Self-rated health is a robust measure of overall health status, encompassing an individual's physical, mental, and social health. This multidimensional characteristic highlights the potential of this variable in studies conducted in regions affected by major disasters. This study assessed the prevalence of poor self-rated health and its association with sociodemographic factors, health behaviors, multimorbidity, and place of residence among adult residents of Brumadinho, Minas Gerais State, Brazil, following the collapse of a mining tailings dam.

It is a cross-sectional study based on baseline data from the Brumadinho Health Project, which was conducted in 2021 and included 2,771 individuals aged 18 years or older. The outcome variable was poor self-rated health, while the exploratory variables included sociodemographic characteristics, health behaviors, multimorbidity, and place of residence (area directly affected by the disaster; region with mining activity; unexposed). The association between exploratory variables and the outcome was evaluated using logistic regression.

The prevalence of poor self-rated health was 6.4% in the municipality's population, being higher in the region directly affected by the tailings mud (12.7%). The likelihood of perceiving health as poor or very poor was higher among women, current smokers, and those with multimorbidity and lower among those who reported consuming alcoholic beverages one or more times per month. Engaging in physical activities at recommended levels reduced the likelihood of poor self-rated health, but only among the unexposed - residents in areas unaffected by mud and without mining activity (p interaction = 0.002).

These results demonstrate that the residential context modifies the effect of physical activity on self-rated health, such that residents in areas affected by tailings mud or with mining activity do not benefit from engaging in physical activity at recommended levels, at least regarding health perception. Greater efforts to improve environmental conditions may be necessary in regions impacted by major disasters or environmental degradation due to mining processes.

First responders experience elevated rates of posttraumatic stress disorder (PTSD) depression, and other stress-related conditions due to frequent exposure to critical incidents. Despite the increasing availability of mental health services, utilization among first responders remains low with stigma consistently cited as a primary barrier to treatment. The Police Officer Stigma Scale (POSS) was developed to measure occupational stigma toward mental illness in law enforcement, but its factor structure remains contested. While Stuart proposed a single-factor solution, other sources found evidence for a two-factor model encompassing fear of disclosure and perceived maltreatment of colleagues. The current study sought to confirm the factor structure of the POSS using a large sample of 1,275 Florida first responders (firefighters, law enforcement officers, and dispatchers). Confirmatory factor analysis (CFA) compared single and two-factor solutions using maximum likelihood estimation with robust standard errors. Notably, the present study evaluates an adapted version of the POSS applied across multiple first responder groups rather than exclusively validating the original police specific instrument. Results supported the optimality of the two-factor model over the single-factor model. The two-factor model yielded lower RMSEA and SRMR values, higher CFI and TLI indices, and significantly improved fit by Satorra-Bentler chi-square difference testing. Findings provide evidence that stigma toward mental health among first responders is best conceptualized as a multidimensional construct involving self-stigma and perceived public stigma. These results inform future psychometric research, stigma reduction interventions, and policy efforts aimed at improving help-seeking behaviors within the first responder community.

The aim of this study was to explore the differential associations of mentally active versus passive sedentary behavior with burnout among nurses.

A cross-sectional study was conducted among 1,132 nurses in Zhejiang, China, daily SBs were self-reported with The Chinese Adult Sedentary Behavior Questionnaire and burnout was measured by Maslach Burnout Inventory-Human Services Survey.

Nurses who accumulated more than 4 h/day of mentally active SBs (working, reading, hobbies, transportation, and chatting) had 47% lower burnout odds than those who reported less than1 h/day (OR = 0.53; 95% CI 0.33-0.86); this inverse association remained after excluding transport-related SB. Mentally passive SB showed no significant association.

Engaging in mentally active sedentary behavior was associated with lower odds of burnout among nurses.

