This study examined associations between psychological need frustration and subjective well-being among vocational college students in physical education contexts, with a focus on cognitive reappraisal and sport-related attentional disruption.

Drawing on Self-Determination Theory, emotion regulation theory, and attentional control perspectives, we tested a moderated mediation model in which cognitive reappraisal statistically accounted for part of the association between psychological need frustration and subjective well-being, and sport focus disruption moderated the association between psychological need frustration and cognitive reappraisal. Data were collected from 2,344 vocational college students in China (M = 19.2 years, SD = 1.3; 52% female) using standardized questionnaires. PROCESS Model 7 with 5,000 bootstrap samples was used to examine conditional associations, controlling for age, gender, and weekly exercise time.

Psychological need frustration was negatively associated with subjective well-being, whereas cognitive reappraisal was positively associated with subjective well-being. Sport focus disruption moderated the association between psychological need frustration and cognitive reappraisal: this association was not significant at low levels of sport focus disruption but was positive and stronger at average and high levels. The conditional indirect association between psychological need frustration and subjective well-being through cognitive reappraisal was significant only at average and high levels of sport focus disruption.

These findings suggest a conditional pattern in which cognitive reappraisal may reflect a compensatory regulatory process under higher attentional disruption. Given the cross-sectional design, all findings should be interpreted as associations rather than evidence of causal or temporal mediation.

Drug addiction is characterized by orchestrated transcriptional changes in brain reward regions, including the nucleus accumbens (NAc). The transcription factor E2F3a has emerged as a novel regulator of cocaine's rewarding effects, yet its sex- and cell-specific mechanisms, as well as its genome-wide targets, remain undetermined. Here, we investigated the motivational and reinforcing roles of E2F3a in cocaine reward using conditioned place preference (CPP) and self-administration, combined with behavioral economics and viral-mediated gene manipulation. Selective overexpression of E2F3a in D1-type medium spiny neurons (MSNs), but not D2-MSNs, increased cocaine CPP in both male and female mice, whereas knockdown produced the opposite effects. Behavioral economics analyses further revealed that E2F3a regulates specific aspects of cocaine reinforcement. Genome-wide mapping revealed increased E2F3a binding to DNA at genes associated with cocaine exposure. Together, these results establish E2F3a as a central substrate of cocaine reward via the recruitment of D1-MSNs and coordinated expression of both proven and new molecular drivers.

Forty-one states in the United States that adopted Medicaid expansion through the Affordable Care Act reached historically low rates of uninsured that have endured through 2025. The One Big Beautiful Bill Act (OBBBA) signed into law on 4 July 2025 contains numerous provisions that place Medicaid expansion coverage at risk. Resulting changes to Medicaid expansion include work requirements, a decrease in federal match funds for expansion programs, cost-sharing fees for recipients, stricter eligibility requirements, more frequent re-enrollment periods, and limitations on family planning services provided by organizations that also provide abortion services. Because each state with Medicaid expansion has implemented this program differently, states will be impacted differently and with various timelines. The impact of OBBBA on Medicaid expansion in the state of New Hampshire is discussed in detail and examined from the perspective of a community mental health center. Nursing implications are discussed within the framework of Fawcett and Russell's conceptual model of nursing and health policy. Recommendations for advocacy and the nurse's role as an important stakeholder are discussed.

To analyze the interplay between family history of type 2 diabetes (T2D) and cardiovascular health (CVH) in relation to T2D onset age and subsequent cardiovascular disease (CVD) risk.

A total of 79 831 participants were included to investigate the association between family history and T2D onset age. Then, 7387 diagnosed T2D patients were 1:1 matched with non-T2D individuals to analyze the association of T2D onset age with subsequent CVD risk. The benefit of good CVH was further assessed. Stratified Cox regression and conditional Cox regression were performed to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).

Family history was associated with younger T2D onset, with an approximately 2.4-year earlier onset of T2D, which further increased the subsequent risk of CVD. Compared with individuals without family history, those with family history had HRs (95% CIs) of 3.911 (3.041, 5.032), 3.785 (3.385, 4.233), 3.627 (3.340, 3.938), 3.465 (3.189, 3.764), and 3.169 (2.787, 3.603) for T2D onset at < 40, 40-50, 50-60, 60-70, and ≥ 70 years old, respectively (P_interaction = 0.007). Among individuals with family history, HR (95% CI) for incident CVD was 3.598 (1.372, 9.433) for those diagnosed T2D < 50 years compared with those without T2D, while the HR (95% CI) was 2.336 (1.232, 4.428) among those without family history. However, high CVH could mitigate risk of young-onset T2D, and could further decrease CVD risk after their T2D diagnosis.

