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The process of overcoming challenges faced by midwives providing perinatal mental health care in obstetric facilities in Okinawa, Japan: A qualitative study.

Shimonaka H et al. · Jul 1, 2026

Aim This study aimed to clarify how midwives overcome challenges in providing perinatal mental health (PMH) care in clinical settings and to inform feasible, context-sensitive educational support. Methods We used an interpretivist-constructivist qualitative design with a sequential two-stage approach. Thirteen midwives working at five obstetric facilities in Okinawa, Japan, each with more than 2 years of PMH care experience, participated in one focus group discussion (FGD) and one in-depth interview (IDI). FGD transcripts were analyzed descriptively to clarify key challenges and concerns and to inform the development of IDI questions. IDI transcripts were analyzed using reflexive thematic analysis to explore how midwives navigated and overcame these challenges, thereby generating an interpretive account aligned with the study aim. Results Five themes were generated, from which we constructed a dynamic thematic map illustrating how challenges were overcome: contextual challenges triggered action; team-based support, reflective practice, and feedback from clinical cases interacted recursively; and motivational substrates underpinned these processes and were reinforced through ongoing practice, sustaining midwives' involvement in PMH care under conditions of uncertainty. Reported barriers included limited opportunities for reflective dialogue within shift-based workflows and limited visibility of post-discharge outcomes. Conclusion This study clarified the contextual challenges in PMH care and the key elements for overcoming them. These findings inform educational and organizational support combining flexible access to knowledge resources with interprofessional collaborative reflection grounded in psychological safety in emotionally and time-constrained obstetric settings, enabling midwives to sustain engagement in PMH care under conditions of uncertainty.

Medicine

gender.neutral@work.de: An experimental approach to the discrimination of nonbinary individuals during job applications.

Dörr L et al. · Jul 1, 2026

For many nonbinary individuals, disclosing their pronouns and preferred forms of address when applying for a job is necessary to avoid being misgendered. The request to be referred to in a gender-neutral way may trigger stereotypes and result in discrimination. Simulating recruitment scenarios, we test the effects of an applicant's request for gender-neutral address and avoidance of pronouns compared to binary-gendered alternatives. We hypothesize that applicants with a gender-neutral request would be discriminated against compared to applicants requesting binary-gendered pronouns. In a pre-registered pre-experiment with a convenience sample (N = 248), we found that applicants with a gender-neutral request were misgendered more often than applicants requesting binary-gendered pronouns and forms of address. No other indicators of discrimination were found, possibly due to the convenience sample. The reviewed experiment tested the hypotheses in a more diverse sample (N = 1275), adding openness towards nonbinary gender (ONBG) as a moderator variable and investigating spontaneous stereotype content. The findings demonstrated that applicants with a gender-neutral request were discriminated against compared to masculine-request applicants during the initial written application stage, with bias being moderated by ONBG. We discuss implications for understanding and reducing discrimination against nonbinary applicants in the work context.

Social Sciences

Sexual prejudice declined across generational cohorts and genders: A cohort sequential latent growth curve model from 2014 to 2024.

Clarke EV et al. · Jul 1, 2026

Despite attitudes towards the LGBTQIA+ community improving in recent years, older (vs younger) cohorts still report higher rates of sexual prejudice. To date, it is unclear if this generational difference emerges due to normative ageing or the distinct social norms in which each generation was born and raised (cohort effects). This pre-registered study clarifies the issue by utilizing cohort sequential latent growth curve modelling to examine the developmental trajectory of sexual prejudice for men and women across 11 annual waves of longitudinal panel data (N = 63,558). Our results reveal a period effect in which older (vs younger) cohorts and men (vs women) display higher initial mean levels of sexual prejudice. But due to shared social conditions, most cohorts experience comparable curvilinear declines in sexual prejudice across time. Collectively, our results highlight the malleability of sexual prejudice across the lifespan and demonstrate the need to examine the socio-political environment when taking a lifespan development perspective on anti-LGBTQIA+ attitudes.

Psychology

Airway secretory cells contain both a perinuclear Golgi ribbon and dispersed Golgi satellites.

