Cyberbullying has become an important concern for adolescent well-being because online harassment can continue beyond school settings and expose young people to repeated social stress. This study examined the relationships between cyberbullying exposure, emotion-regulation strategies, and mental health among adolescents. A quantitative, cross-sectional correlational design was used with 100 secondary-school adolescents aged 13-18 years (M = 15.42, SD = 1.38). Measures included the Cyber-Victimization Scale (CYBVICS), Emotion Regulation Questionnaire (ERQ), and Early Adolescent Mental Health Scale (EAMHS). Descriptive statistics, Pearson product-moment correlations, and simple linear regression analyses were reported. Cyberbullying exposure was negatively correlated with cognitive reappraisal (r = -.42, p < .001) and mental health (r = -.58, p < .001), and positively correlated with expressive suppression (r = .48, p < .001). Cognitive reappraisal was positively associated with mental health (r = .51, p < .001), whereas expressive suppression was negatively associated with mental health (r = -.46, p < .001). Regression analysis indicated that cyberbullying exposure accounted for 33.6% of the variance in mental-health scores, R? = .336, F(1, 98) = 49.68, p < .001. The findings indicate meaningful associations among online victimization, emotion regulation, and adolescent well-being. Because the study is cross-sectional and relies on self-report measures, the findings do not establish causality.
BACKGROUND: Understanding prescription trends and costs of psychotropic drugs is essential to inform mental healthcare policy and practice. However, comprehensive national evidence across psychotropic drug classes is limited, and little is known on how prescription volumes changed during the COVID-19 pandemic. AIMS: We examined prescription trends and costs of psychotropic drugs in the UK and assessed changes in prescription volumes following the onset of the COVID-19 pandemic. METHOD: We analysed national Prescription Cost Analysis data from 2013 to 2023, for six major psychotropic drug classes. Annual prescription volumes, total costs and average costs per drug were estimated. Linear regression was used to assess temporal trends and changes in prescription volume during the pandemic years. Costs were adjusted for inflation to 2023 prices. RESULTS: Between 2013 and 2023, psychotropic prescriptions grew 4% (95% CI 3.9-4.2) annually. Prescriptions for antidepressants, antipsychotics, stimulants and anti-dementia drugs increased, but not for hypnotics and anxiolytics and drugs used in substance dependence. In contrast, total costs declined by approximately £328 million, and the average cost per drug dropped from £11 to £5.9. Prescription volume remained unchanged during the pandemic years, except for anti-dementia medications, which showed an annual reduction of 17.2% (95% CI 7.8-26.6) relative to the underlying temporal trend during the study period. CONCLUSIONS: Our observed rising prescription trend is consistent with global evidence on availability and use of psychotropic drugs. Furthermore, we found a decrease both in total drug costs and average costs per drug.
