There is a very limited number of studies examining how diet is associated with social factors. The aim of this study was therefore to examine the association between type of diet and loneliness, social isolation and social withdrawal.

Cross-sectional data from the general adult population in Germany were used. The sample included 5,000 individuals aged 18-74 years. To quantify loneliness, the De Jong Gierveld tool was used. Social isolation was measured using the Lubben Social Network Scale and Bude/Lantermann tool. Social withdrawal was operationalized using the 25-item Hikikomori Questionnaire. Three types of diet were considered (mainly vegetarian; mainly vegan; neither vegetarian nor vegan, reflecting an omnivorous diet). The analysis was adjusted for sociodemographic, lifestyle-related, health-related and mental health-related covariates in multiple linear regressions.

Overall, 15.4% of the individuals reported following a mainly vegetarian diet and 3.5% of the individuals surveyed followed a mainly vegan diet, with the remaining participants (81.1%) following an omnivorous diet. When adjusting for sociodemographic, lifestyle-related and health-related factors, individuals following a mainly vegetarian diet had significantly higher levels of perceived social isolation and social withdrawal compared to individuals following an omnivorous diet. However, these significant associations disappeared when adjusting for mental health-related covariates. Mainly vegan eaters feel more isolated and withdraw more from society compared to individuals following an omnivorous diet, even in the fully adjusted model.

Following a mainly vegan diet was associated with perceived social isolation and social withdrawal, even when adjusting for sociodemographic, lifestyle-related, health-related and mental health-related covariates. However, the variance explained by diet type was minimal (R2 close to zero and partial eta2 < 0.01), indicating limited practical relevance.

People living with dementia are at an increased risk of multiple hospital admissions due to acute illness, underlying vulnerability, progression of behavioural symptoms of dementia, or breakdown of care provision. Reducing readmission rates is a key clinical priority. This study used linked electronic health records from general practice and hospitals in England, to investigate the determinants associated with hospital readmissions and estimate the mortality risk of older adults with dementia within one year of hospital readmission.

A retrospective cohort study using Clinical Practice Research Datalink and linked data. Patients were included if they were > 65y, diagnosed with dementia, and had a recorded acute general hospital admission. Outcome variables were readmission to hospital within 180 days of discharge, and in the readmitted group, mortality within one year of readmission. Demographics, long term conditions, polypharmacy, antipsychotic medication, medication review, post-discharge primary care appointments, and living in residential care were examined as determinants using stepwise logistic regression for readmission, and Cox regression for survival models.

30,527 patients were included, median age 84y (62.7% female), with 12,351 (40.5%) readmitted within 180 days of discharge. Being male, having multiple long-term conditions, having a medication review or attending a primary care appointment post-discharge were positively associated with readmissions, while Alzheimer's type dementia, having 'Other' ethnicity, and living in residential care were negatively associated. We found a significant effect on mortality risk of age, sex, type of dementia, having two or more long-term conditions, body mass index, antipsychotic medication, polypharmacy, and living in residential care.

The findings of this cohort study suggest that biological, psychological, and social factors interact to influence hospital readmissions in older adults with dementia. Multiple long-term conditions emerged as the strongest determining factor for readmission, while age was important in survival. Future research should assess psychosocial factors such as social support, caregiver burden, and mental well-being. These findings have important implications for strengthening community-based healthcare for adults with dementia, to reduce hospital readmission.

BackgroundPersons involved in compulsory mental health treatment-including clinicians, lawyers, service users, and family members-frequently express dissatisfaction with how the system is regulated and administered. Policy discussions on improving the system often fail to consider the voices of service users and family members. Policy development must also grapple with the contested values of autonomy and wellbeing, and the associated disjuncture in professional views. Community treatment orders (CTOs) are a key mechanism of compulsory mental health treatment in Ontario, and many other jurisdictions. We studied views on CTOs in Ontario to identify agreement across groups about where and how the system ought to be improved.MethodWe conducted semi-structured individual interviews followed by mixed focus groups including 72 participants: healthcare professionals, lawyers, tribunal members, service users ("clients"), family members, and advocates. Interview data were analyzed to identify recurring concerns and inform focus group discussion topics. Focus groups explored potential areas of alignment across participant groups, with particular attention to points of consensus. A lived-experience advisory panel informed study design.ResultsAcross participant groups, 6 main areas of agreement were visible. Participants identified the need for: (1) increased client involvement in treatment decisions, even within compulsory frameworks; (2) improved police involvement during CTO enforcement; (3) improved availability and quality of CTO-related data, enabling evaluation, accountability and attention to equity; (4) enhanced guidance and support for substitute decision-makers; (5) stronger oversight of medical decision-making, though preferred mechanisms varied; and (6) expanded community services-particularly housing, addiction treatment and case management-viewed as essential for CTOs to be able to have their intended benefit.ConclusionsThis study shows there is meaningful agreement on several areas requiring improvement in Ontario's CTO system. These points of convergence represent promising foundations for policy development, although translation into actionable reform will require further policy work.

