Parent depression is a well-established prospective risk factor for adverse offspring mental health. Multiple lines of evidence suggest that improvements in parent depression predicts improved offspring mental health. However, no systematic review has examined the impact on offspring of psychological treatment of purely parent depression after the postnatal period.

To systematically review the literature of randomised controlled trials examining the impact on offspring mental health outcomes of psychological interventions for parental depression after the postnatal period.

We pre-registered our systematic review on PROSPERO (CRD42023408953), and searched the METAPSY database in April 2023 and October 2024, for randomised controlled trials of psychological interventions for adults with depression, which also included a child mental health or wellbeing outcome. We double screened 938 studies for inclusion using the ‘Paper in a Day’ approach. All included studies would be rated using the Cochrane Risk of Bias tool.

We found no studies that met our inclusion criteria.

Robust research into psychological therapy for depression in adults outside the postnatal period has failed to consider the potential benefits for the children of those adults. This is a missed clinical opportunity to evaluate the potential preventive benefits for those children at risk of adverse psychological outcomes, and a missed scientific opportunity to test mechanisms of intergenerational transmission of risk for psychopathology. Seizing the clinical and scientific opportunities would require adult-focused mental health researchers to make inexpensive additions of child mental health outcomes measures to their evaluation projects.

Generalist and specialist parasites are predicted to trade off transmission efficiency with host virulence, depending on host range. However, very few empirical studies test this trade-off in parasites at both ends of this spectrum simultaneously. Here, we examine parasitaemia (as a proxy for transmission efficiency) and virulence (assessed through 2 metrics of host immunity) in birds infected by a generalist lineage of Haemoproteus, comparing these with birds infected by more specialist Haemoproteus lineages, and birds uninfected by any haemoparasite. We compared the same metrics for specialist-infected birds, depending on whether a species was a ‘usual’ host or ‘spillover’ host. Immune metrics of specialist-infected birds did not differ from those of uninfected birds, but generalist-infected birds had elevated heterophil:lymphocyte (H:L) ratios and elevated white blood cell (WBC) counts compared to both other groups. Parasitaemia of specialist lineages was nearly 5 times higher than that of generalist lineages. Moreover, specialist-infected spillover hosts had higher H:L ratios and higher WBC counts compared to usual hosts for these lineages, with parasitaemia nearly 10 times lower in spillover hosts compared to usual hosts, although sample sizes of spillover hosts are, by definition, small. Our data provide support for the evolution of tolerance in specialist host-parasite interactions, with increased transmission efficiency for the parasite and reduced impacts on the host.

Disclosing individual research results to participants is not standard practice. The return of individual research results to participants may increase recruitment, retention, and engagement in research. This study’s objective was to explore the preferences, expectations, and experiences of research participants receiving individual research results.

A mixed-methods approach, consisting of semi-structured interviews and a health literacy assessment, was used with participants enrolled in a cohort study. The interviews were analyzed to produce an understanding of current experiences. Using descriptive analyses, responses were compared to identify alignments and divergences among participants.

Forty-three English-speaking and 16 Spanish-speaking participants enrolled. Ninety-eight percent of participants wanted to receive their individual research results. Seventy-five percent of participants reported they shared results with their healthcare providers. More participants aged 18–65 reported the need to follow up with their provider (70%) as compared to participants > 65 (20%). Two-thirds of participants reported a positive experience receiving their research results; however, 22% reported anxiety and worry. Most participants (69%) described the electronic medical record (EMR) as their preferred method for receiving their results. Yet only 50% of Spanish speakers preferred receiving research results through the EMR compared to 77% of English speakers. Participants with low health literacy preferred receiving study results in person or by phone.

Research participants value receiving their individual research results, and this may increase recruitment and retention within the research enterprise. While more research is needed, the lessons learned from this study lay the groundwork for developing best practices and policies around the return of individual research results.

Promoting recruitment and retention in psychiatry is one of the core objectives for the Royal College of Psychiatrists and coaching initiatives are recognised as a means of improving retention. We developed a programme of medical coaching, available to all career-grade doctors in an NHS Trust in Northern England to support professional development. This overview describes the results of the first 4 years of the programme.

