Early life environmental toxicant exposure is associated with adverse physical and mental health, yet individual susceptibility varies. Psychosocial exposures, like socioeconomic disadvantage and stress, frequently co-occur with toxicant exposure and also influence health outcomes, but are often studied in isolation. This scoping review maps existing literature examining joint environmental toxicant and psychosocial exposures and health outcomes across the life course. Following PRISMA-ScR guidelines, we searched PubMed, PsycINFO, Web of Science, and Embase in July 2025 using terms related to toxicants and psychosocial exposures. Two reviewers independently screened titles/abstracts and full texts. Inclusion/exclusion criteria were defined a priori using a Population, Concept, and Context (PCC) framework. We included original human studies examining joint toxicant and psychosocial exposures in relation to physical or mental health outcomes. We excluded air pollution, animal models, interventions, and neurocognitive and genetic outcome studies. Findings were synthesized narratively. Fifteen studies met inclusion criteria. Metals and phthalates were most commonly assessed. Psychosocial exposures were typically operationalized as socioeconomic disadvantage, perceived stress, or discrimination. Evidence was concentrated in prenatal exposures and pregnancy or birth, with few studies evaluating childhood, adolescent, or adult health. Most studies used interaction or stratified regression approaches and few employed mixture or cumulative risk methods. This review highlights important methodological opportunities for future research, including integrating environmental toxicant and psychosocial exposures and applying analytical methods that better capture real-world co-exposures across the life course. Such approaches may strengthen understanding of how multiple environmental and social exposures jointly influence health and inform future policy and intervention efforts.

Nursing students are highly vulnerable to stress, anxiety, and mental health challenges, particularly during their transition into academic and clinical training. Strengths-based resilience interventions have been shown to enhance coping and well-being in student populations but are underexplored in non-Western nursing education contexts. Grounded in Self-Determination Theory and social ecological theory, this study aimed to examine the short-term outcomes of the Changing Minds, Changing Lives (CMCL) strengths-based resilience program among first-year nursing students in a non-Western context.

This mixed-methods quasi-experimental study included 53 first-year nursing students allocated to intervention (n = 27) or comparison (n = 26) groups according to their existing class sections; one section was assigned to each condition. The intervention group received a 10-session strengths-based resilience program over five weeks. Quantitative outcomes were measured pre- and post-intervention using validated instruments: the Thai Perceived Stress Scale (T-PSS-10), Thai Connor-Davidson Resilience Scale (CD-RISC-25), Emotional Self-Awareness Scale (ESA), and Perceived Cohesion Questionnaire (PCQ). Outcomes were assessed immediately before and after the five-week program; no longer-term follow-up was conducted. Repeated-measures MANOVA with post hoc Bonferroni tests assessed group and time effects, and analyses of covariance adjusting for baseline scores were conducted as sensitivity analyses. Qualitative data were collected via reflective writings and final presentations and analyzed using conventional content analysis.

The groups were not equivalent at baseline: the intervention group reported higher perceived stress and lower resilience. Significant group × time interaction effects were found across all four outcomes, indicating that resilience, emotional self-awareness, and perceived university belonging increased, and perceived stress decreased, to a significantly greater degree in the intervention group than in the comparison group. Univariate interaction effect sizes were large (partial η² =0.15-0.40), and all effects remained statistically significant after adjustment for baseline scores. Qualitative findings revealed four themes: focus on strength, not weakness; sharing, listening, and learning from each other; understanding yourself and understanding others; and transformational learning.

Participation in the CMCL strengths-based resilience program was associated with short-term improvements in self-reported perceived stress, resilience, emotional self-awareness, and perceived university belonging. The translated and contextually adapted program was feasible to deliver within the first-year curriculum. Because allocation followed intact class sections, baseline differences were present, and no attention-matched comparison condition or longer-term follow-up was included, the findings should be regarded as preliminary.

The objective of this study was to investigate the characteristics and trends of intentional substance exposures at school among children 6-18 years old reported to United States (US) poison centers.

