People with cancer who have limited English proficiency (LEP) are at high risk for poor mental health outcomes in survivorship as they face cultural, linguistic, and mobility-related barriers to accessing psychosocial care. Telemental health interventions can be of great utility because they can decrease participation burden and are cost-effective. Patients with LEP who receive telemental health services primarily access them through remote interpretation due to a shortage of bilingual therapists. Remote interpreting can be: (1) simultaneous (rarely used in medical settings) or consecutive (usual care in medical settings). Prior research has found that Remote Simultaneous Medical Interpreting (RSMI) resulted in fewer errors, better medical outcomes, and higher patient satisfaction than consecutive methods in oncology and primary care settings. Yet, RSMI has not been studied in the context of a counseling/psychotherapy encounter. INTERPRET-PSY is a mixed method, 3-arm pilot randomized controlled trial (RCT) designed to determine if RSMI is feasible and acceptable in comparison to usual care (RCMI) and "gold standard" care (bilingual provider) in delivering counseling/psychotherapy to Mandarin-speaking LEP cancer patients.

A total of 45 participants will be randomly assigned to one of 3 arms (n = 15 RCMI, n = 15 RSMI, and n = 15 bilingual provider) to receive 6 counseling/psychotherapy sessions. Feasibility and acceptability of the interpreting modalities (RCMI, RSMI) will be evaluated through self-report assessments. Secondary outcomes will include therapeutic alliance, MCP-Ch content comprehension, and clinically significant interpreting errors across the interpreting (RCMI, RSMI) arms. Semi-structured interviews with a purposively sampled subset of patients, their interventionists, and interpreters (if applicable) across all 3 arms will assess potential barriers and facilitators to successful interpreter-mediated communication and outcomes.

INTERPRET-PSY is the first study to examine the feasibility and acceptability of delivering a culturally adapted, evidence-based, and telehealth-delivered counseling/psychotherapy intervention to cancer patients with LEP via RCMI and RSMI. Results of the pilot RCT will be submitted for publication in a peer-reviewed journal and serve as preliminary data for a larger, multisite RCT grant application for a fully powered RCT of interpreting modalities in the provision of linguistically accessible and culturally appropriate psycho-oncology care.

NCT02112188.

The ubiquity and popularity of social media among youth has led to skyrocketing increases in cyberbullying rates among American teens. National studies show cyberbullying victimization is experienced differently by sex, race, and sexual orientation. While rural youth experience bullying at higher rates than urban teens, few studies have focused on rural victimization.

We analyzed cross-sectional data from county-level YRBS, years 2016, 2018, 2021 and 2023, performing multivariable logistic regressions to assess adjusted relationships between cyberbullying, conventional school bullying and suicidality. Stratified models were used to test for effect modification by sex and sexual orientation and mediation analysis was performed to assess mediation of the relationships between suicidality and bullying modalities by self-harming or sadness. Indirect associations in significant mediated relationships were assessed for effect modification by sex and sexual orientation.

Bullied rural youth were significantly more likely to consider suicide, with larger associations for cyberbullying in girls, and conventional bullying in boys. Cyberbullying and conventional bullying were significantly associated with suicidality, with 55-63% mediation by self-harming, and 51-56% mediation by persistent sadness. Indirect effects were significantly moderated by sexual orientation, but not by sex.

Self-harming and sadness are significant mediators for suicidality in the presence of bullying modalities. Results suggest need for educational programs focused on bullying and responsible internet use alongside tailored interventions based on sex, sexual orientation, and mental health history. Access to compassionate and appropriate treatment in rural school-based health centers may be a solution.

Sex and gender differences may significantly impact health outcomes, yet their role in antibiotic therapy remains underexplored. Despite the urgent threat of antimicrobial resistance, limited evidence exists on how biological, pharmacokinetic, and sociocultural differences affect antibiotic efficacy, safety, and usage. This gap is critical, as women are often underrepresented in clinical trials, leading to suboptimal treatment strategies and a higher incidence of adverse drug reactions.

This narrative review synthesizes current evidence on these disparities. We explore the biological basis for differential immune responses and drug pharmacokinetics, sociocultural drivers of prescribing patterns, gender-specific infections, and the intersection of gender with antimicrobial resistance. The review also addresses antibiotic use in pregnancy and highlights the profound lack of data for both cisgender and transgender women due to their exclusion from research.

Sex-aware prescribing is a practical and necessary step toward equitable care. Key obstacles include historical underrepresentation of women in trials and insufficient sex-disaggregated data. We advocate for powering future trials for sex-specific analyses, updating clinical guidelines, and using decision support tools for dose adjustments. Integrating a gender lens into all levels of antimicrobial stewardship is essential to move from simply describing disparities to actively closing them.

