Background: Despite increasing opioid use in Brazil, the national epidemiological profile of opioid-related poisonings remains insufficiently characterized. Objective: To characterize opioid-notified poisonings reported in the Sistema de Informações sobre Agravos de Notificação (SINAN-Notifiable Diseases Information System), accessed through Departamento de Informática do Sistema Único de Saúde (DATASUS-Department of Informatics of the Unified Health System), between 2019 and 2025. Methods: This retrospective descriptive study used secondary national surveillance data from publicly accessible databases. Records of exogenous poisonings related to medications and drugs of abuse were screened, and notifications involving opioid analgesics were identified and standardized. Descriptive analyses were performed for demographic, clinical, and exposure-related variables. Bivariate analyses and multivariable logistic regression, regression models were conducted for selected outcomes. Incidence rates were estimated by year and federative unit, and temporal trends were assessed using generalized linear mixed models. Results: Between 2019 and 2025, 1,127,265 poisonings related to medications and drugs of abuse were reported in Brazil, of which 12,645 involved opioids. The opioids most frequently implicated in notifications were codeine (38.65%), tramadol (33.98%), and morphine (17.86%). Most cases occurred in women (70.3%), in individuals aged 26-50 years (47.8%), and in residences (85.6%). Digestive exposure predominated (92.3%), and suicide attempt was the main circumstance (73.5%). Most patients recovered without sequelae (75.1%), whereas 1.6% died due to exogenous intoxication. Co-exposure information was classifiable in 9573 records, most commonly involving opioids and medications. In multivariable analyses, suicide attempts were associated with female sex (aOR = 1.98; 95% CI: 1.68-2.34), residence-based exposure (aOR = 8.95; 95% CI: 6.29-12.72), and co-exposure (aOR = 2.17; 95% CI: 1.82-2.60). Hospitalization was less likely among females (aOR = 0.83; 95% CI: 0.75-0.91) and more likely with co-exposure (aOR = 1.14; 95% CI: 1.02-1.27). Serious outcomes were associated with older age (aOR = 1.017; 95% CI: 1.009-1.026), while residence-based exposure and suicide attempt showed lower odds. A significant increasing temporal trend was identified, with higher reported notification rates observed in the South and Southeast regions. Discussion: The predominance of suicide attempts and residential digestive exposures suggests that the notification profile captured by SINAN/DATASUS is predominantly shaped by intentional self-poisoning and household medication availability, while still representing a broader toxicovigilance scenario involving abuse, habitual use, adverse reactions, and other exposure contexts. The contrast between the most frequent notification profile and the profile associated with serious outcomes indicates that occurrence and severity may follow different epidemiological patterns. Therefore, these findings should be interpreted as a toxicovigilance signal reflecting multiple exposure contexts rather than as evidence of a single opioid-use pattern. Conclusions: Reported opioid-notified poisonings in Brazil increased over the study period and were predominantly associated with domestic exposure, suicide attempts, and co-exposure to other substances. These findings highlight the clinical and public health relevance of opioid-notified poisonings and support the need for strengthened surveillance, improved reporting quality, and preventive strategies addressing both opioid use and mental health. Limitations: Underreporting, missing data, regional reporting differences, and possible misclassification in SINAN/DATASUS records; therefore, associations, temporal increases, and projections should be interpreted as exploratory, and hypothesis generating.

