War profoundly affects the well-being of civilian populations and shapes subsequent mental health outcomes. This study aimed to investigate the effects of continuous traumatic stress (CTS) and coping efficacy on mental health outcomes among adults in Ukraine amid ongoing warfare over time. We examined how changes in CTS responses, coping efficacy, and stressful life events predicted posttraumatic stress disorder (PTSD) symptoms and broad mental health outcomes (depression, anxiety, insomnia, well-being). Participants were 157 adults who experienced war-related stress and completed two online surveys approximately 12 months apart. Moderately small but significant symptom reductions were observed, ds = 0.18-0.32, ps = .005-.026. Structural equation models analyzing the associations between initial status and changes in CTS, coping efficacy, and stressful life events and Time 2 PTSD symptoms and broad mental health outcomes explained most of the variance in PTSD symptoms and broad mental health outcomes, R² = .84‒.85. Higher initial severity and worsening CTS responses over time predicted higher PTSD symptom severity, standardized estimate (Est_std) = 0.29‒0.32, ps = .001‒.006, and poorer broad mental health outcomes, Est_std = 0.25‒0.28, ps = .001‒.016. Increased stressful life event exposure was linked to worse broad mental health outcomes, Est_std = 0.16, p = .001. Improvements in coping efficacy predicted superior broad mental health outcomes, Est_std = -0.43, p < .001. Assessing and addressing the impact of CTS, considering the toll of stressful life events, and enhancing coping efficacy may help to optimize service delivery in ongoing war environments.

This study examined the interactive relationships among health literacy, psychological resilience, and fear of progression (FoP) in patients with chronic heart failure and their caregivers.

A total of 300 dyads were recruited. The Actor - Partner Interdependence Mediation Model was used to analyze actor, partner, and mediation effects.

For both patients and caregivers, health literacy and psychological resilience negatively predicted individual FoP. Caregivers' health literacy positively predicted their psychological resilience, while no such association was found in patients. Psychological resilience mediated the health literacy-FoP association in both groups. Patients' health literacy could indirectly alleviate caregivers' FoP via caregivers' psychological resilience.

FoP in chronic heart failure is a dyadic psychological phenomenon. Interventions should target both patients and their caregivers to reduce fear of disease progression and improve family mental health.Clinical Implications: Dyad-based interventions that enhance health literacy and psychological resilience in both patients and caregivers may effectively alleviate FoP and promote overall family well-being.

Animal models demonstrated that pharmacologically-induced lesioning of the locus coeruleus (LC), the brain's primary source of norepinephrine, triggered astrocyte reactivity, exacerbating Alzheimer's disease (AD) pathology and cognitive deficits. We examined whether astrocyte reactivity modulates the relationship between LC dysfunction, tau pathology, and cognitive decline in humans.

We combined ultra-high-field LC functional imaging during an affective task with plasma biomarkers of glial fibrillary acidic protein (GFAP) and hyperphosphorylated tau (p-tau), and longitudinal cognitive data from 78 asymptomatic individuals. Associations between LC activity and norepinephrine transporter-enriched LC functional connectivity (LCFC) with p-tau, GFAP, and cognitive decline were examined.

Lower LC activity and LCFC were related to elevated plasma p-tau₂₁₇, particularly at elevated GFAP. Lower LC FC was also associated with cognitive decline in individuals with elevated plasma p-tau₂₁₇ and GFAP.

LC-norepinephrine system dysfunction may contribute to emerging tau pathology and cognitive decline, with astrocytes playing a critical gating role.

Despite extensive characterisation of immune responses across peripheral organs, the immunological landscape of the central nervous system (CNS) remains incompletely defined. Among the resident immune cell populations in the brain, mast cells and microglia have emerged as key modulators not only of neuroinflammatory processes but also of fundamental homeostatic functions, including regulation of sleep, affective states, and energy balance. These cells engage in complex bidirectional communication, mediated in part by the biogenic amine histamine. Although histamine was first identified over a century ago, its multifaceted roles in CNS homeostasis, immune surveillance, and neuropathophysiology remain poorly delineated. This review examines the biosynthesis, receptor-mediated signalling, and functional consequences of histaminergic activity within the brain, with a particular focus on microglial dynamics. We discuss crosstalk between mast cells and microglia via histamine signalling pathways, and the potential implications of this interaction in the etiology of neurodevelopmental disorders. Furthermore, we evaluate the emerging evidence on the capacity of centrally acting antihistamines, especially those capable of penetrating the blood-brain barrier, to modulate microglial phenotypes. Collectively, these insights underscore the urgent need for deeper mechanistic studies to elucidate histamine's role in CNS immunophysiology.

Anxiety disorders in older adults are commonly underdiagnosed and undertreated, especially among minority ethnic groups. This UK-based multicultural qualitative study explored beliefs about anxiety among White British, South Asian, African and Caribbean older adults who self-reported anxiety, and examined the applicability of Leventhal's Common-Sense Model.

