Aluminum (Al) is a widely encountered heavy metal with known neurotoxic effects. Occupational exposure, particularly in industrial settings, may impair cognitive functions. This study aimed to evaluate the relationship between Al exposure and cognitive function.

A retrospective study was conducted at Gazi University Faculty of Medicine Hospital, Occupational Diseases Outpatient Clinic, between December 5, 2024, and January 5, 2025. The exposed group consisted of 20 male cement factory workers with elevated urinary Al expressed as a function of creatinine, and the control group included 40 age-matched males without occupational Al exposure (1:2 matching). Cognitive status was assessed using the Mini Mental State Examination (MMSE). Urinary Al levels were measured by inductively coupled plasma mass spectrometry (ICP-MS). Statistical analyses were performed with SPSS 29.0.

The mean MMSE score was significantly lower in the exposed group compared with controls (24.3±3.7 vs. 28.5±2.3, p<0.001). Subscale scores for orientation, attention/calculation, recall, and language were also lower in exposed workers. All such workers had elevated aluminum (mean 42.3±21.4 mcg/g creatinine). Urinary Al was positively correlated with working duration (r=0.453, p=0.045) and negatively correlated with MMSE (r=-0.486, p=0.030) and orientation scores (r=-0.494, p=0.027).

Workers occupationally exposed to aluminum exhibited significantly lower cognitive performance than non-exposed controls. Higher urinary Al levels were associated with poorer cognitive outcomes, suggesting neurotoxic effects of aluminum and underscoring the importance of preventive strategies and cognitive monitoring in exposed populations.

The objective of this review was to identify and synthesize qualitative evidence on the lived experiences of facilitators and barriers to accessing mental health care services and social supports among perinatal refugee women.

Perinatal refugee women experience multiple intersecting personal, social, and environmental factors that can influence their mental health and emotional well-being. Understanding the facilitators and barriers to accessing mental health care services will provide a clearer understanding of their experiences to inform health care practices, programs, and policies.

This review appraised published qualitative research that explored perinatal refugee women's experiences of accessing mental health care services and social supports. Non-English articles and studies that did not explicitly state participants' migration status as refugees were excluded.

Searches for published studies located in CINAHL plus, PsycINFO, PubMed, Web of Science, and the Social Sciences Citation Index occurred in May 2022 and were updated in June 2024. ProQuest Dissertations and Theses Database was searched for unpublished literature such as theses, dissertations, and publicly available information consisting of peer-reviewed qualitative studies. Sources of evidence published in English between January 2011 and June 2024 were assessed for inclusion. Study selection involved 2 independent reviewers screening titles and abstracts against the eligibility criteria. The reviewers critically appraised the methodological quality and rigor and extracted study findings. Data synthesis involved assigning categories to findings, which were aggregated into synthesized findings and graded using the ConQual approach.

Forty-one articles were included in the review yielding 159 findings that were grouped into 6 categories. The categories were aggregated to form 2 synthesized findings: i) Women are impacted by unique and interconnected social determinants of migrant health in accessing mental health services and social supports, and ii) Women experienced characteristics of mental health services as both facilitators and barriers to access. Confidence levels for each synthesized finding were rated as low according to ConQual.

Experiences of diverse forms of stigma as well as literacy, migration status, and racial discrimination were expressed as significant barriers to accessing mental health services among perinatal refugee women. Additional barriers described by women included not being given opportunities to express their mental and emotional well-being, fear of sociocultural consequences from pursuing mental health services, and fear of deportation. Cultural navigators, faith-based organizations, and neighbors with similar cultural backgrounds were raised as facilitators to linking with social supports and connecting safely with mental health services. Digital tools were also described as improving inequities in access to mental health service information and social supports. Care provision that provided guidance on services needed to address trauma and violence experienced during migration journeys were recommended. Further recommendations from this review include culturally and gender-responsive care. Recommendations for practice and policy include adopting cultural navigator services to disrupt stigma and providing culturally appropriate supports to perinatal refugee women. Low ConQual scores for both systematic findings indicates the need for more rigorous qualitative research within perinatal mental health and forced migration.

PROSPERO CRD42021245240.

Medical education is associated with high levels of stress that can intensify health-related anxiety, referred to as illness anxiety disorder, medical student syndrome, or nosophobia. This phenomenon often occurs when medical students, after studying a particular illness, start to feel they are having its symptoms and believe they may have the disease. We aimed to determine the prevalence of illness anxiety disorder and its relationship with generalized anxiety among medical students in Karachi.

This cross-sectional study was carried out from February 2025 to May 2025 among MBBS students in Karachi. A pre-validated structured questionnaire, comprising demographic details, the Short Health Anxiety Inventory (SHAI) scale, the Medical Students' Disease (MSD) Perception Scale, and the MSD Distress Scale, was distributed among 300 students from first to fifth year.

