Agricultural work involves high physical demands and organizational and psychological factors that increase the risk of musculoskeletal disorders, especially in environments such as greenhouse horticulture. Migrant workers face additional vulnerabilities stemming from precarious working conditions and reduced access to preventive resources. The aim of this study was to compare functional capacity, musculoskeletal complaints, and psychosocial outcomes between migrant and non-migrant workers engaged in greenhouse horticultural production.

A cross-sectional study was conducted among 146 agricultural workers employed in greenhouse horticultural production in the Basque Country (Spain). Cardiorespiratory fitness, lower-limb strength, musculoskeletal complaints using the Standardised Nordic Questionnaire (SNQ) and perceived stress and anxiety were compared between migrant and non-migrant workers.

Musculoskeletal complaints were lower in migrants workers in both sexes (p < 0.05). A positive correlation was identified between depressive symptoms and musculoskeletal complaints. A multivariable regression model showed that being migrant, lower depressive symptom scores, greater handgrip strength, and higher work ability were associated with lower musculoskeletal complaint levels (R2 =0.574).

Musculoskeletal complaints among greenhouse agricultural workers are not explained solely by physical workload. Migrant status, psychological well-being, muscular strength, and work ability are independently associated with musculoskeletal complaints.

Mood and anxiety disorders are the most common pregnancy complications in the United States. Global public health crises increase the risk of these disorders, impact obstetric professionals that serve perinatal women, and introduce new challenges to accessing mental healthcare, particularly for economically marginalized perinatal women. Accordingly, the study purpose is to develop a taxonomy of mental healthcare access during public health crises for economically marginalized perinatal women.

In-depth interviews were conducted with obstetric professionals (n=14) serving economically marginalized perinatal women during the COVID-19 pandemic. Our research team employed a modified grounded theory to develop a taxonomy comprising dimensions, components and factors for perinatal mental healthcare access. Results from obstetric professionals were then triangulated with data from economically marginalized perinatal women (n=24) who attempted to access mental healthcare during the COVID-19 pandemic.

Obstetric professionals enumerated factors related to a six dimension taxonomy of access, including approachability, availability, affordability, accessibility, accommodation, and acceptability. Dimensions were triangulated and found to align with experiences of perinatal women. Each dimension included multiple components and factors influential to the respective component. For example, the dimension of affordability included direct mental healthcare costs (the component) which reportedly increased for patients due to a rise in un- and under-employment and loss of employer-sponsored health insurance (the factors).

Findings highlight opportunities for policymakers and healthcare professionals to identify components impacted across the six dimensions of access for economically marginalized perinatal women and respond to the factors influential. Interventions could include ongoing support to normalize mental healthcare, collaborations with community-based organizations, prioritization of patient-centered and collaborative care models.

Perinatal mood and anxiety disorders (PMAD's) are the leading cause of maternal mortality, and one of the most common medical complications identified during the perinatal experience. Research indicates that the early identification of PMADs can result in more effective management of mental health conditions. By examining healthcare professionals' perceptions of the barriers and facilitators to these conversations, we can identify what helps or hinders effective dialogue. This understanding not only informs training and practice but also strengthens the use of screening tools, ensuring they are applied in ways that are meaningful, accessible, and responsive to patient needs.

We used a purposive sampling technique to recruit 19 providers who work in the United States; specifically, Ohio, Kentucky, and Indiana. Semi-structured interviews with open-ended interview questions were conducted. Qualitative data were analyzed using thematic analysis, and main themes emerged from the transcripts.

Four major themes were identified regarding screening barriers and facilitators for mental health care observed in OBGYN practice in the Midwest area: (1) Approaches to Screening and Assessment, (2) Provider Responses and Interventions, (3) Facilitators of Engagement and, (4) Barriers at Multiple Levels.

Study findings provide a comprehensive view of the screening barriers and facilitators perceived by these healthcare professionals during the perinatal period. These findings offer insight into how provider perspectives influence the implementation of mental health screening practices. Overall, results may offer evidence for improving screening protocols, provider training, and patient-centered approaches to perinatal mental health care.

Metabolic dysfunction-associated steatotic liver disease is a prevalent chronic liver disease globally. Postmenopausal women may face a higher risk of developing this disease due to the metabolic changes related to menopausal transition. Although lifestyle adjustments remain the core of the care process, sustained self-management often remains highly challenging. This study, based on the theory of active health, aims to explore the self-management experience of postmenopausal women and the supportive needs.

A descriptive qualitative design was employed. From August to October 2025, we recruited 16 postmenopausal MASLD patients from a tertiary Grade A hospital in Nanjing. Semi-structured, face-to-face interviews were conducted. Data were independently analyzed by two researchers using thematic analysis.

Sixteen postmenopausal women with MASLD were interviewed. Five themes were generated: (1) Inadequate awareness of MASLD risk; (2) obstacles under the physical and mental burden related to menopause; (3) gaps in the support system; (4) bidirectional effects of emotional experiences on self-management; (5) active health seeking and self-motivation.

