Motor vehicle collisions (MVCs) are a significant public health challenge, resulting in substantial mortality and morbidity. Entrapment occurs in 12-33% of all MVCs and is associated with greater injury severity, longer on-scene time, and increased mortality. However, the psychological consequences of entrapment remain poorly characterised.

This scoping review seeks to establish the current understanding of the psychological sequelae of entrapment following MVCs and draws on insights from related fields of study in order to inform future research and clinical practice.

A scoping review was undertaken following established methodological guidance. Searches were completed on NHS Knowledge and Library Hub, Proquest, and Ovid. Eligible studies reporting psychological outcomes in casualties trapped following MVCs were included, with no restrictions to publication date. Secondary searches were also undertaken to explore psychological outcomes in the related contexts of MVCs more generally and entrapment in non-MVC settings, with salient findings presented to contextualise the primary search within more established literature.

Seven studies were included from the primary search. One additional study from the secondary searches was included in the primary research discussion due to a high degree of specificity to that topic. No study directly compared psychological outcomes in trapped versus non-trapped casualties. Reported experiences highlighted themes such as perceived threat to life, loss of control and the importance of supportive human contact. Some individuals experienced clinically significant mental health outcomes including post-traumatic stress disorder (PTSD), Acute Stress Disorder (ASD), anxiety, and depression. Secondary evidence supports the likelihood of increased psychological morbidity associated with MVC-entrapment.

Direct evidence on the psychological sequelae of MVC-entrapment is limited. Available findings suggest entrapment may heighten psychological risk through a range of factors, but prospective cohort studies comparing trapped vs non-trapped MVC casualties are needed to determine causal pathways. Further research should also explore rescue-based interventions such as facilitated self-extrication and deployment of extrication buddies, as well as appropriate trauma-informed psychological interventions in the immediate hospital setting and beyond.

The SARS-CoV-2 virus, responsible for COVID-19, was first identified in December 2019 and rapidly became a global pandemic. This health crisis placed unprecedented pressure on healthcare systems, and nurses, as frontline caregivers, bore the brunt of the psychological and physical toll. The burnout from this crisis highlighted the need to focus on nurses' resilience. To evaluate the effectiveness of the RENEW online educational program in enhancing the resilience of nurses working at Imam Hassan ^(AS) Hospital in Bojnurd(The capital of North Khorasan Province in northeastern Iran).

This randomized clinical trial was conducted in 2023 with the participation of 86 nurses who had a resilience score of ≤ 75. Participants were randomly assigned to either the intervention (RENEW) or the control group. The RENEW program consisted of six weekly online educational sessions. Data were collected using the Connor-Davidson Resilience Scale and the Kessler Psychological Distress Scale and were analyzed using SPSS.

The average resilience score in the intervention group showed a significant increase after the program implementation and at the six-month follow-up compared to the control group (P < 0.001). The interaction effect between time and group was also significant (P = 0.019), indicating the sustained effectiveness of the RENEW program in improving resilience.

The RENEW educational program significantly improved nurses' resilience. These findings emphasize the importance of designing structured interventions tailored to nurses' working conditions to enhance their mental health.

Iranian Registry of Clinical Trials (IRCT20240222061081N1). Registered on 19 May 2024.

The wars following the breakup of Yugoslavia led to mass displacement, violence, and long-term psychological suffering among civilians. While clinical responses to war-related trauma and refugee experiences have been widely studied, less is known about how survivors make sense of these events decades later and how trauma and emigration continue to shape their identity, relationships, and wellbeing.

This study examines the long-term psychological impacts of war and migration among civilian survivors of the Balkan wars resettled in the Czech Republic, with attention to meaning-making processes decades after the original events.

We conducted an interpretative phenomenological analysis of in-depth, semi-structured interviews with four adult civilian survivors of the Balkan wars, all of whom experienced emigration and long-term resettlement.

Participants described wartime life as isolating, marked by survival-focused coping. They highlighted the importance of close relationships, routines, and developmental stage in shaping how they endured this period. Decades later, they reported persistent vigilance, moral reflection, and existential questioning, alongside posttraumatic growth. Migration was perceived as a prolonged, transformative process reshaping identities and relationships to cultural roots. Intergenerational impact emerged, with participants reflecting on survival strategies transmitted to their children.

