The optimal maternal age at childbirth has been a topic of bourgeoning literature, with earlier ages offering physiological benefits for maternal recovery. In contrast, later ages to give birth may provide psychological advantages due to greater emotional maturity. This study investigates the impact of maternal age at childbirth on children's internalising problems and explores the mediating roles of housing instability and family support in this relationship.

Cross-sectional study; mediation analysis of the 2022 National Survey of Children's Health (NSCH) data.

Response in the 2022 NSCH in the USA.

This study is based on the 2022 NSCH, collecting a total of 54 103 completed surveys from randomly selected households across the USA. In this study, after excluding participants due to missing values in critical variables, 48 073 participants were included in the final analysis.

Our findings are consistent with the hypothesis that increasing maternal age at childbirth is associated with lower children's internalising problems. Analysis suggested this association operates directly and is indirectly linked to child outcomes through lower levels of housing instability and higher levels of family support. However, a distinct indirect effect emerged: increased maternal age was also associated with reduced family support, which was in turn linked to more internalising problems. The results illuminate potential mechanisms linking maternal age at childbirth to children's internalising problems and underscore the importance of stable housing and family support in mitigating risk factors for children's emotional well-being.

We found an association between advanced maternal age and fewer internalising problems in children. This relationship appears to operate directly and indirectly via a sequential pathway: higher maternal age correlates with lower housing instability, which in turn is associated with increased family support, ultimately correlating with improved child mental health outcomes.

Studies on ageing trajectories typically foreground intrinsic capacities and focus on frailty and mortality outcomes. Instead, research capturing aspects of people's living environment alongside individuals' capacities is limited. This study aimed to identify qualitatively distinctive ageing profiles among deceased older adults in China using individual-based and environment-based indicators. It further examined sociodemographic correlates of profile membership and investigated associations between these profiles and end-of-life and death-related outcomes.

This is a retrospective cohort study.

Individual level, longitudinal data from the Chinese Longitudinal Healthy Longevity Study (CLHLS) between 2008 and 2018 were analysed.

The study included older participants of the CLHLS (2008-2018) who died between survey waves (N=9755).

Ageing profiles were categorised using latent class modelling based on individuals' intrinsic capacity (functional, physical, cognitive, mental and social dimensions; 20 indicators) and environment characteristics (healthcare-related, financial and social aspects; 10 items). Sociodemographic correlates of profile membership included age, sex, education, marital status, living arrangement and residence location. End-of-life and death experiences were assessed by length of survival and functional status measured at the wave prior to death, pain at death and terminal delirium.

Within the study sample, four profiles emerged: healthy-and-supported (57%), cognitively-competent-but-functionally-dependent (12%), functionally-capable-but-cognitively-challenged (18%) and frail-and-support-lacking (13%). While profiles were primarily distinguished by functional and cognitive capacities and financial status, social participation was insufficient across all groups. Sociodemographic disparities (sex, education, marital status, living arrangement and residence) were associated with profile membership. The first and third profiles enjoyed a better quality of life in their final months. The healthy-and-supported adults were most prone to painful deaths in hospitals. The functionally capable participants most often died at home. The frail-and-support-lacking individuals were at the highest risk of terminal delirium.

The heterogeneity of ageing revolved around functional and cognitive capacities and economic/financial characteristics, the latter particularly salient for the frail-and-support-lacking group. The uniformly low social engagement observed across profiles highlighted the need for boosting overall social participation and developing community-level social services. Distinct end-of-life patterns emphasise the importance of targeted care strategies for rural and urban residents and interventions for delirium prevention.

It is widely known that a diagnosis of visual impairment has significant mental health impacts. Proposed approaches to addressing these include cognitive behavioural, problem-solving and stepped care solutions.

Limited research has focused specifically on vision-impaired patients' preferences for mental health support following diagnosis. This study aimed to address this gap.

The study was qualitative and cross-sectional, involving thematic analysis of semistructured interviews with patients diagnosed with vision impairment.

Twenty vision-impaired patients, aged from 20 to 84 years old and with a range of diagnoses, were interviewed regarding their experience of and recommendations for mental health support at the point of diagnosis and thereafter.

