In China, grandparents serve as primary or co-caregivers for millions of children, particularly those separated from rural-to-urban migrant parents. This short communication synthesizes evidence on how grandparenting quality and intergenerational coparenting dynamics shape the mental health outcomes of vulnerable Chinese children, including those in left-behind, three-generation urban, and dual-income family configurations. We distinguish throughout between children whose parents have both migrated (leaving grandparents as sole custodial caregivers) and children who remain in triadic parent-grandparent-child systems, whether through partial parental migration or co-resident urban caregiving arrangements, as these configurations carry differing implications for grandparenting quality and coparenting dynamics. Evidence from cross-sectional surveys, meta-analytic studies, and dyadic interdependence models indicates that positive grandparenting predicts fewer child behavioral difficulties and greater prosocial competence, whereas coparenting conflict, low coparenting relationship quality, and caregiver depressive symptoms constitute compounding risk pathways. Grandparental warmth, harmonious coparenting, and family resilience are identified as protective mechanisms within a family systems framework. Clinical and nursing implications are discussed, with focus on intergenerational interventions that simultaneously engage grandparents and parents. The present paper argues that mental health professionals and nursing practitioners working with Chinese children should adopt a multigenerational assessment lens, given that standard clinical protocols focused on the parent-child dyad may systematically underestimate intergenerational risk and resilience processes. Culturally adapted, evidence-based coparenting programs represent a priority area for intervention development in Chinese psychiatric and nursing contexts.

Psychological well-being is a critical component of disease management and recovery in patients with cardiovascular disorders. Cognitive flexibility, as a key psychological determinant, significantly influences adaptive functioning and health-related outcomes. Self-regulation skills training has recently gained attention as an effective approach to enhancing mental health in individuals with chronic illnesses. This study aimed to assess the effect of a self-regulation skills training program on improving cognitive flexibility among patients with heart failure.

This randomized controlled trial included 69 hospitalized patients with heart failure who were randomly assigned to an intervention group (n = 35) or a control group (n = 34). Cognitive flexibility was assessed at baseline, immediately after the intervention, and 1 month later using the Cognitive Flexibility Inventory. The intervention group received six sessions of self-regulation skills training over 3 weeks. The data were analyzed using SPSS software with independent t-tests, chi-square tests, Mann-Whitney tests, and repeated-measures ANOVA. This trial was registered in the Iranian Registry of Clinical Trials (IRCT20160927030002N4).

The findings demonstrated a significant time × group interaction for total cognitive flexibility scores (F [2,66] = 16.66, p < 0.001, partial η² = 0.34). Immediately afterward, the intervention group showed significantly higher cognitive flexibility compared with those of the control group (mean difference = 8.78 points; 95% CI: 3.64-13.92; Cohen's d = 0.80). At 1-month follow-up, the cognitive flexibility scores in the intervention group showed a slight decline compared with post-intervention levels but remained modestly higher than baseline, whereas no meaningful change was observed in the control group.

The findings suggest that self-regulation skills training may serve as an effective intervention for enhancing cognitive flexibility and supporting the psychological well-being of patients with heart failure.

Borderline personality disorder (BPD) is a serious mental illness that often emerges in adolescence. Although efficacious treatments have been developed, they are often lengthy, expensive, inaccessible, and require specialized training to deliver. Optimizing BPD prevention and early treatment is an important public health priority. Disrupted sleep is closely linked to key BPD features, and prior research has documented a range of sleep problems among BPD samples that appear to worsen symptom course and duration. This intervention trial ( NCT04507308 ) assessed the effects of a single-session sleep-focused treatment on adolescent sleep and BPD-related symptoms. Fifty-seven adolescents (ages 13-18) with 3+ clinically impairing BPD features and at least some self-reported sleep-related difficulties participated with a caregiver. Participants completed baseline surveys, interviews, and 10-day ecological momentary assessment (EMA) protocol to examine BPD symptoms and sleep in daily life. Youth also collected at-home ambulatory electroencephalogram (EEG) recordings before undergoing the treatment informed by the Transdiagnostic Sleep and Circadian Intervention. Post-treatment, youth practiced their new sleep routine for approximately one month before undergoing reassessment (EMA, EEG, surveys). Many indices of sleep quantity and quality improved across both objective (EEG) and subjective assessments (EMA and self- and caregiver-report). Youth reported an earlier bedtime and waketime, more sleep, and fewer awakenings in daily life. Every sleep-related questionnaire score improved at post-intervention and was maintained at one-month follow-up. Multiple indices of BPD symptoms also improved significantly. Findings suggest sleep may be a promising intervention target for at-risk youth.

