Mental health is a fundamental component of overall well-being and a critical determinant of academic success and professional functioning. However, stress is an often-overlooked burden for nursing students, adversely impacting their learning, clinical performance and overall quality of life.

 To determine the levels of stress among nursing students and to examine the associations among demographic characteristics. The study was conducted at a selected Nursing Education Institution in Limpopo province, South Africa.

 A descriptive, cross-sectional quantitative design was employed to determine stress levels among 262 nursing students. Data were collected through an anonymous, self-administered online questionnaire using the Student Stress Inventory, which demonstrated strong internal consistency (Cronbach's α = 0.910). Data were analysed using descriptive statistics in the Statistical Package for the Social Sciences, Version 30.

 Respondents had a mean age of 20.20 years (s.d. = 1.48) and reported moderate stress levels. Female nursing students were significantly more likely to report higher stress than males (p  0.001). Stress levels also differed significantly across study levels (p = 0.005), with second-year students reporting the highest stress.

 Nursing students face significant stress, which may impact their learning and professional development. This highlights the importance of implementing supportive strategies to foster resilience and coping skills.Contribution: The study provides evidence to guide targeted interventions promoting students' mental well-being and academic success.

 Best practice guidelines suggest that patients should be well acquainted with their healthcare provider, and that doctors should introduce themselves or be introduced by another member of the patient's healthcare team. This aligns with the National Patients' Rights Charter by the National Department of Health, which states that every patient has the right to be treated by a named healthcare provider. Nevertheless, many patients have trouble recalling the name of their doctor. This study aimed to determine whether patients admitted to the adult ward of the National District Hospital in the Free State province, South Africa, could recall their doctor's name.

 Structured interviews were conducted with consenting patients to evaluate whether they knew their doctors' names.

 Only 10% of patients recalled their doctor's name. Less than half reported that doctors introduced themselves, 41% noticed a name badge, 63% saw their doctor more than once daily and 86% understood the reason for admission. The education levels of the patients showed no discernible influence on the results.

 A minority of patients could recall their doctors' names, indicating a potential gap in communication and connection. Many patients expressed uncertainty regarding their doctor's name. This study underscores the importance of improving the visibility, accessibility and consistency of doctor identification methods in healthcare settings to strengthen the doctor-patient relationship and optimise patient care experiences.Contribution: This study underscores the necessity for institutions to prioritise and implement strategies to enhance patient-doctor recognition, thereby improving therapeutic relationships and potentially improving patient outcomes.

The duration of untreated psychosis (DUP) is still considerably long in patients with psychotic disorders worldwide. Social determinants, such as the socioeconomic status, can influence DUP, exacerbating health inequalities in access to timely care. We investigated whether subpopulations with shared characteristics are associated with longer DUP.

We performed latent class analyses to investigate whether classes with shared configurations of social and substance use-related risks can be identified in two large cohorts with psychotic disorders: N = 780 patients from the GROUP project and N = 847 patients from the EU-GEI project. Subsequently, we conducted survival analyses to analyze whether identified classes are associated with DUP.

We identified three classes in both samples. Membership of the class with predominantly younger men, higher proportion of cannabis use, and supported living was associated with longer DUP compared with a class with predominantly White ethnicity, higher education, and current employment in GROUP (HR = 1.28, 95% CI: 1.06-1.56, p = .011) and in EU-GEI (HR = 1.27, 95% CI: 1.07-1.51, p = .007). In GROUP, membership of a third class with predominantly White women, without cannabis use, was associated with the shortest DUP (HR = 0.78, 95% CI: 0.63-0.95, p = .016).

Results suggest that specific populations differ in their risk distributions for prolonged DUP and highlight the importance of considering configurations of social determinants in context. Public mental health programs need to establish their differential impact for diverse populations and facilitate more targeted pathways to care.

'Ego dissolution' refers to a temporary state characterized by diminished self-referential processing, which leads to a breakdown of personal boundaries and an enhanced sense of unity with the environment. Both psychedelics, such as ayahuasca, and contemplative practices, like meditation, have been proposed as mechanisms for modulating the ego. While ayahuasca induces transient self-perception alterations, meditation promotes more sustained changes through cognitive and emotional regulation. This study examines whether ayahuasca consumption modulates the ego and compares its effects with those of meditation.

