There is a growing need to enhance healthcare providers’ spiritual care competence, including for people receiving palliative care. A preceding study of predictors of spiritual care competence in a general group of nurses found that more competent nurses rated significantly higher in spiritual training adequacy, frequency of spiritual care provision, and personal spirituality than other nurses; like the demographic variables of level of education, length of nursing experience, and sex, confidence and comfort in providing spiritual care were not related to spiritual care competence. The current study aimed to replicate these relationships in a sample of palliative care nurses. This sample also allowed the testing of a hypothesis that palliative care nurses will tend to subscribe to more competent understandings of spiritual care.

Data were collected from a convenience sample of Australian palliative care nurses who completed an anonymous, online survey. The survey provided qualitative data about what spiritual care means for them and quantitative data regarding nurse characteristics. The qualitative data were used to create sub-groups of nurses based on their understanding of spiritual care and the quantitative data were used to construct a profile of nurse characteristics for each sub-group. The replication analysis determined whether a statistical difference in nurse characteristics existed across sub-groups. The hypothesis testing compared levels of spiritual care understanding across the general and palliative care samples of nurses.

While the results of the palliative care sample are largely concordant with those obtained in the general sample, the current study amends “training adequacy” as a predictor of spiritual care competence to “experience (whether on-the-job or training) in caring for the dying.” The study hypothesis was supported.

The results can be used to assess and develop competence in spiritual care for palliative care nurses.

Global food systems have a key influence on both health and sustainability. Dietary shifts that promote health and sustainability are regarded as a critical synergistic pathway for advancing human and planetary health. In response, consumer interest in the sustainability of food systems has prompted the use of claims highlighting positive sustainability attributes displayed on-pack. This study assessed the prevalence and types of sustainability claims displayed on packaged food in Australia.

Claims data on packaged food were collected at five supermarkets in Sydney in 2024. We determined the prevalence of sustainability claims overall, by claim category and format (text or logo).

Australia

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Over a third of products displayed at least one sustainability claim, the most prevalent being natural and vegan. Text claims were far more prevalent than logos (84% v 16% of total claims identified on pack, respectively).

Frequent use of broad and unspecific sustainability claims raises challenges for substantiation, and there is a risk that consumers are being misled. Our findings support the need for stronger regulation, including criteria for terms used in claims, to improve consumer trust and comparability across products.

Subcortical nuclei – including the thalamus, basal ganglia, and hippocampus-amygdala complex – are key regions in schizophrenia (SZ), bipolar disorder (BD), and major depressive disorder (MDD). While cortical–subcortical connectivity is well studied, fine intra- and inter-subcortical patterns are less known. This study aimed to identify shared and distinct functional connectivity alterations across SZ, BD, and MDD using a high-resolution subcortical atlas.

Resting-state functional magnetic resonance imaging data from 800 participants (200 per group: SZ, BD, MDD, and healthy controls) in a single-site cohort were analyzed. Subcortical structures were parcellated into 27 regions per hemisphere – thalamus (8 regions), hippocampus (5 regions), amygdala (2 regions), and striatum (12 regions) – based on the a priori atlas. Pairwise functional connectivity among the 54 regions was computed for each participant, and group differences were assessed using general linear models.

Patients with SZ exhibited significantly reduced intra-thalamic connectivity and increased intra-striatal connectivity, as well as enhanced connectivity between the thalamus, striatum, and limbic regions. Patients with BD showed reduced intra-thalamic and intra-striatal connectivity, along with decreased thalamus–amygdala and thalamus–striatum connectivity. In MDD, the predominant finding was reduced intra-limbic connectivity, accompanied by mild reductions in intra-thalamic and striatum–limbic connectivity.

The results suggest that intra-thalamic hypoconnectivity appears common to SZ, BD, and MDD, with graded degrees of severity. In contrast, distinct alterations in intra-striatal and striatum–limbic connectivity may differentiate mood disorders from SZ. These shared and disorder-specific subcortical connectivity patterns enhance the understanding of psychiatric neurobiology and may guide the development of targeted, disorder-tailored interventions.

