The journal retracts the article titled "Health Impact and Psychosocial Perceptions among French Medical Residents during the SARS-CoV-2 Outbreak: A Cross-Sectional Survey" [...].

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Limited inclusion of ethnically diverse and socioeconomically disadvantaged populations in pain research undermines external validity, generalizability, and equity. This comprehensive review synthesized evidence on effective strategies to recruit and retain these populations in pain studies. We searched Medline, Web of Science, Embase, Scopus, and CENTRAL (12 April 2025) and included studies in which ethnically diverse and socioeconomically disadvantaged participants comprised ≥75% of the sample. Quantitative data were pooled using random-effects meta-analyses of proportions, with prespecified subgroup analyses, and qualitative findings were integrated through thematic synthesis. Certainty of evidence was evaluated using GRADE. Eighteen studies (n = 4611; 11 experimental, 5 observational, 2 qualitative), primarily from the United States and involving chronic pain, met inclusion criteria. Overall enrollment among ethnically diverse and socioeconomically disadvantaged groups was 37% (95% CI 18-58%), with significantly higher enrollment in observational studies (84%, 95% CI 78-90%) than in experimental trials (22%, 95% CI 10-36%; p < 0.001). Overall retention was 77% (95% CI 64-88%) and did not differ significantly by study design. Statewide disease-clinic networks, purposive community-leader engagement, and snowball sampling produced the highest enrollment, whereas medical-record screening yielded the lowest enrollment but the highest retention. Compensation and reminder strategies were similarly effective for retention. Thematic synthesis highlighted trust, culturally and linguistically tailored communication, hybrid and flexible visit schedules, transportation assistance, and clinician engagement as key facilitators. GRADE certainty was low for enrollment and moderate for retention. Community-engaged recruitment strategies, clinician referrals, culturally tailored materials, hybrid procedures, and modest incentives can substantially improve participation of ethnically diverse and socioeconomically disadvantaged populations in pain research. Standardized CONSORT-style reporting of recruitment/retention flowcharts according to strategy and ethnicity/socioeconomic status is essential to refine evidence-based strategies in the future.

Dementia is a leading cause of disability and death worldwide, yet diagnosis in primary care remains substantially lower than expected, delaying access to treatment, support and future care planning. The Facing Dementia Together Practice Change Program was developed as a co-designed, multicomponent intervention to improve dementia diagnosis in Australian general practice. A mixed-methods process evaluation used the RE-AIM framework with the addition of Appropriateness. The intervention included Primary Health Network (PHN) engagement, GP education, clinical resources, audit and benchmarking reports, specialist support, and a dementia risk-alert tool. Data were collected through surveys, stakeholder interviews, website analytics and program documentation. Clinicians who participated reported increased confidence and changes in dementia-related clinical behaviours, while education, resources and benchmarking were perceived as valuable. However, overall reach was limited by competing clinical priorities, workforce pressures, lack of financial incentives, and PHN implementation challenges. The dementia risk-alert tool was feasible but achieved limited uptake because of software compatibility, usability concerns and incomplete electronic medical record data. Although the program was acceptable to participating clinicians, limited reach constrained its potential impact. These findings highlight organizational, workforce, digital infrastructure and policy factors that influenced implementation of multicomponent interventions in routine primary care.

The COVID-19 pandemic led to distress and an increased prevalence of psychopathology among front-line (FL) healthcare workers (HCWs). A synthesis of the available data on the effectiveness of MH interventions among FL HCWs is essential to inform an MH plan for FL HCWs in future pandemics. The objective of this systematic review is to examine interventions used to support the MH of FL HCWs during the COVID-19 pandemic. All studies published between 1 January 2020 and 1 March 2026 that reported on MH interventions among FL HCWs during the COVID-19 pandemic were identified using PubMed, PsycINFO, Scopus, EMBASE, Cochrane Database of Systematic Reviews, Google Scholar, Medline, and Web of Science. Studies published in peer-reviewed journals that reported data on interventions to support the MH of FL HCWs were included. The study was conducted using the approach by the PRISMA guidelines. The search generated 1450 records, of which 309 were reviewed at length, and 153 studies (N = 153) were included. Interventions in these studies included identification of risk for psychopathology and linkage to mental health care (n = 3), PE/PFA (n = 44), psychotherapy (n = 26), mindfulness programs (n = 58), medications (n = 5), and multiple/combined psychosocial support interventions (n = 17). The majority of studies found their interventions to be beneficial, largely based on user satisfaction scores and symptom screening scores. Importantly, symptoms in the vast majority of control arms also improved over time, though not to the degree that symptoms in intervention arms improved. This systematic review suggests that an established disaster MH response framework may be useful in directing the design of MH responses to FL HCWs in future pandemics, offering screening for psychopathology and connection with formal psychiatric services for full evaluation and provision of MH care, as well as supportive care with mindfulness interventions, crisis-oriented counseling, PE, and PFA.