Out of 300 students, significant health-related anxiety (SHAI ≥ 18) was present in 16% (n = 48), and moderate to severe generalized anxiety (GAD-7 score ≥ 10) was present in 28% (n = 83) of the students. The highest mean SHAI score was shown by fifth-year students (12.31 ± 1.12), while the highest mean GAD-7 scores were shown by second-year students (7.25 ± 0.69). Gender and academic year did not have a statistically significant association with SHAI and GAD-7 scores (p > 0.05). Moreover, the Pearson correlation test revealed a low positive but statistically significant correlation between SHAI and GAD-7 scores (r = 0.462, p < 0.001). Linear regression analysis also revealed that the GAD-7 score was a significant predictor of the SHAI score, accounting for 21.4% of the variance in the SHAI score (β = 0.462, 95% CI: 0.425-0.663, p < 0.001*).

Health-related anxiety and generalized anxiety are prevalent and correlated among the medical students of Karachi. The results of this study emphasize that we must target our mental health interventions to alleviate anxiety-related distress in this population.

Depression is a common mental disorder, associated with a global increase in disabilities and suicidality. Different factors are responsible for depression in which thyroid dysfunction and dyslipidemia are the biological causes. This study aimed to find the association and alteration of thyroid function tests and lipid profiles among patients with depressive disorders.

A case-control study was performed on patients being managed for depressive disorder visiting the Psychiatry Department of Tribhuvan University Teaching Hospital, Kathmandu, Nepal. The blood samples were collected from 40 newly diagnosed cases of depressive disorder not under any drugs and 80 from healthy individuals. Thyroid hormones and lipid profile parameters were analyzed in Johnson and Johnson, ECI Vitros 3600, US, Ortho Clinical Diagnostics, and BT-1500. Data were collected and statistical analysis was done using SPSS version 22.

Among the 40 patients with depressive disorders, 27.5% had thyroid dysfunction with sub-clinical hypothyroidism, overt hypothyroidism, and hyperthyroidism among 12.5%, 12.5%, and 2.5% respectively. Similarly, dyslipidemia was observed in 37.5% of participants. About 52.5% of patients managed for depressive patients were found to have anxiety as well. Despite an alteration of thyroid hormones, there was no significant correlation between thyroid hormones and lipid parameters in patients being managed for depressive disorder.

This study concludes that thyroid dysfunction and dyslipidemia are seen among depressive patients with unclear reasons. For proper diagnosis and treatment of depression, it is better to carry out thyroid function tests and lipid profiles.

Individuals experiencing homelessness in Canada face high morbidity and mortality due to intersecting toxic drug and housing crises. These risks are profoundly gendered; women experiencing homelessness have a median age of death of just 36 years, significantly lower than women in the general population (85 years), and face heightened overdose risk. Despite these inequities, gender-disaggregated analyses across homelessness, shelter systems, and mortality remain limited. This study integrates multiple publicly available datasets to examine how gender and age shape patterns of homelessness, service access, and overdose mortality in Toronto, Ontario.

We drew on publicly available datasets to examine gendered patterns of homelessness, shelter service use and operations, and mortality in Toronto. Data extracted included: demographics, shelter visits, shelter capacity, service availability, and mortality by cause and location. When possible, data were aggregated by quarter and disaggregated by age and gender. Chi-square tests were performed when possible to assess differences by gender.

Men comprised most people experiencing homelessness (57%), shelter users (58%), and individuals living outdoors (68%). However, women and gender-diverse individuals accounted for a larger share of outdoor deaths occurring at younger ages (< 40 years) compared with men. Although men accounted for most deaths in shelters (78%), there was no significant gender difference in the age of in-shelter mortality (p = 0.19). Shelter capacity was structurally gender-imbalanced: there were more men-only beds (37%) than women-only beds (18%). Harm reduction availability was limited across all shelter types and was lowest in women-only shelters (26%). Overdose was leading among women (76% of all deaths) and gender-diverse individuals (80%), compared to 46% of deaths among men. In addition, overdose deaths among women and gender-diverse individuals were significantly more concentrated in younger age groups (< 40 years), compared to men (p = 0.024).

While men represent the largest share of the homeless population, women and gender-diverse individuals account for a disproportionate share of overdose and premature deaths, often at younger ages. Limited women-only shelter capacity, scarcity of gender-responsive harm reduction services, and safety concerns in mixed-gender shelters may contribute to women and gender-diverse individuals relying on hidden homelessness or unsheltered settings, where harms are more likely to occur. Addressing these inequities requires expanding women-only and gender-affirming shelter spaces, strengthening trauma-informed and gender-responsive harm reduction, and ensuring staff are trained to provide safe, non-stigmatizing care.