Objective.Despite the technological advancement of upper limb prostheses, it is unclear how device design affects the cognitive-motor processes and mental workload underlying the acquisition of dexterity skills. This study examined changes in performance and mental workload as individuals with intact upper limbs learned to use either a body-powered (BP) or a myoelectric (MYO) bypass prosthesis.Approach.Motor performance (number of blocks transported in one minute), movement smoothness, perceived mental workload (NASA-TLX), and electroencephalography theta, low-alpha, high-alpha, and beta power were examined across a 10-session prosthetic training program to assess the engagement of cognitive-motor and sensorimotor processes.Main results.While both groups revealed enhanced dexterity and movement smoothness and a decrease in perceived mental workload due to training, differences in cortical dynamics were revealed. From early to late practice, BP prosthesis users revealed an elevation of low- and high-alpha and beta power, whereas no such change was observed for MYO prosthesis users. Also, during both practice and retention, MYO prosthesis users revealed attenuated low- and high-alpha and beta power compared to the BP prosthesis users.Significance.These findings suggest that cortical dynamics for BP but not MYO device users became more refined from early to late practice, along with the latter experiencing greater arousal and recruitment of cognitive-motor and sensorimotor resources to produce a similar box and block test performance relative to the former. This work provides novel evidence of neural correlates of prosthesis-specific cognitive-motor processes underlying mental workload, offering a neurophysiological framework for improving the training and assessment of prosthesis users.

Established standards and guidelines for early psychosis intervention (EPI) in British Columbia (BC) and across Canada define the intent and scope of individual EPI programs. EPI programs are a critical mental health service both in BC and internationally, providing a range of pharmacological, psychological, and social supports under one service. If EPI principles and practices are applied, positive outcomes are expected, including greater reduction of psychotic symptoms compared to standard treatment, improved treatment adherence, fewer recurrent episodes of psychosis, and greater client satisfaction. Low fidelity, or difficulty adhering to the principles associated with the EPI model, may jeopardize attaining these positive outcomes.

Evaluation of program fidelity to established EPI practice standards and guidelines was conducted at 16 mental health service sites in BC that provide care to young adults with early psychosis. Fidelity assessment was performed via utilization of the EPI Fidelity Scale (EPI-FS).

Based on the EPI-FS, two sites (12.5%) met criteria for high fidelity, nine (56.3%) attained moderate fidelity, three (18.8%) attained low fidelity, and two (12.5%) attained very low fidelity. Specialized EPI programs were linked to higher fidelity, while many generic mental health and substance use centres had difficulty following the EPI model. Identified weaknesses included provision of psychological therapy, family education, ongoing program evaluation, and supervision and mentorship for clinicians. Sites with sufficient resources and staff development opportunities had higher overall fidelity.

These findings underscore the importance of equitable resource allocation and the need for specialized EPI services, especially in underserved areas in BC.

