ABSTRACT Sharing one's HIV status with others is complex for youth with perinatally acquired HIV (PAH). However, the support from sharing one's HIV status may assist with HIV-related challenges. This study explored barriers and facilitators of HIV status sharing among UK-based youth living with PAH. Drawing on semi-structured interviews with ten youth with PAH, ten members of their social networks and five HIV professionals, this study examined the complex relational nature of disclosure. The data were examined using thematic analysis. While many youths expressed a desire to be open, sharing was shaped by stigma, cultural silence, familial secrecy, fear of rejection and lack of HIV education. Facilitators included emotional readiness, peer support, increased knowledge and positive prior experiences of disclosure. Social network participants often saw themselves as supportive, although professionals tended to focus on potential emotional risks. This study underscores disclosure as a process requiring ongoing support and suggests that empowering youth with education, skills and confidence is key. It identifies the need for better professional guidance and disclosure interventions co-designed with youth to support health and well-being. The findings have implications for stigma reduction, education and psychosocial support, contributing to improving the quality of life for youth with PAH.

A systematic approach to implementing care standards is needed.

Achondroplasia (ACH), the most common skeletal dysplasia, arises from gain-of-function variants in the fibroblast growth factor receptor 3 gene. Children with ACH experience lifelong medical, functional and psychosocial challenges requiring coordinated and anticipatory care. Although international guidance exists, the UK lacks national clinical care recommendations specific to its healthcare systems. To develop UK-specific, multidisciplinary clinical recommendations for the care of children and young people (CYP) with ACH. The UK Achondroplasia Network developed guidance in stages: stakeholder mapping of the care pathway, integration of contemporary literature with clinical expertise to draft age-specific guidance and Delphi statements, and a modified Delphi process with 25 multidisciplinary experts. The Delphi process involved two voting rounds and an in-person meeting, with consensus defined as ≥80% agreement. In the first Delphi round, all 20 statements achieved consensus; nine achieved 100% agreement. To strengthen consensus, after meeting in person, 17 statements were refined (four were divided into two statements), one created and one removed, resulting in 24 statements for Round 2; all achieved consensus, with 21 reaching 100% agreement. The guidance outlines age-specific monitoring and referral from infancy to adolescence. Recommendations address medical management of complications, psychosocial support, educational planning and transfer to adult care. These are the first UK-specific multidisciplinary recommendations for the care of CYP with ACH. Aligned with international best practices and tailored to UK healthcare systems, they support anticipatory care, promote independence and enhance health and psychosocial outcomes. The guidelines offer a foundation for service planning, standardisation and equitable care.

To investigate international evidence on home visits and parenting interventions delivered by nurses and midwives and to identify core components, such as intervention content, programme characteristics, contextual factors and implementation elements shared by effective interventions. Scoping Review. Nine academic databases and grey literature were searched between June and August 2024 for studies published between 2020 and 2024. Screening and data extraction were independently conducted by two reviewers using covidence. The intervention characteristics were described using the TIDieR framework, and the content was analysed thematically. Of the 3217 screened studies, 23 met the inclusion criteria. The studies employed various designs, including RCTs, quasi-experimental, cohort, cross-sectional, register-based and single-case experimental studies. Interventions were typically guided by theories of human ecology, attachment and self-efficacy. Most used structured materials and were delivered via face-to-face home visits by trained nurses, starting during pregnancy and continuing for up to 2 years. Visits ranged from weekly to monthly, mainly to family homes. Interventions were often tailored to family needs and cultural contexts. Five core themes emerged: (1) parenting education, (2) maternal and infant health, (3) mental health and psychosocial support, (4) community connections and (5) cultural sensitivity. Effective interventions should be early, structured and tailored. Integrating parenting education, health, mental well-being and cultural sensitivity improves outcomes and scalable family care practices. Findings highlight the need for structured training and support for nurses and midwives. Integrating these interventions into routine services, with attention paid to equity and proportionate universalism, can enhance family outcomes. This review addressed the lack of clarity regarding what makes nurse- or midwife-led interventions effective. It identified key components that support child and family well-being and offers guidance for designing scalable, evidence-based interventions in maternal and child health services. The EQUATOR guidelines for PRISMA were met. No patient or public contributions.

