Sexual minority women (SMW) have worse mental and physical health outcomes compared with heterosexual women. Limited research has explored menopause in SMW. This study compared menopause symptoms in cisgender SMW and heterosexual women.

This cross-sectional analysis examined questionnaires from women 40-65 years, seen at women's health clinics in Arizona, Florida, and Minnesota between December 2016 and February 2023. Menopause symptoms were evaluated using the Menopause Rating Scale (MRS). An MRS score ≥ 12 indicates moderate or greater symptoms. Multivariable logistic regression was used to compare scores between cisgender SMW and heterosexual women, adjusting for factors that may impact menopause symptoms.

Data from 2,273 women were included, with 69 SMW. The mean age was 53.2 (SD: 6.1), body mass index 25.7 kg/m2, and a majority were White (91.9%). The median MRS score among all participants was 15 (interquartile range=10, 20); 67.3% reported MRS scores ≥ 12. The likelihood of being on hormone therapy or selective serotonin reuptake inhibitors/serotonin-norepinephrine reuptake inhibitors was comparable between groups. In both univariate (OR: 0.85, 95% CI: 0.52-1.40) and multivariable (OR: 0.83, 95% CI: 0.47-1.48) analyses, no significant associations between sexual orientation and MRS ≥ 12 were found.

Menopause symptoms and likelihood of treatment were similar for cisgender SMW and heterosexual women presenting to tertiary care centers. Limited diversity in the cohort and the small number of SMW reduce the generalizability of the results. The lack of adverse social determinants of health may have contributed to the findings, but additional research in larger cohorts is needed.

Although childhood trauma has been linked to loneliness in adolescents, the psychophysiological mechanisms that may underlie this association remain poorly understood. This study examined whether emotion dysregulation mediated the relation between childhood trauma and loneliness in adolescents, and whether parasympathetic functioning-indexed by baseline respiratory sinus arrhythmia (RSA) and RSA suppression to a social stress task-moderated the relation. Participants were 245 Chinese adolescents (M_age = 12.91 years, SD_age = 0.69 years, 46.12% male). They completed self-report questionnaires on childhood trauma, emotion dysregulation and loneliness. They also completed a public speech task designed to elicit social stress, during which their physiological data were collected. The results demonstrated that childhood trauma was positively related to adolescent loneliness, and emotion dysregulation partially mediated this relation. Moreover, parasympathetic functioning moderated the mediation model, such that the indirect association between childhood trauma and loneliness through emotion dysregulation was significant only among adolescents with lower baseline RSA and blunted social stress RSA suppression. The findings suggest that parasympathetic functioning as indicated by higher baseline RSA and greater RSA suppression in response to social stress may serve as risk-buffering physiological markers, potentially ameliorating emotion dysregulation linked to childhood trauma, which in turn is associated with increased loneliness in adolescents.

Measurement of noise exposure tends to focus on sound level; however, the number of noise events might also influence health and cognition. We investigated how the distribution of noise events over time influences experiences of loudness, annoyance, and task performance.

We presented recordings of a passenger aircraft flying overhead, either as a single 15-s overflight at 80 dB LeqA 15s or four 15-s overflights at 60 dB LeqA 15s . Levels were chosen on the basis that an increase of 10 dB doubles the perceived loudness, thus four stimuli at 60 dB might be expected to seem as loud as a single stimulus at 80 dB. Participants performed a mental arithmetic task during half the stimulus presentations and rated their perception of loudness and annoyance to every presentation, while pulse and skin conductance were monitored.

Overall, the single 80-dB-flight stimulus was perceived as louder ( F  = 124.519, P < 0.001) and more annoying ( F  = 63.530, P < 0.001) than the four 60-dB flights. Noise did not influence task performance; however, there was an interaction ( F  = 36.256, P < 0.001) in that while doing the task, the four 60-dB flights were perceived as louder and more annoying than without the task, whereas the single 80-dB stimulus was less loud and no more annoying than without the task. Physiological markers were consistent with the intent that the task be difficult and that the single high-sound-level stimulus was more stressful for participants.

Results showed that, at the levels used, the higher-level stimulus influenced ratings of loudness and annoyance, even though the lower-level stimulus occurred four times as often. Future research exploring systematically the relationship between the number and sound level of overflights and the reactions they induce is needed.