ABSTRACT The Merdeka Belajar Kampus Merdeka (MBKM) program provides learning experiences that require students to adapt, learn from experience, and develop innovative ideas. Individual differences in personality may be associated with variations in these abilities, making further investigation of personality dimensions necessary. This study aimed to analyze the role of the five Big Five personality dimensions in predicting learning agility and innovative behavior among MBKM participants. A quantitative approach with a cross-sectional correlational design was employed, involving 303 students who were currently participating in or had previously participated in MBKM activities. Participants were selected using a non-probability sampling technique. Data were collected through self-report questionnaires and analyzed using Confirmatory Factor Analysis (CFA) and multivariate regression with Mplus 8.4. The results indicated that openness to experience was the strongest positive predictor of innovative behavior (β = 0.422; p < 0.001) and learning agility (β = 0.361; p < 0.001). Conscientiousness and extraversion were also positively associated with both outcomes. In contrast, agreeableness was negatively associated with innovative behavior (β = −0.116; p = 0.016) but was not significantly associated with learning agility. Neuroticism showed no significant association with either outcome. These findings highlight the relevance of personality characteristics in understanding variations in student competencies and support the development of adaptive MBKM mentoring programs without using personality profiles as the sole basis for student selection. ABSTRAK Program Merdeka Belajar Kampus Merdeka (MBKM) memberikan pengalaman belajar yang menuntut mahasiswa mampu beradaptasi, memanfaatkan pengalaman, dan mengembangkan gagasan inovatif. Perbedaan karakteristik individu diduga berkaitan dengan variasi kemampuan tersebut, sehingga perlu dikaji melalui dimensi kepribadian. Penelitian ini bertujuan menganalisis peran lima dimensi Big Five personality dalam memprediksi learning agility dan perilaku inovatif mahasiswa peserta MBKM. Penelitian menggunakan pendekatan kuantitatif dengan desain korelasional cross-sectional yang melibatkan 303 mahasiswa yang sedang atau pernah mengikuti kegiatan MBKM. Sampel diperoleh melalui teknik non-probability sampling. Data dikumpulkan menggunakan kuesioner laporan diri dan dianalisis dengan Confirmatory Factor Analysis (CFA) serta regresi multivariat menggunakan Mplus 8.4. Hasil penelitian menunjukkan bahwa openness to experience merupakan prediktor positif terkuat bagi perilaku inovatif (β = 0,422; p < 0,001) dan learning agility (β = 0,361; p < 0,001). Conscientiousness dan extraversion juga berhubungan positif dengan kedua variabel tersebut. Sebaliknya, agreeableness berhubungan negatif dengan perilaku inovatif (β = −0,116; p = 0,016), tetapi tidak signifikan terhadap learning agility. Neuroticism tidak menunjukkan hubungan signifikan dengan kedua variabel. Temuan ini menegaskan relevansi karakteristik kepribadian dalam memahami variasi kompetensi mahasiswa, sekaligus mendukung pengembangan pendampingan MBKM yang adaptif tanpa menjadikan profil kepribadian sebagai dasar tunggal seleksi mahasiswa.
Counselling researchers have spent decades arguing about why counselling works. One philosophical camp locates the active ingredient in specific techniques tied to specific disorders. The other locates it in factors common to all bona fide therapies, chiefly the relationship between counsellor and client. This article develops a process-based perspective on the debate, examining how relational and technical elements are used within an unfolding therapeutic interaction. Drawing on the equivalence findings, the contemporary alliance literature, the unresolved question of causal mediation, the routine outcome monitoring evidence, and Australian decolonising scholarship, I propose a culturally situated responsive calibration model. The model reframes the therapist’s continuous, feedback-informed adjustment of relational and technical elements, made within the client’s cultural frame of wellbeing, as a proposed proximal mechanism of change. Calibration is not a new observation about good practice. Building on established responsiveness theory, the proposed contribution is to organise testable episodes of clinical judgement around feedback, action, and the client’s definition of wellbeing. Four testable propositions are advanced, including tests of whether calibration adds explanatory value beyond established process and treatment measures. Implications for practice, training, and measurement are outlined. The model is offered as a conceptual framework awaiting empirical testing, not as an established finding.
The WHO Adolescent Well-being Framework identifies agency and resilience as a central domain of adolescent well-being, yet its expression from a health promotion perspective remains insufficiently understood. Although previous research has often focused on specific behaviours or isolated factors, less attention has been given to how interconnected personal and relational resources coexist as patterns reflecting the WHO domain of agency and resilience. This study explored such patterns among young Swedish persons aged 15–18 years and examined gender differences across these patterns. A cross-sectional survey was conducted among 419 students in Swedish upper secondary schools. Agency and resilience were operationalised through measures of salutogenic health, positive youth development (PYD), playfulness, goal orientation, and physical activity. A person-oriented cluster analysis was used to identify patterns of interconnected resources, and gender differences between patterns. Three distinct resource patterns were identified: a low-resource group (26%), a high-resource group (28%), and an asymmetric-resource group (47%), characterised by relatively favourable intrapersonal resources alongside lower relational PYD resources. Girls were significantly overrepresented in both the low-resource and asymmetric-resource groups. Together, these findings suggest that young persons with seemingly favourable individual resources may nevertheless exhibit underlying vulnerabilities when resources are considered as interconnected patterns rather than isolated characteristics. This perspective contributes to the empirical understanding of the WHO domain of agency and resilience and may inform person-centred, relational approaches to promoting young persons’ well-being.