The setting was a large NHS Trust covering County Durham, Teesside and North Yorkshire employing around 150 consultants and 60 SAS psychiatrists (mean age = 49 years, 51% female). Coaching was promoted to all these doctors through the feedback form sent following their annual appraisal meeting. This coaching was later also made available to locally employed doctors and core and higher specialist trainees working temporarily in the Trust. The intervention was initially provided as a single session coaching event delivered by a consultant psychiatrist trained in medical coaching, and the programme evolved following requests from doctors. It was stated explicitly that the purpose was professional development, not an attempt to retain doctors considering their future. The outcome was measured using a post-coaching questionnaire.

Data was collected from coaching delivered from May 2019 to January 2024. 145 doctors (84 consultants, 23 SAS doctors, 6 Trust doctors, 26 training-grade doctors, 6 grade not-stated) took up the coaching offer. 524 sessions were provided in all. The mean (SD) number of sessions was 3.8 (3.7), for consultants 3.5 (3.9) and for SAS doctors 4.8 (4.4). 48 doctors accessed a single coaching session. 56% of the career-grade doctors receiving coaching were female. Data was collected from 127 post-coaching questionnaires with 116 strongly agreeing and 11 agreeing with the statement that the coaching provided was useful and many reporting a positive impact on well-being.

Findings show that the programme was popular with the medical workforce, with about half of career grade psychiatrists taking up the offer. It evolved following requests to both provide follow-up sessions and to extend the offer to trust doctors and trainees. The sessions were highly valued by the doctors with reported benefits to their well-being, but we cannot measure the impact on retention. The programme is valued by the Trust with an intention to make the programme sustainable into the long term and it now forms part of the Trust's medical workforce charter.

Digital Mental Health Interventions (DMHIs) that meet the definition of a medical device are regulated by the Medicines and Healthcare products Regulatory Agency (MHRA) in the UK. The MHRA uses procedures that were originally developed for pharmaceuticals to assess the safety of DMHIs. There is recognition that this may not be ideal, as is evident by an ongoing consultation for reform led by the MHRA and the National Institute for Health and Care Excellence.

The aim of this study was to generate an experts’ consensus on how the medical regulatory method used for assessing safety could best be adapted for DMHIs.

An online Delphi study containing three rounds was conducted with an international panel of 20 experts with experience/knowledge in the field of UK digital mental health.

Sixty-four items were generated, of which 41 achieved consensus (64%). Consensus emerged around ten recommendations, falling into five main themes: Enhancing the quality of adverse events data in DMHIs; Re-defining serious adverse events for DMHIs; Reassessing short-term symptom deterioration in psychological interventions as a therapeutic risk; Maximising the benefit of the Yellow Card Scheme; and Developing a harmonised approach for assessing the safety of psychological interventions in general.

The implementation of the recommendations provided by this consensus could improve the assessment of safety of DMHIs, making them more effective in detecting and mitigating risk.

Older adults have low levels of mental health literacy relating to anxiety which may contribute to delaying or not seeking help. Lifestyle interventions, including physical activity (PA), have increasing evidence supporting their effectiveness in reducing anxiety. The COVID-19 pandemic also highlighted the potential for technology to facilitate healthcare provision. This study aimed to investigate perspectives of older adults about their understanding of anxiety, possible use of PA interventions to reduce anxiety, and whether technology could help this process.

The INDIGO trial evaluated a PA intervention for participants aged 60 years and above at risk of cognitive decline and not meeting PA guidelines. Twenty-nine of the INDIGO trial completers, including some with anxiety and/or cognitive symptoms, attended this long-term follow-up study including semi-structured qualitative interviews. Transcripts were analyzed thematically.

There was quite a diverse understanding of anxiety amongst participants. Some participants were able to describe anxiety as involving worry, uncertainty and fear, as well as relating it to physical manifestations and feeling out of control. Others had less understanding of the concept of anxiety or found it confusing. Participants generally believed that PA could potentially reduce anxiety and thought that this could occur through a “mindfulness” and/or “physiological” process. Technology use was a more controversial topic with some participants quite clearly expressing a dislike or distrust of technology or else limited access or literacy in relation to technology. Participants who were supportive of using technology described that it could help with motivation, information provision and health monitoring. Wearable activity monitors were described favorably, with online platforms and portable devices also being options.

Our results highlight the importance of increasing information and education about anxiety to older adults. This may increase awareness of anxiety and reduce delays in seeking help or not seeking help at all. Findings also emphasize the need for clinicians to support understanding of anxiety in older adults that they are seeing and provide information and education where needed. It is likely that PA interventions to reduce anxiety, with the option of a technology component with support, will be acceptable to most older adults.