Ventricular fibrillation in paediatric recipients of left ventricular assist devices is rare but potentially fatal; however, because systemic perfusion may be temporarily maintained by the mechanical support, haemodynamic deterioration may be delayed, leading to underrecognition and presentation in the outpatient setting rather than as an immediate in-hospital emergency.

We report three paediatric left ventricular assist device recipients who developed outpatient malignant ventricular arrhythmias, each representing a distinct mechanistic category: structural, mechanical, and endocrine. Clinical presentation, diagnostic findings, and therapeutic responses were reviewed to highlight pathophysiologic heterogeneity and inform individualised management.

The first patient, with biopsy-proven arrhythmogenic right ventricular dysplasia, experienced recurrent ventricular fibrillation refractory to multiple antiarrhythmic agents, ultimately requiring heart transplantation. The second patient presented with ventricular fibrillation secondary to mechanical suction and interventricular septal contact; defibrillation and left ventricular assist device speed reduction restored a stable rhythm with no recurrence. The third patient developed polymorphic ventricular arrhythmias during amiodarone-induced thyrotoxicosis and succumbed to refractory electrical storm and multi-organ failure despite intensive endocrine and antiarrhythmic therapy.

Outpatient ventricular fibrillation in paediatric left ventricular assist device recipients may result from diverse mechanisms, including myocardial structural disease, mechanical pump heart interaction, and systemic endocrine disturbances. Mechanism-guided management combining antiarrhythmic, mechanical, and metabolic interventions is essential for optimal outcomes. Continuous rhythm surveillance and readiness for immediate defibrillation are key to improving survival in this vulnerable group.

The cognitive-behavioral model of body dysmorphic disorder (BDD) implicates impaired cognition; yet existing evidence of cognitive impairment in the disorder is often inconsistent. To date, cognitive performance in BDD has not been measured utilizing the Wechsler Adult Intelligence Scale, Fourth Edition (WAIS-IV), a gold standard cognitive assessment in clinical settings. Accordingly, this study compared WAIS-IV performance between individuals with BDD and healthy controls.

Participants included 59 BDD patients and 56 controls. Cognitive performance was evaluated via the WAIS-IV, and clinical characteristics of the BDD group were examined via multiple clinician and self-report questionnaires.

The BDD group demonstrated significantly poorer performance compared to the control group in the WAIS-IV index and subtests that reflect processing speed abilities (Processing Speed Index: d = −0.55, 95% CI [−0.92, −0.18], Symbol Search: d = −0.70, 95% CI [−1.07, −0.32], Coding: d = −0.79, 95% CI [−1.17, −0.41]), yet other indices were not significantly different. These impairments were not correlated with anxiety or BDD-YBOCS symptom severity. Reduced overall cognitive performance was primarily driven by impairments in processing speed.

The study suggests that in BDD, processing speed is notably lower than other index scores, falling in the low average range. This may reflect difficulties with rapid visual processing, attention to detail, or motor speed. Performance in domains reflective of reasoning and verbal functioning were unimpaired relative to controls. This selective cognitive pattern in BDD may be driven by increased cognitive load associated with perfectionistic traits. This has clinical implications for cognitive-behavioral treatment.

This brief report examines physical and mental health symptom profiles among older adults approximately 5 months after Hurricane Helene–related flooding in Southern Appalachia.

Survey data were collected from 233 older adults and assessed physical health symptoms, posttraumatic stress disorder, depressive symptoms, flood event exposure, environmental contaminant exposure, and post-flood stressors. Cluster analysis was conducted to identify post-disaster physical and mental health symptom profiles, and analysis of variance and chi-square tests were conducted to examine differences in disaster exposure, post-flood stressors, and sociodemographic characteristics across profiles.

Three distinct post-disaster health symptom profiles were identified: a lower symptom profile, an elevated mental health symptom profile, and a combined elevated physical and mental health symptom profile. Disaster exposure, contaminant exposure, and post-flood stressors increased in a graded manner across profiles, indicating a dose–response framework of disaster-related health impacts. Higher symptom burden profiles were disproportionately represented among older adults with disabilities/chronic illness and among older age groups.

Findings highlight heterogeneity in post-disaster health experiences among older adults and underscore the value of identifying high-risk subgroups and implementing recovery strategies that address co-occurring physical and mental health needs among older adults following flood events.