Background and Objectives: Burnout syndrome is a major challenge among healthcare workers, affecting both mental and physical health. Although stress may influence physiological systems, this study does not directly assess biological mechanisms, and interpretations should remain associative. Stress-related associations may be reflected in body composition, but objective data are limited. This study aims to assess the associations between burnout, body composition, and quality of life in medical staff, using bioimpedance as the main tool. Material and methods: The cross-sectional study included 95 medical staff (36 resident doctors, 13 specialists/consultants, 31 nurses, 15 nursing assistants), 75.8% women, mean age 38 ± 10 years, conducted in the medical and surgical departments of Dr. C.I. Parhon Clinical Hospital, Iași, between January and March 2024. Burnout was assessed using the Maslach Burnout Inventory; quality of life was evaluated with SF-12; body composition was measured by bioimpedance (BMI, muscle mass, fat mass, bone mass, hydration, basal metabolism, metabolic age). Statistical analyses included ANOVA, Kruskal-Wallis, and Spearman correlations. Results: Resident physicians had higher muscle, bone mass and basal metabolism, with lower adipose tissue compared to other categories (p < 0.05). Total burnout and exhaustion were positively correlated with muscle mass (r = 0.247, p = 0.016), bone mass (r = 0.219, p = 0.033), basal metabolism (r = 0.219, p = 0.033) and negatively with QoLM (r = -0.315, p = 0.002). Other body variables, including BMI, total adipose tissue, and water level, showed no significant correlations. These associations may be influenced by age, sex, and professional category and do not imply causality. Conclusions: Age, profession, and work seniority are associated with burnout and specific changes in body composition. However, these findings are correlational, and bioimpedance-derived parameters do not reflect direct biological stress mechanisms.

Background and Objectives: Postpartum depression (PPD) is a prevalent mental health condition with substantial consequences for mothers, infants, and families. The Edinburgh Postnatal Depression Scale (EPDS) is the most widely used screening instrument for PPD; however, optimal cut-off scores vary across populations, necessitating local validation. No prior study has evaluated the diagnostic performance of the EPDS against a structured clinical interview in Latvia. To assess the reliability and diagnostic accuracy of the Latvian version of the EPDS and to determine the optimal cut-off score for detecting PPD in a Latvian outpatient population 4-6 weeks after childbirth. Materials and Methods: A cross-sectional study was conducted at the outpatient department of Riga Maternity Hospital between June 2024 and May 2025. Women aged ≥18 years attending routine postnatal check-ups were screened using the Patient Health Questionnaire-9 (PHQ-9). Those scoring ≥5 were invited to complete the EPDS and participate in a structured diagnostic interview using the Mini International Neuropsychiatric Interview (MINI) 7.0.2. Internal consistency was assessed using Cronbach's alpha. Receiver operating characteristic (ROC) analysis was performed to evaluate diagnostic accuracy and identify the optimal cut-off score based on sensitivity, specificity, likelihood ratios, and the Youden Index. Results: A total of 272 women were screened, and 101 completed the EPDS; 78.63% of screen-positive participants underwent the MINI. The EPDS demonstrated excellent internal consistency (Cronbach's α = 0.871). ROC analysis indicated strong discriminative ability (AUC = 0.852, 95% CI 0.759-0.945, p < 0.001). A cut-off score of ≥11 provided the optimal balance between sensitivity (0.74) and specificity (0.82), with the highest Youden Index (0.56) and a positive likelihood ratio of 4.14. Conclusions: The Latvian version of the EPDS is a reliable and diagnostically accurate screening instrument for PPD 4-6 weeks after delivery. A cut-off score of ≥11 appears optimal for routine screening in Latvian outpatient settings. These findings support the integration of EPDS-based screening into structured postpartum care and underscore the value of validating screening instruments within specific cultural and clinical contexts.

