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Introduction: Late preterm infants may have prolonged stay in hospital due to increased care needs and a lack of community support. A neonatal early supported transfer to home (NEST@Home) intervention was introduced. We explored professional perceptions of barriers and facilitators to implementation of NEST@Home. Methods: Neonatal healthcare professionals in England participated in group interviews based on the Consolidated Framework for Implementation Research. Data were analysed using thematic analysis. Findings: Perceived barriers included lack of facilities, poor clinical buy-in, budget restraints, staff shortages, absence of policy, and a lack of commissioning support. Perceived facilitators to implementation included healthcare professional’s positive attitudes, pre-discharge planning, parent education, parent training, and loan of monitoring equipment. Conclusion: This study identified individual, interpersonal, and organisational features that may facilitate or impede the NEST@Home intervention. Further research is needed to identify how this intervention impacts outcomes, and to understand the experience of parents receiving NEST@Home.

Borderline personality disorder is arguably the most prevalent personality disorder seen in healthcare settings, characterised by emotional instability, impulsive behaviours, distorted thinking, and unstable relationships. This commentary explores the effectiveness of pharmacological treatments for borderline personality disorder, drawing on the findings from a Cochrane review. It highlights the limited evidence supporting the efficacy of psychotropic medications such as antipsychotics, antidepressants, or mood stabilizers in improving BPD symptoms, self-harm, suicidal behaviours, or psychosocial functioning. Despite limited evidence, many people with borderline personality disorder receive psychotropic medications, often long-term and with risks of polypharmacy. A cautious approach to psychotropic medication is needed in addition to improvements in research rigor for pharmacotherapy trials. The limited evidence urges judicious prescribing, addressing stigma in practice, and prioritising non-drug options. Non-pharmacological psychotherapies have more support, yet access barriers persist. Monitoring and deprescribing plans are also recommended, as is research examining prescriber behaviour and integration of persons with lived experience.

Iran is a developing country with low levels of economic development and globalization and is ruled by a theocratic government. To address the lack of national research on well-being in Iran, this retrospective observational study aims to examine life satisfaction and its main determinants among Iranian adults. Using World Gallup Poll data collected between 2006 and 2017, we examined life satisfaction as a cognitive aspect of subjective well-being in relation to various factors. Our results show that income is the strongest predictor of life satisfaction, followed by standard of living, gender, social support, age, negative affect, and education. In developing countries such as Iran, which face significant economic, political, and social challenges, individuals prioritize the satisfaction of basic needs by emphasizing factors such as the socioeconomic status. In contrast, developed countries with established welfare systems may emphasize other values such as social connections and healthy lifestyle behaviors as key factors in life satisfaction. This study contributes to a deeper understanding of the determinants of life satisfaction in Iran and provides insights for future research and policy making.

Expedited interventions are integral to reducing mental health related morbidity and mortality in general hospital settings. The early recognition of a worsening mental state is essential for optimizing care and treatment of patients in need of specialist assessment, escalation and response. However, a lack of mental health training provides a challenge for generalist clinicians in recognizing clinical cues of variance consistent with a change in mental state, and subsequently acting upon them. In April 2010, Australian Health Ministers endorsed the National Consensus Statement ‘essential elements for recognising and responding to clinical deterioration’ as the standard national framework for recognition and response to patient clinical deterioration in acute care facilities. In 2012, this consensus statement informed the first National Safety and Quality Health Service Standard for recognizing and responding to acute deterioration, which became part of the inaugural Australian Commission on Safety and Quality in Healthcare (ACSQH) National Standards (hereafter National Standards). Generalist healthcare facilities were thus required to develop systems, processes, education and training to address the criteria contained within this National Standard, which initially focussed on physiological deterioration only. However, the 2012 National Standards have since been rescinded and superseded in 2017, where recognizing and responding to acute deterioration also encompasses acute changes in mental state. Consequently, significant attention within healthcare organizations now focusses on screening, monitoring, escalation and referral for, and of, acute deterioration in a person's mental state. However, screening and assessment of a deteriorating mental state has unique nuances and complexities not found in its physiological counterpart, which provide a significant challenge for Australian healthcare organizations, and perhaps consultation liaison nurses in particular, in me