Background: Family involvement in promoting patient safety is a strategy that is increasingly recognized. Nurses have a major role to play here. This study aims to know the family care process developed by nurses and explore the logistic process identified as support for the development of family care in ensuring patient safety in the hospital. Methods: An interpretative qualitative study was conducted through semi-structured interviews with 10 nurses selected by convenience. Content analysis was performed using Atlas.ti 9.1.7 software and Bardin's methodology. Results: Two large families were identified according to the nature of the strategies mentioned by the participant/s: assistance process and logistic process, 5 categories and 23 subcategories. Care process categories: initial assessment, planning, and implementation. Categories of the logistic process: material and human resources and organization. Conclusions: To implement patient and family-centered care to ensure patient safety, it is necessary to adjust the care and logistic process. At the care level, the importance of the nursing process in the organization of care is evident. At the logistical level, organizational initiatives are needed to stimulate and support this philosophy of care and to intervene at the level of human and material resources.

Pregnant individuals who receive a fetal anomaly diagnosis experience significantly elevated rates of depression, anxiety, and traumatic stress-up to four to six times higher than those for individuals with low-risk pregnancies. In low-risk pregnancies, perinatal mental health conditions are the leading cause of maternal mortality and are associated with adverse birth outcomes, including preterm birth and low birth weight. These risks are likely compounded in pregnancies involving fetal anomalies due to the intersecting psychological and social burdens that complicate maternal well-being and access to care. However, there is a critical gap in understanding how these mental health symptoms translate into diagnoses, treatments, and outcomes due to the absence of a validated screening tool tailored to this population's unique psychosocial needs. This perspective article reviews evidence, highlights the urgent need for specialized screening, and introduces ongoing research aimed at developing and validating an instrument that integrates both mental health symptoms and broader psychosocial distress. By bridging this gap, structured psychosocial screening has the potential to improve care coordination, facilitate earlier intervention, and mitigate long-term distress for individuals navigating pregnancies affected by fetal anomalies.

Persons with communication disorders are susceptible to mental health difficulties and often require the help of mental healthcare professionals. Mental healthcare interventions require a significant amount of communication between the mental healthcare professional and the person with communication disorders, yet not much is known about how mental healthcare professionals provide mental healthcare services to persons with communication disorders. The study, therefore, aims to explore the experiences of mental healthcare professionals in providing mental healthcare services to persons with communication disorders.

A qualitative phenomenological research approach was employed, where 11 semi-structured interviews were conducted with mental healthcare professionals practising in the Gauteng Province of South Africa (n = 7 social workers; n = 3 psychologists; n = 1 counsellor). Participants were purposively selected for the study. Data were analysed using inductive reflexive thematic analysis.

The following four themes emerged from the data that were analysed: (i) lack of preparedness to provide care to persons with communication disorders, (ii) communication barriers, (iii) emotional effects and (iv) accommodations.

Findings suggest that communication barriers are a source of frustration, and they hinder persons with communication disorders from accessing quality mental healthcare services. There is therefore a need to include in the curriculum of mental healthcare professionals, training on communication disorders and on strategies to foster communication with this population during intervention. Conversational partner training and collaborations between mental healthcare professionals and speech language therapists could potentially be used to address the communication barriers in mental healthcare provision for persons with communication disorders.

What is already known on this subject Persons with communication disorders are susceptible to mental health difficulties because the communication impairment reduces their societal and economic inclusivity, thus placing them at a higher risk of developing mental health challenges. Unfortunately access to quality mental healthcare services is a challenge for this population for many reasons, with the most pronounced one being the fact that they do not depend on verbal language to communicate their needs (are voiceless) and require reasonable accommodation to facilitate communication, yet the techniques and methods used in mental healthcare intervention whether formal or informal are predominantly based on verbal communication. What this paper adds to existing knowledge The study advocates for the implementation of educational opportunities for mental healthcare providers through communication/conversational partner training programmes. These programmes can potentially improve their knowledge and skills on how to effectively support communication with persons with communication disorders, to mitigate communication challenges. Research has demonstrated positive effects of communication partner training. Speech language therapists, as communication brokers due to their expertise in facilitating communication, should be at the centre of developing such training programmes. Speech language therapists should also foster collaborations with mental healthcare professionals in clinical spaces when treating persons with communication disorders. What are the potential or actual clinical implications of this work? The lack of knowledge on communication disorders and the subsequent lack of knowledge and skills on appropriate communication strategies to implement when conducting mental healthcare interventions with persons with communication disorders compromises patient care and subjects persons with communication disorders to continuous substandard patient care, which is essentially an infringement on their right to healthcare. It is common knowledge that communication forms the cornerstone of all healthcare interventions, and where there are communication barriers between healthcare providers and their patients, healthcare provision becomes unsuccessful, resulting in negative patient outcomes. The study offers a potential solution to these communication challenges.