Noise exposure is a prevalent environmental factor in learning environments that may interfere with students' cognitive processes and emotional states.

This study examined whether cognitive load mediates the relationship between noise exposure and mathematics anxiety among undergraduate mathematics students in Malaysia.

The study involved 387 undergraduate mathematics majors from four Malaysian universities. Classroom noise levels (equivalent continuous A-weighted sound level [LAeq], maximum sound level during the lecture [LAmax], background noise level exceeded for 90% of the time [LA90]) were measured using a Class 1 precision sound level meter, while mathematics anxiety and cognitive load were assessed using the Brief Math Anxiety Scale and the cognitive load inventory. Pearson correlations and path analysis with bootstrapping (5000 resamples) using the SPSS PROCESS macro were employed to test the hypothesised mediation model.

Noise exposure was positively associated with cognitive load ( β  = 0.115, P < 0.001) and mathematics anxiety ( β  = 0.074, P < 0.001). Cognitive load significantly predicted mathematics anxiety ( β  = 0.407, P < 0.001) and partially mediated the relationship between noise exposure and mathematics anxiety (indirect effect β  = 0.047, 95% confidence interval [0.032, 0.064]). The model explained 42.1% of the variance in cognitive load and 55.5% of the variance in mathematics anxiety.

Classroom noise increases students' perceived cognitive load, which in turn amplifies mathematics anxiety. Optimising classroom acoustics and instructional design to minimise extraneous cognitive load may improve students' emotional well-being and cognitive performance in mathematics learning.

Cardiovascular disease is now a leading cause of premature mortality across Africa and is accelerating faster than the capacity to prevent, detect, and manage chronic illness. Most patients still engage with the health system only when heart failure, stroke, or ischemic disease is advanced, reflecting a legacy architecture designed primarily to confront acute infections. At the same time, multiple African countries have demonstrated that high-impact cardiovascular care can be delivered at scale when services are organized around primary and district facilities, supported by clear protocols, continuous supply of essential medicines, workforce development, and access to remote specialist expertise. Global experience, including major reforms in Brazil and Thailand, shows that population-level gains arise from deliberate health system design. Africa now stands at a turning point. By embedding cardiovascular disease prevention and treatment within national strategies for universal health coverage and by aligning financing and service delivery with the realities of chronic care, the region can prevent millions of avoidable deaths. The opportunity to define a different future for cardiovascular health is within reach and must be acted upon with urgency and coherence.

Diabetes represents a major public health burden in the Middle East and North Africa (MENA) region. However, limited research has explored patients' lived experiences and perspectives on diabetes management, particularly nutrition, within the Arab region. This study examined factors influencing adherence to dietitian-led counseling among adults with diabetes in the United Arab Emirates (UAE), with a focus on social support, outcome expectations, and patient suggestions to enhance motivation for dietary adherence.

A qualitative study using semi-structured individual interviews was conducted with 44 adults with diabetes attending a diabetes management clinic in the UAE. Audio-recorded interviews were transcribed and analyzed using NVivo-12. Inductive thematic analysis guided by Social Cognitive Theory (SCT) was used to identify key concepts related to outcome expectations and social support. Participants' suggestions for improving motivation to seek nutrition advice from dietitians were also explored.

Four main themes emerged from the analysis: (1) positive expectations, (2) negative expectations, (3) enablers and motivators, and (4) participant suggestions. Positive outcome expectations, including improved health, better glycemic control, and weight management, motivated adherence to dietary advice. Social support from family members, friends, and healthcare professionals facilitated adherence and attendance at dietitian consultations. In contrast, misinformation, low awareness of the role of dietitians in diabetes management, and skepticism toward nutrition advice acted as barriers. Participants encouraged others with diabetes to consult dietitians and adopt healthier lifestyle behaviors.

Enhancing culturally appropriate social support and addressing informational barriers may improve dietary adherence, increase engagement in dietitian-led counseling, and improve nutrition-related diabetes outcomes.

To examine qualitative evidence on the barriers and facilitators perceived by Primary Health Care professionals in prescribing physical activity, using the Social Ecological Model as the analytical framework.

A qualitative systematic review using a meta-ethnographic approach was conducted. Searches were performed between 2013 and 2024 in Medline, Scopus, Web of Science, ProQuest, and The Cochrane Library Plus. Two independent reviewers screened studies, applied eligibility criteria, and coded findings according to the Social Ecological Model. Methodological quality was assessed using the Joanna Briggs Institute Qualitative Assessment and Review Instrument.