Immersive Virtual Reality (VR) environments are increasingly adopted in clinical psychology and stress-management contexts; however, their therapeutic effectiveness depends on the system's ability to understand and dynamically respond to users' affective states. Emotional regulation plays a key role in psychological resilience, directly influencing stress coping mechanisms, cognitive performance, and overall mental well-being. Despite recent advances, automatic recognition of scenario-associated affective conditions in VR remains challenging because head-mounted displays occlude facial features. This study proposes a VR-based serious game for affective training and regulation, in which users interact with goal-oriented scenarios targeting fear, anger, and joy. We introduce a multimodal affective computing model to objectively assess users' emotional responses by integrating electrocardiogram (ECG) signals and posture-based features extracted through computer vision. An early-fusion architecture combined with a Long Short-Term Memory (LSTM) network captures temporal dependencies in synchronized multimodal data. We established a controlled experimental framework using immersive VR scenarios, enabling the collection of synchronized physiological and behavioral data from a cohort of 20 healthy adult participants. The proposed model was evaluated under a strict Leave-One-Subject-Out (LOSO) cross-validation scheme across independent subjects, achieving a robust inter-subject accuracy of 78.94%±10.77% and a global macro F1-score of 0.635, demonstrating strong generalization to entirely unseen users without data leakage. Furthermore, the system maintained an outstanding balance in detecting active emotional states (recall > 80.0% for fear, anger, and joy). Additionally, subjective evaluations using the PANAS and SGU questionnaires confirmed the coherence between detected and perceived emotional states, as well as the system's high usability. The results suggest the potential viability of combining immersive environments and multimodal affective computing to explore the technical feasibility of adaptive frameworks that could eventually translate into healthcare contexts. This work may contribute to the development of intelligent digital health technologies by providing a foundation for responsive VR systems that can monitor emotional regulation and are fully aligned with sustainable well-being ecosystems (SDG 3: Good Health and Well-being and SDG 10: Reduced Inequalities).

The German holistic health Kneipp concept (KC) consists of five elements: water applications, physical activity, healthy nutrition, herbs, and mind-body practices. Well-known in German-speaking countries, the program's effects in early childhood education are little known. This analysis examined the qualitative portion of the larger mixed-method Kita Kneipp Study exploring the potential and challenges of implementing Kneipp in kindergartens to promote salutogenesis and prevent illness in children through teachers' and children's experiences.

Semi-structured Expert interviews with teachers and field notes from focused ethnographies of Kneipp activities in kindergartens were used to triangulate data. Data were then thematically analyzed.

Teachers observed improved resilience to cold and calming effects of the interventions. Children learned to support their own and others' wellbeing by engaging in activities. Developing bodily awareness, Kneipp helped with self-regulation, promoted curiosity, self-confidence, and the ability to set boundaries. Acceptance by teachers, children, and parents indicated potential for long-term use. Reported challenges included initial skepticism among teachers and children. Structural issues like staff shortages, limited equipment, and low initial teachers' involvement were also mentioned. Parental misunderstandings, especially in low socio-economic areas, highlighted the importance of proactive communication and family involvement.

The KC can be integrated into kindergartens, supporting physical and mental health while fostering mindfulness, social competence, and resilience. The study shows high acceptance and meaningful developmental benefits, with potential for sustainable implementation in early educational settings. These aspects may positively influence health promotion from an early age.

