The persistent gap between health intentions and actual behavior calls into question accounts of physical inactivity that treat it as a uniformly rational and freely chosen preference. This theoretical article draws on a non-systematic narrative synthesis of research on action initiation, individual differences relevant to physical activity, and public health ethics. Action-initiation paradigms show that neural activity can precede reported awareness of simple actions and, in some cases, predict aspects of ensuing choices, but they do not establish that such activity causally determines complex behavior or explains physical activity maintained over time. Evidence from behavioral genetics and developmental research indicates that self-regulatory characteristics and physical activity are partly shaped by heritable and early-life factors. We therefore develop an account of situated agency in which deliberation retains a meaningful role but operates under biological, developmental, and environmental conditions that are unequally distributed. Within this framework, individual and institutional responsibility are complementary, with greater prospective responsibility falling on institutions where they can modify avoidable barriers while preserving individual choice. Success should therefore be assessed not by equalizing individual capacity or increasing average population physical activity alone, but by whether improvements in access, uptake, and sustained participation extend to people facing greater baseline barriers.

This study examined the links between employees' boundary-spanning behaviour and leadership emergence, focusing on the mediating role of prestige and the moderating roles of coworker support and relational-interdependent self-construal. Two studies were conducted to test the hypotheses. Study 1 (experimental survey, N = 208) tested the mediation hypotheses. Study 2 (questionnaire study, N = 691) extended Study 1 by examining the moderated mediation model. The results show that employees' boundary-spanning behaviour is positively related to leadership emergence, which is mediated by prestige. Additionally, coworker support and relational-interdependent self-construal moderate the relationship between employees' boundary-spanning behaviour and prestige. Based on the social exchange theory, this study revealed the mechanisms and boundary conditions of leadership emergence, enriching the literature and expanding the theory's application to organisational behaviour. It suggested that organisations and managers should encourage employees to engage in boundary-spanning behaviour. This would break down departmental barriers and promote a supportive, collaborative atmosphere, enhancing employees' prestige and leadership emergence.

To synthesise the efficacy of digital third-wave process-based interventions (e.g., ACT, Mindfulness, Compassion) for improving wellbeing and ameliorating mental health symptoms in adults. A prospectively registered systematic review (OSF: 10.17605/OSF.IO/5RMU2) and random-effects meta-analysis of randomised controlled trials (RCTs) was conducted across six databases through January 2026. Certainty of evidence was assessed using the GRADE framework. Interventions (k = 147; N = 26,391) yielded small-to-moderate immediate post-intervention improvements in wellbeing (k = 46, g = 0.36), depression (k = 110, g = 0.44), anxiety (k = 93, g = 0.40), stress (k = 66, g = 0.46), quality of life (k = 32, g = 0.30), and psychological flexibility (k = 51, g = 0.41). Heterogeneity was substantial across most outcomes (I2 > 75%). Benefits were observed across healthy (61 trials; n = 15,770), mental health (41 trials; n = 6,130), and medical samples (46 trials; n = 4,491), with population type not significantly moderating immediate post-intervention effects. Comparator type significantly moderated several analyses, with smaller effects against active than inactive controls. Guidance did not significantly moderate immediate post-intervention effects, although it predicted larger short-term depression effects (QM = 4.17, p = .048). At short-term follow-up, effects remained statistically supported across all outcomes, while only depression, anxiety, and stress remained statistically supported at medium-term follow-up. GRADE certainty was moderate for most immediate post-intervention outcomes and low for quality of life. Digital third-wave interventions produced small-to-moderate average benefits across symptom-focused, wellbeing-focused, and process outcomes. Effects were smaller against active comparators, indicating that pooled benefits should be interpreted in relation to comparator intensity. Future research should prioritise rigorous active controls, longer follow-up, and direct tests of whether changes in psychological flexibility mediate improvements in symptoms and wellbeing.

Fear of childbirth (FOC) increases maternal and perinatal adverse health risks, and family factors are core predictors of FOC. This study aimed to clarify the mediating pathway through which familial emotional expression (FEE) is associated with FOC via pregnant women's inner strength (IS), so as to supply empirical basis for antenatal psychological risk management.

A longitudinal survey was performed among pregnant women from the Department of Obstetrics and Gynecology of a tertiary Grade A hospital in Shenyang from September 2023 to August 2024. A total of 136 participants completed questionnaires in early, middle and late pregnancy, including the Childbirth Attitude Questionnaire (CAQ), Family Environment Scale (FES) and Inner Strength Scale (ISS). Two sets of longitudinal analyses were performed on this sample: latent class growth modeling (LCGM) was conducted via Mplus 8.3 to identify heterogeneous developmental trajectories of FOC; separately, cross-lagged panel mediation analyses were carried out with SPSS 26 and Amos 26.0 using the full-sample raw longitudinal data to examine the mediating mechanism among FEE, IS, and FOC.

Three distinct FOC developmental trajectories were identified: "Low FOC stable group" (11.4%), "Moderate FOC stable group" (33.5%), and "High FOC elevated group" (55.1%). FEE was longitudinally associated with IS (β=0.691, P<0.001), while IS was longitudinally associated with FOC in a negative direction (β=-0.552, P<0.001). No significant association was observed between FEE and FOC (β=0.079, P=0.293). The total effect of FEE on FOC was -0.303 (P<0.05), the direct effect was 0.079 (P>0.05), and the indirect effect was -0.382 (P<0.05), proving that the effect of FEE on FOC operates through IS.