The findings suggest that war trauma and migration are not discrete events but temporally extended, relational processes, unfolding across the lifespan. This perspective advances psychological understanding of trauma trajectories, identity reconstruction, and intergenerational adaptation.

Adolescence is a critical period for brain development, during which dietary patterns may influence neuropsychological functioning.

To examine cross-sectional associations and determine if baseline adherence to the Mediterranean diet (MD) and ultra-processed food (UPF) consumption is associated with changes in adolescent neuropsychological outcomes over 6 months.

This study represents a secondary analysis of the WALNUTs Smart-Snack Trial. We evaluated 653 adolescents (aged 12-16 years) from Barcelona at baseline and at 6-month follow-up. All dietary data used for these analyses were collected at the baseline timepoint only. MD adherence was measured with the KIDMED index and UPF consumption was assessed using a food frequency questionnaire and classified using the NOVA system. Cognitive domains were assessed at both time points using standardised computer-based tasks: attention (alerting, orienting, executive control) with the Attention Network Test; working memory (4-back) with the N-back task; fluid intelligence with the Primary Mental Abilities-Revised; decision-making with the Roulettes Task; and emotion recognition with the Emotion Recognition Task. Behavioural outcomes were also evaluated at both time points using the self-reported Strengths and Difficulties Questionnaire and teacher-reported Attention-Deficit/Hyperactivity Disorder-DSM-IV scales. Associations were examined using multivariable generalised linear models. To further validate UPF consumption estimations, polyphenol biomarkers were measured in urine in a subsample of 257 participants.

Greater adherence to the MD was cross-sectionally linked to fewer behavioural problems and higher scores of executive functioning, while higher UPF consumption was associated with poorer emotion recognition, reduced alerting attention, less advantageous decision-making, more behavioural problems and internalising symptoms. Longitudinally, higher UPF consumption was associated with more internalising symptoms and less advantageous decision-making, whereas MD adherence showed no associations.

Greater MD adherence appears associated with more favourable behavioural and cognitive profiles. In contrast, higher UPF consumption seems to be associated with less favourable profiles across multiple neuropsychological domains in adolescents. However, the limited longitudinal evidence points to complex relationships that warrant further investigation. Overall, these findings highlight the importance of promoting healthier dietary habits during adolescence.

Stimulant-affected drivers are overrepresented in global road trauma statistics, however, studies to date have not accurately defined how drug consumption contributes to increased risk of road trauma. This study examined whether attitudes toward drug driving predicts dangerous driving behaviour among people who currently use methamphetamine, and whether this differs to individuals with no history of any drug use.

Three attitude factors (favourable attitudes toward risks, unfavourable attitudes toward sanctions, and favourable peer attitudes) were explored using an adapted version of attitudes towards drug driving scale and dangerous driving was measured using the Dula Dangerous Driving Index.

A multigroup structural equation model indicated that individuals who use methamphetamine report more favourable attitudes toward drug driving compared to those who have never used drugs. Among people who use methamphetamine, a favourable attitude towards drug driving risks predicted higher dangerous driving behaviour scores, while more unfavourable attitudes toward sanctions for drug driving predicted lower scores. Among those with no history of substance use, favourable peer attitudes toward drug driving predicted dangerous driving behaviour.

Attitudes towards drug-driving, and their relationship to dangerous driving behaviour differs between those who use methamphetamine and those who do not have a history of substance usage. Targeted campaigns aimed specifically at reducing methamphetamine-related road trauma should challenge general underlying beliefs and attitudes about drug driving, rather than simply the impact of potential sanctions or influence of peers.

Exogenous sex hormones have been extensively studied for their influence on stroke risk and outcome. This meta-analysis served to update the pre-clinical acute ischemic stroke (AIS) literature and provide the first synthesis of the intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH) literature on how estrogen, progesterone, and testosterone affect post-stroke outcomes.

This study was pre-registered with PROSPERO (CRD42024544794). Medline, EMBASE, Scopus, and Web of Science were searched; studies using animal models of stroke investigating exogenous estrogen, progesterone, or testosterone, alone or in combination, compared to non-treated controls were included. Assessments of injury volume, edema, and behaviour (neurological deficits, sensorimotor and cognitive outcomes) were analyzed via hierarchical meta-analyses. Risk of bias was assessed via SYRCLE and CAMARADES, and evidence certainty via an adaptation of the GRADE tool.