Mental healthcare service access in South Africa is currently strained due to, among others, shortages of specialised mental healthcare professionals. The National Strategic Plan for HIV, TB and STIs (2023-2028) recommends enabling nurses to diagnose, prescribe and dispense neuropsychiatric medication for promoting mental health services. The aim was to explore and describe the existing practices, strengths and challenges for nurses prescribing neuropsychiatric medication globally through a scoping and document review. A standardised search was conducted across PubMed, CINAHL and EBSCOHost electronic databases. An online Google search was conducted across governmental legislative and regulatory websites. The Joanna Briggs Institute scoping review framework was followed using relevant MeSH terms and free-text words. South African governmental and parastatal documentation relating to relevant regulatory frameworks affecting such prescribing authorisation in South Africa was analysed following Bowen (2009) guidelines. Of 817 citations identified, 20 reports were included. The included reports originated mostly from developed countries, with only one from South Africa. Patients and healthcare professionals were mostly positive towards including the prescription of neuropsychiatric medication in the nursing care model. Prescription of Schedule 5 and 6 controlled substances by nurses is already authorised in the USA and UK. In South Africa, nurses are not yet permitted and will require amendments to the legislative framework that guides nursing practice. Nurses can prescribe neuropsychiatric medications in certain developed countries; however, contextual research is necessary to ascertain whether South African stakeholders will support such an authorisation. Educational and interprofessional concerns will need to be thoroughly assessed to ensure that appropriate competencies are obtained, ensuring the boundaries of the scope of practice. Investigation of potential professional overlap of responsibilities and perceptional biases, as well as transformation of educational platforms, will be needed should such a recommendation come to pass. Furthermore, legislative changes will be required to authorise the prescription of neuropsychiatric medications.

Informal caregivers of individuals with Alzheimer's disease and related dementias (ADRD) face significant physical and psychological demands. Chronic caregiving is linked to mental health challenges, poor cardiovascular health, and accelerated cellular aging, reflected in telomere shortening, with Black caregivers disproportionately affected.

This secondary analysis used data from Black caregivers from a randomized control trial. Telomere length was measured by qPCR. Questionnaires assessed perceived stress, sleep, depression, anxiety, and coping strategies. Salivary cortisol, inflammatory, and cardiometabolic biomarkers were measured. Pearson correlations and linear regression analyses controlled for demographic and health factors.

Shorter telomeres were linked to stress, poor sleep, inflammation, and cardiometabolic markers. Perceived stress was associated with negative coping strategies, anxiety, and depressive symptoms.

More research is needed to uncover mechanisms linking caregiver stress to cardiovascular health, guiding tailored interventions to reduce stress and improve cardiovascular health in Black caregivers of persons with ADRD.

Chronic stress in Black caregivers: Chronic caregiving stress was linked to accelerated cellular aging, inflammation, and poor cardiometabolic health. Perceived stress associations: Higher perceived stress was associated with negative coping strategies, poor sleep quality, anxiety, depression, and reduced telomere length. Telomere length and cardiometabolic risk: Shorter telomere length was significantly associated with elevated cardiometabolic risk markers, including insulin resistance and increased blood pressure. Need for interventions: Findings emphasize the importance of culturally tailored interventions aimed at reducing stress and mitigating health risks in Black caregivers of persons living with Alzheimer's disease.