Individual interviews were conducted with 52 older adults self-reporting current or past anxiety. Data were managed and analysed using the Framework Method. Professional interpreters facilitated interviews with non-English speakers.

The study included 27 participants with distressing anxiety and 25 with non-distressing anxiety. Participants' accounts revealed a fragmented understanding of anxiety. Beliefs varied within and across cultural groups, shaped by the interaction between culture, participants' salient identities, degree of distress and prior contact with mental health services. Despite this variability, participants' beliefs broadly mapped onto Leventhal's Model, supporting its applicability. Inductive analysis identified two new dimensions: aggravating factors and protective factors.

Older adults' understanding of anxiety is often fragmented. Broad cultural classifications risk obscuring within-group diversity. Cross-cultural research should adopt nuanced approaches to provide meaningful, person-centred insights into people's perceptions of illness. While applying Leventhal's Model provided new insights, further theoretical refinement may be needed to capture dimensions extending beyond the model.

Oral health and general health are closely linked, but the association between the two is still under discussion. This study aimed to update and expand a previously published systematic review and meta-analysis to include new data on the correlation between overall Oral Health-Related Quality of Life (OHRQoL) and Health-Related Quality of Life (HRQoL), and to examine how OHRQoL relates to the physical and mental components of HRQoL.

A comprehensive search of online databases (Ovid MEDLINE(R), Embase, CINAHL, PsycInfo, Scopus, and Web of Science) was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligible studies reported correlations between validated OHRQoL and HRQoL instrument summary scores, and/or physical and mental component scores in adult populations. Correlation coefficients were pooled using the random-effects model. Subgroup analyses were performed by population setting (dental, medical, and nonpatient). A sensitivity analysis was conducted to compare pooled correlations for OHRQoL with the physical and mental components of HRQoL. Heterogeneity and publication bias were evaluated using Q, I², τ², funnel plots, and the trim-and-fill method.

Nine studies covering 12 populations from 6 countries were included in this update. The pooled correlation between OHRQoL and HRQoL summary scores was r = 0.42 (95% confidence interval [CI]: 0.33-0.49), indicating a medium relationship with improved precision (narrower CI) compared to prior results. Subgroup analyses showed similar associations across dental, medical, and nonpatient populations with no significant subgroup differences (Q_M = 1.80, P = .41). The pooled correlation between OHRQoL and Physical Component Score (PCS) was r = 0.35 (95% CI: 0.26-0.43), and for Mental Component Score (MCS) it was r = 0.38 (95% CI: 0.30-0.46). Both correlations were moderate in magnitude, meaning that oral health contributes similarly to physical and mental dimensions of overall well-being.

This updated analysis confirms a medium-strength relationship between oral and general health. In addition, oral health connects similarly with both the physical and mental components of HRQoL. These results support the idea that oral and general health influence each other and reinforce the importance of interprofessional collaborative approaches to improve patient health and well-being.

Acute myeloid leukemia (AML) represents 15% to 20% of all pediatric acute leukemias and is responsible for nearly 30% of deaths in this population. While high-income countries report overall survival (OS) rates near 75%, survival in Brazil remains significantly lower, ranging between 30% and 40%.

The objective of this study is to analyze the probability of OS and event-free survival (EFS) in pediatric patients with AML treated at a Brazilian university hospital, evaluate prognostic factors, and compare outcomes with international data.

This retrospective study included 51 patients (under 14 years old) diagnosed between 2004 and 2023 and treated with BFM-based protocols. The median age was 4.6 years. Patients with acute promyelocytic leukemia (APL) achieved an OS of 100% and EFS of 90%. For other AML subtypes, the 5-year OS and EFS were 53.7% and 43.7%, respectively. Implementation of improved supportive care (ISC) after 2008-including the opening of a pediatric ICU and better infection management-was a pivotal prognostic factor (p < 0.001). Following ISC implementation, OS increased dramatically from 8.3% to 74.5%, and the early death rate dropped to 5.7%, reaching levels comparable to high-income countries.

Pediatric AML outcomes in developing regions can achieve international standards when intensive chemotherapy is combined with optimized supportive care. The establishment of specialized pediatric intensive care and advanced management of infectious complications are essential pillars for bridging the survival gap in these populations.

Cervical cancer (CC) is a major public health concern, ranked as the fourth leading cause of cancer. Evidence shows that CC is preventable if detected and treated at the early stages. In the Democratic Republic of the Congo (DRC), national-level evidence on women's awareness of CC and its associated factors remains limited.

This study aimed to assess the level of cervical cancer awareness and identify factors associated with awareness among women of reproductive age in the DRC.

Cervical cancer (CC) is a major public health concern, ranked as the fourth leading cause of death. Evidence shows that CC is preventable if diagnosed at the early stages. In the Democratic Republic of the Congo (DRC), there is limited evidence at the national level and on factors associated with CC awareness among women of reproductive age. This study aimed to address this gap.