A total of 37 ayahuasca users and 137 meditators participated. We used the "Delusion of Me" (DoM) index, a unidimensional self-report measure comprising three domains: acceptance, decentering, and non-attachment. It could be considered closely related to the concept of self 'as a content' and may potentially serve as a measure of ego.

Meditators exhibited significantly higher DoM scores than ayahuasca users. The quadratic regression did not show a cumulative effect, with no significant relationship found between the number of ayahuasca sessions and DoM scores.

Meditation practice correlated with higher DoM scores and cumulative practice showed a significant non-linear association with DoM. Conversely, repeated ayahuasca exposure demonstrated no evidence of a cumulative association in this sample.

This study presents the development of a supplementary questionnaire assessing lifestyle behaviors, psychological well-being, and contextual factors, designed to complement the World Mental Health International College Student (WMH-ICS) survey, within the Italian Health Mode On project.

A preliminary questionnaire, based on a literature review and composed of brief standardized measures across 15 sections, was drafted. Its validation was conducted through a two-round electronic Delphi process involving 17 experts from Italian universities and research institutes. In the first round, the experts rated the relevance of each section and domain and suggested item revisions or additions. Feedback was synthesized and presented in the second round, during which the experts re-rated their agreement with all proposed modifications.

All sections proposed in the preliminary version were retained. Experts provided 115 item-modification proposals and 10 suggestions for new sections or domains; 35 modifications (30.4%) and 3 additions (30%) were accepted. The final instrument comprises 18 sections and 64 items covering anthropometry, socio-economic status, housing, commuting, physical activity, diet, sleep, nicotine product use, social media, gaming, gambling, loneliness, hopelessness, life satisfaction, academic stress, student services, discrimination, and general well-being.

A rapid e-Delphi process produced a concise, expert-validated supplement expanding the WMH-ICS survey's capacity to inform health promotion and prevention interventions.

Participation in daily activities is essential for health and well-being. It helps in physical, mental, and emotional health and plays a significant role in the positive development of children and young people. As it is a crucial goal for health and rehabilitation services, the purpose of this study was to translate and assess the psychometric properties of the Persian version of the Participation and Environment Measure-Children and Youth (PEM-CY) in 5- to 17-year-old children with cerebral palsy.

The study involved 150 parents of children with CP (n = 100) and typically developing peers (n = 50), aged 5-17 years. To evaluate face and content validity, we consulted occupational therapists and parents of children with CP. Moreover, the Mann-Whitney test used to assess divergent validity. Internal consistency was assessed using Cronbach's alpha (α), whereas test-retest reliability was evaluated using intraclass correlation coefficients (ICCs).

The internal consistency (0.77-0.95) and test-retest reliability (0.85-0.95) of various summary scores ranged from moderate to very strong. The divergent validity of the Persian version of PEM-CY was supported by significant differences between children with and without disabilities on the participation and environment scales (p < 0.05).

The Persian version of the PEM-CY is a valid and reliable tool to determine the participation and environmental factors in the home, at school, and in community settings in Persian children and youth aged 5-17 years, with CP.

Sexual assault can lead to long-term health problems, yet many victims do not seek help from sexual assault centers. This cross-sectional observational study examined factors distinguishing help-seekers from non-help-seekers and identified factors related to concerns about help-seeking in non-help-seekers. A sample of 669 recent sexual assault victims (97.5% women; mean age 26) was recruited from sexual assault centers and social media; 251 had attended a sexual assault center and 418 had not. Multiple logistic regression was used to identify factors differentiating help-seekers and non-help-seekers. Logistic regressions identified factors associated with help-seeking, and ordinal logistic regressions examined factors related to 3 types of concerns among non-help-seekers: concerns about the incident, about the health service, and about potential negative consequences. Victims of assaults consistent with the rape stereotype (completed penetration, unknown perpetrator) were more likely to seek help. Among non-help-seekers, concerns about seeking help at a SAC were prevalent (34%-65%), while few felt they had no need (11.5%). Physical violence (OR = 0.33, 95% CI = 0.20-0.52) and higher age (OR = 0.97, 95% CI = 0.95-1.00) were linked to fewer incident-related concerns; penetration (OR = 1.73, 95% CI = 1.10-2.72) and highaer age (OR = 0.97, 95% CI = 0.94-0.99) to fewer service-related concerns; and physical violence (OR = 1.85, 95% CI = 1.18-2.90), penetration (OR = 1.95, 95% CI = 1.26-3.02), and social support (OR = 1.82, 95% CI = 0.68-0.99) to fewer concerns about negative consequences. Public information efforts highlighting the benefits of post-assault healthcare, especially for younger victims and those experiencing less stereotypical assaults, may encourage help-seeking. Support from family and friends may play an important role in victims' decisions about seeking help.

