This paper outlines a strategic approach to strengthen the expertise and skills of mental health nurses. It addresses the ongoing (r)evolutions in how generic nursing standards are being integrated into nursing curricula. Focusing on Flanders in Belgium, it explores the decline of specialised mental health nursing education and its implications for advanced practice nursing at the master's level. Central to this discussion is 'Letie', a newly established Belgian non-profit organisation founded in 2023. Letie aims to inspire and empower professional cohesion within mental health nursing by fostering collaboration, innovation, knowledge sharing, research and professional development. Reflecting on Letie's first year of operation, the paper draws on the author's experiences and vision to propose pathways for advancing the profession, while promoting resilience and adaptability in the face of educational and professional challenges. It seeks to engage mental health nursing professionals working in clinical practice, education and research in a meaningful dialogue about future directions for the discipline.

Orofacial pain (OFP) harms mental health and functionality. The Manchester Orofacial Pain Disability Scale (MOPDS) is a questionnaire for assessing OFP.

The purpose of this study was to examine the validity of the Chinese version of MOPDS in clinical populations, measurement invariance across different clinical statuses and sex cohorts.

This study recruited 387 OFP clinical patients. Confirmatory factor analysis (CFA) assessed the internal consistency and factor structure of the MOPDS. Pearson's correlation coefficient assessed external convergent validity. Composite reliability (CR), the average variance extracted (AVE) and the heterotrait-monotrait ratio (HTMT) were used to assess internal convergent and discriminate validity. Multigroup CFA explored the measurement invariance. T-test compared scores between sex groups across various clinical statuses.

MOPDS in the clinical sample (Cronbach's α = 0.975, McDonald's omega = 0.975) had an acceptable internal consistency. CFA supported the two-factor structure in clinical settings with physical and psychosocial dimensions, which was applicable among different sexes and clinical groups. CR, AVE, HTMT, and correlation coefficient results with other scales proved the convergent and discriminant validity of MOPDS. Multigroup CFA supported scalar measurement invariance across different clinical statuses and sex groups. The females did not have significantly higher average scores (p > 0.05), and clinical samples had significantly higher average scores (p < 0.01).

The Chinese version of MOPDS is a reliable and effective instrument in clinical settings for assessing the physical and psychosocial disabilities caused by OFP by helping to develop personalised treatment plans.

We aimed to assess the cost-effectiveness of non-pharmacological interventions for fatigue in patients with chronic conditions in the UK.

This systematic review of cost-effectiveness studies aligns with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 statement. Data sources: Electronic databases and citation searches. Inclusion criteria: Studies including adults with one or more long-term health condition, either physical or mental. Exclusion criteria: Studies associated with cancer, long-COVID, post-viral fatigue, medically unexplained conditions, developmental disorders and injuries. Assessment: A single reviewer completed a two-stage sifting process.

Four studies met the inclusion criteria. They included patients with either multiple sclerosis or inflammatory rheumatic conditions, and assessed either cognitive behavioral therapy (CBT) or a personalized exercise programme (PEP). CBT was either dominated by usual care or had an incremental cost-effectiveness ratio (ICER) over £30,000. PEP dominated CBT, with the ICER for PEP versus usual care ranging from £13,159 to £35,424.

The economic literature on this topic is much more limited than the clinical effectiveness literature, both in terms of interventions and populations covered. Future research should focus on a de novo economic evaluation to identify interventions with a high potential to be cost-effective across multiple conditions.

PROSPERO (CRD42023440141).

BackgroundThere is still need for a better understanding of which specific follow-up medical assessments might offer greater predictive value for diagnostic conversion from mild cognitive impairment (MCI) to Alzheimer's disease (AD).ObjectiveTo examine the longitudinal predictive importance of follow-up medical assessments to detect diagnostic conversion from MCI to AD.MethodsA sample of 572 participants from the ADNI database with valid data at baseline medical visit were included. Bayesian hierarchical models were employed to investigate longitudinal predictors of diagnostic conversion in a 36-month medical follow-up cohort, for measures of cognitive function, psychopathological symptoms, and demographical data. An additional 48-month medical follow-up cohort was considered to investigate the predictive importance of cerebrospinal fluid biomarkers (Aβ₄₂/Aβ₄₀ ratio) for diagnostic conversion.ResultsMini-mental State Examination (MMSE) (β = -2.6; 95% HDI: [-3.6--1.5]) and Clinical Dementia Rating scale Sum of Boxes (CDR-SB) (β = 5.6; 95% HDI: [4.3-7.0]) can predict diagnostic conversion from MCI to AD over a 36-month medical follow-up, with CDR-SB showing the greatest predictive importance in all Bayesian models. Higher scores on CDR-SB were associated with increased risk for a diagnosis conversion, approximately 30% greater probability at 24-month follow-up, and > 50% greater probability at 36-month follow-up.ConclusionsThe CDR-SB provides a reliable cognitive assessment to detect diagnostic conversion from MCI to AD over a period of 36 months, which is key to help clinicians screening for early diagnosis of AD using affordable non-invasive procedures.

