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Guided parent-delivered cognitive behavioural therapy (GPD-CBT) is an evidence-based, low-burden treatment programme for childhood anxiety disorders with demonstrated efficacy, cost-effectiveness and accessibility. However, it has been tested primarily in Western countries, and the efficacy and cost-effectiveness have not been evaluated in Japanese families. The current study aims to examine GPD-CBT’s efficacy and cost-effectiveness in Japanese samples and explore potential cultural adaptations of the programme.
This study is designed as a Bayesian single-blind randomised controlled trial with two parallel groups: GPD-CBT (intervention group) and a waitlist control group. The primary outcome is remission of primary anxiety disorders evaluated through diagnostic interviews by independent evaluators. Secondary outcomes include child and parent-reported child anxiety symptoms, depressive symptoms and life interference. Additionally, measures of parental psychological characteristics, programme acceptability and quality of life are collected. We will conduct qualitative interviews with parents who participated in the programme and therapists who delivered the intervention to explore potential cultural adaptations. We aim to recruit 54–170 families, depending on the results of sequential Bayesian analyses. GPD-CBT consists of seven weekly 20 min sessions and a 1-month follow-up session. Assessments will be conducted at baseline, 13 weeks post randomisation (primary endpoint for between-group comparison), with an additional 25 weeks post randomisation. The waitlist control group will receive GPD-CBT after the 13-week assessment.
This study has been approved by the Ethics Review Committees of Chiba University and the University of Tokyo. We will disseminate results through academic conference presentations and peer-reviewed journal publications. If the GPD-CBT intervention proves efficacious, we will promote wider implementation in Japan through the development of training programmes for mental health professionals and key stakeholders.
jRCT1032250421 (https://jrct.mhlw.go.jp/latest-detail/jRCT1032250421) and jRCT1030250422 (
The involvement of older adults as active partners in research is increasingly being promoted to improve the relevance and impact of scientific knowledge. However, the evidence base on how older adults have been involved as active partners in healthcare research remains fragmented. To our knowledge, no review of reviews has yet provided a comprehensive overview of this body of evidence. Therefore, this umbrella review aims to synthesise review-level evidence on the involvement of older adults as active research partners. We address three questions: (1) How have older adults been involved as active partners in research? (2) What terminology, models and frameworks have been used? (3) What benefits and challenges have been reported related to involving older adults as active partners in research?
This study will follow the Joanna Briggs Institute (JBI) methodology for umbrella reviews. A comprehensive search will be conducted in Medline, CINAHL, Scopus, PsycINFO, Sociological Abstracts and Web of Science. Eligible reviews will be those reporting on the involvement of older adults (aged 60 years or older) as active partners in research. Two reviewers will independently screen titles, abstracts and full texts and perform data extraction using a standardised form. Methodological quality will be assessed using the JBI Critical Appraisal Checklist for Systematic Reviews. Findings will be synthesised narratively and thematically, with attention to reported roles, terminology, conceptual frameworks and the benefits and challenges of involvement.
As this umbrella review draws exclusively on secondary data from published sources, ethical approval is not required. Older adults, engaged as independent public contributors, have been involved in shaping the review protocol and will take part in interpreting the findings. Results will be disseminated through a peer-reviewed journal and presentations at academic and stakeholder conferences, and used to inform the design of a subsequent mixed-methods study focused on strengthening the involvement of older adults as active partners in research.
CRD420251064947.
The Novara Cohort Study (NCS) was established to investigate the biological, psychological and social factors that influence ageing in the general population. The study aims to identify early risk factors for frailty, allostatic load and cognitive decline, and to uncover molecular and functional markers of accelerated biological ageing. NCS addresses the need for detailed life-course data from Southern Europe to support personalised prevention and early diagnosis, and to promote healthy longevity.
NCS is a population-based, longitudinal cohort in the Novara province (Northern Italy), originally enrolling adults aged 35 and older. The inclusion criteria were later expanded to encompass all residents aged 18 and over, facilitating the study of ageing trajectories from early adulthood onward. As of mid-2025, about 1000 participants have been enrolled, and recruitment is ongoing. The cohort’s diversity in age, employment status and health conditions enhances its value for life-course analysis.