Background: Family resilience plays a crucial role in maintaining psychological well-being and adaptive coping among families caring for hemodialysis patients. Chronic illness and prolonged treatment often impose emotional and physical burdens that challenge the family’s ability to adapt, highlighting the need to identify determinants influencing resilience. Objective: This study aimed to analyze the relationships between demographic and clinical factors: age, gender, education level, duration of hemodialysis, and comorbidities, and family resilience among patients undergoing hemodialysis at Ahmad Yani Islamic Hospital, Surabaya, Indonesia. Methods: This study used a correlational analytic design with a cross-sectional approach. The population included 110 hemodialysis patients, and 86 respondents were selected using simple random sampling. Independent variables included age, gender, education level, duration of hemodialysis, and comorbidities, while the dependent variable was resilience. The Connor–Davidson Resilience Scale (CD-RISC) was used to measure resilience. Data were analyzed using the Chi-Square test with a significance level of α = 0.05. Result: Most respondents (88.4%) demonstrated a very high level of resilience. Significant relationships were found between resilience and gender (p = 0.002), education level (p < 0.001), duration of hemodialysis (p < 0.001), and comorbidities (p < 0.001), while age showed no significant association (p = 0.019). Conclusion: Family resilience among hemodialysis patients was classified as very high. Socio-demographic factors, health conditions, and treatment duration influenced resilience levels. These findings highlight the need for nursing interventions focusing on psychosocial support, patient education, and family empowerment to enhance adaptive coping in long-term hemodialysis care.

End-stage oral cancer is associated with profound psychological distress, particularly among patients from rural areas where access to healthcare and psychosocial support is limited. This case report describes a 67-year-old male farmer from rural Chennai diagnosed with Stage IV oral cancer who experienced severe emotional distress during end-of-life care. He had a long history of snuff use spanning 39 years, which he discontinued three years before diagnosis. Clinically, the patient presented with advanced disease, marked functional impairment, and nutritional dependence on a Ryle’s tube. Psychological assessment revealed high distress using the National Comprehensive Cancer Network (NCCN) Distress Thermometer score of 8/10, characterized by depressed mood, anxiety regarding death, and concerns about his family’s financial and social well-being. A brief psychoeducational intervention was provided, focusing on acceptance of prognosis, emotional support, stress management, and enhancing meaningful family interactions, alongside limited palliative chemotherapy. This case highlights the challenges of delivering holistic palliative care in resource-constrained rural settings and emphasizes the crucial role of integrated psychological support in improving the quality of end-stage cancer care.

PurposeAlopecia is a medical dermatology condition resulting in multiple psychosocial negative consequences in identity and appearence. Despite numerous qualitative studies examining the experience of people with alopecia, a comprehensive synthesis is lacking. This can obscure progress in research and minimize the impact of psychosocial support people with alopecia can receive. This systematic meta‐synthesis aimed to critically integrate the existing literature to enhance psychological understanding of how people with alopecia manage issues about identity and appearance changes, and provide some evidence‐based recommendations for clinicians working in the area of psychodermatology.MethodsA systematic search of six databases: APA PsycInfo (OVID), Medline (OVID), Embase (OVID), CINAHL (EBSCO) and Scopus identified 22 eligible studies on the lived experience of alopecia among adults, adolescents and parents. The Critical Appraisal Skills Programme Qualitative Checklist was used to appraise the quality of the studies. Extracted data underwent inductive thematic analysis.ResultsThe synthesis, representing 990 people living with alopecia, identified five main themes, focusing on managing identity and appearance changes: (1) coming to terms with a changed identity; (2) the journey to acceptance; (3) complexities of concealing hair loss; (4) social influences in both facilitating and hindering adaptation; and (5) treatment experiences highlighting unmet needs. Findings reveal substantial variation in managing identity and appearance changes, with some individuals achieving acceptance swiftly while others struggle. Social reactions and personal interpretations significantly shape adjustment.ConclusionsAlopecia profoundly impacts identity, coping, and social interactions, often accompanied by dissatisfaction with health care and treatment options. The reactions of other people and interpretations of these experiences appear to play a key role in adjustment. The review underscores the need for personalized, non‐pharmacological interventions that address personal and social challenges. Greater co‐production in health care training and intervention development is necessary to improve support for individuals with appearance‐altering conditions.