Background and Objectives: The relationship between mental health and sports injuries has become increasingly important in youth soccer, due to developmental changes in this population, the high demands of training, and the competitive pressures of sport. This cross-sectional study examined the association between injury history (no injuries, 1-2, >2 injuries), mental health indicators (anxiety, stress, depression), and differences by sex, competitive category, and playing position. Materials and Methods: 146 soccer players (79 males, 67 females; ages 12-30; mean age = 16.65, SD = 2.34 years) from youth and senior categories of a professional club in Spain completed the STAI-T (trait anxiety), DASS-21 (state anxiety, stress, depression), sociodemographic and sports-related variables (gender, sports category, playing position), and self-reported injury history: no injuries (n = 39), 1-2 injuries (n = 80), >2 injuries (n = 27). The statistical analyses performed were one-way ANOVA (ηp²), χ² tests, and Games-Howell post hoc tests. Results: 73.3% of the players reported ≥1 injury (54.8% 1-2 injuries; 18.5% >2), with no differences by gender, position, or category (χ² range: p > 0.05). The ANOVA revealed significant differences for trait anxiety (F(2, 143) = 3.68, p = 0.029, ηp² = 0.049; small-to-moderate), and state anxiety (F(2, 143) = 4.63, p = 0.014, ηp² = 0.061; moderate). No effects were found for stress/depression (p > 0.12). The post hoc test (Games-Howell) indicates that the group with no injuries showed significantly lower trait anxiety (p = 0.038, d = 0.33) vs. 1-2 injuries, and state anxiety (p = 0.012, d = 0.70) vs. >2 injuries. Stress and depression showed a non-significant upward trend. Conclusions: A greater history of injuries is associated with higher levels of anxiety in youth soccer players. The findings suggest routine assessment of anxiety and training in emotional self-regulation for injury prevention and rehabilitation. Longitudinal studies are needed to clarify the bidirectional relationship.

Background and Objectives: To assess the reliability and construct validity of the Functional Rating Index (FRI) in Italian-speaking individuals with chronic non-specific low back pain (CLBP), in order to improve assessment and clinical management in this population. Materials and Methods: This cross-sectional study consecutively enrolled 75 individuals with CLBP (52 females; mean age 48.71 ± 19.18 years; mean pain duration 298.64 ± 427.52 weeks). Internal consistency and test-retest reliability were evaluated using Cronbach's α and the intraclass correlation coefficient [ICC_2,1], respectively, while measurement error was estimated through the minimum detectable change (MDC). Construct validity was examined by testing a priori hypotheses through correlations (Pearson's r) between the FRI and disability measures (Roland-Morris Disability Questionnaire, RMQ; Oswestry Disability Index, ODI), pain intensity (Numerical Rating Scale, NRS), and quality of life (Short-Form Health Survey, SF-36). Results: Cronbach's α was 0.88, and test-retest reliability showed an ICC_2,1 of 0.86 (95%CI: 0.82-0.93). The MDC was 18.05, corresponding to approximately 20% of the total score. The Italian FRI demonstrated strong correlations with the RMQ (r = 0.70) and ODI (r = 0.77), and a moderate correlation with the NRS (r = 0.60). The physical and social domains of the SF-36 showed stronger negative correlations with the FRI than the mental and emotional domains. Conclusions: The Italian version of the FRI is a reliable and valid instrument for individuals with CLBP and is recommended for both clinical practice and research applications.

Background and Objectives: Population ageing is a major challenge of the 21st century and is associated with declining physical and mental abilities, increased disease burden, and higher mortality. Latvia has the lowest healthy life expectancy in the European Union. Social well-being is an important component of healthy and active ageing and may be associated with older adults' quality of life (QoL). This study aimed to assess the relationship between social well-being, as a component of health, and QoL, including its components (control, autonomy, self-realisation and pleasure), among adults aged 50 and older in Latvia. Materials and Methods: Data from 1643 Latvian participants in wave 9 of the Survey of Health, Ageing, and Retirement in Europe (2022) were analysed using linear regression. QoL was measured using the 12-item Control, Autonomy, Self-Realisation, and Pleasure (CASP-12) scale. Social well-being factors included household composition, education, employment status, financial capacity, living area, social network (SN) characteristics, and received help, based on self-reported questionnaires. Results were considered statistically significant if the p-value was less than 0.05. Results: The factors positively associated with overall QoL were being employed, better financial capacity, greater satisfaction with SN, larger SN, participation in social activities, and higher educational attainment. Being employed and the ability to make ends meet easily were positively associated with all QoL components. Higher satisfaction with the SN and participation in social activities were positively related to the control, autonomy, pleasure, and self-realisation components. Conclusions: These findings underscore the importance of social and economic resources for QoL in later adulthood, suggesting that both the quality of social relationships and material security play a central role in shaping overall QoL and its components among older adults.

