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by Lei Xiong, Ke Li, Wendy Siuyi Wong
BackgroundDigital media usage has become an integral part of daily life, but prolonged or emotionally driven engagement—especially during late-night hours—may lead to concerns about behavioral and mental health. Existing predictive systems fail to account for the nuanced interplay between users’ internal psychological states and their surrounding ecological contexts.
ObjectiveThis study aims to develop a psychologically and ecologically informed behavior prediction model to identify high-risk patterns of digital media usage and support early-stage intervention strategies.
MethodsWe propose a Dual-Channel Cross-Attention Network (DCCAN) architecture composed of three layers: signal identification (for psychological and ecological encoding), interaction modeling (via cross-modal attention), and behavior prediction. The model was trained and tested on a dataset of 9,782 users and 51,264 behavior sequences, annotated with labels for immersive usage, late-night activity, and susceptibility to health misinformation.
ResultsThe DCCAN model achieved superior performance across all three tasks, especially in immersive usage prediction (F1-score: 0.891, AUC: 0.913), outperforming LSTM, GRU, and XGBoost baselines. Ablation studies confirmed the critical role of both psychological and ecological signals, as well as the effectiveness of the cross-attention mechanism.
ConclusionsIncorporating psychological and ecological modalities through attention-based fusion yields interpretable and accurate predictions for digital risk behaviors. This framework shows promise for scalable, real-time behavioral health monitoring and adaptive content moderation on media platforms.
To explore peer volunteers' experiences of delivering online support through SMART to at-risk mothers during the perinatal period, to inform future improvements to mobile-health-application (mHealth app) based peer-support interventions.
Descriptive qualitative research.
The study was conducted between February 2024 and June 2025 in a tertiary public healthcare institution in Singapore. Twenty peer volunteers were recruited via convenience and snowball sampling and participated in individual semi-structured interviews. Interviews were audio-recorded, transcribed verbatim and analysed using thematic analysis.
Four themes were identified: (a) Giving and receiving: the inner world of peer volunteers; (b) Navigating relational complexity in digital peer support; (c) Facilitating connection and continuity in digital peer support; and (d) Building better connections through supportive ecosystems.
Peers reported experiencing reciprocal benefits, such as a sense of fulfilment and achievement, while supporting mothers. Shared experiences and psychosocial vulnerabilities enhanced relatability, reassurance and rapport, which sustained supportive relationships. Challenges encountered by peers highlighted the need for strengthening both intervention design and peer training.
Regular check-ins by programme facilitators, alongside clear information, flexible guidelines and reassurance, can improve peer volunteers' motivation and resilience, thereby ensuring consistent and sustainable support for at-risk mothers.
Examined peer volunteers' experiences in providing online perinatal support to mothers with diverse psychosocial vulnerabilities. Peers offered emotional, informational and practical support, while mothers benefited from learning how peers had coped with their psychosocial vulnerabilities. Shared experiences fostered confidence and reassurance among mothers that they, too could overcome similar adversities. Valuable in providing both medically accurate perinatal information and meaningful social support to perinatal mothers.
The reporting of the study adheres to the standards outlined in the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist.
Mothers and peer volunteers contributed valuable insights and suggestions that helped in the design of the intervention.
by Piotr Jarocki, Jan Sadurski, Martyna Siuda, Mateusz Romanowicz, Jacek Panek, Magdalena Frąc, Adam Waśko
Lacticaseibacillus rhamnosus is widely recognized for its health-promoting properties, which have led to its broad application in the production of food and dietary supplements. Nevertheless, although rare and typically limited to patients with underlying conditions, adverse effects have also been reported. In this study, we sequenced and characterized the genomes of seven L. rhamnosus strains isolated from blood. Using a hybrid approach that combined Illumina and Oxford Nanopore technologies, we obtained complete genomes ranging from 2.96 to 3.13 Mb, with a GC content of 46.7–46.8%. Comparative analyses with publicly available L. rhamnosus genomes revealed that these isolates were genetically related to strains from highly diverse origins, including plants, dairy products, dietary supplements, the gastrointestinal and genitourinary tracts, as well as blood and other clinical samples from geographically distant regions. Importantly, neither core genome multilocus sequence typing (cgMLST) nor prophage and CRISPR module analyses indicated similarity to the widely used probiotic strain L. rhamnosus GG. Gene-based analysis identified determinants associated with bacteriocin production, adhesion, health-promoting traits, and potential pathogenicity of the strains. Notably, several genes linked to probiotic functions also overlapped with virulence factors found in pathogenic microorganisms. These findings demonstrate the genomic diversity of L. rhamnosus blood isolates and highlight the dual role of certain genetic determinants, underlining the importance of careful strain-level evaluation when selecting L. rhamnosus strains for probiotic use.To examine the perinatal experiences of at-risk mothers and their engagement with mobile-health-based care.
A qualitative descriptive study.
One-to-one semi-structured interviews were conducted with 30 at-risk mothers, defined as those who were single, had low income, were at risk of depression, had adverse childhood experiences, gave birth to a baby with congenital disorders, or had a history of mental health conditions. Participants were purposively sampled at 6 months postpartum from a tertiary public hospital in Singapore between February and September 2024. Interviews continued until data saturation was achieved, were audio-recorded, transcribed verbatim and analysed using thematic analysis.
The study identified four overarching themes: (a) Me and my baby versus the world, (b) navigating vulnerability and strength in motherhood, (c) generational tensions in modern parenting and (d) reimagining perinatal care for every mother. Across the perinatal period, both intervention and control group mothers reported social isolation, emotional and physical strain and challenges balancing traditional family expectations with modern parenting practices. While mothers in the intervention group described receiving holistic support through the SMART program, those in the control group relied on ad hoc sources of support, such as social media platforms.
