This study aimed to develop and validate the Parental Mental Health Literacy (PMHL) Scale for caregivers of children aged 0-6 years. Initial items were developed based on established mental health literacy and health literacy frameworks and were piloted among 1074 caregivers of children aged 0-6 years in Shanghai, China. Exploratory factor analysis using principal axis factoring with oblique rotation identified a four-factor structure. Confirmatory factor analysis was subsequently conducted to examine the dimensionality of the scale and to compare alternative models, including one-factor, higher-order, and bifactor models. The bifactor model demonstrated the best fit to the data (RMSEA = .088, CFI = .931, TLI = .917). The final version consisted of 28 items across four dimensions: recognition, help-seeking, awareness of parenting and parent-child interaction. Criterion validity was examined using the Strengths and Difficulties Questionnaire (SDQ) and the Early Warning Signs Checklist (WSC). PMHL scores showed modest negative correlations with children's emotional and behavioral difficulties. Internal consistency was high (Cronbach's α = .98; ωh = .89). These findings suggest that the PMHL may serve as a useful instrument for assessing parental mental health literacy in early childhood, although further validation in more diverse samples is warranted.

This study aimed to evaluate the chronic impact of occupational noise exposure on physiological and psychological outcomes, including blood pressure, cortisol levels, aggression, and auditory annoyance, among petrochemical workers.

A cross-sectional study, in 2025, was conducted on 300 petrochemical workers. Participants were divided into two groups, including 130 workers exposed to noise levels lower than 85A‑weighted decibels (dB(A)) and 170 workers exposed to noise levels higher than 85 dB. Then, data related to demographic parameters, noise levels (using Casella CEL 815 sound level meter), blood pressure, salivary cortisol level (using measured using the enzyme‑linked immunosorbent assay), and psychological outcomes (using validated questionnaires for annoyance and aggression) were collected. Statistical analyses included independent t -test, Pearson correlation, and multivariate regression.

Workers exposed to noise higher than 85 dB compared to individuals exposed to lower than 85 dB had significantly higher systolic blood pressure (SBP) (133.67 ± 10.33 mmHg vs. 119.99 ± 9.41 mmHg, P < 0.001) and diastolic blood pressure (91.79 ± 3.92 mmHg vs. 82.76 ± 3.84 mmHg, P < 0.001), total aggression scores (122.45 ± 11.92 vs. 76.06 ± 9.85, P < 0.001), and cortisol level (22.09 ± 3.96 µg/dL vs. 14.23 ± 3.09 µg/dL, P < 0.001). Auditory annoyance (8.48 ± 1.63 vs. 4.40 ± 1.41, P < 0.001) mediated 53% of the noise effect on SBP and 48% of its effect on cortisol level.

Chronic noise exposure can significantly affect cardiovascular and mental health of petrochemical workers, with annoyance as a key mediating factor. These findings underscore the importance of noise reduction strategies and regular health monitoring to decrease occupational health risks.

Perceived environmental noise, in addition to objective sound levels, influences stress, sleep, and other health risks. This study examined sociodemographic and mental-distress factors associated with four aspects of noise perception: perceived noise pollution level, noise-related health risk perception, annoyance, and noise sensitivity.

A population-based online survey of 4179 adults was conducted in Estonia, the Oresund area (Sweden/Denmark), Catalonia (Spain), and Kosovo. Participants rated aspects of noise perception on five-point scales. Predictors included region, age, gender, education, minority status, household income comfort, along with symptoms of anxiety, depression, burnout (6-item version of the Shirom-Melamed Burnout Measure), and sleep disturbance (Karolinska Sleep Questionnaire). One-way analyses of variance (Bonferroni-adjusted) tested group differences, and hierarchical regressions assessed unique contributions.

On average, participants rated the perceived pollution level, health risk, annoyance, and sensitivity at 2.89, 2.73, 3.09, and 2.66, respectively, on a 1-to-5-point scale. All ratings on each aspect differed by region and age, with the highest overall ratings in Kosovo and Catalonia. Younger adults rated all four aspects of noise perception higher than older adults. Women rated annoyance and sensitivity higher, minorities reported higher perceived noise pollution and health risk perception, and university education was associated with greater perceived noise pollution, annoyance, and sensitivity. Income difficulties were negatively associated with health risk perception and sensitivity. All mental distress indicators were positively associated with noise perception aspects, with burnout showing the strongest associations. Mental distress accounted for more unique variance (3.3%-9.9%) than sociodemographic factors (2.6%-4.8%).

The perception of environmental noise varies by region and demographic profile but is strongly associated with mental distress, particularly burnout, underscoring the need for interventions that integrate noise mitigation and mental health support.

This study aimed to investigate the effects of combining hierarchical speech rehabilitation with personalised noise-reduced auditory scenery on language function and gait outcomes in patients with Parkinson's disease (PD).