Integrating Medication and Psychosocial Support for Addiction Recovery: A Study of Congress 60

IntroductionDetectable plasma HIV viral loads remain a major public health concern due to its association with increased HIV transmission and disease progression. The aim of this study is to assess the factors associated with a detectable HIV viral load in People Living with HIV (PLHIV) aged between 15 and 60 at the Cité des Palmiers District Hospital in Cameroon.MethodologyThis is a cross-sectional study conducted between July 2023 and January 2024 using a non-probability convenience sampling method. Data were collected using a semi-structured questionnaire administered to PLHIV aged between 15 and 65years (n = 309). Analyses were performed using logistic regression, with a p-value <0.05.ResultsOut of 511 patients recruited, 309 consented to participate, representing a participation rate of 60%. Among the participants, 17% had a detectable viral load. Analyses revealed that living in a rural area [aOR = 4.40, p-value = 0.040], having a primary education as the highest level attained [aOR = 4.82, p-value = 0.025], frequently forgetting to take medication [aOR = 5.67, p-value = 0.002], eating only one meal a day [aOR = 13.02, p-value = 0.007], and fearing that therapy would no longer be effective in the future [aOR = 4.45, p-value = 0.009] significantly increased the probability of having a detectable HIV viral load.ConclusionThese result provide insight into targeting adherence support for PLWH in Cameroon to reduce the community HIV viral load. By improving access to care and providing psychosocial support, it may be possible to reduce community viral load, and reducing HIV transmission.

This scoping review evaluates the effectiveness of community-based interventions addressing frailty's multidimensional impacts (physical, nutritional, and psychosocial) in older adults, emphasizing nurses' roles in crisis-responsive care during pandemics. A scoping review was conducted using Arksey & O'Malley's framework and PRISMA-ScR guidelines. Thirty-one studies were from 2019 to 2023, sourced from PubMed and Scopus, spanning five continents. Study quality was assessed with the Newcastle-Ottawa Scale; outcomes included frailty reduction and quality-of-life metrics. Interventions included physical rehabilitation (e.g., Otago Exercise Program), nutritional optimization, psychosocial support, technology-enhanced models (e.g., telemedicine), and social engagement. Multicomponent interventions outperformed single-domain approaches, improving gait speed, reducing frailty progression, and mitigating depression. Telemedicine maintained 78% care continuity during lockdowns. Asian family-centered models excelled, but 84% of evidence came from high-income countries, highlighting low- and middle-income country (LMIC) gaps. Gerontological nurses are pivotal in delivering culturally adapted care by coordinating interprofessional home-based teams, integrating gerotechnology in resource-limited settings, and advocating for policy reforms to bridge urban-rural disparities. These findings underscore nursing's role in equitable, resilient frailty management.

Ventricular assist device (VAD) nursing is a critical specialty in the management of patients with advanced heart failure and cardiomyopathy. VAD nurses play an essential role in the preoperative preparation, intraoperative coordination, and postoperative care of patients receiving mechanical circulatory support, particularly those awaiting heart transplantation. These devices assist in improving cardiac function, but their use carries risks, such as infection, bleeding, thrombosis, device malfunction, and psychological challenges. Therefore, VAD nurses must possess expertise not only in general nursing care but also in infection prevention, anticoagulation management, patient education, and psychosocial support. As integral members of multidisciplinary teams, VAD nurses are responsible for educating patients on device management, ensuring safety, and promoting quality of life. With technological advancements, the role of VAD nurses has become increasingly significant in preventing complications and maintaining patient stability. In conclusion, VAD nursing is vital for improving patient outcomes and enhancing quality of life. Continued education and interprofessional collaboration are essential for advancing expertise and ensuring high-quality patient care.

Suicidal ideation and associated factors in 2821 school-going adolescents in Uganda.