Reflective Practice (RP) is widely regarded as a cornerstone of psychotherapy training, supervision, and continuing professional development. Yet, despite its prominence across psychotherapeutic traditions, it remains conceptually vague and empirically contested. Recent critiques from basic psychological science (e.g., Lilienfeld & Basterfield, 2020) have argued that reflection may amplify cognitive bias and foster illusions of insight rather than improve clinical judgment. We argue that these criticisms carry weight precisely because the field has often failed to clearly define what RP is, how it functions, and under what conditions it becomes beneficial or harmful. Drawing on developmental models of therapist learning, we conceptualize RP as a multidimensional construct encompassing reflexivity as a capacity, reflective stance as an attitude, and reflection as activity. We propose that RP is most likely to support development when relationally scaffolded, informed by external feedback, and oriented toward testing and revising interpretations rather than confirming them. Reviewing developmental, quantitative, qualitative, and process-oriented evidence, we further argue that RP operates primarily as a probabilistic, context-dependent contributor to therapist development rather than as a discrete intervention with predictable outcomes. We conclude that RP is neither a panacea nor an illusion. Rather, when relationally scaffolded, theoretically informed, and oriented toward learning rather than certainty, it may provide a central mechanism through which therapists learn from clinical experience. Effective psychotherapy depends not only on therapeutic concepts and techniques but also on therapists’ ability to reflect on their clinical work, relationships, and decision-making. This paper conceptualizes Reflective Practice as a developmental process through which therapists may learn from experience, adapt to complex clinical situations, and develop their understanding and skills throughout their professional careers.
This article addresses Deaf Literature in relation to Multimodality within the context of Deaf Education, considering the linguistic, cultural, and visual specificities of this population. It investigates how the multimodal resources present in a literary work addressing Deaf-related themes may offer possibilities for reading practices. The study aims to analyze the multimodal resources in the literary work A pílula de Tábata and discuss the possibilities for reading and pedagogical mediation arising from its multimodal organization. This is a descriptive study with a qualitative approach and documentary research design, based on the analysis of a literary work that combines different semiotic modes and resources, such as drawings, colors, written Portuguese, Libras, and SignWriting. The results demonstrate the presence of resources related to representational, interactive, and compositional meanings, such as narrative and mental processes, offer gaze, framing, and salience. The analysis also highlights the centrality of visuality and the complementary distribution of information among written Portuguese, SignWriting, and other visual elements. It is concluded that the work presents potential for the development of multimodal reading practices and pedagogical mediation in Deaf Education, particularly through the articulation of different modes of linguistic and visual representation. However, these potentialities were not empirically investigated with students, and further research involving reception data and concrete reading situations is therefore needed.
Abstract Background Borderline personality disorder (BPD) is a severe mental illness associated with emotional and functional impairment, elevated suicide risk, and high individual and societal costs. BPD is under-researched in the general population, especially among males, and from a developmental perspective. We examined the prevalence and development of BPD symptoms in young men and explored the longitudinal associations with risk-taking behaviors. Methods Data came from the prospective-longitudinal Cohort Study on Substance Use Risk Factors (C-SURF), a population sample of young men. Participants were screened for BPD risk using the McLean Screening Instrument (MSI-BPD) at mean age 25 (2016–2018; n = 5,516) and again at mean age 28 (2019–2020; n = 5,367). Risk-taking behaviors (e.g., interpersonal violence, gambling, substance use) were self-reported at both time points. Multilevel regression models examined within-person changes in BPD symptoms, including self-harm, and risk-taking behaviors over time. Results 7.4% of participants had a high risk of BPD, defined by endorsing 7 + MSI-BPD items at least once. Among those with 7 + items endorsed at the first assessment, 29.5% still endorsed 7 + items three years later. Despite a general within-person decline in BPD symptoms with age, participants at initially high risk for BPD continued to exhibit elevated levels of risk-taking behaviors after three years. Conclusion BPD symptomatology affects a substantial proportion of young men. Despite its modest stability over time, it is associated with persistent engagement in various risk-taking behaviors. Interventions targeting BPD symptoms in male populations may offer a promising avenue towards mitigating substantial psychosocial burden associated with these behaviors.