Having family history of T2D increased susceptibility to young-onset T2D and subsequent CVD risks, while ideal CVH could counteract these risks, highlighting the necessity of early screening and intervention.

To analyse subjective experiences of power of adults with noncommunicable diseases in relationships with healthcare practitioners as well as underlying facilitators and barriers of these experiences.

Systematic review (4 databases) of experiences using reflexive thematic analysis underpinned by critical realist approach. The analysis was conducted with an abductive reasoning using previous theories on social power as well as retroduction.

Based on 24 studies, we formed three themes, which depict experiences of power as 1) the position, equal ability and freedom to make one's own choices and (re)negotiate within shared dialogue, 2) the ability to use knowledge to claim one's rights, 3) resistance. Facilitators were connected to acknowledgement as an equally valuable individual, positive healthcare practitioner attitudes and actions towards patient activity and views, safety in the relationship as well as to sufficient, clear and varied information. Main barriers were experiences of dehumanisation, negative healthcare practitioner attitudes and actions, perceived or assumed practitioner domination in interactions, lack of or incomprehensible knowledge and testimonial smothering.

Results suggest that adults with noncommunicable diseases may experience power primarily as a positive power: being acknowledged as having legitimate position to make decisions and being in possession of varied knowledge through which they can gain agency to protect and claim their rights, by resisting, if necessary. Healthcare practitioners are in key position to support these experiences through positive transforming actions, while knowledge asymmetries, persistent inequality and paternalistic structures continue to hinder it.

Background and objectives This study validates the discriminative ability of a community-based assessment checklist (CBAC) compared with other point-of-care tools for community screening to identify individuals at high risk of diabetes and hypertension. The data for this study were collected during 2019-20 in selected areas of Mysuru city, Karnataka. Methods CBAC was administered to residents aged 30 yrs and above, without known cases of diabetes mellitus, hypertension, or cancer. Random capillary blood glucose (RCBG) and blood pressure (BP) were measured for comparison with the CBAC score. Screening performance was assessed using receiver operating characteristics (ROC) analysis and the area under the curve (AUC). Results CBAC was administered to 32,686 people, and 31,594 had complete data for CBAC and RBS, and 32,645 had both CBAC scores and BP values. The analysis showed a poor AUC of 0.62 (95% CI: 0.61-0.63) for identifying individuals at risk of diabetes with RCBG value of ≥140 mg/dL and an AUC of 0.61 (95% CI: 0.60-0.61) for individuals at risk of hypertension with BP values of (systolic ≥140 mmHg OR diastolic ≥90 mmHg). Youden's index indicated that the CBAC cut-off of >4, though optimal for both at-risk of diabetes and hypertension, was poor at 0.17 and 0.15, respectively. Interpretation and conclusions The discriminative ability of CBAC was found to be poor compared with other point-of-care tools. We propose that trained frontline health staff administer RCBG and BP tests alongside the CBAC to enable more efficient public health triaging.

The school-age period is crucial nutritional-wise owing to its health and developmental impact. In Tanzania, 11% of school-aged children are thin, while 34% are anemic, representing a significant burden of undernutrition with a potential to have a lasting impact on educational and early onset of non-communicable diseases. This study was designed to evaluate its implementation and effects on dietary adequacy among primary-school children in Kisarawe District, Tanzania. A school-based cross-sectional study was conducted among 300 students aged 10-14 years from 10 primary schools from 22/04/2025 to 25/04/2025. Dietary adequacy was assessed using two measures: Dietary diversity and Meal frequency. Descriptive statistics was used to summarize the status of implementation of the school feeding program, while regression analysis was used to identify the effect of the intervention. All ten schools implemented some components of the school feeding program with a significant limitation. Only 65% students were covered in the intervention. Forty-nine percent of students met the minimum dietary diversity score. Participation in a school feeding program was associated with a 45% higher likelihood of attaining minimum meal diversity (APR = 1.45; 95% CI: 1.00-2.12; p = 0.051), although this did not reach statistical significance threshold. Only 15.3% students reported consuming the minimum of three meals per day. School feeding programs were present in Kisarawe district but faced major infrastructural and logistical challenges, with none of the schools fully adhering to national guidelines. Strengthening infrastructure, ensuring reliable food supply, and expanding universal coverage are essential to maximize program impact.