Transitioning from a dyadic to a triadic family structure after childbirth requires substantial adaptation to maintain relationship harmony. We develop and validate the Harmony Scale for Postpartum Couples (HSPC) to assess harmony among first-time parents. The scale development proceeded in three phases. In Study 1, a conceptual framework was established, and experts evaluated content and face validity. In Study 2, item analysis and exploratory factor analysis (EFA) were conducted to refine items and construct a preliminary scale. In Study 3, psychometric properties were examined using data from 376 participants (188 couples) with infants aged 3-6 months. EFA identified 15 items across four factors:[Intimacy with partner], [Physical・Social Health], [Mental Health], and [Self-Efficacy in Parenting]. The overall Cronbach's α for the scale was .825, indicating good internal consistency. Construct validity was supported by confirmatory factor analysis indices (GFI = .908, AGFI = .869, CFI = .880, RMSEA = .083). The final 15-items, four-factors HSPC demonstrated reliable and valid performance for evaluating couple harmony during the early postpartum period. This concise instrument provides comprehensive assessment of couple harmony, supports early identification of relational difficulties, and can inform targeted interventions to promote healthy family functioning, parental well-being, and infant health. J. Med. Invest. 73 : 176-185, February, 2026.

Major depressive disorder (MDD), a leading cause of disability and mortality globally, carries the highest burden among mental health disorders in industrialized nations. This review article emphasizes accurate diagnosis and effective pharmacologic treatment and management of MDD in adults. A timely, individualized approach to care that addresses the complexity of MDD and improves patient recovery trajectories is recommended.

The aims of the study were to reflect on the methodological and conceptual evolution of the Swiss Spinal Cord Injury Cohort Study, summarize its key scientific contributions, and illustrate how such a cohort can shape future directions in spinal cord injury research, care, and policy.

We conducted a bibliometric analysis to examine the Swiss Spinal Cord Injury Cohort Study's publication trends, leading authors, thematic areas, influential papers, and landmark findings related to morbidity, mortality, and functioning among individuals with spinal cord injury in Switzerland.

The Swiss Spinal Cord Injury Cohort Study comprises two components: the community survey, collecting self-reported data on functioning, morbidity, and mortality in chronic spinal cord injury, and the inception cohort, which enables long-term clinical and biological monitoring of newly injured individuals. Since its inception, the Swiss Spinal Cord Injury Cohort Study has generated 174 publications, primarily from the community survey, with increasing contributions from the inception cohort. Notably, 34% of publications stem from the Swiss Spinal Cord Injury Cohort Study nested projects, highlighting the study's capacity to support additional targeted research. Key themes included secondary health conditions, mental health, healthcare use, and social participation, with growing interest in lifestyle and behavioral factors.

The Swiss Spinal Cord Injury Cohort Study has become a key resource for advancing spinal cord injury research. Its robust, interprofessionnal design provides a foundation for translating research into improved care, policy, and quality of life for individuals with SCI.

Sleep is important for memory consolidation. By strengthening the original memory trace, sleep may improve monitoring processes, and thus the distinction between veridical and false memories. Simultaneously, sleep may facilitate gist abstraction and thus enhance false memory generation. Here, this question is studied using the Deese-Roediger-McDermott paradigm, where participants learn lists of semantically related words, constructed to lead to false retrieval of lure words (semantically linked to the lists but never presented). Previous literature has found sleep to increase or decrease false memories, or no significant effect, which might be due to methodological variance but can also be explained by low statistical power. In this large online study (sleep = 104, wake = 101, AM control = 99, PM control = 94), a preregistered replication of Diekelmann et al. (2010), we find no effect of sleep on false memories nor on general memory performance. We also do not replicate the finding that sleep increases false memories when overall memory performance is low. Instead, we find that false memories increase after sleep when intrusion-adjusted memory performance is high. We interpret this as generalization process during sleep (gist), which helps to form veridical memory but also generates false memories. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Models of mental health emphasize the fundamental role of emotion regulation (ER). Still, it is unknown whether ER impairment varies in severity and type between different disorders. To systematically investigate this question, we searched multiple databases via EBSCOhost for studies comparing adults with mental disorders to nonclinical controls on self-reported ER. We calculated standardized mean differences (SMD) and conducted multilevel meta-analyses to account for nested data. We included 619 studies (1998-2025) that assessed selected ER questionnaires in 41,590 clinical participants and 36,787 controls. Compared with controls, clinical participants overall reported pronounced difficulties in ER (large SMD = 1.70) and different ER strategy use (moderate to large SMDs: less frequent acceptance = -0.85, problem-solving = -0.63, and reappraisal = -0.63; more frequent avoidance = 1.00, rumination = 1.51, and suppression = 0.73). Difficulties in ER, decreased use of reappraisal, and increased use of rumination and suppression were evident in almost all mental disorders, emphasizing the transdiagnostic relevance of these facets. In addition, there were specific profiles for disorders with particularly pronounced effect sizes (e.g., difficulties in ER and acceptance in personality disorders; rumination and reappraisal in depressive disorders). An additional review of 25 ecologically momentary assessment studies of ER in daily life aligned with the main findings. Future research is needed to examine further disorders and the temporal relationship between psychopathology and ER. Nonetheless, there is substantial evidence to assume both universality of ER impairments across disorders and disorder-specific pronunciations. This speaks for using transdiagnostic interventions aimed at improving ER but also points to the need of additional, more targeted interventions for some disorders. (PsycInfo Database Record (c) 2026 APA, all rights reserved).