At-risk mothers experienced significant challenges during the perinatal period, and those who used a mobile-health-based perinatal intervention felt supported through its peer support and multimedia educational resources.
Mobile-health-based interventions can be integral aspects of standard nursing care. Future researchers must ensure that support rendered to at-risk mothers is culturally compatible and specific to the psychosocial vulnerabilities they experience. Increased contact and funding are vital, whereas artificial intelligence, multiple shared access and health monitoring trackers can shape future perinatal interventions.
A mobile-health-based perinatal intervention can have an enormous positive impact on the psychological well-being of vulnerable mothers worldwide.
This study followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist.
This study did not include patient or public involvement in its design, conduct or reporting.
ClinicalTrials.gov (Registration ID: NCT06363019). Registered 4/12/23, first recruitment on 26/02/2024.
Hospitalisation is one of the most stressful life events for older adults, particularly for those who are pre-frail or frail. Multi-component community-based interventions have the potential to address the complex needs of older adults post-acute care admission. While some available interventions have been developed with end-user engagement, fully involving older people who are pre-frail or frail in the design of interventions has been less common. Multi-component community-based interventions that address the needs of older adults and their care partners with potential implementation barriers informed by healthcare providers, community partners and health system decision makers are needed. This protocol paper describes the planned process of co-designing for older patients discharged into the community, a Post-Acute Care Intervention for Frailty using Information and Communication technology.
The development of a complex multi-component frailty intervention which meets older people’s needs involves several concurrent tasks and methodologies, each informed by co-design and conducted with consideration to eventual implementation. These tasks include: (1) establishing a Research Advisory Board, (2) assessing the feasibility and validity of using hospital administrative data to identify frail or pre-frail older adults and their needs, (3) conducting a needs assessment of patients returning to the community, (4) mapping community assets to identify existing programmes and services to help tailor the intervention, (5) co-designing a multicomponent frailty intervention, (6) selecting study outcome measures and (7) selecting and tailoring a digital health patient portal to support intervention delivery, data capture and communication.
Each task requiring ethics approval will be submitted to the Hamilton Integrated Research Ethics Board at McMaster University. Results will be disseminated through peer-reviewed journal articles, conferences and networks of relevant knowledge users who have the capacity to promote dissemination of the results. A toolkit will be developed to help researchers and healthcare providers replicate the methodology for other populations.
Patients with advanced cancer often face numerous physical, psychological, and practical challenges from their disease and treatments, yet interventions addressing their specific unmet needs remain limited.
This study aimed to evaluate the effectiveness of a tailored psychoeducational intervention (PEI) on stress, anxiety, depression, coping, and fatigue among advanced cancer patients in Indonesia.
A randomized controlled trial was conducted from August 2022 to March 2023 in Indonesia.
A total of 151 advanced cancer patients from a referral hospital in Indonesia were randomized into intervention and control (conventional management) groups. Participants were assessed using validated questionnaires including the Depression, Anxiety, and Stress Scale (DASS-21), Fatigue Severity Scale (FSS), and Brief COPE at three time points: baseline (T0, before intervention), after first intervention (T1), and after second intervention (T2). The PEI was delivered face-to-face with telephone follow-up calls. Generalized Estimating Equations (GEE) analysis was used to evaluate the intervention's effectiveness.
The intervention was significantly associated with improved coping and reduced fatigue scores. Significant time effects were observed for depression, stress, coping, and fatigue scores. For anxiety, a significant impact was found at the second time point but not at the third, compared to the baseline. The difference-in-difference (DID) analysis revealed significant effects on coping and fatigue scores, while anxiety only showed significance at the second time point.
This study provides evidence for the potential effectiveness of PEI in improving coping strategies, relieving stress, anxiety, and depression, and reducing fatigue among advanced cancer patients in Indonesia.
The tailored PEI, including follow-up phone calls, can be independently implemented by nurses. Focusing on patients' unmet needs and spirituality, this intervention can help manage mental health issues and strengthen coping mechanisms, potentially leading to positive effects on physical conditions such as fatigue.
To synthesize approaches used to evaluate nurse-led clinics (NLCs) and student-led clinics (SLCs) delivering community-based primary healthcare.
A scoping review based on Joanna Briggs Institute (JBI) guidelines.
This review included articles evaluating the impact of NLCs and SLCs, published between 2013 and 2023. The Quadruple Aim Framework for health systems quality improvement was a reference point for thematic analysis.
CINAHL Complete, ProQuest Nursing & Allied Health, PubMed, Scopus, Health Systems Evidence, Ovid Emcare and grey literature repositories were searched in March–June 2023.
Our search yielded a total of 891 articles and 43 articles were included in this scoping review. Diverse quantitative and qualitative methods and concepts of interest were evident in the evaluations of NLCs (n = 15), medical SLCs (n = 15) and interprofessional SLCs (n = 13). Extracted data spoke to the evaluation of either client experience, health of communities, systems of care delivery or provider experience, with systems of care delivery being the most consistently evaluated domain across all clinic types.
Traditional and non-traditional evaluation measures spanning the Quadruple Aim Framework were used to study community-based NLCs and SLCs. Opportunities remain for broadening the range of indicators and methods used to capture clinic impact on health equity.
Numerous transferable research approaches are available to students and clinical professionals for supporting the design and iterative improvement of innovative primary healthcare clinics.
The results highlight ways in which NLCs and SLCs may be evaluated for their concurrent impact on healthcare service delivery and clinical education systems.
PRISMA-ScR.
Feedback amassed during presentations to nursing audiences informed the enclosed discussion points.
Review protocol was published with the Open Science Framework under ID 10.17605/OSF.IO/FP6S4
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