Parkinson's disease (PD) affects individuals across diverse cultural, linguistic, and socioeconomic backgrounds worldwide. While non-motor symptoms (NMS) are among the most disabling features of PD, the influence of culture on their recognition, reporting, and management remains underexplored. This review examines cultural factors that shape the experience and care of NMS in PD, with particular attention to Asian populations, which have historically received limited focus in health disparities literature. Drawing on evidence from diverse global populations, we explore how cultural beliefs, stigma, family dynamics, spirituality, language, and trust in healthcare systems influence symptom interpretation, help-seeking behaviors, treatment engagement, caregiving, and end-of-life decision-making. Sensitive symptoms such as bladder, bowel and sexual dysfunction, as well as mental health symptoms may be underreported because of stigma, shame, or cultural norms. Immigrant populations may avoid "bothering" healthcare providers, while language barriers and mistrust can further impede communication and access to care. Cultural values also influence decision-making preferences. In contrast to Western models that prioritize individual autonomy, some patients prefer family-centered decision-making, with designated family members guiding healthcare choices. Concepts such as filial piety, "familismo", and culturally defined gender roles (superwoman schema and stoic masculinity) shape caregiving and acceptance of treatment recommendations. Culturally enabled care is essential to equitable and person-centered PD management and can improve communication, reduce disparities, foster trust, and enhance quality of life for people living with PD and their families. Further research is urgently needed to better understand how culture intersects with NMS management and to develop culturally enabled models of care.

To explore the cross-sectional and longitudinal associations of poverty, assessed by deprivation index (DI) and income, with anxiety and stress among adults DESIGN: Longitudinal cohort observational study SETTING: A cohort of adults established in 2014-2015 (T1) in Hong Kong.

493 participants (177 men, median age 56 years) were followed up in the third wave of household survey in 2021-2022 (T3).

Self-reported equivalised household income and DI, measured as material and social deprivation, were recorded. Anxiety and stress were assessed using the Depression, Anxiety and Stress Scale-21 items (Chinese) version.

Being deprived in T3 is significantly associated with higher anxiety and stress score in T3 as compared with being non-deprived cross-sectionally. Income status did not show significant association with anxiety and stress score cross-sectionally in T3. Increased deprivation status since baseline is significantly associated with higher anxiety and stress score in T3 than persistent non-deprivation. Being able to afford one less basic necessity throughout T1-T3 is significantly associated with 0.31-unit higher anxiety score (95% CI 0.18 to 0.45) and 0.36-unit higher stress score (95% CI 0.18 to 0.55) across time.Subgroup analyses further showed that income-poor younger adults aged less than 60 years tended to have higher anxiety and stress scores than their non-income-poor counterparts in the same age group in T3 cross-sectionally. Younger adults with occasional non-income-poverty throughout T1-T3 also had higher anxiety and stress scores in T3 than persistently non-income-poor younger adults. This relationship of income-poverty with anxiety and stress was not significant among older adults aged 60 years or above.

Individual deprivation and increased deprivation over time were associated with higher anxiety and stress scores in T3 cross-sectionally and longitudinally respectively. Young adults' anxiety and stress scores tended to be more affected by income-poverty than their older counterparts. Nevertheless, sample attrition may occur as a proportion of participants dropped out throughout the 7 years of follow-up.Age-specific poverty measurement tools may be developed to assess the age-specific standard of living. Policymakers may consider deprivation, in addition to income, as well as change in poverty status, in healthcare and social welfare policymaking to better address the mental health of the population and health inequality in the region.

This paper constitutes an intervention development paper, illustrating the application of the person-based approach to planning and developing a digital transdiagnostic intervention to support Portuguese adults in managing their stress and emotions, thereby enhancing their mental health.

A multi-method intervention development study following the person-based approach (Phase I: collating and analysing evidence; Phase II: creating the intervention plan). Evidence from three quantitative studies, examining emotional schemas, psychological flexibility, and mental health in the context of stress, a qualitative study, exploring stress-coping experiences, and a scoping review of digital interventions designed for stress, were combined with experts' consultation to facilitate the creation of the guiding principles and the logic model. This guided the development of prototype intervention.