The healthy development of executive function (EF) skills in childhood and adolescence provides a crucial foundation for later outcomes, from mental and physical health to academic achievement and socio-emotional functioning. Although meta-analyses have identified associations between children's EF skills and early experiential factors, these are often examined in terms of broad categories (e.g., socioeconomic status) or cumulative risk factors (e.g., adverse childhood experiences; ACEs). The current study leverages longitudinal data (N = 1295) from six cohorts from the Environmental influences on Child Health Outcomes (ECHO) program to identify unique associations among specific prenatal, perinatal, and early life conditions and three specific EF skills (inhibitory control, working memory, and cognitive flexibility) measured later in childhood. Indicators of socioeconomic status, birth outcomes, parental characteristics, and pre- and post-natal exposures to alcohol and tobacco were measured before age 6 years. EF skills and language were measured from ages 6-15 years (M = 9.95, SD = 1.92), using measures from the NIH Toolbox. Two complementary statistical methods, a psychological network approach and regression trees, were employed to disaggregate early predictors of EF development. Results from both methods converged to suggest that specific early conditions showed associations with specific EF skills, and that higher birth weight (independent of pre-term status) was a stronger predictor of better EF skills than other early conditions. Neither approach showed meaningful associations between EF skills and maternal ACEs. Birth weight appears to serve as a particularly sensitive summary index of prenatal influences on EF development.

Current models of dementia care often perpetuate the legacies of colonization, which highlights the need for a culturally congruent approach. This research describes the necessary components to co-develop a freely available Indigenous-centered dementia model of care in partnership with Indigenous individuals living with dementia, their families, and communities. To prioritize ethical and decolonial research approaches, sequential focus groups were used alongside Keeoukaywin (The Visiting Way)-an Indigenous methodology deeply rooted in Métis and Cree ways of knowing-guided by a group of advisors and Elders. The data were co-analyzed using reflexive thematic analysis guided by Indigenous principles. Three themes were generated: Indigenization, Personalization, and the Intersection of Challenges and Innovations, to illustrate how dementia care can be operationalized and adapted to various cultural and care contexts. This research offers a foundation for developing dementia care that truly aligns with Indigenous ways of doing.

Climate action initiatives primarily target environmental outcomes, but their potential for health co-benefits through green and blue space contact remains understudied. Understanding these secondary outcomes could inform dual-purpose programming addressing climate and health challenges.

This retrospective analysis examined 32 community-led climate action projects funded through Edinburgh Communities Climate Action Network (ECCAN) and their GreenLight programme (2024-2025). Projects spanned energy, transport, food, circular economy, and green space themes, with no formal health evaluation framework. Data were extracted from final reports covering 3195 direct participants.

Despite health not being a primary objective, 21 of 32 projects (66%) reported secondary health and wellbeing outcomes. Projects involving direct nature contact showed the strongest co-benefits: nine of ten high-nature-contact projects reported health benefits, compared to two of eight low-nature-contact projects. Notable outcomes included 94% of participants reporting increased willingness to engage in future community activities and 76% reporting mental wellbeing improvement following community garden workshops. Blue space engagement demonstrated particular significance for mental health and social cohesion.

Green and blue space engagement in climate action projects consistently produces secondary health outcomes. We propose the Community-Environment-Health Nexus (CEHN) framework to understand how community-led environmental action generates synergistic health co-benefits.

The relationships between superficial white matter (SWM) and cognition, and its interaction with gray matter (GM), remain unclear in community-based populations.

We analyzed data from 459 older adults in the Harmonized Diagnostic Assessment of Dementia for the Longitudinal Aging Study in India. SWM microstructures were estimated by multi-shell diffusion magnetic resonance imaging (MRI). We examined cross-sectional associations between SWM with memory, language, executive, visuospatial function, and cognitive impairment (CI); and tested SWM interactions with GM atrophy and modification by socioeconomic status.

Higher SWM neurite density index (NDI) related to better language, whereas higher fraction of isotropic water (FISO) related to greater odds of CI. While GM metrics remained strongest predictors of cognition, these associations were attenuated by better SWM integrity (high NDI and low FISO). No formal education, low literacy, and rural residence worsened SWM-related language deficits.

Neurite-level SWM health may drive resistance to neurodegeneration and cognitive decline.

The present pilot study aimed to (1) Characterize neural markers of reward sensitivity during periods of social stress; (2) Evaluate clinical relations between neural reward markers and anhedonia; and (3) Investigate if peer victimization was associated with ventral striatum (VS) suppression and anhedonia symptoms during social stress.

