JMIR Research Protocols

Background: Nursing interns are at high risk of psychological distress due to academic and clinical stressors. While poor sleep quality is linked to anxiety and depression, the buffering role of social support remains underexplored in this population. Aims: To explore the role of social support in regulating the relationship between sleep and mental health among nursing interns. Methods: A total of 396 nursing interns completed self-administered questionnaires including the Pittsburgh Sleep Qual...

BackgroundPoor patient retention and family engagement compromise the effectiveness of coordinated specialty care (CSC) for first-episode psychosis (FEP). This mixed methods study aimed to identify program-level characteristics (CSC fidelity and engagement strategies) associated with patient retention and family engagement in Massachusetts CSC programs. MethodsPrimary outcomes were rates of patient retention and family engagement ([≥]1 evidence-based family intervention session), based on CS...

KEY POINTSO_ST_ABSQuestionC_ST_ABSDid changes in mental health symptoms from pre-COVID-19 to during the pandemic differ by sex or gender? FindingsIn this systematic review and meta-analysis study of findings from 27 unique cohorts, changes from before to during the COVID-19 pandemic in mental health symptoms, including general mental health, anxiety, depression, and stress, were not statistically significantly different by sex or gender. MeaningThere were not likely substantial sex and gender ...

This bibliometric study focuses on the publication activity of senior staff, consisting of chief physicians, senior physicians, department heads, and division heads at German university hospitals specializing in cardiology. The aim is to identify topics, focal points, study types, and impact factors (IFs) achieved. No studies on this topic have been conducted to date. However, Millenaar et al. [1] provided an overview of the cardiovascular research landscape in Germany, highlighting publication ...

PurposeThe objective of this study was to identify predictors of statin adherence in the primary and secondary prevention of CVD among patients in the first two years after the date of first prescription using real-world data. MethodsThe Electronic Practice Based Research Network Linked Dataset was used in this study. Statin adherence was calculated using a modified proportion of days covered (PDC) formula. Individuals with PDC [≥] 80% during the two years of observation period were consider...

BackgroundCognitive deficits in anxiety disorders (ADs) contribute to clinical and socio-occupational dysfunction, necessitating targeted interventions. NoveltyIntegrated Cognitive Control Training (ICCT), a novel intervention, has demonstrated benefits in other disorders, however, remains unexplored in ADs. With its process-specific training and multi-pronged exercises for stimulation, metacognitive training and generalization, it has potential for enhancing cognitive functions in ADs. Object...

BackgroundHumanitarian settings in Pakistan face major gaps in mental health service delivery, with limited specialist resources and a high burden of untreated conditions. The WHO mhGAP-Humanitarian Intervention Guidelines (mhGAP-HIG) aim to strengthen the capacity of primary care physicians (PCPs) to identify and manage common mental health conditions in humanitarian contexts. However, the evidence for multidimensional training outcomes remains limited. This study evaluated the effectiveness of...

Outcomes from the COSMOS trial have reinforced the notion of flavanols as important plant-derived bioactives contributing to cardiovascular health. As discussions continue on whether specific dietary reference values for flavanols are warranted, it is possible that existing dietary guidelines emphasizing fruits and vegetables already yield sufficient flavanol intake levels. If this were the case, developing flavanol specific dietary reference values might be unnecessary. This study therefore aim...

ContextErogothioniene (EGT), a potent natural antioxidant, exerts hepatoprotection. However, human clinical evidence remains absent. Objectiveto observe the clinical efficacy and safety studies of GeneIII(R) L-Ergothioneine Capsules in the Hepatoprotective Efficacy. Materials and methodsThirty subjects with some abnormal liver function indicators were selected to take 2 capsules of 30mg GeneIII(R) L-Ergothioneine Capsules per day, for 30 consecutive days. The changes in serum liver function bi...

BackgroundPalliative care improves quality of life and reduces healthcare utilization for people with heart failure, yet referrals remain inconsistent and delayed. Clinical decision support (CDS) offers a promising strategy to facilitate timely palliative care, but no CDS tool currently exists to specifically support palliative care decision-making in this population. MethodsGuided by the User-Centered Framework for Implementation of Technology (UFIT), we conducted a qualitative descriptive stu...