Postpartum depression, anxiety, and reduced health related quality of life (HRQoL) are common in the first year after childbirth, a period characterized by marked hormonal fluctuations, sleep disruption, and psychosocial role transitions that increase vulnerability to emotional distress, and have substantial consequences for maternal and child well-being. Aerobic exercise is increasingly recommended as a low-risk behavioral strategy, as it has been shown to improve mood, reduce stress, and modulate neurobiological pathways associated with depression, yet its effectiveness and optimal prescription parameters for postpartum mental health remain unclear. This study evaluated the effects of aerobic exercise on depressive symptoms, anxiety, and HRQoL, and characterized corresponding dose response patterns.

PubMed, Embase, CENTRAL, Web of Science, and Google Scholar were searched from inception to 31 October 2025. Randomized controlled trials lasting at least four weeks and comparing structured aerobic exercise with inactive or minimal control conditions were included. Outcomes were depressive symptoms, anxiety, and HRQoL assessed using validated instruments. Random effects meta-analyses generated standardized mean differences (SMDs). Dose response relationships were examined using model-based methods.

Seventeen trials involving 2,865 women met inclusion criteria. Aerobic exercise significantly reduced depressive symptoms (SMD - 0.37, 95% CI - 0.60 to -0.14), with larger improvements in women with baseline depression and in interventions delivered postpartum. Dose response analysis showed a U-shaped pattern, with maximal benefit at approximately 570 MET minutes per week. No significant effect was found for anxiety (SMD - 0.11, 95% CI - 0.31 to 0.09). Aerobic exercise improved HRQoL (SMD 0.45, 95% CI 0.29 to 0.60), and an inverted U-shaped dose response indicated optimal gains near 420 MET minutes per week.

Aerobic exercise reduces postpartum depressive symptoms and improves HRQoL. Optimal effects were observed at approximately 570 MET minutes per week for depression and 420 MET minutes per week for HRQoL, suggesting that a weekly volume of 400 to 600 MET minutes may be a practical target in postpartum care. Evidence remains insufficient to confirm anxiolytic effects.

Nurses work under high pressure for a long time and are prone to anxiety, depression and other adverse emotions. Due to the nature of their work as well as time and space constraints, it is often difficult for them to pay attention to their own mental health problems in a timely manner. Digital mental health support can give nurses support to a certain extent and effectively relieve their stress. The aim of this study is to investigate and analyze nurses' demand for digital mental health support, to provide reference for the development of digital psychological interventions, and to provide a decision-making basis for the construction of a precise psychological support system and digital platform.

This study employed the Kano model as an analytical tool to classify nurses' needs for digital mental health support. A cross-sectional survey was conducted with 1,571 nurses using a questionnaire developed through literature review and semi-structured interviews. The questionnaire included 26 items representing potential digital mental health features. For each item, participants answered paired functional and dysfunctional questions. Responses were classified into must-be, one-dimensional, attractive, and indifferent attributes using the standard Kano evaluation table. These demand attributes were then combined with the importance-satisfaction matrix to quantify the sensitivity of demand improvement.

Of the 26 needs, 8 were classified as must-be attributes, 8 as one-dimensional attributes, 7 as attractive attributes and 3 as indifferent attributes. Nurses rated the importance index of the digital mental health support demand items from -0.62 to -0.15, and satisfaction index from 0.34 to 0.62.

The KANO model was applied to identify and categorize the different attributes of nurses' digital psychological support needs, offering targeted recommendations and strategies to address these needs, thereby providing a foundation for digital psychological interventions for nurses. Nursing managers can combine the results of Kano model analysis in the importance-satisfaction matrix to improve and satisfy nurses' demand for psychological support, so as to reduce their psychological pressure, improve job satisfaction, and lay the foundation for cultivating a high-level nursing team and promoting the high-quality development of nurses' career.

Obsessive-compulsive disorder (OCD) is a debilitating mental health problem that is frequently inadequately treated in several areas owing to restricted access to specialised services, societal stigma, and elevated treatment expenses Internet-based cognitive-behavioural therapy (ICBT) offers an effective and accessible alternative. To date, no Persian-language ICBT for OCD has been rigorously established or evaluated.