Objectives Alcoholic liver disease is the leading cause of cirrhosis and liver failure in Japan. We assessed hepatologist-led interventions stratified using the alcohol use disorder identification test. Methods This was a single-center, prospective study. Outcomes included total alcohol consumption, number of heavy drinking days, drinking risk level, and liver function over 24 weeks. Patients Patients with chronic liver disease were stratified into three groups according to alcohol use disorder identification test scores: <10 (education only), 10-19 (hepatologist-led intervention), and ≥20 (psychiatric referral). Patients in the hepatologist-led group received drinking guidance, psychosocial support, and nalmefene, when indicated. Results Between August 2022 and September 2025, 932 patients were screened; 823, 78, and 31 had alcohol use disorder identification test scores of <10, 10-19, and ≥20 points, respectively. Of the 78 patients in the hepatologist-led intervention group, 74 completed follow-up. In this group, median total alcohol consumption decreased from 63.1 to 35.1 g/day (p=0.001) and heavy-drinking days from 17.0 to 11.3 days/month (p=0.002). Drinking risk level downstaging was achieved in 52 patients (70.2%), who showed significant improvements in aspartate aminotransferase (p=0.027) and γ-GTP (p=0.014) levels and experienced fewer cirrhosis-related complications in comparison to patients without downstaging. Logistic regression identified baseline hepatocellular carcinoma as an independent predictor of drinking risk-level downstaging (odds ratio, 5.23; 95% confidence interval, 1.10-15.3). Conclusions Hepatologist-led alcohol use disorder identification test-based management of alcoholic liver disease reduces alcohol intake. Drinking risk-level downstaging has been linked to improved liver biochemistry and clinical outcomes, offering a practical strategy in which psychiatric resources are limited.

To report the prevalence of mental health symptoms and influencing factors in retired professional high contact team sport (HCTS) athletes. Mixed-methods systematic review. PsycINFO, Embase, Medline, SPORTDiscus and Scopus were searched in July 2023 and March 2025. Studies that investigated mental health and/or influencing factors within retired professional HCTS athletes were included. Studies that were non-peer-reviewed, could not obtain full text, used secondary data or focused on non-elite/individual/low-contact sports were excluded. 85 studies were included in the final review, comprising 53 996 participants (females; n=247, 0.46%) from six sports (Australian Football League, Canadian Football League, football/soccer, ice hockey, National Football League and rugby). Prevalence ranges varied for each condition; smoking (0.9%-16%), depression (3%-49%), anxiety (4.3%-42%), cannabis use (5%-15.7%), adverse alcohol use (6.4%-68.8%), opioid use (7%-23.6%), stress (8.7%-26.9%), illicit drug use (10%-63.2%), anxiety/depression (10.2%-39%) and adverse nutritional behaviour (23.8%-64.5%). Of the studies including M and SD of validated scales, scores for depression, anxiety and sleep disturbance were equivalent to population norms, whereas mild or higher scores were reported for stress and adverse alcohol use. Concussion, pain, injury, neurological factors and declined physical function were shown to have a negative influence on mental health. Both negative and positive influences were observed for: athletic identity, psychosocial support, retirement autonomy, life events, osteoarthritis, retirement and cognitive function. 48% of studies had good methodological quality; however, most studies were cross-sectional, relied on self-report measures and lacked follow-up data and female athletes. Retired HCTS athletes experience high levels of psychological distress and adverse alcohol use, but depression, anxiety and sleep disturbance were similar to population norms. These results call for greater support measures for retired athletes. CRD42023449114.