Insomnia and anxiety are highly prevalent and often comorbid in older adults. Although cognitive-behavioural therapy is the first-line treatment for insomnia, few interventions simultaneously address both conditions. Furthermore, access remains limited by provider availability and high costs. To address these gaps, we developed an online CBT program for insomnia and anxiety (eCBT+). This randomized controlled trial aimed to assess the usability and acceptability of the eCBT+ program and evaluate...

BackgroundWith rising referrals to child and adolescent mental health services (CAMHS), patient- and caregiver-facing digital platforms could streamline service delivery and research. With South London and Maudsley NHS Foundation Trust and Kings College London, the CAMHS Digital Lab developed myHealthE, a digital platform for families to access advice and support from the point of referral to CAMHS in South London, submit routine outcome measures, and consent to be contacted about relevant resea...

PurposeTo address high levels of depression and anxiety among college students, innovative, feasible, and effective treatment approaches with high potential for dissemination in university counseling centers are needed. This pilot study aimed to develop a toolkit and training intervention to support implementation of nature-based physical activity into group therapy in a university counseling center, and to evaluate the feasibility, acceptability, and preliminary effectiveness of the interventio...

BackgroundDigital health self-monitoring tools are widely used to support weight management and metabolic health. Higher engagement with these tools is often associated with better clinical outcomes; however, real-world engagement-outcome relationships for consumer metabolic monitoring devices remain incompletely characterized, particularly in heterogeneous user populations. ObjectiveTo evaluate whether engagement with a portable breath-based metabolic device (Lumen; Metaflow Ltd.) is associate...

ObjectiveLarge language models (LLMs) are increasingly embedded in mental-health chatbots, yet safe deployment is limited by two unresolved challenges: (1) suicide- and crisis-risk detection lacks a definitive ground truth and is characterized by substantial clinician disagreement, and (2) most evaluations frame risk detection as an offline accuracy task rather than a real-time safety problem. This study aimed to empirically characterize these limitations and to derive design principles for unce...

BackgroundElevated low-density lipoprotein cholesterol (LDL-C) is a risk factor for cardiovascular disease. Despite available lipid-lowering therapies (LLT), lipid control remains suboptimal. Bempedoic acid offers a non-statin oral treatment for hypercholesterolemia. However, real-world data in Asia are limited. The study aimed to investigate the effectiveness and safety of bempedoic acid in Taiwan. MethodsThis pragmatic phase IV study enrolled 180 patients with inadequately controlled hypercho...

Objective: Posttraumatic stress disorder (PTSD) after a traumatic birth is a serious but overlooked maternal morbidity, affecting ~20% of women following medically complicated deliveries. PTSD can undermine maternal caregiving. Rapid screening tools suited to busy obstetric settings are lacking. We developed and evaluated a brief screener, derived from the 20-item PTSD Checklist for DSM-5 (PCL-5), to identify PTSD related to childbirth. Study Design: We enrolled 107 women with traumatic childbir...

ObjectiveThe objective of this study was to explore the predictors of statin intolerance in the primary and secondary prevention of CVD among patients in the first two years after the date of first prescription using real-world data. MethodsThis study used the Electronic Practice Based Research Network Linked Dataset. An algorithm, which considered the muscle symptoms and creatinine kinase of patients, was used to identify statin intolerant patients. The R software was used for all analyses. De...

ImportanceLarge language models (LLMs) have demonstrated diagnostic potential in several medical specialties, but their application to psychiatry - where diagnosis relies heavily on clinical judgment, narrative interpretation, and reasoning under uncertainty - remains insufficiently evaluated. ObjectiveTo evaluate diagnostic accuracy and clinician-judged reasoning quality of multiple large language models using psychiatric case vignettes. DesignMixed-methods evaluation study of diagnostic accu...

BackgroundAnthracyclines are central to childhood cancer therapy but predispose patients to cardiotoxicity leading to long-term cardiovascular risk. Endothelial injury and impaired repair contribute to this, yet pediatric data remain limited. ObjectiveTo longitudinally assess endothelial injury and repair in childhood cancer patients treated with anthracyclines by quantifying circulating endothelial cells (CECs) and endothelial progenitor cells (EPCs). MethodsIn a single-centre retrospective c...