Self-management in postmenopausal women with MASLD is shaped by interacting cognitive, physical, emotional, and family factors, while many retain modifiable motivation and initiative. These findings provide valuable implications for development of future interventions targeting this population.

Mental health disorders represent a growing burden across the Middle East and North Africa (MENA) region, where depression and anxiety are highly prevalent amid conflict, displacement, and socioeconomic strain, affecting up to 40 percent of adults, yet treatment gaps remain at 80-95% due to provider shortages, financial strain, and cultural barriers. In this context, artificial intelligence (AI), in the form of large language models (LLMs) and specialized psychotherapy chatbots, may offer a scalable adjunct to help address these gaps through anonymous screening, predictive risk modeling, psychoeducation, and brief interventions. This narrative review examines current evidence of AI-driven conversational tools in mental health with a specific focus on their application, acceptance, and limitations within the MENA region. To do so, A structured search of MEDLINE and Embase (2000-2026) identified studies on conversational AI in mental health, prioritizing evidence from the MENA region and supplemented by relevant global literature. Overall, findings suggest that while these tools offer high accessibility and user engagement, particularly for low-intensity support, their effectiveness is limited by linguistic and cultural mismatches, including Arabic diglossia and poor alignment with locally grounded expressions of distress. At the same time, user acceptance reflects a paradox in which stigma and privacy concerns drive reliance on anonymous AI tools while simultaneously limiting trust in their clinical reliability, reinforcing a preference for hybrid models with human oversight. Taken together, these findings indicate that current systems remain insufficiently adapted to the MENA context, underscoring the need for culturally grounded, dialect-sensitive, and clinically supervised approaches to ensure safe and effective integration.

Age at menarche is a dynamic indicator of a female's health trajectories. Despite its relevance, the cohesive synthesis of its multifactorial determinants in South Asia is lacking, limiting the targeted public health strategies. This review examines the sociodemographic, nutritional, lifestyle, anthropometric, biological, and environmental determinants of age at menarche among females aged 8-21 years across South Asia.

A systematic review of observational studies on determinants of age at menarche was conducted. Adhering to PRISMA guidelines, articles published between January 2014 and May 2025 were identified from ScienceDirect, PubMed, Web of Science, and Google Scholar. Methodological quality of eligible studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist. Due to significant heterogeneity across the studies, findings were narratively synthesized precluding meta-analysis.

Out of 729 articles, 18 studies from South Asian countries were included. The mean age at menarche clustered between 12 and 13 years across the studies. Menarche <12 years of age was associated with urban residence, a higher socioeconomic status, higher BMI, inadequate sleep and physical activity, higher consumption of fruits, vegetables, and non-vegetarian diet, excessive screen time, low birth weight, absence of biological father, mothers' age at menarche and exposure to environmental factors. On the contrary, the age of menarche >14 years of age was associated with rural residence, lower socioeconomic status, stunting and underweight.

While heredity, demographics, and early-life programming influence age at menarche, modifiable nutrition and lifestyle factors are critical determinants in South Asia. Targeted interventions focusing on these determinants could reduce the burden of metabolic and growth-related disorders among adolescent females. Paucity of studies in South Asian countries is a critical evidence gap that needs attention to better inform policies for adolescent health.

INPLASY, Identifier: INPLASY202610051.

There are over 120 million forcibly displaced people in the world, with numbers steadily increasing. The majority of refugees and asylum seekers are displaced in urban settings with fragmented access to health services, and those living in countries without refugee protections face particularly dire circumstances. High rates of trauma exposure and related mental disorders persist alongside structural barriers to care, underscoring an urgent public health equity challenge. This community case study describes the Cope program, a refugee community-led mental health and psychosocial support (MHPSS) initiative implemented by the Refugees and Asylum Seekers Information Center (RAIC) in Jakarta, Indonesia. Using an apprenticeship model, community members transition from program participants to trained, supervised facilitators across three phases (n = 30 at baseline, n = 16 at endline). Pre- post-assessments using validated measures found significant reductions in depressive symptoms (52%), anxiety symptoms (50%), and Post-traumatic Stress Disorder (PTSD) symptoms (46%) from baseline to endline, with large effect sizes. These findings demonstrate that community-led, culturally grounded MHPSS programming can produce meaningful mental health gains among protractedly displaced populations in non-signatory countries. Beyond individual-level outcomes, the Cope model illustrates how Refugee-Led Organizations (RLOs) can serve as sustainable pillars of inclusive health system delivery-a critical consideration for governments, UNHCR, and global health actors working to advance universal health coverage for displaced populations.

Recognizing outdoor exercise enjoyment as a vital protective factor for public mental health, this study constructed a moderated mediation model to examine the associations between personality traits (specifically extraversion and neuroticism) and outdoor exercise enjoyment. The investigation focused on the dual mediating roles of basic psychological need satisfaction and frustration. Furthermore, it explored the boundary conditions of social support to determine how environmental factors interact with individual dispositions.

A cross-sectional survey was conducted with 527 outdoor exercise participants in first-tier cities in China. Moderated mediation models were examined for both extraversion and neuroticism to enjoyment through basic psychological need satisfaction and frustration, as well as to determine the moderation of social support on this relationship.