International studies exploring the enduring effects of early non-familial childhood care on mental health outcomes show varying impacts depending on the quality of care, age of entry, and socio-economic factors.

This German longitudinal study, involving 225 families, investigated the impact of early non-familial child care on the development of mental health problems, risk behaviors, and academic as well as vocational achievements in young adulthood (M_age = 22.6 years, SD_age = 1.1 years).

In comparison to parental care, early non-familial childcare was associated with significantly elevated levels of risky behaviors (such as risky sexual behavior, alcohol abuse, and tobacco consumption), low intimate relationship quality, and a higher likelihood of achieving advanced vocational qualifications. Migration background was identified as a relevant moderating factor in an exploratory analysis. An early age of entry into non-familial care was weakly associated with more mental health problems in young adulthood.

Parental decisions on early non-familial childcare should carefully consider the child's age of entry, the quality of care, and the family's socio-economic context.

International evidence suggests that Early Intervention for Psychosis (EIP) services are both effective and cost-effective. Such evidence, however, comes almost exclusively from high-income countries.

Our aim was to estimate the cost-effectiveness of EIP services in a Latin American setting.

We compared EIP services against community mental health teams (CMHT) from the Chilean health system perspective. We developed a six-state Markov model to estimate the costs, benefits (measured as quality-adjusted life-years (QALYs)) and incremental cost-effectiveness ratio (ICER) for a 10-year time horizon. The model was populated with data from a Chilean EIP cohort, published literature and expert opinion. We characterised uncertainty through probabilistic sensitivity analysis and calculated the value of information to reduce such uncertainty.

In the base case analysis, EIP was cost-effective compared with CMHT, with an ICER of 5 550 044 Chilean pesos per QALY (USD 13 742 adjusted for purchasing power parity). Uncertainty analysis revealed an 80% probability of EIP services being the most cost-effective option at a willingness-to-pay threshold of one gross domestic product per capita (USD 15 923). Sensitivity analysis showed that the results were sensitive to parameters such as intervention effectiveness and cost, suggesting that a new trial might be worthwhile to reduce uncertainty.

This model suggests that implementing EIP services in Chile may cost more, but it is likely to be cost-effective. Nonetheless, more evidence about affordability, equity and broader perspectives is needed to improve the economic case of implementing EIP services in less-resourced settings, such as in Latin America.

Gender-affirming surgery (GAS) and gender-affirming hormone therapy (GAHT) and are evidence-based components of care that support the health and well-being of transgender and gender-diverse (TGD) individuals, with extensive evidence linking them to reduced suicidality, improved mental health, and quality of life. Whereas most studies examine isolated outcomes-often within urban populations-this review adopts a system-level, cross-domain perspective to examine how access to gender-affirming care is shaped by structural conditions, including the urban concentration of affirming services, limited clinician training, fragmented insurance coverage, and the underrepresentation of rural TGD populations in research. These intersecting barriers undermine timely initiation, continuity, and quality of GAHT and GAS across diverse care settings. A distinctive contribution of this review is its integration of artificial intelligence (AI) as an emerging dimension of gender-affirming care. By synthesizing evidence on AI-enabled decision support, training simulations, and voice therapy, the review positions AI as a promising, equity-enhancing pathway to expand access, strengthen provider competency, reduce administrative burden, and advance global TGD health equity at scale.