The ecological validity of the Norwegian version of The Awareness of Social Inference Test (N-TASIT), a test of social cognition, was explored in individuals with (n = 101) and without (n = 50) traumatic brain injury (TBI). Linear regression analyses revealed that for participants with moderate to severe TBI, N-TASIT performance was associated with proxy-reported (R² = 0.05, F(1, 60) = 4.21, p = 0.045), but not self-reported, social skills assessed with the Social Skills after TBI Questionnaire. Adding demographic and cognitive variables to the regressions did not increase explanatory power. When the TBI and non-TBI sample were collapsed, this result was present in both Virtual reality (VR) and the 2D version. For the VR version, N-TASIT performance was the only significant variable, while for 2D, only processing speed was predictive. There were no differences in experienced presence in the VR version between individuals with TBI and non-injured individuals, but the TBI group had a lower predisposition to engage in media experiences. Finally, adding individual differences in immersive tendency to the regression model increased the explained variance in self-reported social skills, but only in VR. The results indicate modest ecological validity and support the use of the VR version of N-TASIT in assessment of social cognitive impairment after TBI.

This study characterizes a rare phenotype of Amyotrophic Lateral Sclerosis (ALS) presenting with predominant proximal lower limb weakness at onset, a presentation often mimicking myopathy. We retrospectively reviewed 1980 patients, identifying 15 (0.75%) with this atypical onset. The majority were males (73%) with a median age of onset of 58.7 years. Approximately half presented with symmetric proximal lower limb weakness. Nine of the 11 tested patients had higher CK. Follow-up (median 53.7 months) revealed that 6 patients maintained isolated lower limb weakness for a median of 60.1 months, while others progressed to upper limbs or bulbar regions. NSG sequencing (in nine patients) identified mutations in three patients (SOD1, VAPB, and C9ORF72). This pattern poses a diagnostic challenge. While limitations include a small sample size and retrospective design, the findings highlight a heterogenous but often slow-spreading and benign course for this specific ALS subtype, offering valuable clinical information for differential diagnosis.

People living in low-income settings facing humanitarian crises are at risk for comorbid cardiovascular disease (CVD) and mental health (MH) illness, yet there are limited population-based data available.

We estimated CVD-MH illness comorbidity and associated risk factors using enrollment data from the Haiti Cardiovascular Disease Cohort Study (2019-2021). Adults aged >18 years were recruited using multistage random sampling across Port-au-Prince. Prevalent CVD (hypertension, heart failure, stroke, or myocardial infarction) was adjudicated by a physician panel integrating clinical examinations, imaging, and laboratory data. Prevalent MH illness was defined as depression symptoms (Patient Health Questionnaire 9 score >5) or stress (Perceived Stress Score >5). We conducted multivariable Poisson regression to analyze the association between risk factors (age, sex, low income, education, smoking, alcohol consumption) and the outcome of prevalent CVD-MH illness.

Among 2993 adults in this analysis, the median age was 40 years, 42% were women, and 70% earned an income <1 USD per day. CVD-MH illness comorbidity prevalence was 30% (95% CI, 28-32), with CVD prevalence 34% and MH 85%. In multivariable regression, older age (≥60 versus <40 years; adjusted prevalence ratio, 5.79 [95% CI, 4.57-7.38]), female sex (female versus male sex: adjusted prevalence ratio, 1.22 [95% CI, 1.06-1.42]), and lower education (secondary versus primary education: adjusted prevalence ratio, 1.46 [95% CI, 1.24-1.71]) were significantly associated with CVD-MH illness after adjusting for all other factors.

CVD-MH illness comorbidity is highly prevalent in urban Haiti, especially among older adults and women. These findings underscore the need for integrated, contextually adapted approaches to address multimorbidity in crisis-affected low- and middle-income countries.

The relationship between psychological stress and sleep quality is essential for mental health. While self-reported questionnaires are commonly used in epidemiological studies, wearable devices have been increasingly utilized to obtain objective sleep data. This study examined whether daily subjective psychological stress is associated with objectively measured sleep stages in naturalistic (real-world) conditions using wearable devices. We conducted a secondary analysis of a 90-day randomized controlled trial recruited full-time workers with metabolic syndrome (Mets) or high risk of Mets from five Tokyo-based companies. Participants (mean age 43 y; 93% men) used the Fitbit Versa for sleep structure and a dedicated smartphone application for daily questionnaires. Daily psychological stress was assessed using a binary question. Mixed-effects multi-level regression models were used to examine associations between stress and time spent in REM and NREM sleep, respectively. Within-individual psychological stress was positively associated with REM minutes (β: 4.7; 95% CI 2.9, 6.4) and NREM minutes (β: 17.8; 95% CI 13.8, 21.9) in adjusted models. This result suggests that daily individual-level data may be essential for sleep health recommendations. Further research using wearable devices is needed to investigate the possibility of individually optimized interventions targeting psychological stress and its impact on sleep stages.