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease associated with significant physical, psychological, and social distress. Given its terminal nature and high symptom burden, early integration of palliative care is essential. The inpatient Palliative Care Consult Team (PCCT) provides specialist palliative care to hospitalized patients with ALS. Hospitalizations are common throughout the ALS disease trajectory, particularly as patients experience progressive functional decline, respiratory compromise, and increasing care needs, making inpatient encounters important opportunities for specialist palliative care involvement. To extend palliative care beyond the inpatient setting and facilitate earlier involvement, an ALS ambulatory clinic was established in 2018. Despite the importance of palliative care, limited data describes its involvement among hospitalized ALS patients. This retrospective review examines the relationship between the PCCT and ALS patients admitted to a tertiary care facility between 2006-2019. Data collected included patient demographics, referral indications, clinical course, and disposition. Most patients referred to the PCCT had poor functional status and a guarded prognosis at initial consultation. Symptom management and support for complex decision-making were leading reasons for referral. Approximately half of patients died in the hospital within three months of referral. Most deaths occurred within one week, underscoring the importance of timely palliative care.

Psychosocial working conditions are important determinants of employee health, work ability, and organizational sustainability, yet existing instruments often assess job demands, job resources, psychosocial risks, or well-being outcomes separately. This study examined the structural validity of the Multidimensional Psychosocial Work Experience Scale for Employed Persons (MPWES), an instrument designed to assess a multidimensional occupational psychosocial profile comprising workplace conditions and demands, psychosocial resources, adverse exposures, health-related experiences, and subjective functioning. A cross-sectional validation study was conducted among 1631 employees from the pharmaceutical, energy, healthcare, and administrative sectors in Latvia. Confirmatory factor analysis with the robust WLSMV estimator was used to test the predefined measurement model. The refined eight-factor model demonstrated acceptable fit in the calibration subsample (N = 400; CFI = 0.930, TLI = 0.922, RMSEA = 0.066, SRMR = 0.078) and was replicated in the held-out validation subsample (N = 1231; CFI = 0.911, TLI = 0.901, RMSEA = 0.068, SRMR = 0.067). Reliability indices were acceptable for several domains, although some factors showed modest or borderline values. Discriminant validity was supported, with all HTMT values below 0.85, and measurement invariance testing supported configural, metric, scalar, and strict invariance across samples. The findings provide initial evidence of the MPWES's structural validity and measurement stability in the present sample. However, further studies using external validity criteria, longitudinal designs, and culturally diverse samples are needed before the scale can be considered fully validated for broader occupational and public health applications.

Background: Rural and resource-constrained settings face major barriers to timely cancer screening, diagnosis, and treatment due to limited specialist availability and centralised service-delivery models. In the Eastern Cape, a largely rural province with a constrained oncology workforce, a decentralised-centralised hybrid model was introduced to improve access to cancer care. Nelson Mandela Academic Hospital serves as the central referral hub within this model. This study evaluates the implementation process and impact of this decentralised cancer care model on service utilisation, access, and continuity of care. Methods: A quantitative quasi-experimental pre-post implementation and quality improvement evaluation was conducted using retrospectively collected routine service utilisation and programme data from April 2023 to February 2025. The study assessed the impact of a decentralised oncology care model on access, service integration, and utilisation outcomes. Data from facility registers and district health information systems were managed using Microsoft Excel and analysed using Stata and IBM SPSS Statistics. Descriptive statistics, correlation analysis, and linear regression were used to compare pre- and post-implementation changes in patient volumes, screening coverage, referral completion, workforce capacity, gender distribution, and service uptake. The intervention decentralised screening, diagnosis, follow-up, and patient navigation services to district and satellite facilities while centralising specialised oncology care at referral centres to improve accessibility, efficiency, and continuity of care. Results: Cancer patient attendance increased substantially over the study period, from 355 patients in April 2023 to a peak of 1039 in April 2024, with a sustained upward trend (B = 18.03, p = 0.005), reflecting an average monthly increase of 18 patients. Female patients accounted for most visits, while male attendance showed a significant increasing trend (B = 8.03, p < 0.001). Service integration improved, with strong positive correlations between new patient registrations, follow-up care, palliative services, and inpatient admissions, indicating an expanding continuum of care. Breast and cervical cancers contributed the highest service burden, while cervical and lung cancers showed significant upward trends. Seasonal variation in attendance was observed, particularly during festive periods. From an implementation perspective, screening coverage for priority cancers increased by 18%, while 732,349 individuals were reached through community awareness initiatives. Access improved substantially, evidenced by a reduction of 56,400 km in cumulative patient travel distance over one year. Workforce capacity was strengthened through the training of 517 healthcare workers, and 1943 patients received structured navigation support. Referral efficiency and continuity of care improved, although persistent bottlenecks were observed in diagnostic and referral pathways. Conclusions: The decentralised-centralised oncology care model demonstrated improved cancer service utilisation, access, and continuity of care in a rural, resource-limited setting. However, increasing patient volumes and interconnected service demands place additional pressure on health system capacity. Sustained investment in workforce development, screening-particularly for cervical cancer-and system efficiency is required. This model provides a scalable and context-appropriate framework for strengthening oncology services in similar low-resource settings.