A total of 28 adolescents between the ages of 13 and 17 (M_age = 15.31; SD = 1.51; 55.2% cisgender girls) were included in analyses and completed a semi-structured interview, self-report questionnaires regarding social anxiety, stress, depression, and anhedonia, and a magnetic resonance imaging (MRI) scan while engaging in the Island Getaway task. VS BOLD signal activation estimates were then extracted during discrete phases of the task (e.g., anticipation of social feedback and outcome of social feedback) and statistically compared within-subjects.

Results revealed that when in the presence of social stress (defined as the potential for negative feedback), socially anxious adolescents demonstrated significantly suppressed VS activation relative to feedback anticipation. Additionally, the reduced VS activation during the outcome phase was significantly correlated with anhedonia. Moreover, relational peer victimization was associated with suppressed VS activation.

Findings identify novel mechanisms associated with anhedonia and blunted reward processing in socially anxious youth that could be improved via interventions that target positive-valence systems.

Metacognitive interventions have emerged as promising therapeutic approaches for individuals experiencing a first episode of psychosis (FEP), given the relationship between metacognitive deficits, reduced cognitive insight, and symptom persistence. This systematic review synthesizes the available evidence on the effectiveness of metacognitive therapies in adults with FEP, focusing on their impact on cognitive insight, psychotic symptoms, and global functioning.

A systematic search was conducted in PubMed, PsycINFO, Web of Science, and Scopus following PRISMA guidelines, with prior registration in PROSPERO (CRD420261281443). Studies published between 2014 and 2025 were included if they applied metacognitive interventions to adult FEP samples and evaluated changes in psychotic symptomatology and/or cognitive insight using validated instruments. Methodological quality was assessed using the Mixed Methods Appraisal Tool.

A total of 15 studies met the inclusion criteria. Overall, metacognitive interventions demonstrated consistent improvements in cognitive insight, notably increased self-reflectivity, and reduced overconfidence. Findings regarding psychotic symptom reduction were heterogeneous, although several studies reported significant improvements. Additional benefits were observed in neurocognitive domains, whereas results concerning social cognition were mixed. Interventions varied substantially in duration, format, and intensity, with most being delivered individually.

The available evidence suggests that metacognitive therapies constitute a promising treatment option for individuals with FEP, showing robust effects on cognitive insight and potential benefits for clinical and functional outcomes. Nonetheless, further high-quality research, particularly comparative trials and long-term follow-up studies, is needed to consolidate these findings and clarify their applicability across diverse clinical settings.

Neurological disorders are a leading cause of disability, morbidity, and mortality globally, imposing a substantial and growing economic burden. In Europe, several factors including demographic aging and improved diagnostics have increased the prevalence of these conditions. Despite their significant societal impact, comprehensive and comparable estimates of the economic burden of neurological disorders across Europe remain limited. Existing studies are mostly outdated, disease-specific, or geographically narrow. The Cost Of Illness in Neurology in EUrope (COIN-Eu) study addresses this gap by developing a standardized framework to assess the disease- and country-specific economic burden of major neurological disorders across all 47 member countries of the European Academy of Neurology (EAN).

This burden-of-disease study employs a prevalence-based approach to estimate three key economic measures per disorder and country: (1) annual per-patient costs by cost type, (2) total annual costs on a national level, and (3) relative total costs as a percentage of GDP. The study includes twelve major neurological disorder groups affecting adults (≥ 20 years). Epidemiological data are primarily sourced from the Global Burden of Disease Study 2021, supplemented by systematic literature reviews where necessary. Cost data are extracted from systematic reviews of peer-reviewed publications and converted to 2019 Euros using standardized procedures. Data gaps are addressed through structured imputations based on income group stratification. Final estimates are validated by an expert panel from the EAN.

The framework enables the generation of harmonized cost estimates across countries and disorders, accounting for direct and informal care costs and indirect costs. Expert review ensured plausibility and consistency of the results.

The COIN-Eu study framework provides a comprehensive and transparent methodology to estimate the economic burden of neurological disorders in Europe. It facilitates evidence-based health policy planning, highlights data gaps, and supports future cross-national burden-of-disease assessments in neurology and beyond.