Artificial light at night (ALAN) has been classified as a significant environmental endocrine disruptor. Excessive exposure to ALAN has associated with an increased risk of depression. With the extensive use of high-density blue light LED screens, the risk of blue light exposure at night has increased. Animal studies have suggested a close relationship between blue light and depression, but the research on human population is limited. The mechanisms linking blue light to depression require in-depth investigation. We investigated whether nighttime artificial blue light exposure (NABLE) serves as a potential independent risk factor for depression and explored its underlying molecular mechanisms. A case-control study demonstrated that prolonged nighttime device use (> 4 h), high blue-light display patterns, and the use of nightlights during sleep were significantly associated with depressive symptoms in adolescents. This association was independent of demographic and sleep-related factors. Machine learning analyses confirmed these exposures as key predictors of depression. Our previous experimental work demonstrated that blue light exposure during sleep (BLS) induced depression-like behaviors in rodents. Building upon this, we have now reported that BLS elevates lactic acid levels in the lateral habenula (LHb), which upregulates the RNA demethylase ALKBH5 and modifies N⁶-methyladenosine (m⁶A) level. This cascade disrupts neuronal plasticity and induces depression-like phenotypes. Further validating the mechanism, LHb-specific ALKBH5 knockdown reduced both behavioral and synaptic abnormalities, while peripheral blood samples from adolescents with high NABLE exposure exhibited increased Alkbh5 expression. In conclusion, our findings indicate that NABLE is significantly associated with adolescent depression. The identified lactic acid-ALKBH5-m⁶A axis correlates environmental light exposure with neuroplasticity and mood regulation. These findings provide mechanistic insight into environmentally light-associated depression and highlight the significance of managing nocturnal blue light exposure as a potential preventive strategy for adolescent mental health.

Adverse paternal perinatal mental health is recognized as a serious public health concern due to the negative implications for fathers, their families, and wider society. However, in the Irish healthcare system there is no evidence that the assessment and management of paternal perinatal mental health is part of current public health nursing practice.

The authors designed a hypothetical case study and used it with the public health nursing intervention wheel to analyze and illustrate how public health nursing practice is more likely to focus on maternal and infant health outcomes.

The case illustrated that there are opportunities to integrate applicable interventions such as assessment, screening, consultation, counseling, health teaching, referral, and follow-up at paternal and family level, as well as outreach, advocacy, and social marketing at community level. Evidence from the research-based literature is used to discuss how these interventions can result in beneficial outcomes for fathers, families and population health.

Furthermore, it illustrates how case studies can enhance teaching in relation to public health nursing education.

Non-Communicable Diseases (NCDs) pose a serious global health challenge. The burden of NCDs affects individuals across various demographic categories. Socioeconomic status (SES) has long been recognized as a determinant of health outcomes. Previous research suggests a complex interplay between SES and NCDs, with disparities in prevalence and disease management observed across different socioeconomic strata. This study aims to further examine the association between NCDs and socioeconomic characteristics to inform evidence-based interventions that can effectively mitigate the burden of NCDs.

this study was a secondary analysis of a cross-sectional dataset collected in 2021 by the Tanzanian National Institute for Medical Research (NIMR). The original study assessed willingness and ability to pay for medical insurance. The current study employed quantitative approaches. Logistic regression is used to assess the association between SES and NCDs, adjusting for potential confounders including age, gender, family size, health insurance status, and place of residence. A backward elimination approach was used to retain variables with p < 0.2 in the final model. Socioeconomic status was assessed using an asset index generated through principal component analysis.

a total of 3,566 households were analyzed, with a mean age of 38.04 (SD: 11.76), 53.7% of whom were male. The overall prevalence of NCDs was 12.9%. Households in lower SES quintiles had higher NCD prevalence than those in higher SES quintiles, although this association was not statistically significant after adjustment. However, age, larger family size, and lack of health insurance remained statistically significant predictors of NCD prevalence.

while a clear association was observed between lower SES and NCDs in the univariate analysis, this relationship lost statistical significance after adjusting for demographic and household characteristics. However, age, family size, and lack of health insurance remained significant predictors of NCD prevalence.

As per WHO, in 2023 more than 700 women died every day from preventable causes related to pregnancy and childbirth. Early identification and management of high-risk pregnancies are essential for improved maternal and child health outcomes and reduced mortality rates.