Genetic studies of serious mental illness (SMI, including schizophrenia and bipolar disorder) have implicated two classes of risk variant: common variants ^1-3 , each of small effect but collectively accounting for most population-level risk, and ultra-rare coding variants ^4,5 which confer large risk in a small number of individuals. Most such studies cannot directly assess the impact of specific variants on SMI, transdiagnostically, as the phenotypic information that they collect is focused on a single diagnosis. Here we report results of association analysis of predicted deleterious variants from exome sequencing of 21,958 cases (SMI and severe major depressive disorder) and 19,826 controls from the Mision Origen biobank in the Paisa genetic isolate of Colombia. We identified transdiagnostic associations to seven genes, three at an exome-wide and four at a false discovery rate significance threshold. Five of these genes have not previously been implicated in SMI ( ADAP1 , WIPI1 , NFE2L1 , FBXO10 , and HLA - DPB1 ); for the first four of these the association is driven by variants enriched in the Paisa due to a founder effect, filling the gap between ultra-rare and common variants. The strongest association that we observe is to a frameshift variant (7:904169:T:TC) in ADAP1 that is genome-wide significant for SMI, schizophrenia, and bipolar disorder and increases risk for both diagnoses by more than threefold; it truncates ADAP1 , a brain-enriched Arf6 GTPase-activating/scaffolding protein that has been mechanistically linked to post-mitotic neuronal morphogenesis and regulation of dendritic differentiation ⁶ . Variant carriers differ significantly from other SMI cases in Mision Origen for psychotic, manic, and cognitive item-level phenotypes assessed through analyses of electronic health records ^7-9 and displayed impaired executive function on neurocognitive testing. Variant carriers differ significantly from other SMI cases in Mision Origen for multiple item-level phenotypes (psychotic, manic, and cognitive) assigned through natural language processing of longitudinal electronic health records. Although the 7:904169:T:TC variant is not significantly associated with major depressive disorder, carriers compared to others with this diagnosis display a significant increase in symptoms typical of bipolar disorder. The variant's high allele frequency in Mision Origen (~0.4%) will enable population-level studies to stratify SMI based on causation and identify additional factors influencing risk and resilience.

The World Health Organization (WHO) Global strategy and action plan on oral health 2023-2030 emphasizes the need to strengthen oral health information systems, including surveillance, to support public health action. Objective 5 of the Global strategy and action plan on oral health 2023-2030 calls for reliable, timely and policy-relevant data to inform decision-making, promote accountability and monitor progress, in other words, surveillance of oral diseases. However, most countries face challenges in identifying and applying practical tools to generate such population-level data. Until recently, the WHO STEPwise approach to noncommunicable disease risk factor surveillance (STEPS) included an oral health module that relied on self-reported data on perceived oral health and oral health-seeking behaviour. However, this module is outdated. In response to growing global demand and policy needs, the new STEPS oral health module updated the self-reported questionnaire and added a clinical assessment component that can be done by oral or non-oral care workers after a short training. This paper presents the rationale, development process, structure and policy implications of the updated module. The paper provides an outline of the updated module and evidence to support this new approach as a practical, scalable and aligned solution to one of the most persistent gaps in noncommunicable disease surveillance. As countries move towards universal health coverage and integration of oral health into broader noncommunicable disease strategies, the updated WHO STEPS oral health module is a timely and necessary improvement in surveillance of noncommunicable diseases and their risk factors.

  BACKGROUND: Physical inactivity is a major risk factor for noncommunicable diseases, contributing to both substantial morbidity and premature mortality. In Switzerland, the prevalence of physical inactivity varies across language regions. This study aimed to quantify differences across Swiss language regions in the physical inactivity-attributable burden of disease, expressed as Years Lived with Disability (YLD) and Years of Life Lost (YLL) for 2022. The analysis focuses on YLD and YLL attributable to physical inactivity across 15 physical inactivity-associated diseases.