BackgroundSpeech-based features extracted from telephone-based cognitive tasks show promise for detecting cognitive decline in prodromal and manifest dementia. Little is known about the cerebral underpinnings of these speech features.ObjectiveTo examine associations between speech features, brain atrophy, and longitudinal cognitive decline in individuals at risk for Alzheimer's disease (AD).MethodsHealthy volunteers, individuals with subjective cognitive decline, and those with mild cognitive impairment completed phonebot-guided semantic verbal fluency (SVF) and 15-word verbal learning task (VLT). Speech features were automatically extracted, and a global cognitive score (SB-C score) was computed. We analyzed data from 161 participants for cognitive trajectories, 141 for cross-sectional brain atrophy, and 102 for longitudinal brain changes. Analyses were conducted using multiple linear regressions, mixed-effects models, and voxel-based morphometry.ResultsThe SB-C score was associated with bilateral hippocampal volumes, SVF features were primarily associated with left hemisphere regions, including the inferior frontal, parahippocampal, and superior/middle temporal gyri (p_uncorr < 0.001). SB-C score, SVF correct counts, and VLT delayed recall were associated with atrophy rates in the hippocampal/parahippocampal gyrus and left middle/inferior temporal gyri (p_FDR < 0.05). These features were also associated with cognitive decline assessed via Preclinical Alzheimer's Cognitive Composite 5, SVF, and Wordlist learning delayed recall (p_FDR < 0.01). Word frequency and temporal cluster switches showed varying associations with cognitive trajectories. Other features did not show robust associations.ConclusionsIn this study, we highlight the potential of digital speech features for identifying brain atrophy and cognitive decline over time in at-risk AD populations.

Osteoporotic fractures are a major public concern as a serious, fatal condition. We aimed to investigate the differences in the incidence and types of osteoporotic fractures between people with and without disabilities, including both mental and physical disabilities.

This is a serial cross-sectional study using the National Disability Registration and National Health Insurance claims data. After excluding individual with Paget's disease and cancer that damages bone, we analyzed trends and associated factors of osteoporotic fractures between 2008 and 2017.

The age-standardized incidence rate (ASIR) of osteoporotic fractures was higher in the disabled than in the non-disabled for 10 years (41.3 and 24.0 per 10 000 persons, respectively, in 2017). Vertebral fractures were the most common. However, the incidence of non-vertebral fractures was about twice as high in the disabled as in the non-disabled. In multivariate analysis, the highest odds ratios were observed for epilepsy (OR = 3.80; 95% confidence intervals = 2.40-5.99), liver disease (OR = 2.38), and intellectual disability (OR = 1.95) in men and for epilepsy (OR = 3.19), liver (OR = 1.64), and respiratory (OR = 1.49) disease in women.

Given the preventability and high incidence of fracture in disabled people, health systems should be designed to ensure timely and appropriate prevention and intervention for disabled people.