The study objectives are: (a) To identify the barriers and facilitators in implementing existing national programs and the continuum of care for high-risk pregnant women. (b) To co-develop, optimize and implement a context-specific, scalable, and sustainable model of implementation strategies that will help achieve population-based coverage of high-risk pregnancy identification and management. (c) To evaluate the effect of the optimised and contextualised implementation model on the key performance indicators (d) To document the processes of evolution implementation, adoption, adaptation and fidelity of the implementation model.

The study will utilize the Consolidated Framework for Implementation Research and will be implemented in Nagaur district of Rajasthan, India. The study involves formative research and situational analysis, as well as developing a package of implementation strategies through an iterative process of concurrent implementation, evaluation, and model refinement based on programme learnings. The intervention package will include refresher training of ASHA/ANM workers, strengthened community awareness, and monthly Pradhan Mantri Surakshit Matritva Abhiyan specialist camps.

The study is expected to improve the identification and management of high-risk pregnancies and enhance the quality of institutional deliveries by strengthening the continuum of care across all stages of pregnancy. Thus, the study is expected to improve maternal and child health outcomes by developing sustainable strategies for scaling up evidence-based, context-specific interventions.

The study will generate a scalable implementation model that can be adopted more widely to streamline high-risk pregnancy care and contribute to long-term improvements in maternal and child health outcomes.

Marginalised populations face significant health risks in pregnancy with reduced access to preventive and life-saving services due to conflict and migration. Infectious disease risk is high and the double burden of malnutrition increases risk from non-communicable disease although only weak epidemiological data supports this in refugees and migrant communities. This manuscript describes the SMRU Refugee and Migrant Pregnancy Cohort commencing nearly 40 years ago, established in response to the very high rate of Plasmodium falciparum maternal mortality in refugee camps on the Thailand Myanmar border.

Pregnant women who registered to antenatal care clinics of the Shoklo Malaria Research Unit from 1986 to 2024 living in marginalised communities of refugee and migrants were the eligible population. Pregnancies were prospectively followed from enrolment through to childbirth. Types of data include: 1) medical and obstetric records including patient characteristics, pregnancy progress and birth outcomes and 2) investigations (such as HIV).

Among 94,645 pregnancies maternal mortality was 176 per 100,000 livebirths (120/68,024). Embedded cohorts included observational and clinical trials, providing evidence on the optimisation of treatment of malaria in pregnancy and on the rapid changes towards non-communicable diseases in refugees and migrants. Low mean height (151.4 cm), well below European and American populations from which the majority of guidelines have been created, questions appropriateness, such as gestational weight gain in pregnancy. A broad scope of research findings including tropical infections impacting pregnancy outcomes, mental health and suicide, a shared platform of "-omics" of Karen and Burmese women from first trimester, and practice of care in low-income settings have emerged and been shared.

The SMRU Refugee and Migrant Pregnancy Cohort findings have had significant local and international impact including changing the World Health Organisation Malaria Treatment Guidelines in pregnancy; and establishing a range of guidelines and tools improving maternal-child health practices.

Beta thalassaemia, an inherited blood disorder, exhibits a broad range of phenotypes from asymptomatic to severe anaemia. Pulmonary hypertension (PH) is a major complication in thalassaemia patients, significantly impacting morbidity and mortality. This study aimed to assess the clinical condition of thalassaemia patients with PH over the course of one year while receiving treatment in accordance with the guidelines of the European Society of Cardiology (ESC).

A prospective cohort study was carried out at Rohani Hospital in Iran from May 2020 to May 2021. The study included patients diagnosed with beta thalassaemia intermedia who also had PH confirmed by echocardiography. Treatment was administered according to ESC guidelines, incorporating vasodilators and other supportive medications. Clinical and laboratory data were gathered, and statistical analyses were conducted.

Nineteen patients, with a mean age of 42.57 ± 8.62 years, participated in the study. Treatment resulted in notable improvements in the 6-minute walk test (6MWT) (p < 0.001), reduced proBNP levels (p = 0.016), and a lower E/e' ratio (p = 0.01), suggesting enhanced right ventricular (RV) function. However, there were no significant changes in pulmonary artery pressure (PAP) or RV size. Additionally, repeated blood transfusions were linked to RV dysfunction.

Repeated blood transfusions correlate with RV dysfunction in thalassaemia patients with PH. Vasodilatory treatment improves 6MWT, proBNP levels, and E/e' ratio, indicating RV function enhancement. This study underscores the importance of comprehensive management strategies for thalassaemia patients with PH to mitigate associated complications and improve outcomes.