Carers of people living with breathlessness face common challenges due to the chronic, distressing and unpredictable nature of the symptom. These include unmet information and support needs resulting in worsened health and psychosocial outcomes. This review aimed to (1) identify the relative volume of studies on supportive interventions for carers of people living with breathlessness due to different respiratory diseases, (2) characterize the nature of the interventions, and (3) explore their reported effectiveness on outcomes identified by carers as being important.

Medline and CINAHL were searched for studies reporting interventions targeting unpaid adult carers of people with breathlessness, lung cancer, chronic obstructive pulmonary disease (COPD), Interstitial Lung Diseases (ILD) published 2000-2025. Intervention characteristics and reported outcomes were extracted and compared across diagnoses and intervention categories. Our findings were shaped by consultation with unpaid carers in a series of patient and public involvement workshops.

From 72 included interventions, three approaches were identified: Education, therapeutic support, and interventions for patient management. Interventions for lung cancer carers most frequently offered therapeutic support to the carer, while those for COPD carers most frequently focused on managing the patient. COPD and ILD carers have been underserved by research. We found few therapeutic support interventions for COPD carers. Reporting of carer demographics was poor, including among RCTs.

There was a dominance of research focusing on carers of people with lung cancer (56% of participants). In PPI consultations, carers identified stigma and poor communication with health providers as factors contributing to the disparity between lung cancer and other respiratory diseases. More research is needed to compare the efficacy of different intervention strategies to improve outcomes that matter most to carers. To improve equity, researchers must consistently report carer demographics and prioritize developing interventions for carers underserved by research.

Electroconvulsive therapy (ECT) is an effective treatment of severe manifestations of mental illness. Since delay in initiation of ECT can have detrimental effects, prediction of the need for ECT could improve outcomes via more timely treatment initiation. Therefore, this study aimed to predict the need for ECT following admission to a psychiatric hospital.

This study was based on electronic health record (EHR) data from routine clinical practice. Adult patients admitted to a hospital within the Psychiatric Services of the Central Denmark Region between January 2013 and November 2021 were included in the study. The outcome was initiation of ECT >7 days (to not include patients admitted for planned ECT) and ≤67 days after admission. The data was randomly split into an 85% training set and a 15% test set. On the 7th day of the inpatient stay, machine learning models (extreme gradient boosting) were trained to predict initiation of ECT and subsequently tested on the test set.

The cohort consisted of 41,610 patients with 164,961 admissions. In the held out test set, the trained model predicted ECT initiation with an area under the receiver operating characteristic curve of 0.94, 47% sensitivity, 98% specificity, positive predictive value of 24% and negative predictive value of 99%. The top predictors were the highest suicide assessment score and mean Brøset violence checklist score in the preceding three months.

EHR data from routine clinical practice may be used to predict need for ECT. This may lead to more timely treatment initiation.

Ischaemic heart disease (IHD) is a global health issue, with people of Indian origin facing earlier onset and more severe cases, leading to higher mortality at younger ages compared to Western countries. Indian migrants maintain similar risks post-migration. Managing modifiable risk factors and improving risk knowledge and health-seeking behaviours are essential, but research on IHD risk perceptions among Indian migrants is limited.

This study explores how first-generation Indian migrants perceive their IHD risk and the factors influencing these perceptions.

As a component of a mixed- method study, a qualitative descriptive study design was employed to examine study participants perception of their IHD risk and the influencing factors. Semi-structured interviews were conducted with Indian migrants residing in metropolitan Melbourne, Victoria using multiple Indian languages and English. Data were analysed in the original language, with findings reported in English. NVivo software was used for data management and analysis. A qualitative content analysis was conducted using a hybrid coding approach where the main categories were developed deductively and subcategories were developed inductively from the data.

Twenty interviews were conducted with participants aged 32 to 70, 55% of whom were female, with an average stay in Australia of 11.2 years. The main themes included: perceptions shaped by personal experiences, especially family history, with most underestimating their risk; migration, cultural norms, and time constraints hindering behaviour change; family support, religious beliefs, and longevity aspirations motivating healthier behaviours; and limited primary healthcare engagement and culturally appropriate health resources. These results are discussed within the context of Capability, Opportunity and Motivation model of behaviour change (COM-B).

The study highlights key factors influencing IHD risk perceptions among Indian migrants. By understanding these specific risk perceptions and cultural nuances, healthcare professionals can develop and implement more effective, culturally sensitive health promotion and disease prevention strategies. This tailored approach can lead to better patient outcomes and a more equitable healthcare system.

The aim of this review was to identify, review, and synthesize primary qualitative literature to answer the question “what are the roles and experiences of informal caregivers providing care to a person with non-malignant respiratory disease at end of life from the perspectives of the caregiver and recipient of care?”