Background and Objectives: Cyberchondria (CYB) has been associated with health anxiety and anxiety sensitivity (AS); however, its role in panic disorder (PD) remains unclear. This study aimed to compare CYB and AS levels between patients with PD and healthy controls and to examine their associations with PD severity. Materials and Methods: This cross-sectional case-control study included 71 patients with PD and 69 age- and sex-matched healthy controls. Participants completed the Cyberchondria Severity Scale (CSS), Anxiety Sensitivity Index-3 (ASI-3), and Beck Anxiety Inventory (BAI). PD severity was assessed using the Panic Disorder Severity Scale (PDSS). Group comparisons were additionally conducted using analysis of covariance (ANCOVA), controlling for relevant sociodemographic and clinical variables. Pearson correlation and hierarchical multiple regression analyses were performed. Results: Patients with PD had significantly higher CSS (80.70 ± 22.71 vs. 60.62 ± 17.22) and ASI-3 total scores (35.66 ± 17.87 vs. 12.25 ± 10.18) than healthy controls. In the PD group, CYB was positively correlated with AS (r = 0.38, p < 0.01), whereas no significant association was found between CYB and PD severity (r = 0.09, p > 0.05). AS showed a moderate positive correlation with PD severity (r = 0.46, p < 0.01). In hierarchical regression analyses, CYB did not predict PD severity. Adding AS significantly increased the explained variance; however, in the final model, only general anxiety severity (BAI) remained a significant predictor of PD severity. Conclusions: Patients with PD exhibit elevated levels of CYB and AS, which are positively associated with each other. Nevertheless, PD severity appears to be primarily driven by general anxiety symptoms rather than CYB. These findings suggest that CYB may represent a parallel maladaptive coping behavior rather than a direct determinant of symptom severity, with potential implications for assessment and intervention. Longitudinal studies are warranted to clarify causal relationships.

Background: Tirzepatide is a novel therapeutic option for the management of metabolic disorders which has started to be implemented in routine practice. The study aimed to analyze the effectiveness of tirzepatide use and patient education in the field of healthy eating and weight loss, based on real-life data from the practice of a primary care physician, in metabolic syndrome (MetSyn) patients during a one-year follow-up period. Methods: This is a retrospective study based on real-life data of 118 MetSyn patients who were under the supervision of a general practitioner (GP). Analysis was conducted on 62 patients supported by trizepatide (2.5 mg for 4 weeks, then 5 mg for 4 weeks and 7 mg for 46 weeks) with dietary education and 56 patients that underwent dietary education with motivation only. Lipid profile, glucose level and blood pressure were assessed. Body Mass Index (BMI), waist-to-height ratio (WHtR), A Body Shape Index (ABSI), Lipid Accumulation Product (LAP), Visceral Adiposity Index (VAI) and Body Roundness Index (BRI) were calculated. The KomPAN^® questionnaire was used for dietary assessment and WHO Quality of Life-BREF for the quality of life assessment at 52 weeks. Results: Patients from both groups significantly reduced their body weight and WC and the values of the following indices: BMI, WHtR, ABSI, LAP and BRI. A significant increase in LDL cholesterol and triglyceride values was observed in both groups and a significant decrease in glucose level only in the group with tirzepatide combined with dietary modification. Energy value, energy density of food and nutrient intake did not differ between groups, while the intensity of beneficial nutritional features (pHDI-10) was low. Significant differences in patients' QoL were observed, especially in the domain related to mental health (higher in trizepatide + diet group). Conclusions: Support in primary care by a physician was successful from a long-term perspective in the group using tirzepatide in combination with diet modification as well as in the group based on dietary modification only. The data do not indicate a significant advantage of any one approach for patients, prioritizing an individualized approach to treatment.