Physical activity is believed to positively influence brain health and cognition and is considered a modifiable lifestyle factor that may protect against cognitive decline and neurodegeneration. In this observational study, we investigated the cross-sectional and longitudinal effects of self-reported total and moderate-to-vigorous physical activity on cognitive scores on the Trail Making Test (TMT-A and TMT-B), hippocampal volume, and Brain Age Gap Estimate (BrainAGE) in a large population-based cohort from the LIFE-Adult Study (n=2576). Furthermore, we examined the effect of objectively measured physical activity on brain structure in a subgroup with available accelerometry data (n=227). Multiple linear regression analyses did not show any positive effects of self-reported or objectively measured physical activity on hippocampal volume or processing speed and executive function. Longitudinal path analyses suggested a potential for reverse causation, where a higher BrainAGE at baseline was associated with lower physical capacity at follow-up. Additionally, we observed an age-related bias in the self-reporting of physical activity, indicating that older individuals tend to overestimate their level of activity. Future interventions targeting middle-aged adults may be necessary to raise awareness of potential misperception and encourage increased physical activity.

Motor-cognitive dual-task performance is closely related to age-related changes in cognitive and motor function. Community-based approaches combining cognitive screening with neurophysiological and nutritional assessment may help characterize cognitive health in older adults. This study explored the feasibility of combining prefrontal oxygenated hemoglobin (Oxy-Hb) responses measured using functional near-infrared spectroscopy (fNIRS) during a seated motor-cognitive dual-task paradigm with cognitive screening and nutritional evaluation among older adults attending community salons.

A total of 127 community-dwelling older adults attending local salons were included. Cognitive function was assessed using the Montreal Cognitive Assessment-Japanese version (MoCA-J) and the Mini-Mental State Examination. Nutritional intake and body composition were evaluated using a food frequency questionnaire and bioelectrical impedance analysis. Prefrontal Oxy-Hb responses were recorded using an 8-channel fNIRS system during a seated motor-cognitive dual-task condition. Exploratory hierarchical multiple regression analyses examined associations between MoCA-J scores and Oxy-Hb responses. Age and sex were entered as covariates, and all eight fNIRS channels were entered simultaneously using the forced-entry method. Multiple comparisons across fNIRS channel predictors were addressed using Benjamini-Hochberg false discovery rate correction.

Approximately 60.3% of participants scored below the MoCA-J cutoff, suggesting possible cognitive decline based on screening. For the MoCA-J total score, the overall regression model was significant, and adding the eight fNIRS channels significantly improved model fit beyond age and sex. After false discovery rate correction, Ch6 was positively associated and Ch8 was negatively associated with MoCA-J total score. In exploratory subdomain analyses, Ch8 remained significantly associated with naming and attention scores. Nutritional and body composition analyses suggested a marginal negative association between fat intake and MoCA-J scores, whereas protein mass was positively associated with MoCA-J scores.

fNIRS-derived prefrontal Oxy-Hb responses during a seated motor-cognitive dual-task paradigm, together with nutritional and body composition indicators, may provide complementary information for characterizing cognitive health in community-dwelling older adults. Although exploratory and requiring longitudinal validation, this multidimensional assessment approach may contribute to practical community-based strategies for dementia prevention and healthy aging.

Due to a variety of personal factors and the nature of their occupation, farmers experience heightened levels of stress that can lead to more severe mental health outcomes. Currently, there is a lack of consistent measures to assess stress and farmer wellbeing nationwide. The purpose of this study was to investigate the mental wellbeing of Florida farmers and identify risk and protective factors for perceived stress, sadness and depression, and suicide ideation.

This research reports on survey responses from a sample of 373 adult Florida farmers collected from August-November 2024. We used t-tests, ANOVAs, chi-square analyses, multiple linear regression, and binary logistic regression to characterize and predict stress, sadness and depression, and suicide ideation using personal and farm-related items.

Farmers reported moderate stress (M = 23.61, SD = 8.19). T-tests and ANOVA results identified stress differences based on gender, marital status, income source, living arrangements, job satisfaction, age, farm role, farm type, and hours worked. The regression model for stress was significant, F(26, 259) = 6.939, p < 0.001. Age (p < 0.001), hours worked (p = 0.013), income source (p = 0.005), and job satisfaction (p < 0.001) predicted farmer stress. Of respondents, 66.9% of farmers reported feeling sad/depressed. Chi square analyses indicated significant differences in sadness/depression based on job satisfaction, farm type, living arrangements, and income source. The logistic regression model for sadness/depression was significant, χ²(9) = 136.756, p < 0.001. Sadness/depression was predicted by stress (p < 0.001), job satisfaction (p < 0.001), and farm managerial role (p = 0.037). Of respondents, 10.3% of respondents had ideated suicide in the last three months. Chi square analyses indicated differences in suicide ideation for age, relationship status, and job satisfaction. The logistic regression model for suicide ideation was significant, χ²(6) = 39.642, p < 0.001. Suicide ideation was predicted by stress (p < 0.001), age (p = 0.007-0.017), and marital status (p = 0.003).