This study employed the Population Attributable Fraction approach to estimate the proportion of YLD and YLL attributable to physical inactivity in Switzerland. The analysis included individuals aged >20 years and was stratified by disease, age, sex and language region (German-, French- and Italian-speaking). Physical inactivity was defined according to WHO guidelines as not meeting at least 150 minutes of moderate or 75 minutes of vigorous physical activity per week. Prevalence data on physical inactivity were derived from the 2022 Swiss Health Survey. Prevalences were combined with relative risks (RR) of corresponding diseases, identified through a systematic literature search to derive Population Attributable Fractions. Estimates of YLD and YLL for Switzerland for 2022 were derived from the Global Burden of Disease study. YLD and YLL estimates attributable to physical inactivity are presented as rates per 100,000 people aged >20 years. Uncertainty was assessed using parametric bootstrapping.

Overall, the physical inactivity-attributable burden of disease was estimated at 227.08 (95% CI: 214.74-240.08) YLD and 424.23 (95% CI: 383.15-479.23) YLL per 100,000 people aged >20 years. This corresponds to approximately 2% of total DALYs in Switzerland in 2022. Clear regional differences were observed. Estimated physical inactivity-attributable YLD rates were highest in the Italian-speaking region (134.90; 95% CI: 122.04-148.25) followed by the French-speaking region (130.72; 95% CI: 120.78-141.50) and German-speaking region (96.26; 95% CI: 88.81-104.01). Similarly, estimated YLL rates attributable to physical inactivity were highest in the Italian-speaking region (287.74; 95% CI: 245.82-349.99), followed by the French-speaking region (221.56; 95% CI: 192.54-264.55) and German-speaking region (186.67; 95% CI: 162.64-222.27). Disease-specific analysis indicated that depression (93.38; 95% CI: 85.46-101.80) and low back pain (52.01; 95% CI: 45.90-58.47) contributed most to physical inactivity-attributable YLD rates, whereas coronary heart disease (132.12; 95% CI: 115.60-149.55) and Alzheimer's disease and dementia (83.61; 95% CI: 51.90-134.97) were the main contributors to physical inactivity-attributable YLL rates. Women showed consistently higher burden of disease than men, with physical inactivity-attributable YLD rates of 286.06 (95% CI: 264.58-308.90) versus 166.32 (95% CI: 155.06-178.44) and physical inactivity-attributable YLL rates of 475.23 (95% CI: 404.85-577.64) versus 371.69 (95% CI: 337.50-414.96).

Results of this analysis suggest that physical inactivity significantly contributes to YLD and YLL rates in Switzerland, with pronounced regional and sex-specific disparities. The higher burden of disease observed in the Italian- and French-speaking regions highlights the need for regionally tailored prevention strategies that address cultural and contextual differences.

Criminal activity is a major societal and public health concern. However, little is known about how exposure to ambient air pollution influences the incidence of crime. We aimed to examine the short-term associations between air pollution and criminal behavior.

We used a nationwide time-stratified case-crossover design to analyse 483 718 crime events in China (2013-19). Conditional logistic regression models were employed to estimate associations between individual pollutants and crime, while weighted quantile sum (WQS) regression was used to assess joint effects. Stratified analyses were conducted by crime type, season, geographic region, and socioeconomic status. An Air Quality Score was constructed to facilitate interpretation.

All six examined pollutants, i.e. fine particulate matter, coarse particulate matter, nitrogen dioxide, carbon monoxide, sulfur dioxide, and ozone, were associated with increased crime incidence, with the largest estimates observed on the day of exposure. Each interquartile range increase corresponded to increases of 1.66%, 1.88%, 4.03%, 2.03%, 2.81%, and 1.30%, respectively. Associations were stronger in the cold season, northern regions, and lower-socioeconomic regions, with consistently stronger associations observed for violent crimes and theft across the examined pollutants. Moreover, a one-unit increase in the WQS index was associated with a 3.22% increase in crime incidence.

Short-term exposure to air pollution is associated with increased crime incidence, as evidenced by both independent and joint-pollutant effects. These findings suggest that joint exposure to multiple pollutants may be relevant to crime incidence. Improving air quality may have potential co-benefits for public safety.