Maternal mental health issues such as depression, anxiety and stress are prevalent among mothers of neonates in the neonatal intensive care unit (NICU). These psychological challenges can impact both maternal well-being and the mother-neonate bond.

This meta-analysis aims to evaluate the effectiveness of nursing interventions in improving maternal mental health outcomes, including depression, anxiety, stress, mother-neonate interaction and sleep quality in NICU settings.

Systematic review and meta-analysis were conducted in databases including PubMed, Scopus, Cochrane Library, CINAHL and PsycINFO. Data were pooled using standardised mean differences (SMDs) and analysed using a random effects model. Heterogeneity was assessed using I² statistics, and publication bias was evaluated with funnel plots and Egger's test.

Final number of included studies was 36. Nursing interventions significantly reduced maternal depression (SMD = -0.296, p = 0.002), stress (SMD = -1.326, p < 0.001) and anxiety (SMD = -0.694, p = 0.001). However, no significant effects were observed for mother-neonate interaction (SMD = 0.071, p = 0.903). Heterogeneity was high for stress (I² = 95.0%) and anxiety (I² = 89.2%), while there was no publication bias detected for depression, anxiety or stress.

Nursing interventions significantly reduce maternal depression, anxiety and stress in the NICU. However, their impact on mother-neonate interaction and sleep quality remains unclear.

Given the substantial impact of stress and anxiety on maternal well-being, implementing structured interventions such as psychoeducation, stress management and mindfulness could significantly reduce the psychological burden on mothers.

Limited existing research on mental health and health-related quality of life (HRQoL) in people with hemophilia (PwH) suggests these patients still may have poor mental health despite treatment advances significantly improving somatic outcomes.

This multicenter study aimed to systematically assess mental health and HRQoL and their association with disease severity, age and treatment regimen among PwH.

This cross-sectional study, conducted in nine Swiss hemophilia treatment centers, included participants aged six years and older with congenital hemophilia of any severity. The study procedure comprised a semi-structured psychiatric diagnostic interview and an online survey comprising age-validated psychological measures to capture mental health and HRQoL. Treatment centers provided clinical data.

Of 164 PwH enrolled in the study, 156 participants completed the psychiatric diagnostic interview. 25% met the criteria for a mental disorder (MD). Most common among the MD were affective disorders, substance use disorders, and attention deficit hyperactive disorder. Moderate/severe hemophilia and lower baseline factor activity were significantly associated with higher psychopathology and lower HRQoL. Of participants with moderate/severe hemophilia, 26% of those on prophylaxis versus 45% of those on on-demand met the criteria for an MD.

Elevated prevalence of MD, and the association of psychopathology with disease severity and treatment regimen, highlights the continued relevance of mental health in hemophilia research. Further objective clinical research is indispensable to define targets for improved and individualized comprehensive treatment care plans.

Major treatment advances have transformed hemophilia care, allowing most people with hemophilia (PwH) to have average lifespans. Reduced bleeding complications have shifted attention to overall well-being and mental health of PwH. The multicenter Swiss HERMES study examined 164 children and adults with hemophilia to explore the link between disease severity, treatment regimen, mental health, and health-related quality of life using standard questionnaires and a psychiatric interview. About one in four participants had at least one mental disorder-most often depression, substance use disorders, or ADHD. Participants with moderate or severe hemophilia, or lower clotting factor levels, reported poorer health-related quality of life. Prophylactic treatment may support mental health in participants with moderate or severe hemophilia. These findings show that mental health issues are common in PwH and highlight the need to integrate psychological screening and support into comprehensive hemophilia care.

Novel risk factors for stroke, such as occupation, are increasingly under exploration. We investigate if specific occupational exposures and settings increase the risk of developing small-vessel disease (SVD), including SVD-related strokes.

We performed a systematic review on stroke-occupation associations and then analyzed data from patients presenting to Lothian stroke services with mild ischemic stroke (modified Rankin Scale score ≤2). We performed magnetic resonance imaging and inquired about occupational status. We assessed relationships between high-risk occupations (per Control to Substances Hazardous to Health guidelines) and standard occupational classifications (per Standard Occupational Classifications criteria) against white matter hyperintensity volumes, SVD score, and stroke subtype.