We sought to evaluate the impact of antibiotic selection and duration of therapy on treatment failure in older adults with catheter-associated urinary tract infection (CA-UTI).

We conducted a population-based cohort study comparing antibiotic treatment options and duration of therapy for non-hospitalized adults aged 66 and older with presumed CA-UTI (defined as an antibiotic prescription and an organism identified in urine culture in a patient with urinary catheterization documented within the prior 90 d). The primary outcome was treatment failure, a composite of repeat urinary antibiotic prescribing, positive blood culture with the same organism, all-cause hospitalization or mortality, within 60 days. We determined the risk of treatment failure accounting for age, sex, comorbidities, and healthcare exposure using log-binomial regression.

Of 4,436 CA-UTI patients, 2,709 (61.1%) experienced treatment failure. Compared to a reference of TMP-SMX (61.9% failure), of those treated with fluoroquinolones, 56.3% experienced failure (RR 0.91, 95% CI: 0.85–0.98) and 60.9% of patients treated with nitrofurantoin experienced failure (RR 1.02, 95% CI: 0.94–1.10). Compared to 5–7 days of therapy (treatment failure: 59.4%), 1–4 days was associated with 69.5% failure (RR 1.15, 95% CI: 1.05–1.27), and 8–14 days was associated with a 62.0% failure (RR 1.05, 95% CI: 0.99–1.11).

Although most treatment options for CA-UTI have a similar risk of treatment failure, fluoroquinolones, and treatment durations ≥ 5 days in duration appear to be associated with modestly improved clinical outcomes. From a duration of therapy perspective, this study provides reassurance that relatively short courses of 5–7 days may be reasonable for CA-UTI.

Washington State established a Memorandum of Understanding (MOU) and operational plan in 2012 to coordinate pharmacy infrastructure and workforce during a public health emergency. The objectives of this study were to adapt the MOU operational plan to the context of the coronavirus disease 2019 (COVID-19) pandemic and assess community pharmacies’ organizational readiness to implement COVID-19 testing and vaccination.

This mixed methods study was conducted June-August 2020. Three facilitated discussions were conducted with community pharmacists and local health jurisdiction (LHJ) representatives to test the MOU operational plan. Facilitated discussions were thematically analyzed to inform adaptations to the operational plan. Pharmacists were surveyed to assess their organization’s readiness for COVID-19 testing and vaccination before and after the facilitated discussions using the Organizational Readiness for Implementing Change (ORIC) measure. Survey responses were analyzed using descriptive statistics.

Six pharmacists from 5 community pharmacy organizations and 4 representatives from 2 LHJs participated in at least 1 facilitated discussion. Facilitated discussions resulted in 3 themes and 16 adaptations to the operational plan. Five of 6 community pharmacists (83% response rate) completed both surveys. Mean organizational readiness decreased from baseline to follow-up for COVID-19 testing and vaccination.

Operational plan adaptations highlight opportunities to strengthen MOUs between local and state health departments and community pharmacies to support future emergency preparedness and readiness efforts.

We undertook a rapid review of literature relating to the diagnosis of blood cancers, to find out what factors contribute to delays in diagnosis, including symptom recognition, appraisal and help-seeking behaviours.

We used rapid review methodology following Tricco et al. to synthesise current literature from two electronic databases. We searched for studies about symptom appraisal help-seeking for all blood cancers published between 2001 and 2021, written in English.

Fifteen studies were included in the review, of which 10 were published in the United Kingdom. We found a number of factors associated with delays in blood cancer diagnosis. These included patient factors such as gender, age and ethnicity, as well as health system factors such as poor communication and seeing a locum clinician in primary care. A narrative synthesis of the evidence produced four types of symptom interpretation by patients: (1) symptoms compatible with normal state of health, (2) event-linked problems, (3) mild or chronic illness and (4) non-specific unwell state. These four interpretations were linked to different help-seeking behaviours. After seeking help, patients often experienced delays due to healthcare professionals’ (HCPs’) non-serious interpretation of symptoms, misleading blood tests, discontinuity of care and other barriers in the diagnostic pathway.

Blood cancers are difficult to diagnose due to non-specific heterogeneous symptoms, and this is reflected in how those symptoms are interpreted by patients and managed by HCPs. It is important to understand how different interpretations affect delays in help-seeking, and what HCPs can do to support timely follow-up for patients.