FOC presents heterogeneous developmental trajectories across different gestational trimesters. FEE is indirectly associated with lower FOC levels by promoting pregnant women's IS. The findings provide empirical evidence for understanding the developmental characteristics and psychological influencing factors of FOC, and can inform targeted, individualized antenatal psychological screening and intervention strategies to alleviate childbirth fear and improve maternal mental health in clinical obstetric care.

Cold-water exposure (CWE), including cold showers, cold-water immersion, and winter swimming, is increasingly discussed as a behavioral strategy for improving mood, stress regulation, and mental wellbeing, but clinical evidence remains fragmented.

MEDLINE, Embase, PsycINFO, and Web of Science were searched from inception to June 6, 2025, with an update in December 2025. Eligible studies included adults exposed to CWE through cold showers, cold-water immersion, or winter swimming. Randomized, non-randomized controlled, cohort, case-control, and single-group pre-post studies were eligible. Two reviewers independently screened studies, extracted data, and assessed risk of bias. Random-effects multilevel meta-analyses used standardized mean differences, expressed as Hedges g. Sensitivity analyses were conducted where possible.

Thirteen studies including 4105 participants met inclusion criteria. Pooled estimates generally favored CWE for depressive symptoms, perceived stress, wellbeing, and mood or affect, but confidence intervals were wide and several estimates attenuated in controlled-only analyses. Anxiety showed little evidence of consistent benefit. Additional outcomes, including sleep, cortisol, heart rate, and pain, were sparse but generally directionally favorable. Most studies had high, serious, or critical risk of bias.

The available evidence does not establish that CWE improves mood, depressive symptoms, perceived stress, wellbeing, or related outcomes. The evidence remains limited, heterogeneous, and at substantial risk of bias, and several estimates became smaller in controlled only analyses. CWE should not currently be regarded as a standalone treatment for psychiatric disorders. Larger controlled trials are needed to clarify clinical relevance, safety, mechanisms, and optimal use.

https://www.crd.york.ac.uk/PROSPERO/, identifier CRD420250654531.

The rapid advancement of brain-computer interfaces (BCIs), particularly adaptive closed-loop systems, presents unprecedented opportunities for medical intervention and human augmentation. At the same time, the growing adoption of applications outside clinical settings also poses significant risks to mental privacy. In this article, we review the current state of neural decoding advancements and their projected trajectory to assess what current and foreseeable technologies can reveal about mental states and the implications for mental privacy. Drawing on a neuroscientific perspective, we clarify the scope and limits of emerging mental privacy risks and argue for a shift in responsibility from reactive regulation to proactive, privacy-embedded design.

Spontaneous abortion (SA) is a common adverse pregnancy outcome that severely impacts women's physical and mental health. Polycyclic aromatic hydrocarbons (PAHs) are one of the most prevalent classes of environmental endocrine disruptors with known reproductive and developmental toxicity. The accumulation of PAHs and their effect on the incidence of SA should be investigated. In this study, PAHs were measured in human chorionic villi of 15 SA cases and 14 controls. The concentration of PAHs was significantly elevated in patients with SA compared to the controls (98.07 ± 25.50 μg/g vs 125.0 ± 24.28 μg/g, P = 0.0071). Genome-wide methylation analysis revealed that metabolic and apoptotic signaling pathways were involved in SA. Compared to controls, villous samples from patients with SA exhibited reduced succinate dehydrogenase complex iron sulfur subunit (SDHB) DNA methylation, increased SDHB expression, and decreased succinate levels. The accumulation of PAHs in villi was inversely associated with SDHB methylation levels in patients. Furthermore, phenanthrene (Phe) exposure decreased the proliferation of human trophoblast cells and increased the expression of SDHB. Taken together, PAHs exposure up-regulated SDHB level, suppressed succinate accumulation, and increased the risk of SA.

Emergency holds are commonly used in mental health crisis care, yet pediatric-specific data on their application and downstream consequences for emergency department (ED) care remain limited. We sought to describe sociodemographic and clinical factors associated with emergency hold status, including their relation to ED physical restraint use, among youth presenting to the ED for mental or behavioral health (MBH) concerns.

We conducted a retrospective cross-sectional study of patients aged 6 to 18 years presenting with an MBH concern to an urban, tertiary pediatric ED from January 2019 through December 2024 using multivariable generalized estimating equation models to identify factors associated with emergency holds and physical restraint use.

Of the 14 883 MBH ED visits, 2219 (15%) arrived under emergency hold; 87% identified as Black, 85% were publicly insured, 20% arrived by mobile crisis unit, and 64% arrived with law enforcement. Emergency holds increased year over year during the study period and were associated with multiple sociodemographic and clinical factors, including Black race, male sex, any prior MBH ED visits in the past 12 months, longer ED stay, and physical restraint use. Physical restraint use also increased year over year and was associated with emergency hold status; however, mobile crisis involvement was not associated with physical restraint use.

Emergency holds in this single-center cohort were frequent, increased over time, and were associated with physical restraint use and longer ED stays. Mobile crisis may mitigate restraint use; further study is needed to clarify its impact. Strategies to reduce restrictive interventions warrant further evaluation.