Conectar
Trauma-focused cognitive behavioural therapy (TF-CBT) is the established first-line treatment for paediatric post-traumatic stress disorder (PTSD), but access to evidence-based care remains limited. This study aimed to evaluate the feasibility and acceptability of a therapist-guided, 12 week, internet-delivered TF-CBT (iTF-CBT) programme for adolescents with PTSD and to explore preliminary changes in PTSD symptoms.
Single-group feasibility trial.
Save the Children, Sweden.
Twenty-two adolescents (13–17 years, 82% female) with primary PTSD.
A 12 week, therapist-guided, asynchronous, internet-delivered TF-CBT comprising eight modules and parallel caregiver modules with joint adolescent–caregiver activities.
Feasibility measures included recruitment pace, participant retention, treatment adherence (module completion) and therapist time. Acceptability was evaluated through satisfaction, credibility, negative effects and reported adverse events. Within-group changes in PTSD severity using independent evaluator-rated Clinician-Administered PTSD Scale (CAPS-CA-5) and the self-reported Child and Adolescent Trauma Screen 2 (CATS-2) were used as indicators of potential clinical change. Assessments occurred at baseline, during treatment, post-treatment and at 1 month follow-up (primary endpoint).
Recruitment was completed after 7 months of active enrolment. Retention and adherence were high, satisfaction and credibility ratings were favourable, and no intervention-related serious adverse events occurred. Within-group improvements were observed at the primary endpoint, with large reductions on CAPS-CA-5 (Cohen’s d=1.27) and CATS-2 (Cohen’s d=1.51). At follow-up, 47.6% of participants no longer met criteria for PTSD.
Therapist-guided iTF-CBT for adolescents with PTSD was safe, feasible, acceptable and associated with potentially meaningful symptom improvements. These findings support further evaluation in larger, controlled trials to determine efficacy, cost-effectiveness and long-term outcomes.
To describe how persons with diabetes experience learning about self-care, with a particular focus on foot self-care.
Narrative, semi-structured interviews were conducted with persons diagnosed with Type 1 or Type 2 diabetes. Participants were recruited through an advertisement in a diabetes association magazine and through convenience and snowball sampling. Eleven participants aged 53–87 were interviewed between December 2024 and April 2025. Interviews were audio-recorded, transcribed verbatim and analysed using a phenomenological hermeneutic approach.
Learning about foot self-care emerged as a gradual, lived process shaped by bodily experiences, social relationships and access to support. Three themes were identified: the social landscape of self-care, the being of the feet and taking knowledge into your own hands. Learning was influenced by encounters with healthcare professionals, informal support from relatives and personal experiences over time. Bodily symptoms acted as driving forces for learning and self-care actions. Understanding why self-care mattered was essential for motivation, while seeking and evaluating knowledge became a strategy for control and participation in care.
Learning about foot self-care among persons with diabetes is an embodied, relational and ongoing process. That develops through interaction among lived bodily experiences, social support and personal responsibility rather than through information alone.
Healthcare professionals must integrate persons' experience-based knowledge and support dialogue, reflection and shared learning to strengthen foot self-care practices.
The study addressed the limited understanding of how persons with diabetes learn foot self-care. The results showed that learning is shaped by lived experience, relationships and meaning-making. The findings are relevant for persons with diabetes and healthcare professionals involved in diabetes care.
The study adhered to the COREQ criteria.
No patient or public contribution.
To describe the normal heart rate (HR) of healthy newborns ≥35+0 weeks’ gestation in the first 10 min after caesarean delivery (CD) with extrauterine placental transfusion, using dry-electrode ECG (NeoBeat).
Single-centre, prospective observational study.
Norwegian County Hospital.
Newborns ≥35+0 weeks’ gestation delivered by CD under regional anaesthesia were eligible for inclusion. Newborns delivered by CD under general anaesthesia, or who needed medical intervention, were excluded.
NeoBeat was attached to the newborn’s chest immediately following delivery. The placenta was delivered without cord clamping after 60–90 s and transferred with the newborn to a resuscitation table. Modified physiology-based cord clamping (PBCC) was performed.
HR was recorded every second for 10 min. HR quartiles were calculated. Events possibly influencing HR were annotated using Liveborn Observation App.