Previous studies have indicated that adolescents are susceptible to emotional cues and can benefit from peers' interpersonal emotion regulation (IER). However, it remains unclear how an adolescent regulator's personal traits shape an effective IER. The present study examined the role of regulator's trait empathy and social distance between the regulator and the target on IER effectiveness among adolescents and explored the underlying behavioral mechanism. A total of 420 adolescent dyads with ages ranging from 12 to 18 years participated (212 dyads of friends; 208 dyads of strangers). After reporting their empathy levels, each regulator inferred the emotional intensity of the target based on the given negative events the target had experienced and then wrote down regulation strategies. Targets rated their own emotions before and after reading regulation strategies and evaluated the suitability of the strategies for them. The results showed that regulators with higher cognitive empathy were better at accurately perceiving targets' negative emotions, which, in turn, enhanced their regulation effectiveness. Similarly, regulators' behavioral empathy was positively related to regulation effectiveness through target-perceived strategy suitability. Additionally, close social distance enhanced the role of regulator's cognitive empathy in emotion perception accuracy and strengthened the impact of the regulator's behavioral empathy on regulation effectiveness. In contrast, closer social distance weakened the positive effect of regulator's behavioral empathy on target-perceived strategy suitability. These findings first highlight how and when different components of an adolescent regulator's trait empathy are linked to IER effectiveness, emphasizing the importance of adopting a dyadic design in the field of IER. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Myhre syndrome is a rare progressive genetic disorder characterized by hearing loss, cardiovascular and joint problems, neoplasia, and neuropsychologic disabilities. Parents of children with Myhre syndrome and adults themselves face unique challenges, stresses, and fears associated with this diagnosis. Reflective writing in the form of journaling can provide psychosocial support and help individuals cope with this diagnosis. Adult patients and parents whose children were evaluated at the Massachusetts General Hospital Myhre Syndrome Clinic were invited to participate in a three-month journaling intervention. Participation in the study required the completion of a series of surveys prior to starting and upon completion of the study. Data from these surveys were analyzed to assess for change in mental well-being. Eleven individuals participated, six of whom completed the three-month journaling intervention and post-journaling surveys. Three participants indicated that journaling had an impact on their mental well-being, and of these, two planned to continue journaling. However, there was no statistically significant difference in mental well-being scores pre- and post-journaling intervention. The very small size of the study limits interpretation, but we think it is reasonable to suggest that expressive writing through journaling may be a coping mechanism and means of improving well-being for some individuals in the Myhre syndrome community.

Asthma is characterised by variable airflow obstruction and is associated with symptoms of cough, wheeze, and dyspnoea, and with airway inflammation and hyperresponsiveness. There are approximately 300 million people with asthma worldwide. Despite a current plateau, the burden of this disease is likely to increase due to population growth, urbanisation, and ageing. Disease onset is associated with low birthweight, preterm birth, viral infections, in-utero passive smoke exposure, urbanisation, and occupational exposures. Obesity is associated with increased incidence and severity of asthma, whereas exposure to small allergen particles leads to severe disease. In adults and adolescents, inhaled corticosteroids in combination with formoterol (as anti-inflammatory reliever or as maintenance and anti-inflammatory reliever therapy) are widely recommended to control the symptoms of asthma. For children, low-dose inhaled corticosteroid is the preferred first-line treatment. Monotherapy with short-acting β-agonists is strongly discouraged. The WHO Global Action Plan for the Prevention and Control of Non-communicable Diseases includes availability of affordable combination inhalers for asthma. Co-ordinated national asthma policies, ensuring access to inhalers, have resulted in fewer hospitalisations and school and work absences. Future asthma prevalence could be reduced by good maternal and infant care, with reduction in premature births and reduction in infant respiratory infections, and by reduction in obesity at all ages.

Gestational diabetes mellitus is defined as any glucose intolerance that begins during pregnancy, and it is one of the most common metabolic disorders complicating pregnancies, affecting approximately 10-14% of all pregnancies. Maternal carbohydrate metabolism changes during pregnancy to ensure adequate nutrition for the fetus, with the human umbilical vein and the placenta being important regulators of this physiological state. This study aimed to evaluate fractalkine (FKN) immunoreactivity in GDM pregnancies and its association with maternal/fetal health outcomes.

In this case-control study, a total of 89 pregnant women (44 GDM and 45 non-GDM) underwent a 50 g glucose loading test (GCT) between 24 and 28 weeks of gestation. GCT cutoff value was chosen as <140 mg/dl. Women with high GCT values underwent rapid diagnostic testing with a 3-hour glucose tolerance test (GTT). Placenta samples were obtained after cesarean section. Immunohistochemistry for FKN was performed on formalin-fixed and paraffin-embedded sections. Finally, the relationship between FKN expression and clinical manifestations of GDM was evaluated.

FKN expression was significantly different between pregnant women with and without GDM. Specifically, FKN expression was increased in the capillary endothelium (p < 0.0001) and human umbilical vein endothelial cells (HUVECs) (p = 0.0011) in pregnant women with GDM compared to those without GDM. Furthermore, FKN expression in HUVECs was found to be associated with fetal macrosomia (p = 0.0099) and neonatal hypoglycemia (p = 0.0291). Additionally, FKN expression in the capillary endothelium was found to be associated with preeclampsia (p = 0.0250). Regarding the pathological changes of the placenta with FKN expression, significant correlations were identified with both capillary endothelial FKN expression and HUVEC FKN expression.

The observed differences suggest a potential association between the immunohistochemical expression of FKN and the presence of GDM, placental changes, and adverse outcomes of pregnancy.