Orthorexia nervosa (ON) is a clinical condition characterized by rigid and inflexible rules about consuming healthy food, potentially leading to harmful consequences for physical and mental health and significant impairment in major life domains. Overlap or independence between ON and other clinical entities, like other eating disorders (EDs) or obsessive compulsive disorder (OCD), still needs clarification. Objectives: This study aims to examine the overlap versus independence of core symptoms of ON from these two classes of disorders using a network approach. Methods: A group of 422 university students (71.8% females), with a mean age of 20.70 years (SD = 3.44), completed questionnaires assessing those symptoms. Results: Results revealed that no ON symptoms were nested within the OCD and ED clusters, and vice versa, thereby supporting their empirical distinctiveness. Although the symptoms were organised into distinct communities, ON symptoms were more strongly linked to EDs than to OCD. Bridge symptom analyses revealed that the nodes "Emotional consequences due to healthy eating", "Worry about healthy food", and "Obsessing" exhibited the highest bridge strength connecting clusters of ON, EDs, and OCD symptoms. Conversely, the nodes "Food safety" and "Ordering" showed the lowest bridge strength, suggesting that these nodes played only a marginal role in linking ON, EDs, and OCD. Conclusions: From a nosological perspective, the findings provide empirical support for conceptualizing ON as a distinct yet symptomatically related condition within the broader spectrum of eating-related psychopathology, while acknowledging that definitive nosological classification requires further longitudinal and clinical research.

Background/Objectives: This qualitative study investigated the perspectives and lived experiences of individuals with obesity, with a specific focus on psychological needs, beliefs, attitudes, and experiences related to psychological support. The study aimed to identify perceived barriers and facilitators to adherence in weight management and to examine participants' views on digital psychological interventions designed to promote mental health and well-being. These findings represent the preliminary phase of a broader research project aimed at developing and implementing personalized digital psychological interventions to enhance engagement, treatment effectiveness, and equity of care in obesity management. Methods: Five focus groups were conducted with a purposive sample of 35 patients (48.6% female) diagnosed with obesity and enrolled in a four-week multidisciplinary weight-reduction program at the IRCCS Istituto Auxologico Italiano, San Giuseppe Hospital, Piancavallo (VB), Italy. Sessions were audio-recorded, supplemented with field notes, transcribed verbatim, and analyzed using reflexive thematic analysis to identify recurrent patterns of meaning across participants' narratives. Results: Six overarching themes were identified: (1) obesity as an embodied and pervasive experience; (2) the interplay between emotions, weight stigma, and identity construction; (3) family and social relationships as both supportive and ambivalent; (4) personal agency and self-regulation processes in weight management; (5) access to healthcare services and experiences with healthcare professionals; and (6) the perceived role of psychological support within multidisciplinary care. Participants described obesity as a complex, multidimensional condition encompassing physical, emotional, relational, and contextual challenges that directly influence treatment engagement and adherence. Conclusions: Psychological support emerged as a central component of comprehensive obesity care. Findings underscore the need for personalized, flexible, and digitally supported psychological interventions to enhance long-term adherence, acceptability, and overall well-being.

The harms associated with substance use continue to disproportionately affect marginalized populations. This study presents a retrospective program evaluation of a mobile health unit that delivers integrated clinical and harm reduction services to marginalized populations in Eastern Puerto Rico.

A secondary data analysis was conducted using administrative data from a mobile health unit, capturing client encounters, service utilization (e.g., mental health support, health screenings, safe injection counseling, and case management), visit frequency, and demographic characteristics. This study is framed as an implementation-focused program evaluation. Descriptive and exploratory analyses were conducted to assess service delivery, program reach, utilization patterns, and selected program outcomes over a 1.5-year period.

Between January 2022 and October 2023, the mobile health unit served 279 participants across eight municipalities. Participants exhibited higher rates of intravenous drug use, mental health disorders, homelessness, and incarceration history compared with previously published estimates for the general Puerto Rican population, although these comparisons are indirect. The program delivered multidisciplinary services and facilitated referrals addressing key social determinants of health, including housing, nutritional assistance, identification services, in-patient treatment, and medication-assisted treatment. Model-based estimates using the Mobile Health Map Impact Tracker tool suggest that, in 2023, mobile health screenings may be associated with a return on investment of approximately 6:1, 259 avoided emergency department visits, 29 life-years saved, and approximately USD 2.4 million in healthcare cost savings.

This evaluation demonstrates the feasibility of a mobile health model integrating harm reduction and clinical services to reach highly marginalized populations and facilitate connections to health and social services. Findings reflect program implementation, service reach, and engagement rather than causal effectiveness. Mobile health approaches may represent a feasible and potentially beneficial strategy for expanding access to care, although further research incorporating patient-level outcomes is needed to assess effectiveness.