Our systematic review identified 37 papers assessing occupations/broad occupational classifications (n=13), psychosocial work-related factors (n=11), and occupational exposure to hazardous substances (n=13). We then analyzed data from 414 participants and found, after adjustment for age, hypercholesterolemia, socioeconomic status, years of education, hypertension, diabetes, and smoking history, that high-risk occupations were associated with higher SVD scores (odds ratio, 1.64 [95% CI, 1.07-2.54]; n=357; P=0.02) but not for lacunar stroke subtype (odds ratio, 1.03 [95% CI, 0.64-1.67]; n=358; P=0.90) or white matter hyperintensity volume (% intracranial volume) (β=-0.003 [95% CI, -0.015 to 0.008]; n=357; P=0.60). Examples of high-risk occupations include drivers, engineers, and skilled trade workers. No associations were found for standard occupational classifications.

This systematic review shows limited data on stroke-occupation associations. Our analysis showed that high-risk occupations are associated with higher SVD scores but not stroke subtype.

URL: www.crd.york.ac.uk/PROSPERO; Unique Identifier: 42024466671.

Understanding service users' knowledge of and attitudes towards the rapidly progressing field of mental health technology (MHT) is an important endeavour in clinical psychiatry.

To evaluate the current use of and attitudes towards MHT (mobile apps, online therapy and counselling, telehealth, web-based programmes, chatbots, social media), a 5-point Likert-scale survey was designed based on previous studies and distributed to attendees of an adult community mental health service in Ireland. Chi-square tests were used and corrected for multiple comparisons.

107 mental health service users completed the survey (58% female, aged 18-80). 86% of respondents owned a smartphone. 27.1% reported using a mental health application, while 33.6% expressed interest in using one in the future. 61.7% reported they had not used and were not interested in using AI for their mental health, and 51.4% indicated they would not feel comfortable using it. 46.8% were not comfortable with psychiatrists utilising AI in their care. The majority (86.9%) preferred face-to-face appointments, while 52.6% would consider using MHT while on a waiting list. Younger participants reported significantly greater comfort using mental health apps and higher self-rated knowledge of AI.

There were low levels of knowledge about and comfort using MHT, accompanied by concerns about confidentiality and privacy. Younger service users tended to be more comfortable with and knowledgeable about MHT. Despite the growing interest in digital approaches, there remains a clear preference for face-to-face appointments, underscoring the importance of addressing privacy and safety concerns, together with training and education.

Cosmetic tourism has become increasingly popular, with patients seeking lower cost cosmetic surgery overseas. However, complications often necessitate management in local public hospitals upon their return, placing a burden on healthcare systems. This study examines the demographics, complications, interventions and resource utilisation of patients presenting to an Australian hospital with complications from overseas cosmetic surgery.

This study retrospectively reviewed patients who presented to Westmead Hospital, NSW, during two time periods-01/07/2022 to 01/01/2023 and 01/05/2024 to 30/12/2024-with complications following cosmetic surgery performed overseas. Hospital records were analysed to extract data on patient demographics, comorbidities, presenting complications, interventions, diagnostic tests and resource utilisation. Descriptive statistics were used to summarise the findings, and patterns in clinical management were evaluated.

Twenty-four patients met the inclusion criteria, with a mean age of 38.4 ± 12.5 years; 87.5% were female. Comorbidities included smoking (50%), mental health conditions such as anxiety, depression, or self-harm (20.8%) and hypothyroidism (12.5%). Abdominoplasty (54.2%), breast augmentation (20.8%) and liposuction (25%) were the most frequently performed procedures. The mean Charlson Comorbidity Index was 0.2 ± 0.4, and the mean LACE Index was 5.9 ± 1.5. Complications included wound dehiscence (45.8%), infection (41.7%) and seroma (20.8%). The median time from surgery to presentation was 3.8 weeks, with a mean hospital stay of 3.3 ± 2.9 days. Interventions included oral antibiotics (83.3%), IV antibiotics (58.3%), drainage or aspiration (33.3%) and surgery (54.2%).

Overseas cosmetic surgery is associated with high complication rates and significant utilisation of public hospital resources. These findings highlight the impact of cosmetic tourism on the Australian healthcare system.

This study aimed to investigate the prevalence and determinants of depression and subthreshold depression among Chinese university students, with a focus on the influence of demographic, behavioral, and academic factors.

A cross-sectional survey was conducted among 3,600 undergraduates from five universities in central China using the CES-D scale and a self-designed lifestyle questionnaire. Multivariate logistic regression and ANOVA were employed to identify risk and protective factors.

The overall depression detection rate was 25.60%, with 9.97% classified as subthreshold depression. Male gender, senior year, low family income, and major dissatisfaction were significant risk factors. Regular exercise served as a protective factor, while excessive smartphone use, smoking, alcohol use, and family history of mental illness were associated with increased risk. A dose-response relationship was observed between major satisfaction and depression severity.

The findings support a spectrum-based view of depression and highlight the need for multidimensional, personalized mental health interventions targeting high-risk student subgroups.