Community-based recruitment across Portugal, collected online and at hospitals, senior universities and patient organisations.

Quantitative studies used a convenience sample (Study 1, n=666; Study 2, n=583; Study 3, n=276). 29 adults purposively sampled from the Study 3' highest and lowest stress quartiles took part in semi-structured interviews. In the scoping review, 5867 articles were identified, and 131 studies of digital psychological interventions for stress were included. Six experts in stress, cognitive behavioural therapy, acceptance and commitment therapy, emotional schema therapy, digital interventions, intervention development and public health reviewed the draft intervention plan.

Stress responses, more than stressor type, were the strongest predictor of both positive and negative mental health, with emotional schemas (negative evaluation of emotions, difficulties in reappraisal) and psychological flexibility (behavioural awareness, valued action, openness to experience) acting as mediators. Qualitative interviews highlighted maladaptive thoughts as the main barrier and emotional management as the main facilitator to coping, alongside preferences for intervention content and delivery. The scoping review found common components in existing digital interventions for stress, but none integrated the emotional schemas model. Together with expert consultation, these findings led to the development of EmOcean prototype, a guided self-help digital intervention comprising eight integrated and five optional modules, tailored to users' needs, characteristics and preferences, which are completed sequentially on a weekly basis. Modules include psychoeducation and exercises on topics such as stress, emotions, cognitive reframing, mindfulness, acceptance, values, activities, problem-solving, time management, physical exercise, sleep, social support, assertiveness and emotional management.

Combining empirical, theoretical and person-based evidence supported the development of EmOcean, an intervention hypothesised to support stress and emotion management and enhance mental health. Its acceptability, feasibility and efficacy will be evaluated in future studies.

Despite increased awareness of its multi-dimensional nature, pain remains often underestimated, and its management across different therapeutic areas remains complex. A patient-centred approach is needed to bridge the gap between clinical assessment and individual experience. This project aimed to explore the pain experience across different therapeutic areas through narrative medicine (NM). DIAMOND, the project name, is not an acronym but a symbol meant to shed light on physical and mental pain.

DIAMOND involved 19 Italian centres and collected narratives from patients experiencing chronic pain, epilepsy, Gram-positive infections or depression, as well as from their caregivers and treating clinicians. Narratives and socio-demographic data were collected anonymously via a dedicated platform. Narratives were analysed using MAXQDA (VERBI Software, Berlin, Germany), applying NM classifications and content analysis; metaphors used by participants to describe pain were also analysed.

Narratives were collected from 64 patients and 56 caregivers; 20 clinicians contributed 40 parallel charts, all of which were included in the analysis. Pain emerged as a deeply embodied and emotional experience, often described through metaphors of darkness, oppression and distortion. At diagnosis, fear, anxiety and disbelief predominated; however, over time, some participants reported acceptance and resilience. Caregivers described significant emotional, relational and economic burdens, often reporting feelings of helplessness and a sense of responsibility. Clinicians presented more progressive narratives, often focusing on technical aspects of care. The narratives revealed a perceptual gap between patients, caregivers and clinicians, especially regarding the emotional meaning of illness and treatment. The narrative process was seen as beneficial by most participants, supporting inner reflection.

This pioneering NM initiative mapped the lived experience of pain across multiple conditions, incorporating the perspectives of patients, caregivers and clinicians. NM proved essential in identifying unmet needs and emotional drivers of care, fostering more empathetic, patient-centred approaches in pain management.