Hoang ON et al. · Jul 1, 2026

Rationale Finely tuned production and secretion of the polymeric mucins MUC5AC and MUCB are required for lung health, but knowledge of many details between their translation and their packaging into secretory granules is lacking. Objectives To analyze the structure and function of the Golgi apparatus, a key site of mucin glycosylation, folding, polymerization, and packaging, in airway epithelial secretory cells. Methods Lung tissue was obtained from mice stimulated or not with IL-13 to upregulate mucin production and from normal human lungs. Golgi elements in mouse and human tissue were imaged by high-resolution immunofluorescence microscopy and electron microscopy. Tissue from mice with deletion of both polymeric mucins was also examined. Measurements and main results By immunofluorescence microscopy, both mouse and human airway secretory cells contained approximately 100 dispersed puncta labeled by markers of medial and trans-Golgi cisternae and the trans-Golgi network (TGN), but only a few perinuclear puncta were labeled by markers of cis-Golgi cisternae. By electron microscopy, secretory cells contained both a perinuclear Golgi ribbon and numerous dispersed Golgi stacks, termed satellites. In mucous metaplastic cells, satellites were concentrated among immature mucin granules. Increasing mucin production by cytokine stimulation did not increase the number of TGN puncta, nor did preventing polymeric mucin production by gene deletion reduce TGN puncta. Conclusions Mucin-producing airway secretory cells express an unusual Golgi structure consisting of a conventional perinuclear ribbon as well as dispersed satellites. While the Golgi satellites are likely an adaptation for mucin production and packaging, their presence is specified developmentally, independent of mucin production.

Biochemistry, Genetics and Molecular Biology

A Systematic Review and Meta-analysis of Sex Differences in Subcutaneous and Visceral Abdominal Fat in Children.

Ortega-Avila JG et al. · Jul 1, 2026

Context Sex-based differences in abdominal fat distribution are well documented in adults, with men typically accumulating more visceral adipose tissue (VAT), located around intra-abdominal organs, and women exhibiting higher levels of subcutaneous abdominal adipose tissue (SAAT), distributed in the abdominal subcutaneous layer. However, the developmental onset of these differences remains unclear. Objective This systematic review and meta-analysis examined sex-specific VAT and SAAT distribution differences among normal-weight prepubertal children aged 0-10 years. Data sources A systematic search of PubMed, Embase, LILACS, and Web of Science was conducted to identify studies published from the inception of each database through June 2024. Data analysis Standardized mean differences (SMDs) for sex-based differences in VAT and SAAT were calculated using a random-effects model, stratified by age group. The analysis included data from 20 studies. In the overall analysis, prepubertal girls had significantly higher SAAT compared with boys (pooled SMD = 0.23; 95% CI: 0.15-0.32; I2 = 89%). This sex difference became apparent starting in the 3- to 6-year age group (SMD = 0.59; 95% CI: 0.38-0.79; I2 = 80%). In contrast, no significant sex differences in VAT were detected in either the age-stratified analyses or the overall estimate (pooled SMD = 0.09; 95% CI: -0.01 to 0.19; I2 = 91%). However, this finding should be interpreted with caution due to the high degree of heterogeneity observed across studies. Conclusion Sex differences in abdominal adiposity appear to emerge early in childhood, with prepubertal girls exhibiting higher SAAT than boys from the age of 3 years. In contrast, the absence of sex-based differences in VAT should be interpreted with caution. Systematic review registration PROSPERO registration no. CRD42022361412.

Medicine

Swedish Intensive Care Physicians' Attitudes Towards Withholding or Withdrawing Life-Sustaining Treatment in Critically Ill Children.

Ahlerup M et al. · Jul 1, 2026

Background Decisions to withhold or withdraw life-sustaining treatments for critically ill children are challenging. This study aims to identify Swedish intensivists' attitudes, values and experiences towards the decision-making process concerning withholding or withdrawal of life-sustaining treatment in critically ill children. Methods The nine intensive care units in Sweden that treated more than 10 children for more than 48 h during 2023 were approached. A web-based questionnaire on attitudes and experiences on end-of-life decision-making in critically ill children was distributed to the 360 physicians employed at the above-mentioned intensive care units. The results were analysed descriptively. Results Fifty-five answers were retrieved. The participating physicians were experienced, 93% having personal experience with end-of-life decision-making in children. The main findings were that the child's wishes were considered important or very important by 93% of respondents. The guardians' wishes were considered important or very important by 82% of respondents. Seventy-three percent of physicians considered it ethically acceptable to withdraw life-sustaining treatment against the patients' and guardians' wishes. To continue life-sustaining treatment without the patient's and guardian's consent was considered ethically acceptable by 26% of participants. Conclusions This study demonstrated that Swedish intensivists share common attitudes and values regarding most issues related to end-of-life decisions in critically ill children. However, there is variability in attitudes concerning patients' and guardians' wishes. Further studies concerning end-of-life decisions in critically ill children within a Nordic context are warranted. Editorial comment This survey study presents a sampling of views on pediatric intensive care withholding or withdrawing of treatment and from specialist physicians in one Nordic country.

