Psychiatric rehabilitation in Oman: service gaps and a framework for recovery-oriented care

Human immunodeficiency virus (HIV) infection remains a growing public health concern in the Philippines, where new infections rose by about 550% between 2010 and 2024 and diagnosis gaps persist in CALABARZON. Nurses are often the first and most sustained point of contact in HIV testing and care, yet knowledge gaps, stigmatizing attitudes, and procedure-focused training may limit their ability to provide compassionate, person-centered counseling. This study aims to develop and validate a Caring-Based HIV Counseling Training Program for Nurses in Laguna, Philippines, using a methodological research design and a modified Delphi technique. Registered nurses from selected government and private healthcare facilities in Laguna will complete a researcher-developed training-needs assessment questionnaire covering six competency domains: HIV-related knowledge; counseling and therapeutic communication; caring behaviors and person-centered practice; ethical and legal responsibilities; cultural sensitivity and stigma reduction; and linkage to prevention, treatment, care, and support. The questionnaire will undergo expert review, pilot testing, and reliability testing using Cronbach’s alpha. The needs-assessment findings, together with a review of current literature and guidelines, will inform a preliminary training program, which a multidisciplinary panel of approximately 15 to 20 experts will evaluate over successive anonymous Delphi rounds for relevance, clarity, comprehensiveness, cultural appropriateness, feasibility, and applicability. Consensus is defined in advance as at least 80% expert agreement, a median rating of at least 3.00, and an interquartile range of no more than 1.00. Content validity will be established through an Item-Level Content Validity Index of at least .78 and a Scale-Level Content Validity Index (average) of at least .90, overall agreement will be measured with Kendall’s coefficient of concordance, and the experts’ qualitative comments will undergo directed content analysis. The study is expected to produce an expert-validated, contextually relevant training program that strengthens nurses’ capacity to deliver compassionate, stigma-free HIV counseling, with its effectiveness to be tested in a future pilot or quasi-experimental study.

Transitioning out of professional sport can present challenges for athletes and their wider environments, frequently necessitating coordinated physical, psychological, and economic support. Although these concerns have been documented in elite cycling, the extent to which structured transition programmes exist within the sport remains insufficiently understood, particularly in Europe, the historical centre of professional cycling. We conducted a cross-sectional qualitative documentary analysis, distributing a standardised inquiry to all European Cycling Federations (ECFs; N = 51) between December 2024-March 2025. Federations were asked whether they had formal strategies, policies, or resources related to athlete retirement. Responses were categorised as “ECF-level literature or initiative”, “No ECF-level provision”, or “No response” and relevant materials were descriptively synthesised. Amongst the 21 federations that responded, the majority (n = 17; ≈81%) reported no ECF-level retirement initiatives. Common reasons included limited resources, low perceived demand, or reliance on national or international bodies (i.e., Olympic Committees or sport-specific unions). Four ECFs (~19%) described transition-related structures, though these varied considerably in scope, definition, and delivery. Despite well-documented needs, structured retirement support for professional cyclists remains uncommon across European national federations, and existing programmes appear heterogeneously applied. As cycling expands globally, effective transition planning becomes increasingly important for athlete wellbeing and the long-term sustainability of the sport. Holistic, international collaborations led by cycling’s major governance bodies could strengthen career-long support systems, reinforce the public image of cycling as a health-promoting discipline, and create responsible, athlete-centered ecosystems.

Objective: The study aimed to evaluate the internalised stigma and self-esteem in adult outpatients with major depressive disorder (MDD) attending a psychiatric outpatient clinic in Iraq, and to explore the relationship between these variables. Methods: A cross-sectional correlational study among 120 adults with MDD who attended psychiatric outpatient clinics of Azadi Teaching Hospital in Kirkuk, Iraq. All participants filled out a sociodemographic and clinical questionnaire, the Internalised Stigma of Mental Illness Scale (ISMI), and the Rosenberg Self-Esteem Scale (RSES). Data were analysed using descriptive statistics, Pearson's correlation coefficient and simple linear regression. Results: The overall mean ISMI score was 2.90 (SD = 0.42), with the highest scores for stereotype endorsement (M = 3.16) and alienation (M = 3.14) and the lowest for stigma resistance (M = 2.19). The overall mean RSES score was 2.29 (SD = 0.38). There was a negative correlation between internalised stigma and self-esteem (r = −0.338, p < 0.001). Self-esteem was statistically associated with internalised stigma (β = −0.338, t = −3.897, p < 0.001), explaining 11.4% of the variance (R² = 0.114) in simple linear regression. Conclusions: In this single-centre sample of adults with MDD, internalised stigma and self-esteem were inversely related. Since the study is a cross-sectional design, the association observed cannot be considered a causal relationship. The results provide a basis for consideration of the psychosocial aspects of routine psychiatric care (stigma and self-esteem) and for further longitudinal and multicentre research to establish temporal relationships and to determine potentially modifiable factors.

The increasing use of computers, predominantly involving prolonged static sitting, may increase the risk of musculoskeletal disorders (MSDs). This study aims to examine workstation ergonomic risk and musculoskeletal disorders among computer users through a literature review based on the Rapid Office Strain Assessment (ROSA) and the Nordic Musculoskeletal Questionnaire (NMQ). A systematic search was conducted in PubMed and Google Scholar for articles published between 2020 and 2025, following PRISMA guidelines. A total of nine studies that met the inclusion criteria were analyzed narratively. The results indicate that most studies reported moderate to high levels of ergonomic risk, with chair-related factors as the dominant contributors. The prevalence of musculoskeletal complaints was also high, particularly in the neck, shoulders, and lower back. However, the relationship between ROSA scores and musculoskeletal complaints was inconsistent across studies, suggesting the influence of multifactorial determinants. Therefore, ROSA is more appropriately used as a screening tool for ergonomic risk, while NMQ complements it by capturing subjective complaints. The combined use of both instruments is essential to support a more comprehensive ergonomic assessment and the development of effective interventions.

Mental health services are constantly evolving with the gradual introduction of functionalized care, which means medical intervention has become more focused on a particular clinical area or stage of the illness. This has progressed to having designated teams for inpatient psychiatry. Usually, psychiatrists manage their patients both in outpatient and inpatient settings while working in a particular geographical area or sector. Moving away from this model to a functionalized inpatient setting, where other psychiatrists take care of their patients, is seen as a breach in continuity of care. In this context, it was intended to review the current literature for the experience of clinicians and patients in these sectorized (medical continuity) or functionalized models of psychiatric inpatient care. A narrative review of the current literature from multiple databases was conducted. The results suggested that there are positive and negative observations in both models. It appeared that neither met the expectations of patients nor clinicians. Patients preferred to be seen by the same consultant in community and inpatient settings, but clinical outcomes were not significantly different in the two models. The functionalized care was mostly medical continuity rather than multidisciplinary. Any changes in the care models may be driven by local facilities and issues. There is a need to improve the quality of care through existing models before any changes. More studies are needed to improve the evidence on the effectiveness of these service models.