Barriers and facilitators to physical activity prescription were identified across all five domains of the Social Ecological Model. Key barriers included time constraints, insufficient training, lack of organizational and policy support, and limited referral pathways. Facilitators included professionals' willingness, interdisciplinary collaboration, community partnerships, and the availability of structured guidelines.

Barriers to implementing physical activity prescription remain more prominent than facilitators. Effective implementation requires a comprehensive, system-level strategy involving healthcare organizations as well as local, regional, and national structures to support both the management and prevention of noncommunicable diseases.

PROSPERO under the number CRD42024613298. https://www.crd.york.ac.uk/prospero/.

Background and Objectives: Diabetes is one of the most common chronic non-communicable diseases and represents a major public health problem. At the global level, the epidemic character of diabetes mellitus can be attributed to an extended life expectancy but also to lifestyle. The aim of this study was to examine the sociodemographic, health, and lifestyle characteristics of adults with type 2 diabetes mellitus in Serbia. Materials and Methods: The research is part of the Serbian Population Health Survey conducted in the period from October to December 2019 by the Republic Statistical Office, in cooperation with the Institute of Public Health of Serbia "Dr Milan Jovanović Batut" and the Ministry of Health of the Republic of Serbia. The research instrument was standardized questionnaires constructed in accordance with the European Health Interview Survey (EHIS-European Health Interview Survey, wave 3) questionnaire, which were adapted to the specifics of our area. The research was conducted as a cross-sectional study on a representative sample of the adult population of Serbia. Results: Among 1138 adults with type 2 diabetes in Serbia (52.8% female; mean age 66.0 ± 11.9 years), overweight and obesity were highly prevalent (40.1% and 34.4%, respectively), with Obesity I predominating. Significant gender differences were observed: female more often reported obesity, multimorbidity, and depressive symptoms, whereas men were more physically active and more frequently overweight. Most participants were physically inactive, consumed breakfast and bread daily, and had low engagement in cycling and sports. Alcohol consumption was significantly higher in men, while dietary habits differed by gender for bread intake. These findings highlight substantial gender- and lifestyle-related disparities among adults with type 2 diabetes in Serbia. Conclusions: Targeted interventions promoting healthy lifestyle, physical activity, psychosocial support, and chronic disease management are urgently needed to address gender- and lifestyle-related disparities in adults with type 2 diabetes in Serbia.

Background/Objectives: To identify major dietary patterns among adults aged ≥45 years and examine their associations with metabolic health-obesity phenotypes. Materials and Methods: We analyzed 32,091 adults aged ≥45 years from the 2015 China Adults National Chronic Disease and Nutrition Surveillance. Diet was assessed using three consecutive 24 h dietary recalls, with household condiment weighing used to improve estimation of cooking oil and salt intake. Dietary patterns were derived using principal component analysis and categorized into quartiles. Multinomial logistic regression adjusted for energy intake and key sociodemographic/lifestyle factors to estimate odds of metabolically unhealthy non-obesity (MUNO), metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO) versus metabolically healthy non-obesity (MHNO). Results: Four patterns with geographic variation were identified: (1) the Rice-Vegetable-Pork pattern; (2) the Fruit-Egg-Dairy pattern; (3) the Red Meat-Offal-Snack pattern; and (4) the Soybeans-Tubers-Grains pattern. Compared with Q1, Q4 of Pattern 1 was associated with lower odds of MHO (OR = 0.42, 95% CI: 0.38-0.46) and MUO (OR = 0.40, 95% CI: 0.36-0.44). Pattern 2 and Pattern 3 were associated with higher odds of MHO (Q4 vs. Q1: OR = 1.42 and 1.21) and MUO (OR = 1.36 and 1.14, all p < 0.001). Pattern 4 was inversely associated with MHO (OR = 0.85, 95% CI: 0.79-0.92) but positively associated with MUNO (OR = 1.16, 95% CI: 1.08-1.24). Conclusions: The Rice-Vegetable-Pork pattern was associated with more favorable obesity-related metabolic phenotypes, whereas energy-dense, animal-derived patterns were associated with higher odds of obesity phenotypes; the Soybeans-Tubers-Grains pattern showed mixed associations.