Background: Early identification of posttraumatic symptoms in children and adolescents is essential for timely intervention. The Child and Adolescent Trauma Screen-2 (CATS-2) is a brief, freely accessible instrument that simultaneously assesses DSM-5 PTSD, ICD-11 PTSD, and ICD-11 complex PTSD (CPTSD) symptoms across child and caregiver report forms. Cross-cultural validation of the CATS-2 in underrepresented settings remains limited. This study examined the psychometric properties of the Turkish CATS-2 in a clinical sample.Method: Participants were 196 children and adolescents referred to a child and adolescent psychiatry outpatient clinic. ICD-11 PTSD and CPTSD diagnoses were established through clinician-administered assessments. Internal consistency, test-retest reliability, convergent and discriminant validity, child-caregiver agreement, confirmatory factor analysis (CFA), known-groups validity, and diagnostic accuracy were examined.Results: The CATS-2C showed good to excellent internal consistency (α=.81-.94) and test-retest reliability (ICC = .86-.90). CFA supported a two-factor correlated model of ICD-11 PTSD and disturbances in self-organization (DSO), and the DSM-5 four-factor model, for both forms. The CATS-2C showed strong convergent validity (r = .79-.89) and negligible associations with externalizing symptoms (r = .08-.12, ns). Known-groups validity was excellent for the CATS-2C (η² = .48-.58) but limited for the CATS-2P (η² = .076-.119). Diagnostic accuracy was good to excellent for the CATS-2C (AUC = .868-.947) and poor to acceptable for the CATS-2P (AUC = .606-.735), all subscales significant. Optimal CATS-2C cut-offs against clinician ICD-11 diagnoses were ≥7 for ICD-11 PTSD (sensitivity = 84%, specificity = 78%), ≥17 for ICD-11 CPTSD (93%, 85%), and ≥30 for DSM-5 PTSD (85%, 89%). Child-caregiver agreement was poor (ICC = .259-.344).Conclusions: The Turkish CATS-2C demonstrated sound psychometric properties, supporting its use as a reliable screening tool in child and adolescent mental health settings. The CATS-2P showed acceptable structural validity and internal consistency but more limited diagnostic discrimination, underscoring the importance of directly assessing symptoms from the child. These findings contribute preliminary evidence regarding ICD-11 PTSD and CPTSD constructs in an underrepresented, middle-income clinical setting.Trial registration: ClinicalTrials.gov identifier: NCT06975852.

Sleep-related and chronotype traits have been shown to impact health in observational studies. To identify whether these associations are potentially causal, we conducted phenome-wide Mendelian randomisation analyses of short sleep, insomnia symptoms, total sleep duration, long sleep, snoring, daytime sleepiness and morning chronotype with a broad range of health-related phenotypes. We assessed the association between the genetic predisposition to these traits and the occurrence of 702 health-related phenotypes, using summary statistics of the largest genome-wide association studies in European individuals. Results that were significant (multiple comparisons: False Discovery Rate) and valid (robust genetic instruments, unaffected by horizontal pleiotropy) were validated using data from the second largest European genome-wide association study. Genetically determined short sleep was associated with increased risks of attention-deficit/hyperactivity disorder and neuroticism, musculoskeletal conditions, asthma and gastroesophageal reflux and lower educational attainment. Genetically determined insomnia symptoms showed associations with increased risk of coronary artery disease, major depression and osteoarticular disease. Genetically determined long sleep was linked to higher risk of iron deficiency anaemia and lower bone mineral density. Genetic predisposition to snoring was associated with more falls, greater body mass and higher low-grade inflammation. Genetically determined morning chronotype was related to higher vitamin D levels and lower risk of irritable bowel syndrome. No associations were found for daytime sleepiness. Overall, these findings indicate that genetically determined short sleep duration and insomnia symptoms are associated with mental and neurological problems, cardiovascular disease and musculoskeletal disorders, suggesting a potentially preventive, causal role of healthy sleeping patterns on chronic disease.