Using a retrospective cohort study design, National Poison Data System data from 2000 to 2024 were analyzed. National population estimates from the US Census Bureau were used to calculate population-based rates, including age- and sex-specific rates, of exposure per 100,000 US population. Analyses included descriptive statistics and calculation of risk ratios (RRs) with 95% confidence intervals (CIs).

From 2000 to 2024, US poison centers received reports of 122,700 intentional exposures that occurred at school among children 6-18 years old. Exposures most commonly involved high school-aged children (45.9%), males (56.7%), or a single substance (91.3%). Although most intentional exposures did not receive treatment at a healthcare facility (64.2%), 23.2% were treated/evaluated and released, and 5.3% resulted in admission to a non-critical care or critical care unit. Almost half (48.2%) of intentional substance exposures were not followed (judged to be a non-toxic exposure or to have minimal clinical effects possible), while 21.8% were associated with a minor effect and 20.0% with no effect. However, 10.0% had a serious medical outcome, including 0.7% (n = 741) with a major effect; there were two deaths. More than half of the intentional exposures occurring at school were attributable to intentional misuse (62.2%), followed by abuse (23.6%) and suspected self-harm or suicidal intent (14.2%). Exposures among high school-aged children were more likely to be associated with a serious medical outcome (RR: 5.00, 95% CI: 4.78-5.22), abuse (RR: 2.99, 95% CI: 2.92-3.06), or suspected self-harm or suicidal intent (RR: 3.28, 95% CI: 3.17-3.39) than those among elementary school- and middle school-aged children. Abuse was more likely to be associated with a serious medical outcome (RR: 4.51, 95% CI: 4.35-4.68) than non-abuse-related intentional exposures. Likewise, suspected self-harm or suicidal intent-related exposures were more likely to be associated with a serious medical outcome (RR: 2.33, 95% CI: 2.24-2.43) than exposures not related to suspected self-harm or suicidal intent. The rate of intentional exposures at school per 100,000 US children 6-18 years old fluctuated over time and increased overall by 77.5% from 7.5 in 2000 to 13.3 in 2024, including a transient sharp decline in 2020 and 2021 coinciding with the COVID-19 pandemic. The rate increased by 287.4% from 3.1 in 2000 to 11.9 in 2024 among elementary school-aged children, 111.9% from 10.0 in 2000 to 21.3 in 2024 among middle school-aged children, but decreased by 4.2% from 10.1 in 2000 to 9.7 in 2024 among high school-aged children. The exposure rate of middle school-aged children surpassed that of high school-aged children in about 2015.

The increasing rate of reported intentional substance exposures at school among elementary school- and middle school-aged children, combined with the greater severity observed among high school-aged children, underscores the need for targeted and coordinated prevention and early identification strategies that integrate substance use education and mental health screening and intervention.

Among people with bipolar I disorder (BD), cannabis use disorder (CUD) is highly comorbid and correlated with poorer clinical outcomes, including increased suicidal behaviors and decreased quality-of-life (QoL). However, research on different levels of CUD severity and their links to suicidal behaviors and QoL are underexplored. Using data from the National Epidemiologic Survey on Alcohol and Related Conditions-III (NESARC-III), this study examined the relationships between DSM-5 CUD severity and lifetime suicide attempts or health-related QoL in participants with and without lifetime bipolar I disorder (ns = 753 and 35,556, respectively). A logistic regression model, adjusted for sex, age, and race/ethnicity, indicated the rate of lifetime suicide attempts was 16.65% (95% CI [13.17, 20.83]) in people without BD and with severe CUD compared to 33.71% (95% CI [21.64, 48.36]) in people with BD and severe CUD. Additionally, an adjusted linear regression model showed that mental health QoL significantly declined in individuals without BD from those with no CUD symptoms (M = 51.49, 95% CI [51.33, 51.65]) to severe CUD (M = 45.28, 95% CI [44.35, 46.21]), whereas the mental health QoL for individuals with BD did not significantly vary across CUD severity. Physical health QoL was not significantly different across BD status nor CUD severity. Overall, these findings suggest that CUD severity is significantly associated with altered outcomes on lifetime suicide attempts and mental health QoL depending on lifetime BD status; however, BD may still play a more prominent role in mental health outcomes, regardless of CUD severity.