Three main themes were identified: (1) Mapping the Journey: The Critical Role of Accessible Information, (2) Navigating the Emotional Impact: Help-Seeking Attitudes and Experiences and (3) Tailored Mental Health Support: Timing, Delivery and Preferred Providers. Each theme had three subthemes.

It was concluded that clear information about diagnosis, prognosis and available supports is fundamental to promoting and maintaining mental health for vision-impaired patients. Person-centred and/or peer support is highly valued. To be maximally effective, specific mental health support should be informed by knowledge of vision impairment, with standardised treatment programmes not being valued highly. The study results strongly suggest that mental health support needs to be tailored to the unique needs of each individual, and therefore, a stepped care approach may be most helpful, encompassing clear information, practical advice and ongoing peer and professional support.

Physical exercise is known to enhance both physical and mental health. Surfing, an emerging water sport practiced in "blue space", offers unique well-being benefits, including for individuals with disabilities through Para-Surfing.

This study analyzed the Quality of Life (QoL) among 146 Spanish participants (126 Surfers and 20 Para-Surfers), comparing competitive and recreational modalities, reasons for engagement, and the relationship between sociodemographic factors, surf practice, and QoL.

Overall, participants reported high scores QoL. Despite the absence of discernible global disparities in Global QoL attributable to practice or surfing modality, Para-Surfers exhibited comparatively diminished QoL in the Physical Health and Level of Independence (PHLI) domain relative to Surfers. The predominant reasons for engaging in surfing activities among the study participants encompassed the enhancement of both mental and physical well-being, augmented personal autonomy, and the fulfillment derived from personal challenges. However, competitive Surfers and Para-Surfers were more likely to highlight performance and recognition as key motivators. Notably, recreational surfers who valued social connections reported higher QoL, unlike competitive surfers who placed less importance on these relationships. For Para-Surfers, equipment adaptation was significantly associated with better overall QoL, as well as improvements in psychological health and spirituality (PHS).

The findings underscore the importance of aligning individual motivations with the type of surf practice to maximize QoL benefits. For Para-Surfers, access to safe, enjoyable, and adapted equipment is essential. Promoting surfing as a health-enhancing activity should consider both personal goals and structural support to optimize QoL outcomes.

Mesenchymal stem cells (MSCs) hold substantial promise in regenerative medicine owing to their immunomodulatory, neuroregenerative, and self-renewal properties. Adipose tissue (AT) serves as an optimal MSC source due to its high yield and rapid proliferation. This study evaluated the safety and exploratory clinical effects of non-cryopreserved, culture-expanded autologous AT-MSCs in patients with secondary progressive multiple sclerosis (SPMS).

High-dose fresh autologous AT-MSCs (4.4 × 10⁶ ± 1.7 × 10⁶ cells) were intravenously administered to 10 female patients with SPMS (Expanded Disability Status Scale [EDSS] score 4-6) in two doses, seven days apart. Adverse events were monitored for 9 months post-transplantation. Magnetic resonance imaging (MRI) assessments quantified lesion number, volume, and contrast-enhancing lesions. EDSS scores, depression, and quality-of-life measures were evaluated over 9 months. MSC immunomodulatory effects were assessed via gene expression of inflammatory and anti-inflammatory cytokines and peripheral blood regulatory T-cell (Treg) proportions.

No serious adverse events occurred over 9 months. AT-MSC therapy reduced T2-FLAIR lesion number and volume, improved EDSS scores, and enhanced psychological outcomes. It also increased Treg cell proportions and anti-inflammatory cytokine expression while decreasing inflammatory cytokines.

High-dose fresh AT-MSCs appear safe and well-tolerated in SPMS patients, with promising exploratory clinical benefits. These findings support AT-MSCs as a potential multiple sclerosis therapy. Trial registration Registered with the Iranian Registry of Clinical Trials (Reference: IRCT20091127002778N1 at 2018-01-10).