Positive Youth Development (PYD) theory emphasizes strengths that emerge from person-context exchanges, yet item-level, time-ordered relations among PYD attributes (i.e., Competence, Confidence, Character, Caring, and Connection) remain unclear in high-pressure school systems. Using four-wave data from a cohort of grade 10 students in three public high schools in Shouguang, Shandong Province, China, we examined time-ordered relations among the 16-item Chinese Positive Youth Development-Very Short Form (PYD-VSF). At baseline, N = 2086 (Mage = 15.41, SD = 0.52; 53.74% girls); wave-level participation was T2 = 1522, T3 = 1860, and T4 = 1776, with lag-specific analytic samples of 1296-1550 across adjacent intervals. We estimated cross-lagged panel networks (CLPNs) for each successive wave pair using LASSO-regularized regression, summarized networks with out- and in-expected influence. Across intervals, connection-related indicators tended to occupy relatively upstream positions, showing stronger prospective associations with subsequent changes in other PYD indicators, whereas caring indicators more often appeared relatively downstream. Findings indicate that connection indicators were relatively more predictive within the observed system; stronger perceived relational support was prospectively associated with subsequent increases in caring. Clarifying these developmental dynamics can inform interventions to enhance adolescents' mental health and well-being in high-pressure contexts.

While challenges surrounding vaccine acceptance in pregnancy have long been prevalent in Canada, the COVID-19 pandemic introduced a new context for perinatal vaccine decision-making. Pregnant people had to weigh concerns about SARS-CoV-2 infection during pregnancy and the introduction of the new mRNA pandemic vaccines, with less access to in-person perinatal care and social support than usual. This qualitative analysis sought to understand how trust influenced the decision-making of pregnant people during the early COVID-19 pandemic regarding both routine and SARS-CoV-2 vaccinations.

This qualitative study, as part of a larger mixed-methods study, analyzed interviews with 73 participants who gave birth in Ontario or British Columbia, Canada from May 1st, 2020, to December 1st, 2021 via reflexive thematic analysis.

Three types of trust were influential to pandemic vaccination decisions during pregnancy: 1) trust in prenatal care providers, shaped by goals of alleviating mental load, cultural norms, and perceived transparency, 2) trust in institutions, focused on the government, healthcare system, and pharmaceutical industry, and 3) trust in networks, encompassing (dis)trust in social media, valuation of lived experiences, and views of vaccination as a reciprocal obligation to the broader community.

Several dimensions of trust played vital roles in the experiences of pregnant people navigating vaccine decisions amid high uncertainty. Trust in providers was composed of both honesty and transparency, with the latter enabling a new approach to the patient-provider relationship. Avenues to increase trust include social media moderation and discussion of original research by prenatal care providers.

Persons diagnosed with endometriosis report deleterious effects to their physical, psychological, and relational well-being. While some couples state that these challenges extend beyond the person in pain to also affect their partners, other couples have described positive changes to their lives associated with their ability to adapt to endometriosis. These differential experiences indicate that relational dynamics are involved when coping with a condition like endometriosis, yet there have been few investigations with concurrent inclusion of both members of the couple.

This study investigates the experiences of both partners' coping, addressing their individual perspectives and shared narrative around the management of endometriosis.

Couples coping with endometriosis were recruited as part of a larger, mixed-methods study focused on understanding their lived experience. Persons diagnosed with endometriosis and their partner (N=49 couples) participated together in semi-structured interviews probing challenges, successes, and strategies used to cope with endometriosis. Following an inductive approach to thematic analysis, data underwent iterative comparison of codes by two independent coders.

Distinct themes were developed within two domains: Shared Challenges and Coping Together. Under Shared Challenges, the themes of Compounded Illness Burden, Psychological Barriers, and Undermined Agency are described. Within Coping Together, couples described Mutual Support and Psychological Resilience, encompassing the importance of learning new physical and psychological and coping strategies, including lifestyle changes, acceptance, and emotional support.

Findings highlight the potential benefits of a relational framework and how partnered coping processes provide support and impact both the person with endometriosis and their partner. Recommendations for clinicians and efforts to develop psychosocial support programs for endometriosis include collaborative, multidisciplinary care models that provide support to patients and partners.

Substance use during pregnancy poses significant risks to maternal and neonatal health, yet less than half of pregnant women with substance use disorders (SUDs) receive appropriate treatment. State-level prenatal substance use policies may influence treatment outcomes, but their impact on treatment completion remain understudied. This study examines how criminal justice, provider reporting, and treatment support policies are associated with substance use treatment completion among pregnant women.