This study aimed to develop and evaluate the feasibility of a culturally adapted Persian ICBT for OCD in Iran, examining its acceptability, applicability, and preliminary clinical outcomes from the perspectives of both clinicians and clients.

The ICBT protocol was designed and constructed based on Salkovskis's model and culturally tailored for Iran. Feasibility was evaluated by 19 CBT therapists and 15 clients using a structured feasibility scale. Clients also completed pre- and post-treatment assessments of OCD severity (Y-BOCS), satisfaction (CSQ), credibility/expectancy (CEQ), and adherence (TAAS).

All feasibility subscales were rated significantly above threshold (p < .001), with "Applicability/Demand" receiving the highest endorsement. Secondary exploratory outcomes demonstrated significant symptom reduction (M baseline = 27.80; M post = 18.06; Z = -3.42, p < .001), with 53% showing clinical response and 13% remission in the client group. Also, high satisfaction, credibility, and adherence were reported. Exploratory regressions did not identify significant predictors of outcome.

These findings suggested the preliminary feasibility and strong demand for ICBT for OCD in Iran. The positive evaluations from both professionals and clients, coupled with significant symptom reduction and high user satisfaction, position this program as a promising, accessible treatment alternative for OCD patients.

Irritable bowel syndrome (IBS) is a prevalent gastrointestinal disorder associated with reduced quality of life and psychological distress. Although several effective self-management interventions exist, patient access is often limited. Internet-delivered interventions may enhance accessibility and scalability. We aimed to evaluate the effectiveness of a CBT-based module, a FODMAP diet module, or their combination, when added to internet-delivered general patient education, compared to general patient education alone, on IBS symptom severity in adults.

In this four-arm randomized controlled trial, 642 adults with IBS were allocated to (1) internet-delivered general patient education alone (control) or with the addition of (2) a CBT-based module, (3) a FODMAP diet module, or (4) both the CBT-based module and the FODMAP diet module. All groups could receive personalized guidance from a clinical dietitian via the platform's asynchronous messaging function. The primary outcome was the proportion of IBS symptom responders at 3 months, defined as a ≥ 50-point reduction on the IBS severity scoring system. Secondary outcomes included IBS-related quality of life, psychological symptoms, module adherence, and treatment satisfaction.

Of 557 participants who received their allocated intervention, 373 (67%) completed questionnaires at the primary endpoint at 3 months. Responder rates were comparable across all groups at 3 months ranging from 42.6% to 45.1%, with no significant between-group differences in the primary outcome (OR (95% CI) = 0.97 (0.54 to 1.72), p = 0.989). Adherence to the content-specific modules was low, with 9-20% of participants completing the CBT-based and/or FODMAP diet module. All groups showed within-group improvements in IBS symptoms and IBS-related quality of life in secondary continuous analyses, but these did not translate into between-group effects.

All intervention groups, including internet-delivered general patient education alone and general patient education with an additional CBT-based and/or FODMAP diet module, demonstrated clinically and statistically meaningful improvements in IBS symptoms and IBS-related quality of life. Although no additional benefit of the content-specific modules was observed, this finding should be interpreted in the context of the low adherence to these modules. These findings highlight the value of low-intensity internet-delivered interventions for IBS within resource-constrained health systems and emphasize the importance of addressing adherence and engagement in future research.

ClinicalTrials.gov ID: NCT06117865. Registered 31.10.2023.

