Attention-Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder and an emerging public health concern in India. This review summarizes current evidence on the epidemiology, diagnosis, treatment, environmental influences, and public health implications of ADHD in the Indian context. Reported prevalence estimates vary widely across regions and populations, reflecting differences in study design, diagnostic practices, awareness, and access to healthcare. Although DSM-5-based diagnostic frameworks and culturally adapted assessment tools are increasingly available, access to specialist evaluation and treatment remains uneven, particularly in rural and underserved areas. Current management strategies emphasize a multimodal approach combining pharmacotherapy, behavioral interventions, educational support, and family-centered care. However, treatment access and continuity are often limited by financial constraints, inadequate healthcare infrastructure, specialist shortages, and sociocultural barriers. The review also examines the potential influence of early-life adversity, environmental exposures, lifestyle factors, and pandemic-related disruptions on ADHD risk and symptom expression. Overall, the available literature highlights persistent challenges, including underdiagnosis, regional disparities in care, and important gaps in evidence. Strengthening epidemiological surveillance, improving equitable access to services, and supporting context-specific research are essential for improving ADHD outcomes in India.

As population aging and digital transformation continue simultaneously in China, the digital divide among older adults has become an increasingly important social issue. This study examines the associations between multiple dimensions of the digital divide and depressive symptoms among older adults, as well as the potential role of bonding social capital.

Drawing on three waves of data from the China Family Panel Studies (CFPS, 2018-2022), this study employs two-way fixed effects models and mediation analyses to examine the relationships between digital access, digital usage, digital outcomes, and depressive symptoms among older adults. Robustness checks were further conducted using propensity score matching (PSM), sample restriction adjustments, and replacement of the dependent variable.

Internet access was significantly associated with lower levels of depressive symptoms among older adults (p < 0.05). Compared with non-Internet users, entertainment-oriented, instrument-oriented, and mixed Internet use were all significantly associated with lower depressive symptoms (all p < 0.05). Digital outcomes were also negatively associated with depressive symptoms (p < 0.01). Bonding social capital showed significant indirect pathways linking all dimensions of the digital divide and depressive symptoms, with mediating proportions ranging from 5.95% to 26.67%. Period heterogeneity analyses further indicated that the associations remained generally stable before and during the COVID-19 period, although mixed Internet use exhibited a significant structural difference across periods (p = 0.036).

The findings suggest that the digital divide is closely associated with the mental well-being of older adults, while bonding social capital constitutes an important social pathway linking digital engagement and psychological health. Policy efforts should move beyond technological access toward broader digital empowerment and the construction of a more inclusive digital society for aging populations.

When consumers experience mental health crises, carers are often key supporters and are also impacted significantly themselves. The Prevention and Recovery Care (PARC) model offers a community-based residential program for consumers, in times of mental health crisis. The potential of PARC services to engage carers is under-examined. This study addresses two questions: How do carers experience the PARC service; and what are carers' experiences of their own wellbeing, during and after engagement with PARC?

This is a mixed-methods convergent study of carer experience, whereby quantitative survey data and qualitative survey and interview data were gathered, analysed concurrently, and integrated to report carers perspectives of PARC services. Carers reported their wellbeing across 4 timepoints (n = 71) and also their experience of PARC services in a Carer Exit Survey (n = 50). An independent sample of six family members, each from a different PARC service, engaged in semi-structured telephone interviews.

For service experience, carers rated the PARC service as highly satisfactory. Interviewees reported a sense of relief, gratitude, and period of regrouping, while valuing the PARC service and feeling positive about accessing PARC services in the future. Positive experience was defined in contrast with distressing experiences of acute wards; concerns were expressed about limits to timely access of PARC services in future if needed. Regarding carer wellbeing, time 1 levels varied across participants, and all measures showed improvement for carers over time. They reported experience of respite, with confidence to entrust their family member to the team, and learning from PARC service staff ways to cope and interact with their family member.

Carers considered the PARC service a positive environment for the person to receive treatment and support and also experienced PARC services as supporting their own quality of life and wellbeing. This study contributes evidence about how highly valued these recovery oriented sub acute residential services are for carer service users; however, there is potential to further enhance the engagement of carers in PARC service delivery, including through inclusion of carers in co-design.