89 newborns with a mean (SD) gestational age of 39+3 weeks (10 days) and birth weight of 3649 (536) g were included. Median (IQR) HR was 164 (117–176) and 169 (145–186) beats per minute at 20 s and 30 s, respectively, peaking at 169 (152–183) beats per minute at 4 min and then slowly decreasing to 157 (146–167) beats per minute at 10 min. HR was not significantly affected by intact-cord blood sampling (mean difference=5.4 (95% CI –1.4 to 12.1)), placental delivery (mean difference=0.7 (95% CI –3.5 to 4.9)) or cord clamping (mean difference =–0.6 (95% CI –2.1 to 0.9)).
This report describes, for the first time, HR quartiles for healthy newborns ≥350 weeks’ gestation from 15 s to 20 s and up to 10 min after CD with extrauterine placental transfusion and PBCC.
Despite the high rates of early enrolment in preschool and of poor mental health in adolescence in Sweden, knowledge regarding their association in Sweden is lacking. We investigated whether age at starting preschool and weekly hours spent at preschool in different ages are associated with mental ill-health in Swedish adolescents.
A cohort study based on data from KUPOL (Swedish acronym for ‘Knowledge about Adolescents Mental Health and Learning’).
We used data from KUPOL, a longitudinal study conducted during 2013–2018, involving Swedish adolescents born 2000–2001. We included in the current analyses adolescents with available information on the exposures and the outcomes of interest (n=2261).
Study participants and their parents completed questionnaires concerning the child’s age (in months) at start of preschool, the average weekly hours in preschool in different ages, the adolescent’s mental health, lifestyle, school-related, psychosocial and parental sociodemographic factors. We analysed the association between preschool-related factors and mental health using logistic regression.
Children enrolled in preschool at the age of 12–15 months had increased odds of high overall and externalising problems score on the Strengths and Difficulties Questionnaire relative to those enrolled at 20 months or later. The corresponding ORs (95% CIs) were 1.39 (95% CI 1.02 to 1.90) and 1.52 (95% CI 1.08 to 2.16), while the corresponding population attributable fractions were 8% and 9%, respectively. There were no associations between age at start of preschool and internalising problems, nor between the average weekly hours at preschool and mental health.
We found weak and inconsistent evidence for a link between early preschool attendance and mental health in adolescence; population attributable fractions suggest limited public health implications for the studied associations. The results should be interpreted in light of the methodological constraints of observational studies, the multitude of our comparisons and the sample selection.
Social media is a significant source of information for post-secondary students, who are usually at the age at which many common mental disorders first express themselves. Social media can have a role in the way post-secondary students identify and act on mental health issues.
Explore how the use of social media influences post-secondary students’ adoption of mental health labels.
We included empirical studies on mental health labelling in the context of social media use among post-secondary students published in English between January 1995 and April 2025.
The review includes references from five databases: Scopus, PubMed, Ovid MEDLINE (to access APA PsycINFO), Web of Science and ProQuest Global Dissertations and Theses. Based on the included studies from the initial search, we built a complementary search strategy using Research Rabbit artificial intelligence.
We present a table listing characteristics of the studies and brief summaries of their findings. A narrative synthesis compiled the information from each study to answer the research questions.
The search identified 7551 references and 1099 additional records from Research Rabbit. 11 studies published since 2011 met the inclusion criteria with qualitative, mixed methods and quantitative designs, without major quality concerns. Approaches to measuring social media exposure varied, including platform reports of user activity and self-reported indicators. Individuals adopted labels themselves or received labels from peers or researchers. Most research focused on self-presentation and symptom disclosure rather than labelling itself. The accuracy of self-diagnosis was higher for common disorders and lower for complex conditions such as mania or panic disorders. Labelling varied across social media platforms. Online interaction revealed issues that students were reluctant to share face-to-face. Label use appeared to influence help-seeking and peer support, with effects shaped by social stigma.
The adoption of mental health labels via social media among post-secondary students remains largely unexplored. The concept of labelling and its operationalisation vary across research. Future studies should provide more formal definitions, investigate mechanisms driving labelling and assess its potential effects on human health.