The study analysed secondary data from a total weighted sample of 27 583 women aged 15-49, drawn from the 2023-2024 DRC Demographic and Health Survey (DRCDHS). The dependent variable was CC awareness, and the independent variables were the sociodemographic characteristics of a woman. Descriptive, bivariable and multivariable analyses were conducted. A significant factor was determined at p-value < 0.05 at 95% confidence intervals (CIs).

The overall CC awareness among women of reproductive age in DRC was 21.3% (95% CI = 19.5-23.2). Logistic regression results revealed that women aged 25-34 (AOR = 1.36; 95% CI = 1.12-1.66) and 35-49 (AOR = 1.60; 95% CI = 1.27-2.02), women who were residing in urban areas (AOR = 1.53; 95% CI = 1.06-2.20), women with primary education (AOR = 1.45; 95% CI = 1.03-2.04), secondary education and above (AOR = 1.73; 95% CI = 1.22-2.45), employed women (AOR = 1.48; 95% CI = 1.20-1.84), women who had been examined for breast cancer (AOR = 4.72; 95% CI = 2.91-7.67), women who had been listening to radio (AOR = 1.60; 95% CI = 1.28-1.99), women who had visited health facility last 12 months (AOR = 1.63; 95% CI = 1.35-1.97), Christian (AOR = 2.35; 95% CI = 1.06-5.21), use internet (AOR = 1.67; 95% CI = 1.23, 2.28), reading newspaper/magazine (AOR = 1.33; 95% CI = 1.01-1.76) and delivered at health facility (AOR = 1.53; 95% CI = 1.18-1.98) were statistically significant associated with having CC awareness compared to their counterparts.

The study revealed overall suboptimal CC awareness among women of reproductive age in DRC. Although health education interventions should target all women of reproductive age, special attention should be given to younger women aged 15-24 years, those with no formal education and those living in rural areas, as these subgroups demonstrated particularly lower awareness levels. Strengthening tailored interventions for these vulnerable groups may therefore improve awareness within the broader reproductive-age population and the community at large.

Gastric cancer (GC) is a leading contributor to cancer-related illness and death globally, presenting a significant public health concern in Iran. There is a lack of extensive data regarding long-term trends at both national and regional levels for GC incidence and its anticipated future impact. This research aimed to investigate the changes in gastric cancer rates in Iran from 1990 to 2021 and to forecast incidence rates through 2030 by gender, age groups, and provinces.

This research used secondary ecological data from the GBD 2021 research to investigate the incidence of GC in Iran from 1990 to 2021. Temporal trends were assessed with Joinpoint Regression to determine the Average Annual Percent Change (AAPC). Also, a Bayesian age-period-cohort model was then applied to project new cases and incidence rates up to 2030. We used from R and Joinpoint software for all analyses.

From 1990 to 2021, Iran saw nearly a twofold increase in new GC instances; however, the age-standardized incidence rate (ASIR) significantly fell from 23.12 to 14.37 per 100,000 individuals. The most significant decreases were observed in the northwestern provinces and among females. Forecasts for 2030 show that the absolute number of cases will likely increase to around 12,070, yet the ASIR is predicted to see a slight drop to 13.44, with a stagnation in decrease for individuals over 80 years old, suggesting a gradual slowdown in the overall trend.

Although there has been a persistent reduction in the age-standardized incidence rate of GC in Iran over the last thirty years, the sheer number of cases is still increasing owing to demographic growth and an aging population. To combat this rising challenge, future initiatives should focus on implementing targeted screening in high-risk areas and for elderly populations, improving geriatric healthcare, and addressing inequalities in healthcare access through better collaboration across sectors.

 With the increasing burden of non-communicable chronic diseases, it is important to empower people to self-manage their conditions. This study aimed to explore the support that persons living with chronic disease require to self-manage their conditions at a Primary Health Care (PHC) facility in the Victor-Khanye subdistrict, Delmas, Mpumalanga.

 Individual in-depth interviews were conducted with 14 adult participants who collected their monthly medication for diabetes, human immunodeficiency virus or hypertension. Data were analysed manually using thematic analysis.

 Three themes were identified: (1) individual self-management; (2) support enhancing for self-management; and (3) barriers to self-management. The study highlights that self-management requires a combination of individual beliefs, capabilities, education, access to healthcare resources, financial assistance, emotional support from family and friends, and community support. While knowledge is crucial for empowering individuals to manage their diseases effectively, challenges such as financial constraints and a lack of specific self-management support provided by healthcare workers hinder many from fully implementing self-management strategies.

 Persons living with chronic disease require comprehensive care that extends beyond healthcare and includes emotional, social and financial support. Effective self-management requires access to tailored education and community support networks that allow people to take an active role in their health.Contribution: Understanding the support persons living with chronic diseases require for effective self-management is critical for improving health outcomes, enhancing quality of life and promoting sustainable healthcare systems.