Caregiving competence is considered an important protective factor in reducing the burden of family caregivers in hospice care. However, whether this relationship is influenced by caregiving duration remains unclear. Previous studies have typically treated caregiving duration as a single quantitative indicator, overlooking potential differences arising from distinct temporal structures.

To examine the moderating role of caregiving duration in the relationship between caregiving competence and caregiver burden, with particular attention to two temporal structures: daily caregiving hours and continuous caregiving duration.

Family caregivers of patients receiving hospice care at a secondary hospital in Wenzhou between January 1 and July 31, 2025, were recruited using a convenience sampling method. A total of 345 caregivers participated in the study and completed a general information questionnaire, the Family Caregiver Task Inventory (FCTI), and the Zarit Burden Interview (ZBI-22). Spearman correlation analysis was performed to examine associations among the variables, and the SPSS PROCESS macro was used to test moderating effects.

Caregiving competence was significantly negatively correlated with caregiver burden (r = -0.876, P < 0.01). Daily caregiving hours (r = 0.604, P < 0.01) and continuous caregiving duration (r = 0.388, P < 0.01) were both positively associated with caregiver burden. Moderation analysis showed that daily caregiving hours had no significant moderating effect (B = 0.007, P = 0.563), whereas continuous caregiving duration significantly moderated the relationship (B = 0.0270, P = 0.004). Simple slope analysis indicated that the protective effect of caregiving competence on burden was stronger among caregivers with shorter caregiving duration (B = -1.609, P < 0.001) and weakened as caregiving duration increased (B = -1.374, P < 0.001).

The negative association between caregiving competence and burden may be influenced by caregiving time structure. Daily duration did not modify this association, but total cumulative time showed a trend toward a negative association with burden. Thus, cumulative caregiving length, not daily intensity, may be key. Public health practice should focus on long-term family caregivers and explore phased support based on caregiving trajectories to reduce caregiving-related mental health risks and improve hospice care system sustainability.

Against the backdrop of a rising organic composition of capital driven by industrial automation, this paper examines how industrial robot adoption is associated with worker health in China and how these effects vary across groups, with particular attention to the role of labor-market institutions. Using data from the China Family Panel Studies matched with regional measures of industrial robot penetration, the analysis considers three health-related outcomes: subjective health change, objective health, and mental health. We further test the mechanisms underlying the direct health effects in manufacturing and explore the channels consistent with the cross-sector spillover patterns observed in non-manufacturing by focusing on workers' labor-market position and on the substitutability and complementarity of labor across sectors. The results indicate that, in terms of direct effects, robot adoption is associated with significant declines in all three health measures among workers in the manufacturing sector. For workers in non-manufacturing sectors, the estimates provide suggestive evidence of cross-sector spillovers, with effects differing across health dimensions. Moreover, the health consequences of robot adoption exhibit substantial heterogeneity across worker groups, suggesting uneven health effects among workers. Overall, the findings suggest that, as capital deepening reshapes labor processes, strengthening health-risk protection and improving access to medical insurance may help mitigate adverse health consequences, especially for more vulnerable workers.

Occupational fatigue among nursing professionals is a multifactorial and complex phenomenon, with significant repercussions for both health and professional performance. In light of this scenario, Work Capacity (WC) emerges as an important indicator of job sustainability, reflecting the balance between individual resources and occupational demands.

To analyze the relationship between fatigue levels and work capacity and their associations with sociodemographic, occupational, and health characteristics in nursing professionals from Brazil and Portugal. Methods: This cross-sectional, analytical, and comparative study involved 579 nursing professionals, 370 from Brazil and 209 from Portugal. Sociodemographic, work-related, and health variables were collected, in addition to the application of the Fatigue Assessment Scale (FAS) and the Work Ability Index (WAI). Descriptive and inferential statistical analysis was performed.

The prevalence of fatigue was high in both countries, reaching approximately 70% of participants, with a higher proportion of severe fatigue in Brazil (p = 0.030). In the subdomains, Brazilians presented greater mental fatigue, and Portuguese presented greater physical fatigue (p < 0.05). Work capacity was lower in Portugal (p < 0.001). A significant inverse correlation was observed between fatigue and WC in both countries (p < 0.001).