This article examines the process of developing the diagnostic and consultative competence of speech and language therapists. The issue is particularly relevant at the present stage of special education development in Ukraine, where competency-based approaches have become central to the professional preparation of future specialists. The study establishes that diagnostic and consultative competence begins to develop during pre-service professional training at higher education institutions and continues to evolve throughout a specialist's professional career. Furthermore, each type of professional activity is accompanied by corresponding emotional responses, which are considered important indicators of successful professional development. The study employed the following research methods: theoretical analysis and synthesis, a sociological survey (questionnaire), and mathematical methods for data processing. The concepts of phase, period, and stage are theoretically distinguished. Four stages in the development of a specialist's diagnostic and consultative competence are identified. Stage I marks the initial development of this competence during professional training. Stage II involves the foundational development of diagnostic and consultative competence in novice practitioners. Stage III is characterized by the formation of an individual professional style of diagnostic and consultative practice. Stage IV represents mastery in both speech and language therapy practice and diagnostic and consultative competence. The article describes the principal characteristics of professional activity and the corresponding changes in specialists' emotional responses throughout each period of every developmental stage. A sociological survey of speech and language therapists with varying lengths of professional experience was conducted to clarify the duration of the developmental periods for diagnostic and consultative competence, as well as the characteristics of their professional activities and the associated emotional states. Physicians with different levels of professional experience also participated in the survey, as diagnostic and consultative competence is similarly essential in medical practice. A pilot study based on interviews with 18 respondents demonstrated that the development of diagnostic and consultative competence follows a sequence of stages throughout the professional careers of speech and language therapists. Each stage encompasses different forms of both cognitive and professional speech therapy activities. The study also describes changes in specialists' emotional responses—from unpleasant emotions to positive feelings of enthusiasm, satisfaction, and psychological comfort—that accompany different types of professional activity at each stage of the development of diagnostic and consultative competence.
Mothers often manage everyday discipline while also carrying the strain and worry that come with raising a child, yet these experiences are rarely studied together in Indian samples. This study examined the relationship between parenting attitude, parental stress, and anxiety in mothers. A quantitative, cross-sectional correlational design was used with 59 mothers selected through convenience sampling. Participants completed a 30-item questionnaire rated on a five-point Likert scale, in which parenting attitude was assessed through three dimensions (laxness, over-reactivity, and verbosity), and parental stress and anxiety were each assessed with ten study-developed items. Data were analysed using descriptive statistics, Cronbach's alpha, and Pearson's correlation, with Spearman's rank correlation as an additional check. Mean scores were 3.30 (SD = 0.54) for parenting attitude, 3.06 (SD = 0.89) for parental stress, and 3.16 (SD = 0.72) for anxiety. Significant positive correlations were found between parenting attitude and parental stress (r = .52, p < .001), parenting attitude and anxiety (r = .44, p < .001), and parental stress and anxiety (r = .51, p < .001), and all three remained significant in a sensitivity analysis. Over-reactivity and verbosity were more strongly related to stress than laxness was. The findings suggest that difficulties in discipline, parenting strain, and worry tend to occur together, and that support for mothers could address emotional strain alongside parenting skills.