Individuals with ADHD face great challenges accessing formal psychosocial treatment. ADHD coaching has rapidly emerged online as a popular and accessible form of grassroots psychosocial support; however, there is a paucity of documentation about this workforce or the safety and effectiveness of its services. To document patterns in the ADHD coaching workforce, including workforce entry dates, services, and coach characteristics. The US National Survey on ADHD Coaching was conducted from October 1, 2024, to April 3, 2025, using a purposive electronic survey and snowball sampling. The survey was distributed online and in person to ADHD community hubs, professional listservs, and direct outreach to self-identified ADHD coaches providing care to at least 1 client in the US during the past year. The ADHD coaching workforce's characteristics and practices were assessed using descriptive statistics. The survey was completed by 481 ADHD coaches. Among 464 coaches who provided age data, the mean (SD) age was 51.3 (11.5) years. Among 467 coaches who provided gender data, 381 (81.6%) identified as women. Most of the ADHD coaching workforce (283 of 465 [60.9%]) began practicing during or after the COVID-19 pandemic, actively received referrals from health care professionals (312 of 481 [64.9%]), and served clients across state lines (389 of 481 [80.9%]). Many practiced internationally (194 [40.3%]). Most participants self-identified as either having or suspecting they have ADHD (338 of 465 [72.7%]), used lived experience with ADHD to inform their services (460 of 465 [98.9%]), and previously received ADHD coaching (207 of 465 [44.5%]). Coaches were typically self-employed (440 of 481 [91.5%]), worked from home (417 of 480 [86.9%]), had no professional license (396 of 466 [85.0%]), and operated without formal clinical supports (420 of 464 [90.5%]). ADHD coaches predominantly offered virtual 1:1 weekly sessions with self-pay fees similar to those of psychotherapists, advertising via social media or other online platforms. While 417 of 467 (89.3%) reported no professional background in mental health, 292 of 467 (62.5%) completed an ADHD coach-led curriculum prior to workforce entry. Most ADHD coaches reported using executive function skills training, cognitive restructuring, and motivational interviewing. They discussed clinical topics such as mental health crises, substance use, trauma, and medication adherence. The findings of this survey study suggest that there was a spike in ADHD coaching workforce entry at the outset of the COVID-19 pandemic that continues presently. Randomized clinical trials are essential to establish the safety and effectiveness of ADHD coaching. Conditional on positive findings of these trials, the health care and ADHD coaching communities might collaborate to develop standardized educational, credentialing and/or licensing, and clinical oversight.

Abstract Erectile dysfunction (ED) is one of the most frequent and distressing complications after radical prostatectomy (RP), significantly impairing patients’ quality of life and intimate relationships. Penile rehabilitation (PR) aims to preserve erectile tissue integrity, prevent fibrosis, and facilitate early functional recovery by restoring oxygenation to the corpora cavernosa. Current PR strategies include oral phosphodiesterase type 5 inhibitors (PDE5is), intracavernosal injections, and vacuum erection devices, used alone or in combination. Adjunctive options, such as low‐intensity shockwave therapy, stem cell therapy, and platelet‐rich plasma, are currently under investigation. Despite widespread use, there is no standardized PR protocol, and evidence remains mixed regarding optimal timing, dosage, and duration. This review summarizes contemporary and emerging PR modalities, highlighting evidence‐based principles, patient selection, and integration of preoperative counseling to set realistic expectations. Psychosocial support, partner involvement, and multidisciplinary collaboration are essential to maximize adherence and recovery. Future research should prioritize high‐quality randomized controlled trials to define standardized, evidence‐based PR protocols tailored to individual risk profiles and preferences, ultimately improving functional recovery and quality of life after RP.

ObjectivesDiabetes is highly prevalent in older women worldwide. This study explores the associations of psychosocial factors with both health service utilisation and self-management in older women aged 68 to 73 years with type 2 diabetes (T2D) or pre-diabetes.Design and settingThis cross-sectional study used data from the Australian Longitudinal Study on Women’s Health (ALSWH), which is a national population-based cohort study that has collected information on factors related to women’s health and well-being over 20 years.ParticipantsWomen aged 68–73, born between 1946 and 1951, participated in ALSWH and self-reported their diagnosis of T2D or pre-diabetes.Outcome measuresResilience, dispositional optimism and perceived control were the measures of psychosocial factors. The associations between these factors and diabetes self-management behaviours, healthcare visits and preventive service use were examined by numerous regression models.ResultsThere were 939 women aged 68–73 years with T2D or pre-diabetes. Women with T2D who exhibited higher dispositional optimism had significantly higher odds of participating in moderate/vigorous physical activity (OR: 1.06), visiting a dentist (OR: 1.07) and a lower rate of general practitioner (GP) visits (rate ratio (RR): 0.99). Women with T2D with greater resilience were likely to have a lower rate of consulting with mental health professionals (RR: 0.63) and higher odds of blood sugar level checks (OR: 1.68). The rate of GP visits within a year decreased by 16% for women with pre-diabetes who had a higher resilience score (RR: 0.84), and women with pre-diabetes with greater resilience had a 13% lower rate of visits to a nurse (RR: 0.87).ConclusionsPsychosocial aspects of diabetes care may be important for supporting the physical and mental well-being of older women with T2D or pre-diabetes. Healthcare providers may consider whether integrating assessments of resilience and optimism into routine diabetes management might help identify older women who could benefit from targeted psychosocial support.