Negative misconceptions about the inevitability of declining physical health and cognitive functioning in old age abound in society and in literature on autistic ageing. But there is a paradox of ageing: most older adults in the general population experience increases in life satisfaction and emotional wellbeing in later life that are associated with quality of life and indicative of successful ageing. Parallel patterns of later-life improvement in psychosocial functioning and emotional wellbeing have been found in attention deficit hyperactivity disorder and schizophrenia, which raises the tantalising question: could the paradox of ageing be true for older autistic adults too? Contemporary gerontological research that reconciles the contradictions inherent in this paradox from a lifespan developmental psychology perspective also informs global public health initiatives. These promote healthy successful ageing as a process of recovery, adaptation and growth in later life for people of all abilities. By contrast, there has been relatively little examination of autistic ageing from this perspective. Drawing on analyses of both gerontological and autism literature, this gap is addressed. Lifespan psychology's potential relevance to the developmental trajectory of autism is explored, and an evidence-based theoretical framework to guide future autism research and clinical practice aimed at promoting successful autistic ageing is proposed.Lay AbstractWhat is already known about this topic?Despite experiencing physical and mental losses as they age, most older people are satisfied with life. They have more positive than negative emotions, and this is related to wellbeing and improved quality of life. According to lifespan psychology, this unexpected pattern is evidence of successful ageing. By contrast, the potential for successful ageing in autism is not well understood. Even though it informs the World Health Organization's guidelines on healthy ageing, there has been relatively little consideration of lifespan psychology in relation to autistic ageing. The researchers' aim was to address this gap.What does this article add?This article provides a novel approach to understanding and promoting successful autistic ageing. It describes lifespan psychology and associated models and theories and how they relate to autistic experience. It also explains how and why positive outcomes like quality of life and life satisfaction are realistic goals for older autistic adults.Implications for practice, research or policyLifespan psychology offers an evidence-based framework for guiding future research, policy and clinical practice to help older autistic adults achieve positive life outcomes, productivity, personal growth and wellbeing. Future research should test whether autistic older adults experience the same improvements in social and emotional wellbeing in later life as other groups in the population. This will help to make sure that health policy and clinical support are not based on negative assumptions about autistic ageing that do not reflect real-life experiences. Most importantly, this article shows that by thinking about ageing differently, there are opportunities for all autistic adults to enjoy healthy successful ageing.

Anxiety is a common non-motor symptom of Parkinson's disease (PD). There is no specific pharmacological intervention for people with PD who experience anxiety. Current non-pharmacological treatments have mixed or inconclusive results and there does not appear to be a non-pharmacological intervention for people with PD disease and anxiety that focuses on activity and participation.

To co-produce an occupation-focused complex intervention to help people with PD live well with anxiety that community-based occupational therapists can deliver.

Six-stage complex intervention development was conducted using online logic modelling and a participatory approach to organise the new intervention's key inputs, processes and outcomes important to people with PD living with anxiety.

Data were collected via online logic modelling sessions involving people with Parkinson's, care partners and occupational therapists across the UK from April 2022 to June 2022.

34 participants were recruited (people with PD n=14, care partners n=9, occupational therapists n=11) for the online logic modelling sessions.

Resources to support the new intervention ('inputs') include adequate resourcing, education for professionals and people with PD, flexibility of delivery methods and goal setting. The intervention's actions to produce outcomes ('processes') should include 1:1 support, lifestyle management, providing meaningful information, collaborative goal setting, therapeutic use of everyday activities, and involvement of friends and families. The intended results ('outcomes') should include a reduction in anxiety symptoms, people with PD enjoying more meaningful activities, increased understanding of anxiety and PD, improvement in clinical outcomes and improvement of service-level outcomes. These key aspects were incorporated into an intervention manual, educational material and training video.

We have systematically coproduced a new occupation-focused complex intervention to help people with PD to live well with anxiety. This provides the basis for the next project in which this intervention will be tested for feasibility.

ISRCTN62762494.