Findings revealed personal and farming-related factors contributing to stress, sadness/depression, and suicide ideation. This study gathered needed baseline data regarding perceived stress, experiences with sadness and depression, and suicide ideation among Florida farmers that will be helpful for better understanding and, potentially, mitigating risk of Florida farmers' mental health crises in coming years. Recommendations focus on prioritizing prevention over crisis response to target stressors. Findings hold implications for agricultural industry leaders, health professionals, Extension and community educators, and policymakers seeking to address farmer health through legislation, educational programming, and outreach.

Background/Objectives: Diet quality among university students is influenced by multiple behavioural and lifestyle factors, yet limited research has examined how cannabis use relates to overall diet quality within this population. This study examined the association between cannabis use and diet quality among university students and assessed whether this relationship was explained by behavioural, contextual, and psychological factors. Methods: A cross-sectional online survey was distributed to all registered students at a large Canadian university in January 2026. Diet quality was assessed using the Canadian Food Intake Screener (CFIS), and past 30-day cannabis use was examined as the primary exposure. Hierarchical multiple linear regression models were conducted sequentially, adjusting for demographic characteristics, health behaviours, mental health variables, living arrangements, meal skipping, and other substance use. Results: Among 1581 survey respondents, 1467 participants were included in the fully adjusted regression analyses. Past 30-day cannabis use was reported by 33.7% of participants. In demographic-adjusted analyses, cannabis use was associated with lower diet quality scores (B = -0.81, p < 0.01). This association remained statistically significant following adjustment for health behaviours, mental health variables, and living arrangements. However, after adjustment for meal skipping, the association between cannabis use and diet quality was attenuated and no longer statistically significant (B = -0.44, p = 0.09). Meal skipping emerged as one of the strongest behavioural correlates of lower diet quality. Additional adjustment for other substance use did not materially alter findings. Conclusions: Cannabis use was initially associated with lower diet quality among university students; however, this association was attenuated after accounting for broader behavioural factors, particularly meal skipping. Given the cross-sectional design, these findings do not establish whether cannabis use influences dietary behaviours or whether meal skipping represents a pathway linking cannabis use and diet quality. These findings highlight the importance of considering diet quality within a broader behavioural framework and suggest that eating patterns represent an important correlate of diet quality among university students.

To estimate the prevalence of long COVID identified through hospital registry data and examine associated occupational and demographic factors among healthcare workers (HCWs) in Spain.

A multicentre study was conducted between 2020 and 2023 in three Spanish hospitals (Madrid, n = 1; Barcelona, n = 2). Long COVID prevalence and 95% confidence intervals (CIs) were estimated overall and by sex, age group, and occupational category. Associations between long COVID and occupational category were assessed using Poisson regression models with robust variance, stratified by sex and hospital, and adjusted by age and occupation.

Registry data included 8,439 HCWs. Long COVID prevalence ranged from 3.0% to 5.0% and increased with age, with an adjusted prevalence ratio (PR) increase of 3-9% per year. Occupational differences were more pronounced among men. In University Hospital Ramon y Cajal, male nurses (PR 2.56; 95% CI 1.13-5.81) and other HCWs (PR 3.67; 95% CI 1.12-12.08) had higher prevalence compared with physicians. In Hospital Parc Tauli, male nurse assistants (PR 20.33; 95% CI 3.64-113.42) and support staff (PR 8.30; 95% CI 1.46-47.19) showed markedly elevated prevalence, although confidence intervals were wide. Among women, occupational associations were weaker and less consistent. Overall sex differences were modest, but sex modified the association between occupational role and long COVID prevalence.

Long COVID affected approximately 3-5% of HCWs across participating hospitals. Occupational differences in long COVID prevalence were observed, although estimates varied across centres. These findings highlight the importance of occupational health surveillance and follow-up strategies that consider both occupational role and potential sex-specific patterns.