Background. Grounded in the Integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework, we investigated the Train-the-Trainer (TTT) to expand access to evidence-based psychological treatments (EBPTs) in community mental health centers (CMHCs), focusing on the Transdiagnostic Intervention for Sleep and Circadian Dysfunction (TSC). Methods. Eight Californian counties were cluster-randomized to Standard TSC or an adapted version designed to improve the "fit" of TSC to CMHCs. University-based trainers trained CMHC providers ("Generation 1 providers") in either Adapted or Standard TSC. These trained providers were then trained to become local CMHC trainers ("Generation 1 trainers"), who then trained a new cohort of providers ("Generation 2 providers") in TSC. Within each county, patients diagnosed with serious mental illness (SMI) were randomized to receive either immediate TSC or usual care and delayed treatment with TSC (UC-DT) from the Generation 2 providers ("Generation 2 patients"). This study focused on 53 Generation 2 providers (Adapted TSC = 47; Standard TSC = 6), and 143 Generation 2 patients (Adapted TSC = 127; Standard TSC = 16) (the larger Adapted sample was driven by recruitment, perhaps reflecting preference for the "fitted" approach). Patient assessments were conducted pre-treatment, post-treatment, and six-month follow-up (6FU). Provider assessments occurred after completing TSC training and post-treatment for each patient treated. Results. Combining Adapted and Standard, TSC was associated with improvements for Generation 2 patients from pre- to post-treatment in sleep disturbance ( p < 0.001, d = -0.90), sleep-related impairment ( p = 0.001, d = -0.69), psychiatric symptoms ( p = 0.002, d = -0.48), and functional impairment ( p = 0.002, d = -0.54), relative to UC-DT. The effects of sleep disturbance and impairment on the relationship between treatment condition (TSC vs. UC-DT) and psychiatric symptoms and functional impairment were significant. Higher provider perception of TSC fit predicted improvements in selected patient outcomes. Conclusion. TSC can be delivered by CMHC providers trained by local CMHC trainers with strong outcomes. These data contribute to the dearth of evidence for TTT collected from locally trained providers and from patients treated by local CMHC trainers. Trial registration: Clinicaltrials.gov identifier: NCT05805657. Registered on March 10, 2023. https://clinicaltrials.gov/ct2/show/NCT05805657.

Sex hormones, such as oestrogen and testosterone, display significant immune modulatory properties. This is highly relevant for transgender (trans) people who undergo gender-affirming hormone (GAH) treatment. However, only a limited number of studies have evaluated the immunological impact of GAH treatments, and almost none have assessed the impact in trans young people. Following recruitment to the Gender and IMmunity study (GIM) (n =100), biological samples were collected from trans young people (n = 47) including: trans males (birth-registered females taking testosterone-based GAH) and trans females (birth-registered males taking oestrogen-based GAH). All trans participants had taken GAH for at least 6 months. Samples were also collected from control individuals not taking GAH (n = 53). Immune profiles were evaluated using an 18-colour flow cytometry panel. In addition, the commercially available 37-parameter MaxPar panel was used for analysis of a subset of samples (n = 36) by mass cytometry (CyTOF). Immune cell abundance was compared across experimental groups, and correlated with plasma concentrations of oestradiol and testosterone using multiple regression models. From multiple comparisons analyses grouped by birth-registered sex, several differences were detected in the trans groups compared to control groups, in particular relating to abundance of B and T cell subsets. These differences appeared to be mainly associated with levels of plasma testosterone. The most notable differences were in trans males, who had lower numbers of CD11c⁺ B cells and higher numbers of CD4⁺ regulatory T cells (Tregs) compared to control females. Using CyTOF, further analysis of B and T cells subsets revealed the frequency of naïve B cells was higher in trans males compared to control females. This also correlated with testosterone concentration in this group. Differences in the abundance of other T cell subsets were detected in both trans males and trans females, however only a decrease in CD161⁺ T effector memory cells in trans males, compared to control females, was associated with lower testosterone levels. This cross-sectional observational study of young trans individuals suggests that testosterone treatment may have immune modulatory effects, which should be investigated further, including functional studies. While oestrogen treatment was associated with differences in some immune cells in trans females compared with controls, these were generally not associated with plasma oestradiol levels but rather with testosterone levels. Continued immunological research of young trans individuals taking GAH treatment is crucial for positive long-term health outcomes.