The Mount Sinai Resilience Scale (MSRS) assesses cognitive, behavioral, and emotional resilience processes, yet the interrelationships among these processes, including which are most central and most strongly associated with mental health outcomes, remain poorly characterized. This study used network analysis to characterize the structure of MSRS-assessed resilience processes and their associations with clinical outcomes in a population-based sample of U.S. adults (N = 1794) enriched for elevated perceived stress and trauma exposure. Participants completed the MSRS and validated measures of depressive, anxiety, and posttraumatic stress disorder (PTSD) symptoms and well-being. Regularized Gaussian graphical models were estimated to characterize network structure and centrality, with clinical outcomes incorporated as nodes to identify unique associations with individual MSRS items. The network demonstrated moderate density (157 of 276 possible edges), reflecting widespread conditional associations among resilience processes. Engagement in meaningful activities, perceived positive impact of spirituality, and active emotional recovery demonstrated the highest centrality, while emotional awareness and directly facing fears also showed high expected influence. Staying hopeful about the future, directly facing fears, and engaging in meaningful activities were consistently associated with lower depressive, anxiety, and PTSD symptoms and higher well-being. Forgiveness was positively associated with PTSD symptoms, suggesting a more complex role in trauma-related adaptation. Overall, MSRS resilience processes were organized around interconnected domains of meaning, spirituality, and emotional regulation. Hope, behavioral approach to feared experiences, and engagement in meaningful activities emerged as resilience processes with consistent associations across multiple mental health outcomes, highlighting their potential relevance for resilience-focused interventions.

Loneliness, including its associations with mental health, is recognised as a major global public health concern. While much research has focused on chronic loneliness, state loneliness - experienced in moment-to-moment contexts - remains underexplored. This gap is important, as daily experiences may provide critical opportunities for intervention. Intensive data collection approaches such as Ecological Momentary Assessment (EMA), Experience Sampling Method (ESM) and Daily Diary are well-suited for moment-to-moment capture and a review of their use for illuminating loneliness would be valuable for characterizing the state of the art and identifying gaps. This review thus synthesised findings from the intensive data collection approach to explore factors that may influence state loneliness and its consequences for mental health/well-being across all ages, providing valuable insights for targeted interventions.

This review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Four databases (PsycINFO, PubMed, Web of Science, and EMBASE) were searched from inception to 25th May 2026. Abstracts and full texts were screened, and the quality of the included studies was assessed. Data extraction was conducted independently by two reviewers.

One hundred and seventeen studies were included in this review, addressing measurement practices and quality (RQ1-2), predictors and correlates of state loneliness (RQ3), and mental health and wellbeing outcomes (RQ4). State loneliness was predominantly assessed using single items with varied response formats; most items met expert-based formulation criteria, though empirical psychometric evidence was rarely reported. Associations were observed between state loneliness and mental health outcomes (e.g., internalising, suicidality) and social interaction, with several studies reporting effects in both directions, though the nature of these associations varied with study design and analytic approach. Other factors, including physical health, age, and gender, were also linked to state loneliness.

Taken together, the review provides an improved understanding of the factors that may influence loneliness and its consequences for mental health/well-being. The results of the review could help to inform targeted prevention and intervention strategies for all age ranges, facilitating the mitigation of loneliness.

Mandatory Reporting (MR) is a range of regulations that, in its simplest form, mandate the reporting of suspected child abuse and neglect to state authorities and is widely implemented globally. Despite the common usage of the term MR, it masks significant divergences in goals and operational definitions. This paper discusses data from previous studies and official records to understand the various elements used and how responsibilities for protecting children are conceptualized. The paper highlights three main areas of focus for the MR regulations: children's focus (children's rights, child protection, and child intervention); professionals' focus (training and supervision); and the public's focus (crime detection and cultural changes toward safeguarding). Research regarding MR can identify different legal frameworks, give insight into the concept, and identify the reporting practice. This approach guards against 'all or nothing' and seeks to discuss the different aspects under MR regulation, as well as to suggest angles for further research, changes, and reforms.