The rapid proliferation of generative artificial intelligence in educational contexts has transformed how students encounter academic content, yet a fundamental question remains underexamined: Do English as a Foreign Language (EFL) learners possess the critical literacy competencies needed to evaluate AI-generated texts? This study investigated whether students in Morocco’s Classes Préparatoires aux Grandes Écoles (CPGE)—one of the nation’s most academically selective post-secondary programs—demonstrate readiness for AI-era literacy demands. We developed a diagnostic assessment instrument, the Critical Reading Diagnostic Assessment (CRDA), designed to mirror common characteristics of AI-generated academic content: a confident, authoritative tone, a logical structure with subtle gaps, claims requiring verification, and culturally embedded assumptions. Thirty first-year CPGE students (M age = 18.6 years) evaluated argumentative passages across five critical dimensions: argument identification, evidence evaluation, assumption recognition, multi-source synthesis, and source criticism. Metacognitive self-assessment data were also collected. Results revealed systematic evaluation failures across all dimensions, with mean accuracy rates of only 18–39% and large effect sizes confirming substantial deficits (d = 1.11–2.25). Metacognitive analysis showed that students overestimated their abilities by 11–38 percentage points across all dimensions, indicating profound self-assessment inaccuracies.
Context and relevance. The study investigates the contributions of Lev Vygotsky's cultural-historical theory to Brazilian special/inclusive education, particularly regarding the constitution of the subject with autism in school contexts. The theoretical framework is grounded in the concepts of drama, freedom and singularity, understanding the schooling process as a privileged pathway of human (trans)formation. Objective. To analyse how pedagogical knowledge impacts the constitution of the child with autism, based on the notion of constitutive singularity. Hypothesis. The schooling process anchored in critical-emancipatory pedagogical knowledge operates as a promoter of the subject's humanisation, in opposition to traditional clinical approaches that reduce the subject to diagnosis and to ableist perspectives that position them in a state of devaluation. Methods and materials. The research, adopting a cultural-historical approach, was configured as intervention-research with an eight-year-old student with autism, enrolled in the second year of primary education. Video recordings, audio recordings, photographs, field diaries and interviews with the teacher, the child and his mother were utilised. Data were analysed through the microgenetic approach. Results. The analysis of two paradigmatic episodes of story retelling through illustration and physical education class evidences that the child, upon inserting personal elements into school tasks, manifests his will and singularises himself, expressing the drama of the social personality as a struggle for existence. Conclusions. Understanding singularity as a dialectical, historical, cultural and dramatic process allows us to overcome pathologising views and to recognise that disability is not a destiny, but a condition that, in relations with others and with culture, can be transformed into potentiality.
Background: Insomnia is an important public health concern and may be particularly relevant among security personnel because of irregular work schedules, occupational demands, sustained vigilance, and inadequate rest. This study was conducted to determine the prevalence of insomnia and its association with selected sociodemographic and health-related factors among security personnel in a tertiary care government hospital in south India. Methods: A cross-sectional study was conducted among 100 security personnel. Sociodemographic characteristics, including age, gender, income, education, and marital status, and health-related characteristics, including body mass index, diabetes, and hypertension, were assessed using a structured questionnaire. Insomnia was assessed using the Insomnia Severity Index (ISI). Associations between insomnia and selected variables were examined using the chi-square test. Results: Sub-threshold insomnia was present in 32% of participants, while no cases of moderate or severe insomnia were identified. Significant associations were observed between insomnia and gender (p=0.019) and income level (p=0.020). No significant associations were observed with age, education, marital status, or metabolic health status. Self-reported Diabetes and Hypertension were present in 10% and 4% of participants, respectively, while 74% were classified as obese. Conclusions: Although moderate or severe insomnia was not observed, nearly one-third of security personnel had sub-threshold insomnia. Workplace-based sleep hygiene interventions may be beneficial, particularly among women and lower-income employees. Further studies incorporating objective sleep assessments and detailed evaluation of shift schedules are warranted.