Evidence to support an asymmetrical dual mediation mechanism was confirmed; extraversion largely supported enjoyment through psychological need satisfaction, while neuroticism detracted from enjoyment primarily through psychological need frustration. Social support demonstrated complicated moderation patterns; social support strengthened the positive social association of extraversion with psychological need satisfaction (a gain dynamic), yet, in the neuroticism group we observed a paradox. Specifically, while high social support did buffer against the detriment of neuroticism on psychological need satisfaction, it increased the positive association of neuroticism and psychological need frustration.

Social support is not an absolute remedy, but is conditional on personality traits and can be a stressor under certain conditions. By delineating these boundaries within the Person-Environment Fit framework, this study highlights the necessity for differentiated intervention strategies. We propose different intervention approaches: strengthening social connections for extraverted individuals, and providing non-judgmental non-invasive support for neurotic individuals to break the frustration link, thereby informing targeted public mental health services and mitigating psychological distress.

Accelerating urbanization has intensified psychological stress and mental health problems among urban residents. As accessible natural spaces for leisure and recreation, urban parks have received increasing scholarly attention for the potential restorative effects of their soundscapes. Existing studies have mainly focused on the restorative benefits of visual landscapes or examined only the direct relationship between soundscapes and perceived restorativeness. However, the potential psychological pathway through which soundscape cognitive image is associated with perceived restorativeness via emotional pleasure has not been sufficiently clarified. Based on the stimulus-organism-response framework, this study constructed a model linking soundscape cognitive image, emotional pleasure, and perceived restorativeness.

Twelve urban parks in Foshan, China, were selected as case study sites. A field questionnaire survey was conducted among recreational visitors, and 300 valid responses were collected. Python 3.10 was used for data processing and descriptive analyses, and AMOS 26.0 was used for structural equation modeling and mediation tests.

The results showed that soundscape cognitive image was positively associated with emotional pleasure. Soundscape cognitive image was positively associated with the being away, fascination, and compatibility dimensions of perceived restorativeness, whereas its direct relationship with coherence was not significant. Emotional pleasure was positively associated with being away and compatibility, was not significantly associated with fascination, and showed a significant negative association with coherence. Bootstrap analysis further indicated that emotional pleasure served as a significant indirect pathway between soundscape cognitive image and being away, compatibility, and coherence. The indirect pathway for coherence was negative and the total relationship was not significant, suggesting that this result should be interpreted cautiously. No significant indirect pathway was found for fascination.

This study extends the application of the stimulus-organism-response framework to urban park soundscape research by showing how visitors' subjective soundscape cognition is related to perceived restorativeness through emotional pleasure. Because the study used cross-sectional self-report data, the findings should be interpreted as evidence of statistical associations and potential psychological pathways rather than as proof of causal effects. The results provide empirical references for soundscape evaluation and health-oriented urban park planning.

Obsessive-compulsive disorder is one of the common mental health problems among perinatal women, and the postpartum period represents a particularly vulnerable stage for the emergence of clinically significant obsessive-compulsive symptoms. Postpartum infant care-related obsessive-compulsive behaviors may exacerbate maternal negative emotions such as anxiety and depression through a cognitive-behavioral cycle and impair the development of the mother-infant relationship. Birth trauma is one of the influencing factors of perinatal mental health, and obsessive-compulsive behaviors may develop or worsen as a response to birth trauma, highlighting the need to explore the potential psychological mechanisms underlying the association between birth trauma and postpartum infant care-related obsessive-compulsive behaviors. This study examined the relationship between birth trauma and postpartum obsessive-compulsive behaviors, as well as the chain mediating role of intolerance of uncertainty and dyadic coping.

A total of 278 hospitalized parturients were recruited using the convenience sampling method, and the questionnaires included the general information questionnaire, Psychological Birth Trauma Scale, Intolerance of Uncertainty Scale, Dyadic Coping Scale, and Postpartum Infant Care-Obsessive Compulsive Behavior Scale. Data were analyzed using correlation analysis in SPSS, and the PROCESS macro was employed for mediation effect analysis.

(1) Birth trauma exerted a significant positive effect on postpartum infant care-related obsessive-compulsive behaviors. (2) The association between birth trauma and postpartum obsessive-compulsive behaviors was independently mediated by intolerance of uncertainty. (3) Dyadic coping independently mediated the relationship between birth trauma and postpartum care-related obsessive-compulsive behaviors. (4) Intolerance of uncertainty and dyadic coping played a chain mediating role between birth trauma and postpartum care-related obsessive-compulsive behaviors. Our study enriches existing research on birth trauma and postpartum care-related obsessive-compulsive behaviors, deepens the understanding of their effects, and provides a reference for optimizing perinatal care practice.

Intolerance of uncertainty and dyadic coping serve as important mediators between birth trauma and postpartum infant care-related obsessive-compulsive behaviors, providing key evidence for developing potential interventions and support services in perinatal mental health. Future efforts should focus on maternal childbirth experiences and postpartum negative emotional and behavioral problems, provide sufficient social support, and improve family infant caregiving skills.