This qualitative systematic review was undertaken using thematic synthesis. Electronic databases (British Nursing Database, Cumulative Index to Nursing and Allied Health Literature Plus, Medline, PsycInfo, ProQuest Sociology, Allied and Complementary Medicine Database [AMED]) covering nursing, medicine, and social sciences were systematically searched from inception to October 2024. Studies were included if they reported data on the experiences and roles of caregivers in non-malignant respiratory disease at end of life, from the perspective of the caregiver or the person with non-malignant respiratory disease. Twenty-two papers met the eligibility criteria and were included in the review. Quality assessment was undertaken using the JBI Critical Appraisal Checklist for Qualitative Research.

Thematic synthesis of the data generated five analytical themes: Caregivers experience shifting identity and new roles; Adaptation is necessary to cope with loss and change; Caregivers need more information and coordinated care services; Emotional effects of caregiving; and Future uncertainty and facing death. The findings illustrated the complexity of the caregiving role and highlight unmet needs during the end of life stage.

This evidence synthesis highlights the significant contribution caregivers make in the lives and deaths of those with non-malignant respiratory disease. Challenges of caregiving in this context increase the stress of caregivers, including unpredictable disease progression and difficult symptoms such as breathlessness. There are persistent inequalities between malignant and non-malignant care pathways. Caregivers would welcome more recognition and information from healthcare professionals to support their role.

A clinic to assess and treat mental health (MH) within a community substance use disorder (SUD) service has been implemented with the aim to facilitate engagement, progress, and completion of substance use treatment.

This study was completed to assess the effectiveness of such an integrated service. The records of individuals seen within the clinic during 2022 and 2023 were assessed for the reason for referral, diagnosis, and treatment offered, and outcome of MH and SUD.

A total of 118 individuals were assessed. The majority (58%) were referred due to a lack of progress in treatment. The most frequent MH diagnosis was bipolar disorder (57%), followed by smaller numbers of diagnoses of psychosis, PTSD, anxiety and depression. Seventy-four (63%) individuals improved in MH, and eighty (68%) in SUD.

Despite the limitations due to the naturalistic methodology, this early work suggests that an integrated type of provision of MH treatment within a SUD service might have a beneficial complementary role within the existed parallel treatment model implemented in England.

This study explores the relationship between sustainable earthquake awareness and earthquake stress coping strategies among university students following the February 6, 2023, earthquake.

A descriptive, cross-sectional study was conducted between March and April 2024, involving 239 university students. Following the STROBE checklist, data were collected using the Personal Information Form, Earthquake Stress Coping Scale (ESCS), and Sustainable Earthquake Awareness Scale (SEAS). Ethics approval was obtained, and data were gathered through face-to-face surveys.

The average participant age was 21 years; 67.8% were women, and 20% had direct earthquake experience. Among participants, 67.4% reported negative academic impacts due to the earthquake. Higher SEAS scores were associated with higher income, prior earthquake experiences, having an emergency kit, securing belongings, and participation in earthquake training and drills. Higher ESCS social support-seeking scores correlated with higher income, earthquake preparedness training, drill participation, awareness of emergency meeting areas, and enrollment in the child development department.

The findings highlight gaps in earthquake preparedness among university students while emphasizing the role of personal earthquake experiences in fostering awareness and adaptive coping strategies. Enhancing earthquake preparedness training could improve resilience among students in earthquake-prone regions.

The objective of this study was to develop, implement, and refine a food environment survey to capture people’s perceptions of their food environments in low-and middle-income countries: the Food Environment Perceptions Survey (FEPS).

Identifying aspects of food environment to include: drawing from existing survey instruments; a Delphi survey with food environment experts working globally; workshops with local experts in India and Cambodia; cognitive testing of the survey items; and piloting the tools in diverse field settings in India and Cambodia.

Rural, peri-urban, and urban communities in India and Cambodia.

Global food environment experts for Delphi survey; food environment experts in India and Cambodia for workshops; convenience sample of participants in India (n=44) and Cambodia (n=60) for FEPS piloting.

The FEPS underwent many iterations prior to piloting. The initial versions of the survey were long, leading us to remove questions and reconfigure the survey to streamline it. The workshop participants rated the revised survey versions relatively favorably. The final survey consists of 109 questions covering six sections: accessibility and availability (48 questions); affordability (5 questions), convenience (17 questions); quality and safety (3 questions); information, promotion, and labeling (16 questions); and an optional sustainability section (20 questions). Based on pilot data, we found significant differences in how participants interacted with different food environment types across rural, peri-urban, and urban transects.

The finalized FEPS is a newly developed survey instrument that can be incorporated by other researchers to characterize diverse perceptions of food environments in LMICs.