Anxiety disorders represent a significant public health burden with limited treatment options, particularly amidst the escalating rates observed over the past two decades. While psychological and pharmacological treatments are available, often these treatments do not facilitate complete symptom remission for many individuals. Consequently, there is a pressing need for innovative interventions. Current systematic reviews have provided clinical support for adjunctive minocycline in psychiatry, particularly schizophrenia and major depressive disorder. While anxiety symptoms have been investigated as secondary outcomes, there has been no direct clinical studies of minocycline and anxiety disorders. Additionally, there is no existing literature specifically exploring the biological mechanisms of minocycline relevant to the pathophysiology or presentation of anxiety disorders. This review investigated the potential of minocycline, a tetracycline antibiotic with anti-inflammatory, antioxidant, glutamatergic and neurogenic properties, as a potential treatment for anxiety disorders. Drawing upon existing preclinical literature, we explore the role of microglial activation in anxiety behavior, elucidating the relationship with neurotransmitter dysregulation, synaptic plasticity, and neuroendocrine functions. Preclinical evidence suggests that minocycline may modulate these pathways through its inhibitory effects on microglial activation, thereby mitigating neuroinflammation, restoring neurochemical balance, and alleviate anxious behaviors. Through a comprehensive analysis of available preclinical data, this review aims to inform future research on the potential utility of adjunctive minocycline in managing anxiety disorders.

Differentiating between bipolar disorder (BD) and schizophrenia (SZ) is challenging due to overlapping clinical symptoms and shared genetic risks, resulting in frequent misdiagnoses and ineffective treatments. This study investigates whether overnight polysomnography (PSG), particularly EEG-derived power spectral and coherence features, can robustly distinguish BD from SZ. We collected PSG data from 196 BD and 154 SZ patients and selected a propensity-score matched cohort of 137 patients per group (N = 274) to obtain comprehensive sleep parameters, EEG power spectra, and coherence metrics. A random forest classifier integrating these features achieved the highest classification accuracy (71.88%), F1-score (0.709), and ROC-AUC (0.770) among tested models, significantly outperforming logistic regression and gradient boosting decision trees. Notably, F3_Theta_Pow, total wake time, C3_Theta_Pow, sleep efficiency emerged as the most discriminative features. Our findings highlight that distinct neurophysiological signatures during sleep effectively differentiate BD from SZ, underscoring the clinical utility of PSG as a practical and objective biomarker. This approach not only addresses diagnostic challenges but also provides insights into the underlying neurobiological mechanisms distinguishing these disorders, potentially guiding more precise clinical interventions.

Although subtle differences in cortico-striato-thalamo-cortical (CTSC) circuit structure and function are critical to the current understanding of the neurocircuitry in obsessive-compulsive disorder (OCD), emerging evidence suggests that the cerebellum may also be involved. However, much of this evidence comes from studies with small samples and notable methodological heterogeneity.

We conducted a mega-analysis of individual participant data on cerebellar sub-regional volumes, comparing individuals with OCD and healthy controls (HC) from the ENIGMA-OCD Working Group. 3D T1-weighted volumetric structural brain magnetic resonance imaging (MRI) scans from 1,954 individuals with OCD and 2,091 HC across 22 sites (40 datasets) were processed using the ACAPULCO (Automatic Cerebellum Anatomical Parcellation using U-Net Locally Constrained Optimization) pipeline to extract cerebellar parcellations. We harmonized the volume measures across sites using the ComBat algorithm. Multiple linear regression models were fitted to estimate group differences separately within the pediatric (<12 years), adolescent (12-18 years), and adult (from 18 years) samples, adjusting for age, gender, and intracranial volume (ICV).

In adults with OCD (versus HC), we found significantly smaller volumes of the corpus medullare (d=-0.093, p_fdr=0.036), left VIIb (d=-0.085, p_fdr=0.039) and right VIIb (d= -0.091, p_fdr= 0.036). None of the comparisons between children or adolescents with OCD versus HC remained statistically significant after FDR correction. In all three age groups, cerebellar (subregional) volumes were significantly moderated by medication status.

We report novel findings implicating specific cerebellar sub-regions across developmental stages of OCD, and the key impact of medication status. Further research on the functional significance of these findings may offer new translational leads.