The clinical data of 100 patients with PD admitted to our hospital between January 2021 and December 2023 were retrospectively analysed. Based on the different adjuvant therapy regimens implemented during distinct time periods, patients were divided into the following two groups: the speech rehabilitation group ( n  = 52), which received hierarchical speech rehabilitation therapy, and the combined therapy group ( n  = 48), which received personalised noise-reduced auditory scenery combined with hierarchical speech rehabilitation therapy. Language function (assessed by the speech item of the Movement Disorder Society Unified Parkinson's Disease Rating Scale Part III [MDS-UPDRS-III] motor examination and the Voice Handicap Index [VHI]) and rehabilitation outcomes (gait parameters [stride length, cadence and gait speed]) were compared between the two groups before and after the adjuvant therapy period.

Following the adjuvant therapy period, the combined therapy group exhibited significantly lower scores on the speech item of the MDS-UPDRS-III motor examination and the VHI compared with the speech rehabilitation group ( P < 0.05). Concurrently, the same group demonstrated significantly greater improvements in gait parameters, including stride length, gait speed and cadence ( P < 0.05).

This retrospective analysis preliminarily indicates that the combination of hierarchical speech rehabilitation and personalised noise-reduced auditory scenery may yield positive effects on language function and gait parameters in patients with PD. These observations require further validation through prospective, large-sample, randomised controlled trials.

Children's health-related quality of life (HRQoL) varies in their country's conditions, with physical and mental well-being challenges being more prevalent in low- and middle-income countries.

This study aimed to improve children's HRQoL through the school nurse program in Bangladesh.

A nonrandomized controlled trial with a pre- and posttest design was conducted in Bangladesh. A total of 455 primary schoolchildren consented to enroll and completed the entire study, and their data were analyzed.

Children were allocated into the control group (CG; n = 220) and the intervention group (IG; n = 235). Regarding household characteristics, most participants did not use water purification methods in both the groups (CG = 71.8% and IG = 73.2%). Subsequently, they had poor accessibility to handwashing facilities (CG = 39.5% and IG = 33.6%), with limited or no access to handwashing facilities. To explore the study's primary outcome, a t -test was used to compare the difference in HRQoL from endline to baseline between CG (mean = 25.12, standard deviation [SD] = 21.99) and IG (mean = 26.47, SD = 25.48), which showed no statistically significant difference between the groups ( P = 0.549). Furthermore, the T -score of HRQoL was improved chronologically in the IG compared with the CG.

Although children's HRQoL is influenced by various factors, it could be enhanced by an effective and sustainable school health program. Therefore, a collaborative initiative from the government and nongovernmental organizations is required to secure better HRQoL for children.

This study aimed to evaluate the knowledge, attitudes, and lived experiences during the peri and postmenopausal phases among women slum dwellers in Kanpur, Uttar Pradesh, India.

This qualitative study comprised 35 women slum dwellers aged between 40 and 64 years who had experienced menopause in the previous 5 years. Data were collected using semi-structured interviews and analyzed using reflexive thematic analysis after an iterative approach to understand the knowledge, attitudes, and lived experiences of women. The identified themes were further compared and discussed with the help of available literature to draw significant conclusions.

This study unveiled the misery of women slum dwellers during the perimenopausal and postmenopausal stages in terms of sociocultural constraints, accessibility of services, information, and health-seeking behaviors. Attitudinal variations were also observed; the majority of women enjoyed this phase and viewed it as a sign of freedom from pain and mental liberation. In contrast, women also felt upset by viewing it as an end to their femininity and womanhood. Medical implications are generally ignored by these women despite experiencing a range of physical, emotional, and psychological changes. Those seeking medical support are vulnerable in terms of receiving the right information and guidance, making them further stigmatized for adopting traditional unsafe practices. Government policies also neglect women's health during menopause. All these factors lead to the creation of a vicious circle during menopause.

Breaking the culture of silence surrounding menopause empowers women to make their own decisions. If they are treated inappropriately, it may lead to severe health consequences. The findings underscore the critical need to design culturally appropriate, gender-sensitive, and community-oriented health education programs, along with improved access to menopausal health services, especially for women belonging to marginalized groups. A focused intervention with an integrated approach is substantially needed to improve menopausal health, along with providing the right information and encouraging healthy behavioral practices.

Cognitive complaints are common in multiple sclerosis, but their relationship to non-cognitive symptoms such as fatigue, sleep dysfunction and psychopathology has not been systematically examined in patients referred for specialist cognitive evaluation. These potentially modifiable symptoms may warrant attention in a clinical context.

This study aimed to characterise common patterns of cognitive and non-cognitive symptoms in a referred patient cohort and determine whether cognitive complaints are associated with clinically significant fatigue, sleep dysfunction and psychopathology.

Cognitive complaints were captured using (a) a binary classification derived from clinical impression and (b) a severity rating from a self-report instrument. Objective cognitive performance was measured across five cognitive domains. Patients also completed self-report measures of fatigue, sleep dysfunction and psychopathology.