The advancement of digital technology has led to increased use of the internet and social media, particularly among adolescents. However, this development has also contributed to various challenges, one of which is cyberbullying. A low level of digital literacy knowledge may influence how students communicate and behave in digital environments. This study aimed to analyze the relationship between the level of digital literacy knowledge and cyberbullying behavior among high school students. This study employed a quantitative approach with a cross-sectional design. A total of 99 students were selected as research participants using a total sampling technique. Data were collected using a questionnaire, while the relationship between the variables was analyzed using the Chi-Square test. The results showed that the majority of respondents had a high level of digital literacy knowledge (59.6%), while the majority demonstrated a low level of cyberbullying behavior (57.6%). Statistical analysis revealed a significant relationship between the level of digital literacy knowledge and cyberbullying behavior (p-value = 0.001). Thus, the better the students' level of digital literacy knowledge, the lower their tendency to engage in cyberbullying behavior. Therefore, strengthening education and understanding of digital literacy should be enhanced as a preventive strategy to reduce the occurrence of cyberbullying in school environments.
Background: Rural women in India are often confronted with situations that make it difficult for them to access formal mental health services such as inaccessibility, internalized stigma, believing that suffering is due to external causes and gender inequalities. These barriers delay receiving formal care for mental health and make these women resort to informal ways of coping such as community support and local faith healers. Methods: This study aimed to explore the informal coping strategies and beliefs around mental health among 100 rural women over the age of 18 years residing in Amroha district of Uttar Pradesh, India. Being a qualitative study, the method employed for the survey was focused group discussions and the participants were included through a convenience snowball sampling. The discussions were held in Hindi language for the ease of the participants and were recorded for analysis which was done through a thematic analysis approach. Results: The results highlighted six broad themes: (1) burden of responsibilities and emotional burnout, (2) physiological manifestations of psychological distress, (3) normalization of chronic stress, (4) psychological distress arising from marital conflict and gender-based adversity, (5) reliance on spiritual and informal coping strategies in place of formal mental healthcare, and (6) emotional suppression and silent tolerance. Conclusions: The findings suggest the urgent need to design culturally aligned psychotherapeutic interventions that focus on creating awareness through psychoeducation that could reduce stigma as well as helping rural women deal with their unmet mental health challenges.
The article provides a theoretical and methodological rationale for the use of creative psychological and pedagogical technologies in teaching subject-specific methodologies of natural science disciplines in higher education. The relevance of the study is determined by the need to shift from the acquisition of reproductive knowledge to productive, inquiry-oriented, and professionally focused learning activities in the training of prospective teachers in natural science disciplines. Such activities enable students to generate ideas, formulate and test hypotheses, model natural processes, make methodologically grounded decisions, and create educational products. The aim of the article is to clarify the concept of creative psychological and pedagogical technologies, identify the features that determine their creative orientation, and substantiate the principles, conditions, and criteria for their selection and implementation in the professional training of prospective teachers of natural science disciplines. The study is theoretical and analytical in nature. The source base comprises regulatory documents, research articles, and methodological publications addressing the development of creativity, inquiry- and problem-based learning, teacher education in natural science disciplines, and the use of project-based, digital, and geoinformation tools. Analysis and synthesis, comparison, generalization, systematization, classification, pedagogical modeling, and methodological extrapolation were employed. Creative psychological and pedagogical technologies are understood as pedagogical technologies whose organization creates conditions for productive creative activity through openness to problems, variability of possible solutions, independent generation and verification of ideas, and the creation of a result that is new to the learner. Their implementation in natural science teacher education requires combining originality and variability with scientific validity, evidence-based reasoning, and verifiability. The methodological tools were systematized according to their functional purposes, distinguishing pedagogical technologies, methods, and types of activity, educational approaches, and digital tools. Psychological and pedagogical conditions and criteria for their selection were identified. The theoretical analysis provides grounds for considering problem- and inquiry-based learning, project-based learning, case-based learning, design thinking, modeling, open-ended tasks, geoinformation services, and virtual laboratories as promising tools for organizing creatively oriented learning activities of prospective teachers of natural science disciplines. Their appropriate integration may potentially contribute to the development of creative, critical, and systemic thinking, inquiry skills, and the ability to apply knowledge in non-standard educational and professional situations; however, these effects require further empirical verification. The findings may be used to develop educational programs and instructional materials for the professional training of prospective teachers in natural science disciplines.