Non-communicable diseases represent a major cause of morbidity and mortality in Jordan and place increasing demands on primary healthcare services. Community pharmacists (CPs) play an important role in providing health promotion and disease prevention (HPDP) services. However, limited evidence exists regarding factors influencing their involvement in these activities.

The study aimed to explore CPs' perceptions and experiences regarding the provision of HPDP services in Jordan and to identify factors influencing service delivery, including facilitators and barriers.

Between January and April 2025, face-to-face semi-structured interviews were conducted with CPs in Amman, Jordan, recruited through purposive and snowball sampling. Interviews were audio-recorded, transcribed verbatim, and analyzed in NVivo® QSR 14 using inductive thematic analysis following Braun and Clarke's six-step approach. Transcripts were independently coded by two researchers. The identified themes were subsequently deductively mapped to the Capability, Opportunity, Motivation-Behavior (COM-B) framework. Data collection and analysis were conducted concurrently, and data saturation was achieved when no new themes emerged.

Fifteen CPs participated. Four themes were identified: (1) Diverse and evolving roles of CPs in HPDP; (2) Barriers to providing HPDP services, including workload, limited patient engagement, lack of appreciation from pharmacy owners, and the absence of financial incentives; (3) Professional requirements and capacity building, including continuing professional development, undergraduate training, and physician collaboration; and (4) Impact of providing HPDP services on patients, pharmacists, and the healthcare system. Deductive mapping indicated that pharmacists' engagement in HPDP services was influenced by capability-, opportunity-, and motivation-related factors.

CPs in Jordan play an active role in HPDP services; however, their contribution is hindered by structural, educational, and motivational barriers. Addressing these barriers through targeted training, infrastructure development, enhanced pharmacist-physician collaboration, and public awareness initiatives is essential to strengthen pharmacist-led HPDP services and support their integration into broader public health strategies in Jordan.

Transcription Factor EB (TFEB) is widely recognized as a key transcription factor regulating lysosomal biogenesis and autophagy. Although the TFEB gene is highly expressed in the testes, the mechanism by which it affects male fertility remains unclear. Here, we report that spermatogonia-specific deletion of TFEB in mice results in a multifaceted reproductive phenotype, including impaired fertility, compromised sperm motility, and attenuated androgen production. Immunofluorescence results showed a significant decrease in the expression levels of TNP1, a marker for spermiogenesis. Under electron microscopy, we observed abnormalities in the mitochondria of the testes and sperm. Integrated transcriptomic and biochemical analyses identified a cluster of mitochondrial-associated genes, including Star, Slc25a48, Gss, and ROMO1, with functional enrichment pinpointing disruptions in steroidogenic flux and calcium homeostasis. In summary, our study identifies TFEB as a pivotal regulator of mitochondrial integrity in the testes, the loss of which drives male subfertility through metabolic and hormonal dysregulation.

Background and objectives India ranks third in global cancer incidence. Groundwater often carries undetectable contaminants such as arsenic, a highly toxic element, and chromium, a probable carcinogen. This systematic review aims to identify patterns of arsenic and chromium exposure in Indian population through groundwater and surface water, and the resulting health effects, including cancer and other non-communicable diseases. Methods A comprehensive search was conducted in PubMed, Embase, and Scopus for English-language studies from inception to January 8, 2025. Studies assessing health effects of arsenic or chromium in groundwater or surface were included. After screening the articles, data on key health risk indices: hazard quotient (HQ) and carcinogenic risk, were extracted and categorised by standard thresholds. Heat maps and violin plots were used to represent health risk levels across studies and regions. Joanna Briggs Institute (JBI) critical appraisal tool was used for quality assessment. Results A total of 1259 articles were identified, with 63 included studies. All reported studies presented a low risk of bias. Arsenic ingestion indicated non-carcinogenic risks in 49% of adult and 60% of child-focused studies. Chromium ingestion risks were lower, reported in 12% and 14% of adult and children-focused studies, respectively. Carcinogenic risk was higher for both metals, particularly through ingestion. Higher non-carcinogenic risk was reported from groundwater than surface water, especially via dermal exposure in children. Affected regions were Punjab, West Bengal, Haryana, Delhi, Uttarakhand, and Jammu and Kashmir. Interpretation and conclusions Groundwater arsenic contamination poses a major public health threat in India, while evidence on chromium ingestion risks are limited.