Medicine

"I'm Going to Do Everything I Can to Keep You From Having to Interact With the Police": Queer Therapists' Perceptions of Police.

Cooke S et al. · Jul 1, 2026

This study investigated queer therapists' perceptions of police bias and attitudes toward police. We used a mixed-methods explanatory approach by administering the Perceptions of Police Scale (POPS) to mental health professionals and conducted follow-up qualitative interviews with participants who identify with a queer sexuality to explore the factors influencing their perceptions of police and the ways in which they view and utilize reliance on police when a client is experiencing a mental health crisis. Quantitative data were analyzed with SPSS using correlations and t-tests to assess the relationship between sexuality and perceptions of police scores. Sexuality significantly correlated with perceptions of the police, meaning queer therapists viewed the police less favorably compared to heterosexual participants. A qualitative analysis using reflexive thematic analysis revealed seven themes that address how queer therapists perceive police and strategies utilized to decide if calling 911 for a client in crisis would be lifesaving or life-threatening.

Psychology

With a little help from my 'ordinary friends': relationships, networks, and resilience in Masisi, North Kivu, eastern Democratic Republic of the Congo.

Fontana SG. · Jul 1, 2026

Are social networks the key to understanding resilience in conflict? Recent studies suggest so, but relational research in conflict-affected areas is rare. What exists stresses the importance of small circles of close family members, trusted friends, and co-ethnic persons/groups, but tends to overlook their aggregate effect. Drawing on data from a relational study of personal support networks in Masisi, a rural area of North Kivu province, eastern Democratic Republic of the Congo, I show how people rely on large, widespread networks of ethnically diverse recent strangers. I highlight the types of relationships people value most, assess how they make and maintain them, and begin to explore some of their cumulative socio-political effects. I posit that reputation and improved local security are support networks' most important outcomes, although the latter comes at a price. The findings reveal a fundamental paradox: while resilience in conflict is primarily relational, its dependence on connections limits its scope and makes it inherently unstable.

Social Sciences

Newborns' Language Discrimination May Not Reflect Sensitivity to Speech Rhythm: Evidence From Computational Modeling.

Famularo RL et al. · Jul 1, 2026

Human newborns are able to discriminate between certain languages but not others. This ability has long been attributed to sensitivity to rhythm-the temporal regularities in speech of different languages. Here, we demonstrate through a series of computational simulations that this discrimination behavior can be achieved using no temporal information at all. Our results raise the possibility that early language discrimination may be independent of speech rhythm, and call for theoretical reconsideration of how infants learn suprasegmental information in the first few months of their lives. SUMMARY: We simulate newborn language discrimination with machine learning models on naturalistic speech stimuli. Models can discriminate between languages just like newborns, even when rhythmic information is removed. This means that infants' behavior could rely on their ability to perceive global properties of speech, rather than rhythm. Our results challenge theories of how newborns perceive speech, and how that shapes later language.

Psychology

On being better than average in values.

Elster A et al. · Jul 1, 2026

Do people feel that their personal values are better than others, even though they are happier if their values are similar to those around them? We examined the Better Than Average (BTA) effect in values in four cultures (Study 1: USA, China and Malaysia; Study 2: USA, using diverse online panel samples) and relative to either a more abstract (university) or a more concrete (department) reference group (Study 3, conducted with students in Israel). Across all samples and cultures, we found that people perceived their personally desired values as more important to the self than to others, and they perceived their less personally desired values as more important to others than to the self. Self-other comparisons favouring the self were even stronger for values that are normatively desired in society, and self-other comparisons favouring others were even stronger for values that are less normatively desired in society. We also found a relatively greater BTA effect towards a more abstract group and its positive consequences to self-esteem. This research contributes to the theoretical understanding of value perception as prone to biases, generalizability and robustness of the BTA effect, and cross-cultural psychology. We discuss important societal implications of this effect.

Psychology