Abstract Purpose Forced migration increases vulnerability to exploitation. Globally, around 50 million people are affected by human trafficking, which often involves trauma with negative mental health effects. Forced migrants already face elevated risks of PTSD, depression, and anxiety, yet the specific association of trafficking on their mental health remains unclear. Methods Symptoms of posttraumatic stress disorder (PTSD), depression, anxiety, and overall stress were assessed using standardized screening instruments (PC-PTSD-5, PHQ-4, and the Distress Thermometer). Experiences of human trafficking were measured with a modified version of the Adult Human Trafficking Screening Tool (AHTST) among forced migrants in Germany. Missing data were handled using multiple imputation. Logistic regression analyses were conducted to examine the association between human trafficking and positive screenings for the respective mental health conditions. Results A total of N = 1108 forced migrants participated in the study. Depending on the imputation model, between 49% and 56% of all participants screened positive for PTSD, 60% to 71% for depression, and 41% to 52% for an anxiety disorder. Among participants who screened positive for these mental health conditions, a positive screen for human trafficking was associated with a 30–40% higher probability of screening positive for PTSD and a 15% to 20% higher probability of screening positive for depression or anxiety disorder. Conclusions Forced migrants with a history of human trafficking are at elevated risk for PTSD, depression, and anxiety than those without, underscoring the need for early identification and tailored psychosocial support.
Mental health systems face a persistent gap in accessible, continuous, and person-centred support. Conversational AI can expand access to psychoeducation, emotional check-ins, self-management, and service navigation, but may also introduce risks of digital exclusion, cultural mismatch, privacy concerns, unsafe advice, and overreliance on automation. This paper develops a conceptual framework integrating Orange Technology, which promotes emotional wellbeing, cultural sensitivity, social connectedness, and resilience, with empathetic AI for mental health support. An integrative literature review examined peer-reviewed systematic reviews and WHO and UN guidance published from 2021 to 2026. Evidence suggests that conversational AI can improve depression, distress, anxiety, and engagement, although effects are heterogeneous and may decline over time. Personalization and empathic interaction may enhance engagement, while the framework's effects on community resilience, cultural sensitivity, and community resource integration require further empirical validation. The framework therefore positions AI as a supportive, human-in-the-loop layer rather than a replacement for clinicians, families, peers, or communities. It connects emotional sensing, empathetic dialogue, personalized support, escalation pathways, community connection, inclusive access, and governance, while aligning mental health innovation with SDG 3, 9, and 17.
The purpose of this paper is to identify the strategies for developing and unlocking the professional capability and capacity of senior hospital managers in Nepal. This research is the first published study outlining the self-perspectives of Nepalese senior hospital managers on their capability and capacity development. The study utilised a qualitative descriptive design as the second phase of a larger sequential mixed methods research project. Data were collected from 11 senior hospital managers through semi-structured interviews conducted online via the Zoom online videoconferencing platform between August to October 2024. Four key themes identified were: Stability, continuity and coherence; Practical and logistical constraints; Interference, conflict and control; and managing the mismatch between ability and expectations. Findings highlight breakages in work roles and pervasiveness of political and opportunistic individual actions alongside complex and lengthy bureaucratic processes that stifled senior public hospital managers working roles. Along with well-organised administrative procedures, appropriate compliance training for senior hospital managers is sought essential. Findings from this study may be broadly applicable to other under resourced countries in the Asia Pacific region.