In total, 211 studies were included. Estrogen and progesterone improved all post-AIS outcomes (SMDs = 0.32-1.30, 95% CIs [0.02, 2.07], very low to moderate certainty of evidence), whereas testosterone had mostly null effects (very low to moderate certainty). Fewer studies investigated hemorrhagic stroke, with null effects of estrogen (very low to low certainty) and conflicting results of progesterone (SMDs = 0.15-1.16 [-2.20, 2.58], very low to moderate certainty) in ICH, as well as benefit of progesterone in SAH (SMD = 2.63 [0.98, 4.30], very low certainty). Uncertainty in our evidence arose from low scientific and translational rigor. Sex and gonadal status were consistent moderators of these effects, and gonadal depletion length (i.e., the 'timing hypothesis') was a significant moderator of estrogen's effect on post-AIS injury volume.

Estrogen and progesterone are promising cerebroprotectants for AIS. Further focussed and rigorous pre-clinical research on remaining research gaps (e.g., dosage parameters) are needed to guide clinical investigations and maximize the likelihood of translational success. The impact of testosterone and sex hormones in hemorrhagic stroke remain inconclusive due to lack of research.

Transgender and gender-diverse (TGD) adolescents experience elevated rates of depression, anxiety, and suicidality compared to cisgender peers. These outcomes are largely hypothesized to be linked to social stigma and gender minority stress. Resilience constructs like identity pride and community connectedness may buffer these stressors, but their role, especially in clinical populations, remains underexplored. This study investigates the interplay between gender minority stress, resilience, and mental health in clinic-referred Dutch TGD youth through network analysis.

A sample of 172 Dutch TGD adolescents was assessed using commonly employed measures of gender minority stress, resilience, and mental health. Network analysis was conducted to examine network structure and centrality of these constructs. Among the 172 clinic-referred Dutch participants (mean age = 15.70, SD = 0.79), 86.0% (n = 148) were assigned female at birth, 14.0% (n = 24) were assigned male at birth, and 9.9% (n = 17) of the total sample identified as non-binary and genderqueer (NBGQ).

Among the participants, 41.7% scored within the clinical range for internalizing problems, and 32.7% exhibited scores indicative of mild to severe depression. Non-affirmation, an established construct in gender minority stress literature, emerged as the most central construct in the network, with strong associations to internalized transphobia and negative expectations for future events. Distal gender minority stressors, such as gender-related rejection and victimization, were less central within the network, but indirectly influenced mental health via pathways involving the more central stressors. Resilience constructs, specifically pride and community connectedness, showed limited centrality.

The findings highlight the substantial psychological vulnerabilities of Dutch TGD adolescents and underscore the importance of addressing non-affirmation, internalized transphobia, and negative expectations for future events in clinical settings to mitigate mental health challenges among TGD youth. The study also emphasizes the necessity of societal-level interventions, such as raising awareness about the value of affirming gender identity. Future research should explore the nuanced distinctions within and between different gender minority stressors and their specific impacts on TGD youth.

Digital mental health interventions (DMHIs) have shown promise improving depression, anxiety, and psychiatric distress, yet real-world engagement remains low. Increasing engagement has great potential to improve the impact of DMHIs, but little is known about the drivers of engagement in naturalistic settings. To better understand predictors of engagement, we examined sociodemographic and clinical characteristics associated with DMHI usage among a large clinical sample of adults.

1223 adults (74% White, 68% women, Mage = 36.8 years) with scheduled intake appointments for outpatient psychiatric services were randomized to either a mindfulness-based app (Headspace) or a CBT-based app (SilverCloud). Usage data were automatically collected, and participants were neither required nor compensated to use the apps.

Participants engaged with their assigned DMHIs a median of 8 days, with 88.2% of participants using their assigned DMHI at least once. Participants engaged with Headspace for more than twice as many days [IRR (95% CI) = 2.4 (2.1, 2.7)] as SilverCloud. Female sex, white race, a college degree, and older age up to 60 predicted greater engagement. Further, depression severity was associated with engagement in a non-linear manner for those assigned to Headspace, with less engagement at minimal/mild and severe symptoms compared to moderate and moderately-severe symptoms.