To assess the use of sodium-glucose cotransporter 2 inhibitors (SGLT2i) and glucagon-like peptide 1 receptor agonists (GLP-1 RA) among patients with coexisting ischaemic heart disease (IHD) and type 2 diabetes (T2D) in primary care, in relation to European guidelines.
Cross-sectional observational study.
209 primary healthcare centres in Region Västra Götaland, Sweden (population 1.8 million in 2023).
14 414 patients with registered prevalent diagnoses of coexisting IHD and T2D, September 2023, in QregPV, the regional primary care quality of care register in Region Västra Götaland. Data on dispensed drugs were retrieved from the regional prescribed drug register, Digitalis.
The primary outcome was the proportion of patients with dispensed SGLT2i or GLP-1 RA in relation to sex, age and primary healthcare centres (including private vs public ownership). The secondary outcome was estimated additional prescription costs.
SGLT2i was dispensed to 37.2%, less often to women (adjusted OR (aOR) 0.64 (95% CI 0.59 to 0.70)). GLP-1 RA was dispensed to 10.0%, with no sex difference (aOR 1.04 (95% CI 0.92 to 1.18)). Use of SGLT2i and GLP-1 RA declined with age (p
SGLT2i and GLP-1 RA were underutilised in patients with coexisting IHD and T2D. The sex disparity in SGLT2i use warrants attention, as does the substantial variation between primary healthcare centres and the challenges of implementing costly cardioprotective therapies.
This study aimed to describe palliative medicine physicians’ experiences performing pain assessment using the Numeric Rating Scale (NRS)—one of the most widely used pain assessment tools—for patients with cancer receiving specialised palliative care.
This qualitative study used reflexive thematic analysis.
The study was conducted in specialised palliative care settings.
Semi-structured interviews were conducted with 14 palliative medicine physicians in specialised palliative care.
The interviews were transcribed and analysed using reflexive thematic analysis.
Four themes were identified: ‘Striving to create a shared understanding’, ‘Meeting individual needs’, ‘Interpreting and managing ratings’ and ‘Importance of organizational structures’. This can be seen as a process that moves from creating a shared foundation through individual patient meetings and handling NRS ratings to organisational-level challenges.
The study shows the complexity needed within palliative cancer care when using the most common pain assessment tool in Sweden, the NRS. The tool may seem simplistic, but, as shown in this study, the physicians found interpreting the assessments challenging for the whole team. This complexity should be incorporated into future healthcare education and training within the palliative care area, where patients often have chronic pain conditions in combination with cognitive impairment. Future research needs to focus on developing reliable pain assessment methods for patients who are cognitively impaired because of the cancer.
Medication-related problems (MRPs) are common among older adults. The global population is ageing and there are health-related challenges linked to ageing in rural areas. Home-living rural older adults often face barriers to access healthcare, like long distances to healthcare services and poor continuity of care. Telepharmacy is the remote provision of pharmaceutical care, and telepharmacy could be of particular importance for rural older adults to improve their access to clinical pharmacy services and reduce the incidence of MRPs. The objective of this study is to develop and evaluate a novel telepharmacy service in primary care for home-living older adults in Northern Sweden’s rural areas. The primary objective is to evaluate the effect of the telepharmacy service regarding the identification, classification and resolution of MRPs.
This study will be conducted as a single-arm interventional study. A total of 100 people ≥65 years will receive the telepharmacy service for 12 weeks. The key principles of the telepharmacy service are to perform medication interviews and follow-up meetings with study participants, to conduct structured medication reviews, to conduct regular electronic medical record reviews and to have interprofessional collaboration with primary care physicians. All meetings will be conducted through video conferencing via a secure virtual care platform. Identified MRPs will be classified, and the acceptance rate of the pharmacists’ recommendations will be evaluated. The results will be presented with descriptive statistics. As secondary objectives, intra-individual changes in participants’ medication adherence, health-related quality of life and beliefs about medicines will be assessed through self-report questionnaires. Statistical analysis will be conducted using two-sided McNemar’s tests. Semi-structured interviews will also be conducted to explore participants’ and healthcare professionals’ experiences and attitudes towards this telepharmacy service.
This study has been granted ethical approval by the Swedish Ethical Review Authority (registration number 2022-03819-01 and 2024-08441-02). Participant informed consent is required. The results will be published in peer-reviewed journals and presented at scientific conferences.
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