Over the past decades substantial progress has been made in addressing health disparities of people with intellectual disability. The "era of awareness" (pre-2005) identified a "cascade of disparities" of more adverse health conditions, less attention to health needs, poorer health care access, and fewer opportunities for health improvement. This occurred alongside emerging governmental recognition of the poor health of people with intellectual disability. The "era of assessment" (2005-2015) saw advances in improved health data, population health surveillance, attention to environmental contributors, and passage of the Convention on the Rights of Persons with Disabilities. Research extended from clinical samples to population-based studies with greater focus on social determinants of health. The "era of context" (2015-2025) was characterized by the COVID-19 pandemic, technology, and greater inclusion of people with intellectual disabilities in their communities. Data advances included a disability data framework, clearer disability definitions and identification, and greatly expanded data-linkage research to inform programs and policies. Disability health competencies were developed in multiple countries for multiple disciplines. For the coming decade, we anticipate greater use of technology, especially Artificial Intelligence, expansion of the "inclusion movement," and attention to ableism. Data linkage and analysis in multiple countries will map longitudinal health trajectories. We anticipate a much-needed resurgence in attention to mental health. Global climate change will demand inclusive emergency preparedness. Future advances require that research, health care, service programs, and communications be co-designed with people with intellectual disability and their supporters. Focus and funding are critical through investment proportionate to need.

Globally, reports of suicide by sodium nitrite poisoning have been growing. To determine whether sodium nitrite poisoning in suicide is an issue in the UK, we conducted an analysis of the cohort of cases analysed by the sole provider of nitrite assessment for postmortem sample in the UK.

Retrospective cohort analysis of biochemical measures for nitrite and nitrate anion in postmortem samples of 201 cases provided by HM coroners of suspected suicide over a period from March 2019 to August 2024. Secondary measures included sample collection and analysis dates, age and sex of deceased, sample number per case, sample types, and coroner regional location.

Of the 201 cases assessed by the laboratory during the inclusive time period, permission to include data was received from HM coroners for 164 of the cases. Suspected suicide by sodium (or potassium) nitrite/nitrate was confirmed in 87% of cases, with measured nitrite and/or nitrate concentrations ~100× normal physiological levels. Sex was known for 98% of cases and 68% were men. The age range was 14-82 years, and most (71%) cases were from Generation Z and Millennial generation. Cases came from across the UK, with the greatest proportion from Greater London, South East England, the Republic of Ireland, and the Midlands.

The data indicate that suicide associated with the ingestion of nitrite or nitrate salts is substantial in the UK, with a disproportionately high prevalence in young men. There is an urgent public health need for policy makers to consider strategies aimed at preventing and mitigating the harms associated with free access to these salts. This could include restrictions to purchase to facilitate prevention and adoption of easy to implement treatment protocols for both prehospital and emergency healthcare staff in suspected suicide by sodium nitrite/nitrate.

This study investigated emotion regulation (ER) difficulties and repetitive negative thinking (RNT) in individuals with depression, anxiety disorders, or both, compared to nonclinical controls. We aimed to determine which aspects of ER difficulties and RNT are transdiagnostic or specific to one of the disorders, and whether the presence of comorbidities is associated with greater ER difficulties and higher levels of RNT. A total of N = 731 participants, including n = 354 individuals with depression, anxiety disorders, or both (mixed group), and n = 377 nonclinical controls, completed the Difficulties in Emotion Regulation Scale (DERS) and the Perseverative Thinking Questionnaire (PTQ). Parametric and nonparametric analyses were conducted to assess group differences and comorbidity effects. The depression and anxiety disorders groups exhibited significantly greater ER difficulties and higher levels of RNT than nonclinical controls. The mixed group showed more pronounced difficulties in certain aspects of ER (nonacceptance of emotional responses, difficulties engaging in goal-directed behavior, impulse control difficulties, and limited access to ER strategies) and higher levels of RNT compared to the single-diagnosis groups. No significant differences were found in emotional awareness and clarity across clinical groups. Evidence regarding the relationship between the number of comorbid diagnoses and the severity of the difficulties was less clear. This suggests that specific disorders may have a more significant impact than comorbidity alone. Our findings highlight the transdiagnostic role of ER difficulties and RNT in depression and anxiety disorders and suggest that they may be a promising target for transdiagnostic interventions. Future research should further explore the nuanced ways in which ER difficulties and RNT vary across different mental disorders.