These findings indicate meaningful differences in engagement between DMHIs based on sociodemographic and clinical characteristics. There may be opportunities to improve engagement by tailoring DMHI offerings, with a particular emphasis on meeting the needs of less-engaged populations.

Secondhand smoke (SHS) and thirdhand smoke (THS) have been shown to increase the risk of physical health and mental health. However, the impact of SHS and THS exposure on ADHD symptoms and executive function remain to be elucidated.

Online surveys were used to recruit participants at a Chinese vocational college. The frequency of contact with smokers or detecting tobacco odors in residential environments was used to define SHS exposure, whereas the frequency of contact with surfaces contaminated by smokers was used to define THS exposure. The associations of SHS and THS exposure with the risk of ADHD symptoms and the executive function (Behavioral Regulation Index, BRI; Metacognitive Index, MI; Global Executive Composite, GEC) scores were evaluated by logistic regression analysis or linear regression analysis.

The rate of SHS and THS exposure was 87.7% and 76.9%, with 8.2% stating SHS exposure ≥15 min at least 1 day/week. After adjustment for confounding variables, SHS exposure (≥15 minutes on ≥1 day/week) had higher odds of ADHD symptoms (OR, 1.31; 95% CI, 1.02-1.67), and higher BRI score (β, 2.34; 95% CI, 0.95-3.73), higher MI score (β, 3.12; 95% CI, 1.29-4.95), higher GEC score (β, 5.46; 95% CI, 2.26-8.66). Additionally, the higher the frequency of SHS/THS exposure and the greater the number of surrounding smoker, the higher risk of ADHD symptoms and the poorer executive function (P trend <0.001).

SHS and THS exposure were related to the occurrence of ADHD symptoms and impaired executive function among young adults at a Chinese vocational college in this cross-sectional study. Further researches are warranted to validate these associations in more diverse populations.

This study investigated the intervention effects of different physical exercise programs on multidimensional health outcomes in patients with substance use disorders. Through systematic categorization of intervention types, duration, frequency, and outcome indicators, this research aimed to provide evidence-based exercise prescriptions for rehabilitation treatment of patients with substance use disorders.

A systematic search was conducted across six databases: PubMed, Web of Science, Cochrane Library, EMBASE, SCOPUS, and ScienceDirect, retrieving 11,689 articles related to substance use disorders. The search period was limited from database inception to July 1, 2025. Data extraction and quality assessment were performed using Review Manager 5.4 software, ultimately including 33 articles meeting inclusion criteria, encompassing 2,922 participants. Subsequently, network meta-analysis was conducted using Stata 16.0, with results presented as standardized mean differences (SMD) and 95% confidence intervals (CI).

A total of 33 randomized controlled trial articles were included, comprising 57 randomized controlled trials with 2,922 subjects. Network meta-analysis results demonstrated that aerobic exercise and mind-body exercise exhibited significantly different advantages: aerobic exercise performed optimally in physiological health indicators (SUCRA = 0.874), followed by substance use outcomes (SUCRA = 0.468) and sleep quality (SUCRA = 0.446); mind-body exercise showed the greatest advantage in improving sleep quality (SUCRA = 0.884), with cognitive function (SUCRA = 0.608) and mental health (SUCRA = 0.588) ranking second and third, respectively. In pairwise comparisons, substance use outcomes in the mind-body exercise network showed significant advantages compared to sleep quality (effect size 44.58, 95% CI: 3.30-85.85), while all comparisons in the aerobic exercise network did not reach statistical significance.

Different types of exercise exert therapeutic effects in their respective advantage domains through unique molecular biological mechanisms. Aerobic exercise primarily improves physiological health indicators through AMPK signaling pathways and anti-inflammatory mechanisms, while mind-body exercise optimizes sleep quality and cognitive function through HPA axis regulation and GABA receptor upregulation. These findings provide important evidence-based medical evidence for developing personalized exercise prescriptions for substance use disorders, contributing to the establishment of evidence-based rehabilitation treatment guidelines.

https://www.crd.york.ac.uk/PROSPERO/, identifier CRD420251144089.