Following a pilot phase in 2022–2023, the whole study protocol now includes detailed demographic, clinical, behavioural, cognitive and psychosocial data, along with biological samples stored in the UPO Biobank. The protocol incorporates validated tools, comprehensive physical and cognitive assessments, and over 90 laboratory biomarkers covering inflammation, metabolism, hormonal function and coagulation. Additionally, a subset of participants underwent advanced inflammatory profiling by simultaneous measurement of 92 immune-related proteins and comprehensive genomic profiling using Illumina Single Nucleotide Polymorphism (SNP) arrays, capturing common genetic variation across multiple biological domains. Preliminary results demonstrate the feasibility of integrating deep phenotyping, reveal the roles of frailty in ageing and show initial evidence of age-related changes in inflammatory proteins.
NCS plans to enrol at least 10 000 participants and will conduct long-term follow-up using both passive methods, such as linking with clinical records and administrative health databases, and active in-person reassessments. Future phases will integrate clinical, behavioural and cognitive data with large-scale omics analyses, including genomics, proteomics, metabolomics and transcriptomics. Machine learning techniques will be employed to model biological age, identify early signs of age-related decline and develop personalised prevention strategies. By combining high-resolution phenotyping with multidimensional data, NCS aims to find modifiable risk factors and molecular signatures of ageing, supporting national and European research efforts and encouraging collaborative studies through open data-sharing frameworks.
To explore existing research regarding how nurses' unclear responsibilities influence their professional role development in hospital settings.
A scoping review was conducted according to Arksey and O'Malley.
The Population Exposure Outcome framework was used to identify eligible inclusion and exclusion criteria and search terms. The included articles have been thematically analysed in guidance by Braun and Clarke.
Twenty-six studies conducted between 2016 and 2024 were identified in CINAHL, PubMed and Scopus.
The roles of nurses were highly adaptable within hospital settings and healthcare teams, requiring nurses to assess both organisational shortcomings and colleagues' needs. These assessments depended on the nurses' competence and motivation for professional growth.
There was a clear need to strengthen organisational structures and frameworks to support the evolving role of nurses. Basic nursing education must be better at preparing nurses for their upcoming leadership role.
Increasing complexity and unclear responsibilities contribute to role ambiguity among nurses. The review highlights the importance of recognising nurses as visible and accountable leaders. There is also a need to support nurses' adaptability through improved basic education, which may have implications for both clinical practice and education.
The PRISMA Scoping Review checklist was used during the review process. The PRISMA flowchart was used to report the database searches.
This study did not include patient or public involvement in its design, conduct, or reporting.
To quantify the costs associated with a stepped model of depression care—Integrated Chronic Care Clinics-Depression Module (IC3D)—in rural Malawi.
Cross-sectional cost analysis.
Integrated chronic care clinics (n=14) throughout Neno District, Malawi.
The stepped model of depression care provided behavioural therapy (Problem Management Plus (PM+)) to adults (aged 18+) with moderate depression and joint PM+ and antidepressant therapy (ADT) to those with moderate-to-severe and severe depression. The model incorporated two cost-saving features: treatment was integrated into existing chronic care services within the health system, and PM+ was group-based rather than one-on-one.
We conducted time-driven activity-based costing to quantify the marginal economic cost of implementing PM+ and ADT, inclusive of training and supervision. We measured all costs in 2025 US dollars and quantified costs from a societal perspective—including human resources, infrastructure, equipment, consumables, indirect costs and opportunity costs.
The marginal cost of PM+ was $90 per patient treated for five sessions over 2 months, while ADT was $138 for eight sessions over 8 months. In both instances, human resources (45% from PM+, 52% for ADT) and consumables (30% for PM+, 31% for ADT) represented primary health system cost drivers. In the first year of implementation, 15 002 depression screenings were conducted, 724 adults were evaluated with a diagnostic tool and 398 adults subsequently received care: 263 received PM+ alone, 31 received ADT alone and 104 received both PM+ and ADT. The total cost of introducing operations throughout Neno District was $62 806.
These findings indicate that integrating depression care services into the Malawian health system is financially feasible and successfully reached many individuals with major depressive disorder.
FreshRSS 