% with no familiarity with any protocols), which were particularly low for bioterrorism-specific education (15% described potential agents correctly pre-education). The DPET and EPIQ measures were both valid and reliable measures of competencies but did not measure the competence specific to bioterrorism. The missing themes in the findings included an absence of exposure to training, standardization for standards of practice, or competency, with no discussion of mental readiness for emergencies that require equivalent faculty support. Conclusion: Simulation-based education and standardization improve nurse preparedness and readiness, although education relating to bioterrorism scenarios and equipping mental health capacity for nurses is essential prior to a public health emergency.

This article examines the early implementation of a provincial initiative aimed at improving mental health supports in Canadian elementary and secondary schools. A content analysis of 60 proposals submitted by school jurisdictions uncovered the organizational and cultural strengths and challenges that influence the development of mental health initiatives. The analysis revealed three strengths: readiness for change, tailored mental health solutions, and strategic leadership. Five challenges also emerged: fragmented service delivery, an overreliance on external service providers, a lack of qualified staff, difficulties in forming authentic partnerships with families and communities, and impediments to establishing an effective organizational infrastructure. The findings highlight the complexity of embedding mental health initiatives in schools and the importance of sustained leadership, professional learning, and community collaboration for long-term integration.

Impact of resistance training on sleep quality, mental health, and functional capacity in older women with varying baseline sleep quality: A randomized controlled trial.

In Northern Ireland, the current main legal framework for compulsory intervention is the Mental Health (Northern Ireland) Order 1986. It is a traditional mental health law which enables detention in hospital if mental disorder and risk criteria are met. However, under Article 3(2), it states that people should not be detained "by reason only of personality disorder". There has been a process of law reform in Northern Ireland to create a non-discriminatory, comprehensive legal framework for all. This resulted in the Mental Capacity Act (Northern Ireland) 2016. The Act, when fully implemented, will replace the Order for everyone aged 16 and over, which is in contrast to most other countries where there are both mental health and mental capacity laws. Under the new Act there are no specific exclusions so, if a person is unable to make the relevant decision, including if the cause of impairment relates to issues associated with personality disorder, then compulsory intervention is allowed as long as the proposed intervention is in the person's 'best interests'. The Act was partially implemented in 2019 and currently is only used when the Order does not apply. This article explores: the development of this new legal framework; the implementation of the Act; and some of the ongoing debates, and practice complexities, related to services for people with a diagnosis of personality disorder.