The mental health and wellbeing of the dental team is of paramount importance in ensuring the delivery of oral healthcare. This perspective emphasises the importance of developing mechanisms of supporting the oral healthcare team. We propose a tripartite approach: a practitioner support network; a mechanism for support of members of the dental team who are referred to the General Dental Council; and crisis support for those facing severe mental health challenges. A practitioner support network would build on the known efficacy of mutual support in addressing the ongoing stress of delivering patient care. Referral to the General Dental Council has been identified as a major source of stress, and a support mechanism providing guidance and realistic discussion of likely outcomes would be of great benefit. Finally, as with all professions, some individuals will need more intense support as a result of mental health crises. We suggest that these three approaches could build on and co-ordinate existing initiatives to support the wellbeing of the dental care team.

Adolescent-onset type 2 diabetes (T2D) has increased in prevalence in recent decades. However, the efficacy of preventative interventions targeting health behaviours is limited, and key developmental factors that may influence effectiveness, such as executive functioning (EF) and stress, are often overlooked. Within-person fluctuations in EF and stress are linked to the adoption and maintenance of physical activity, a critical component of T2D prevention, yet little is known about the between- and within-person temporal variability of these constructs or their relationship with physical activity in adolescents at risk for T2D. Ecological momentary assessment (EMA) is ideal to capture these processes in real-time to inform intervention development and personalisation.

We will enrol a subset of participants from a larger intervention study involving assigned-female-at-birth adolescents aged 12-17 years, with elevated depression symptoms (CES-D≥21) and T2D risk (BMI≥85th percentile) and diabetes family history. Prior to the intervention, a minimum of 50 participants will complete a 7-day EMA protocol consisting of repeated daily gamified EF assessments and brief surveys about EF, stress and physical activity. Participants will simultaneously wear an activity monitor to provide objective measures of physical activity. Recruitment began in Spring 2024 and is ongoing. Multilevel models will be used to separate between- and within-person variability and to estimate short-term lagged within-person associations between EF/stress and subsequent physical activity across 15-60 min windows. Primary analyses are planned for Winter 2026.

The Colorado Multiple Institutional Review Board approved this study (COMIRB#22-0180). Findings will be disseminated in peer-reviewed journals and conference presentations.

NCT05543083.

Non-communicable diseases (NCDs), including cancer, cardiovascular, neurodegenerative, autoimmune, and allergic diseases, account for a significant amount of global morbidity and mortality. Chronic viral infections have not been recognized as NCDs, despite the availability of several therapeutic vaccination strategies against oncogenic viruses, such as the hepatitis B virus (HBV) and the human papillomavirus (HPV). Indeed, chronic viral infection leads to the development and progression of malignancies directly linked to the viruses. These considerations support a connection between NCDs, infectious diseases, and therapeutic vaccination. Recent advances in technology have paved the way to the use of vaccines beyond the prevention of infectious diseases, heralding innovative therapeutic and preventative strategies for a variety of chronic NCDs. Here we will review the state of the art of personalized vaccine strategies for NCDs, with an emphasis on the diverse technological platforms used to develop them, including mRNA and DNA vaccines, viral vectors, dendritic cell-based vaccines, nanoparticle delivery systems, and next-generation adjuvants. The review intends to make the case for personalized and antigen-specific vaccination strategies as a compelling option for precision immunotherapy primarily in oncology, where neoantigen-based vaccines are being developed. In addition, we will also review tolerogenic vaccination strategies, vaccination strategies targeting pathological proteins and pathways in neurodegenerative and cardiovascular diseases, and vaccine-based treatment of chronic viral infections. Current evidence about vaccines suggests that several ways are available to induce an immune response or create tolerance to a disease, and possibly altering its course instead of simply controlling the symptoms. However, many challenges are still to be overcome, including disease variability, how to identify appropriate target antigens, the complexity of manufacturing process, long-term safety, and integration with already established treatments. By virtue of the convergence of multiple fields-immunology, genomics, bioinformatics, and new delivery systems-precision vaccinology is gaining momentum. Thus, it is envisaged that personalized vaccines will be an increasingly essential component of future preventive and therapeutic approaches for non-communicable diseases.