Fifty-one patients were included. Although 98% had cognitive complaints, only 29% had objective cognitive impairment. Most (90%) had significant non-cognitive symptoms, primarily fatigue (86%), sleep dysfunction (28%) and depression (26%). Pattern analysis revealed that the most common symptom phenotype was cognitive complaints with significant non-cognitive symptoms, occurring in the absence of objective cognitive impairment. More severe cognitive complaints were associated with greater psychopathology (r = 0.57, BF₁₀ = 2188.48), fatigue (r = 0.53, BF₁₀ = 366.44) and sleep dysfunction (r = 0.47, BF₁₀ = 69.27).

Cognitive complaints in multiple sclerosis may reflect broader non-cognitive symptom burden rather than objective cognitive impairment, even among patients referred for specialist evaluation. Their presence should prompt consideration of fatigue, sleep disturbance and psychopathology as potential targets for intervention.

The COVID-19 pandemic has a significant impact on global mental health. In China, men who have sex with men (MSM) faced more challenges and experienced psychological distress due to social and cultural factors. The pandemic has further exacerbated their situation. However, few studies have examined mental health and coping strategies among Chinese MSM in the post-COVID era.

A semi-structured interview was conducted with 32 Chinese MSM participants to discuss stress and coping in the post-COVID era. Participants were recruited online. Thematic analysis was used to analyse the data to identify key patterns and themes regarding stressors and copings.

It was found that Chinese MSM faced multiple stressors, including economic instability, family expectations, and digital overload. Coping strategies included emotional minimalism or active engagement in daily life. Financial independence and supportive connections were identified as protective factors. However, the legal invisibility of same-sex relationships and the homophobic content on online platforms still affected their mental health.

This study explored the challenges faced by MSM in China post-COVID, increasing the understanding of the mental health challenges faced by this group. There is a need for culturally competent mental health services. Mental health professionals should provide culturally appropriate mental health services and support to improve the well-being of MSM in the post-COVID era.

To investigate multidimensional impulsivity and its neuroelectrophysiological correlates in adolescents with depression and non-suicidal self-injury (NSSI).

A case-control study was conducted including three groups: depressed adolescents with non-suicidal self-injury (NSSI group), depressed adolescents without NSSI (non-NSSI group), and healthy controls (HCs group). The Ottawa Self-Injury Questionnaire was administered to assess NSSI behaviors in depressed participants and to quantify NSSI severity within the NSSI group. Impulsivity was evaluated using a multimodal approach, including the Barratt Impulsiveness Scale-11 (BIS-11), a go/no-go task, and event-related potentials (ERPs), with particular focus on the N2 and P3 components.

Both depressed groups exhibited significantly higher BIS-11 total and subscale scores than HCs, particularly in motor impulsivity (p < 0.05). A significant overall group difference was observed in go trials accuracy among the three groups (p = 0.009). Post hoc analyses with Bonferroni correction showed that the NSSI group had significantly lower go-trial accuracy than the HCs group (p_Bonf < 0.05), whereas no significant differences were observed between the NSSI and non-NSSI groups (p_Bonf > 0.05) or between the non-NSSI and HCs groups (p_Bonf > 0.05). No significant group differences were found in N2 or P3 latency or amplitude across the three groups (all p > 0.05). Correlation analyses revealed that NSSI severity over the past 1, 6, and 12 months was positively correlated with BIS-11 total and motor impulsivity scores (r = 0.198-0.417, all p < 0.001) and negatively correlated with go-task accuracy (r =  - 0.248 to - 0.193, all p < 0.001).

Depressed adolescents with NSSI exhibited elevated self-reported impulsivity and impaired behavioral inhibitory control, both of which were associated with NSSI severity, whereas no significant neurophysiological differences were observed between depressed adolescents with NSSI and HCs.

Critical Incidents (CI) during clinical practice offer valuable insights into medical students' experiences of stress, gaps in the teaching process, psychological safety, and systemic issues within healthcare. This study explored the elements that students identified as CIs during their clinical internships during the COVID-19 pandemic in Chile.

This qualitative study involved voluntary participation from 24 final-year medical interns. Researchers collected data through documentary analysis of CI narratives from learning portfolios and two focus groups. The research team performed a reflexive thematic analysis.

Analysis yielded 22 definitive codes, grouped into nine subthemes and three themes: types of CIs, influencing factors, and personal impact on interns. Most CIs were unrelated to COVID-19 itself and triggered by complex biopsychosocial cases involving ethical dilemmas, questionable or unacceptable behaviors of healthcare personnel, and emotionally charged situations. Some CI related to the human relationship between interns and supervisors, between the health team, or in communication with patients and their families. Interns' reflections focused on their professional role, ethics, communication, and self-care. Most adaptations described were self-directed due to limited faculty involvement.

CI analysis allows interns to reflect on their roles and envision improvements for future practice. The primary emotions associated with CI were predominantly negative, and their adaptations were self-directed. One important topic to address is whether faculty are available and prepared to support interns, or whether they may themselves be contributors to CIs. These findings suggest the need for structured faculty support to improve psychological safety and reflective learning during internships.