This descriptive cross-sectional study was conducted between January and March 2024 at the University Hospital in Oujda and several educational institutions, involving a randomly selected sample of children and adolescents aged 7-18 years. The University Hospital Center of Oujda and the selected educational institutions were chosen for their accessibility and their capacity to represent a broad spectrum of children and adolescents from various socioeconomic backgrounds within Oujda and neighboring areas. This allowed for the recruitment of a diverse and representative sample reflective of the local population. The objective was to assess the prevalence of eating behavior disorders - namely, anorexia nervosa, bulimia nervosa, and avoidant/restrictive food intake disorder (ARFID) - and to identify potential risk factors. Data were collected using structured questionnaires and two validated screening tools: the Eating Behavior Disorders in Youth Questionnaire (EDY-Q) and the Eating Attitudes Test (EAT-26). The mean age of participants was 14 years, with the 13-17 age group being the most affected, and the majority were female. Psychological vulnerabilities related to eating disorders were observed. Significant associations were found between susceptibility to eating disorders and factors such as older age, female gender, exposure to major family stressors, excessive media use, and academic pressure. However, socioeconomic status did not show a significant correlation. These findings suggest a notable prevalence of eating disorders among adolescents, emphasizing the urgent need for early prevention strategies and health promotion programs to mitigate long-term mental and physical health consequences.

Keratoconus is one of the most common forms of corneal ectasia. In severe cases, patients experience significant visual impairment, which can be further exacerbated by the development of cataracts. This deterioration may not only impact their vision but also affect their emotional well-being and mental health. Here, we report a case of a patient with severe keratoconus who underwent cataract surgery in both eyes, leading to a remarkable transformation in her life. An 80-year-old woman with underlying hypertension initially presented with bilateral blurring of vision and elevated intraocular pressure (IOP). She was diagnosed with bilateral primary angle closure glaucoma (PACG) and was started on antiglaucoma treatment, with cataract extractions planned. Before surgery, she was semi-dependent and experienced frustration and depression due to her deteriorating vision. The preoperative assessment revealed keratoconus, with cylindrical power of -10.00DC in the right eye and -9.00DC in the left eye. She consented to monofocal toric intraocular lens (IOL) implantation. Postoperatively, her cylindrical power was significantly reduced to -2.50DC in the right eye and -1.50DC in the left eye. Her vision improved markedly despite underlying PACG and tunnel vision. The patient now feels more independent and her quality of life has significantly improved. Careful biometry calculations, thorough planning, and patient counseling are essential for achieving optimal postoperative outcomes in cataract surgery for stable keratoconus patients. This case highlights that significant astigmatism correction due to keratoconus is possible in selected individuals, improving both vision and overall quality of life.

Background: Occupational stress refers to the psychological pressure from work-related factors. Stress overload is a key contributor to the global nursing shortage. Excessive workloads and psychological pressure further exacerbate stress among healthcare professionals. Aims: This study aims to examine the impact of psychological counseling (PC), job characteristics, and perceived respect on occupational stress among Pakistani nurses. Methods: This cross-sectional study was carried out by nurses from Pakistan, using a random sampling method. Data were collected between April 1 and May 31, 2024. We have access to the nurses' work-related stress, respect, and PC through an online questionnaire. A total of 292 nurses took part in the study. Results: Out of 292 participants, 276 completed the survey, with 71.38% male and 28.62% female. The main causes of occupational stress were low income (95.56%), high workload (80.80%), occupational injury (65.95%), family factors (64.50%), strict leadership (60.50%), and physical problems (56.16%). Additionally, 36.23% of nurses had limited faith in the effectiveness of PC, followed by a moderate belief. According to multiple logistic regression analyses, a correlation between a PC high work-related stress significantly affects nurses' mental health, increasing the need for PC (p=0.0979). Stress relief methods like reading, music, or outdoor sports reduce the stress (OR 2.298-11.031, p < 0.001). At the same time, factors like nurse-patient relationships and strict leadership contribute to high-stress levels (p=0.417, p=0.682), with reducing work intensity showing minimal impact (p=0.993). Conclusion: Our study indicated that low salaries, a high workload, and low respect could cause occupational stress among nurses who need high PC. Implications for Nursing Management: These findings can guide hospital administrators and nurse managers in enhancing rewards, reducing work hours, and improving job satisfaction. Additionally, better working conditions and training programs can help mitigate occupational stress and support nurses' mental health.