We analyzed data from the Treatment Episode Data Set-Discharge (TEDS-D) for pregnant women aged 12 or older who were admitted to publicly funded substance use treatment facilities between 2020 and 2022 in the United States (n = 38,410). Multivariable-adjusted logistic regression models were used to assess associations between state-level prenatal substance use policies and treatment completion, adjusting for other covariates.

About 29.5% of pregnant women completed treatment. Women in states with criminal justice policies had a higher likelihood of treatment completion (adjusted odds ratio [AOR], 1.23; 95% confidence interval [CI], 1.13-1.34; p < 0.001), as did those in states with treatment support services (AOR, 1.14; 95% CI, 1.03-1.28; p = 0.014). Conversely, those in states with provider reporting mandates had a lower likelihood of treatment completion (AOR, 0.49; 95% CI, 0.36-0.67; p < 0.001).

State-level prenatal substance use policies are associated with treatment completion among pregnant women. While criminal justice and supportive treatment policies may enhance treatment completion, mandatory provider reporting requirements may deter retention. These findings underscore the importance of designing policies that foster trust, reduce stigma, and prioritize access and engagement for pregnant women.

Activity-dependent trafficking of AMPA receptors (AMPARs) and subsequent long-term synaptic strengthening underlie different forms of learning and memory. The AMPAR subunit GluA1 amino-terminal domain (ATD, a. k. a. NTD) plays a critical role in synaptic AMPAR trafficking and LTP. The GluA1 ATD accounts for almost half the proteins' size and protrudes significantly into the synaptic cleft, hence it is ideally localized for interactions with synaptic cleft proteins. Using unbiased proteomics, we identified the epilepsy and intellectual disability-associated voltage-gated calcium channel (VGCC) auxiliary subunit α2δ-1 as a GluA1 ATD-interacting protein. At CA1 synapses, postsynaptic deletion of α2δ-1 selectively enhanced basal synaptic AMPAR, but not NMDAR currents. Conversely, presynaptic α2δ-1 deletion did not affect basal synaptic transmission but decreased LTP. α2δ-1 deletion in hippocampal field CA3 impaired performance in an object location memory task, but not other forms of memory. Collectively, our work identifies α2δ-1 as an extracellular AMPAR regulatory protein with distinct pre- and postsynaptic functions: in cis, limiting AMPAR access to synapses; in trans, facilitating LTP. Furthermore, it expands our understanding of the mechanisms underlying α2δ-1's regulation of hippocampal function and raise the possibility that α2δ-1-dependent AMPAR regulation may contribute to the effects of gabapentinoid drugs.

Effectively preventing child sexual exploitation and abuse (CSEA) requires understanding the barriers that hinder program success.

This study examines barriers to program implementation (hindering set-up and maintenance), access (hindering groups of individuals from access), and utilization (hindering individuals from engaging with or benefiting from programs), to identify barriers with high and low levels of endorsement across European Union (EU) Member States.

Participants were experts in CSEA prevention. A modified two-round Delphi technique was used. Round 1 was a qualitative online survey analyzed using reflexive thematic analysis, capturing diverse perspectives to inform the development of the Round 2 survey. Round 2 was a quantitative online survey analyzed using a three-step strategy: (1) retaining only items rated by experts from at least two-thirds of EU Member States, (2) calculating country-level mean ratings for each item, and (3) calculating the proportion of Member States endorsing each item, categorizing them as barriers with low, medium, or high levels of endorsement.

Negative public perception, lack of funding, concern for practitioner wellbeing, and a preference for punitive policies were identified as barriers with high levels of endorsement, mainly concerning the implementation of prevention initiatives. Specific legal regulations and a lack of certain prevention initiatives were identified as having low levels of endorsement across Member States but still requiring country-specific targeting.

To enhance CSEA prevention, improved public perceptions, sustainable funding, and practitioner support should be prioritized across the EU. Targeted strategies are needed to address country-specific barriers with low levels of endorsement.