This article examines the Aarhus Model as one of Europe’s most influential and empirically grounded reintegration frameworks in the post-radicalization process, situating it within a comparative analysis of France, Germany, and the United Kingdom. Drawing on a human-security perspective, the study argues that contemporary counter-extremism policies increasingly require a shift from punitive, state-centric approaches toward preventive, welfare-based and trust-oriented strategies. The analysis explores five core components of the Aarhus Model—outreach, counselling, education, family engagement, and aftercare—and evaluates how these principles have been adapted, transformed, or challenged across different governance structures. The findings show that while Denmark’s community-centered and voluntary design yields strong outcomes, transferability depends heavily on institutional capacity, public trust, and multi-agency cooperation. France’s centralized civic-re-education approach, Germany’s federal NGO-state partnerships, and the UK’s statutory Prevent system collectively reveal both the potential and vulnerabilities of European reintegration efforts. Overall, the study argues that sustainable disengagement requires continuous psychosocial support, community ownership, and policy designs that balance security with dignity.

Tungiasis is a neglected tropical skin disease caused by the sand flea Tunga penetrans. Female fleas burrow into the skin, typically of the feet, producing inflammation, pain, and itching. Although poverty is a major risk factor, not all households or children in the lowest economic bracket are affected, and boys appear disproportionately infected. This study investigated environmental and behavioral characteristics of households and children to explain these variations. A total of 3,871 pupils (equal numbers of boys and girls) aged 8-14 years from 44 primary schools in Kwale and Siaya counties, Kenya, were examined for tungiasis. In each school, infected and uninfected pupils were randomly selected for household observations and caregiver interviews. Overall, 273 cases and 548 controls were enrolled, from whom 198 infected and 199 uninfected pupils were selected for in-depth interviews. Mixed-effects logistic regression was used to identify risk factors at individual and household levels. Separate models were run for Kwale and Siaya due to contextual differences, and for boys and girls to explore sex-specific determinants. At household level, tungiasis was associated with higher odds in Muslim households in Kwale (aOR 2.44, 95% CI 1.28-4.62) and traditionist households in Siaya (aOR 2.27, 95% CI 1.06-4.86) compared to Christian households. Additional risk factors included having a male caregiver (Kwale: aOR 2.31, 95% CI 1.02-5.23), a child with disabilities (Siaya: aOR 7.19, 95% CI 1.64-31.65), and lack of caregiver involvement in schoolwork (Siaya: aOR 1.90, 95% CI 1.13-3.19). For girls, infection odds were higher if parents rarely attended school meetings (aOR 2.11, 95% CI 1.00-4.44) or when mothers were frequently absent (aOR 2.46, 95% CI 1.07-5.64). Caregiver stress scores were positively associated with infection risk across sexes (aOR 1.03, 95% CI 1.00-1.06). This study identifies novel risk factors for tungiasis beyond poverty, including caregiver characteristics, psychosocial stress, and parenting practices. Effective control interventions should integrate psychosocial support for caregivers and promote positive parenting alongside traditional One Health prevention and treatment strategies. not applicable.

The article examines the relationship between depersonalisation and the provision of psychosocial support among women in helping professions. The aim of the study was to determine the extent to which depersonalisation, as a consequence of occupational burnout, is present in women working in these professions, and to identify the factors that predict it. The research was a quantitative empirical cross-sectional study that applied a descriptive/analytical approach. The sample included 302 women from the Western Balkans. The findings show that approximately one-third of the participants exhibited mild symptoms of this phenomenon, whereas 12.5% had moderate to high levels. It was revealed that marital status, holding a professional licence, intercultural training, and international/intercultural experience are predictors of depersonalisation levels. Keywords: burnout, depersonalisation, helping professions, secondary traumatisation, vulnerable groups, gender.