Fatigue is high in Nursing and shows a consistent inverse relationship with work capacity in different national contexts. There is a clear need for organizational and occupational health interventions aimed at reducing fatigue, improving sleep, mitigating occupational stressors, and promoting job sustainability in nursing.

Lifestyle Medicine (LM) and Behavioral Health (BH) are increasingly recognized as complementary, synergistic disciplines that positively impact chronic disease. Limited data exist on public awareness, perceptions, preferences, and barriers to care. This study evaluated United States (U.S.) adults' understanding and attitudes toward LM, BH, and their integration. A cross-sectional, nationally weighted survey of U.S. adults was conducted in November 2025. Measures included health status, familiarity with LM, provider communication, access barriers, BH attitudes, and preferences for integrated care. Overall frequencies and cross-tabulations were reported. Respondents included 1,001 adults (51% women), with 71% reporting one chronic disease. Half had never heard of LM, 91% were at least somewhat interested in changing lifestyle habits, and 41% were very or extremely confident in their ability to make behavior changes. Seventy-five percent said addressing mental health was very or extremely important, with 82% responding they would be at least somewhat likely to use BH services if offered by their primary care doctor. Commonly cited barriers were cost, insurance coverage, and scheduling difficulties. Overall, U.S. adults reported a strong desire to improve health through lifestyle changes and access integrated LM and BH services within primary care.

The cingulate cortex is highly vulnerable in end-stage renal disease (ESRD) patients, but whether ESRD disrupts its functional gradient and the links to clinical phenotypes and underlying molecular mechanisms remain unclear.

We prospectively enrolled clinical and resting-state functional MRI data from 125 participants (77 ESRD patients, 48 healthy controls) to explore cingulate gradient alterations. Associations between cingulate gradients and canonical functional networks, clinical phenotypes, and meta-analytic behavioral domains were analyzed. A gene expression decoding analysis based on the Allen Human Brain Atlas was performed to advance understanding of how molecular mechanisms relate to hierarchical changes in ESRD.

Across global, network, and regional scales, patients with ESRD showed significant cingulate gradient dysfunction, with these anomalies exhibiting associations across multiple functional domains. Notably, serum urea and hemoglobin levels were correlated with cingulate gradient dysfunction. Spatially, these alterations correlated with genes enriched in neurodegenerative processes. Excitatory and inhibitory neurons' specific transcriptional changes account for most of the observed correlation with ESRD-specific cingulate gradient alterations.

Our findings highlight ESRD-related cingulate gradient dysfunction and its links to clinical phenotypes and gene expression profiles, providing critical insights into the neurodegenerative underpinnings of cerebral dysfunction in ESRD.

Longitudinal binary or count functional data are common in neuroscience, but are often too large to analyze with existing functional regression methods. We propose one-step penalized generalized estimating equations that support generalized functional outcomes (e.g., count, binary, proportion, continuous-valued) and is fast even when datasets have a large number of clusters and large cluster sizes. The method applies to functional and scalar covariates and the one-step estimation framework enables efficient smoothing parameter selection and joint confidence interval construction. Importantly, this semi-parametric approach yields coefficient confidence intervals that are provably valid asymptotically even under working correlation misspecification. By developing a general theory for adaptive one-step M-estimation, we prove that the coefficient estimates are asymptotically normal and as efficient as the fully-iterated estimator; we verify these theoretical properties in simulations. We illustrate the benefits of our approach for analyzing large-scale neural recordings by applying it to a recent calcium imaging dataset published in Nature. We show that our method reveals important timing effects obscured in non-functional analyses. In doing so, we also demonstrate scaling to common neuroscience dataset sizes: the one-step estimator fits to a dataset with 150,000 (binary) functional outcomes, each observed at 120 functional domain points, in only $\sim 6.5$ minutes on a laptop without parallelization. We release our methods in the $\tt {R}$ package $\tt {fastFGEE}$, which supports a wide range of link functions and working covariances.

ObjectiveOlder adults living with mental illness experience significant physical health inequities and premature mortality. The Equally Well (EW) framework promotes integrated, person-centred care to address these disparities, yet its application in older adult mental health services remains underexplored.MethodUsing a phenomenological approach, focus groups with nine allied health clinicians working in a community-based older adult mental health service explored understanding and implementation of EW. Data were thematically analysed using the Theoretical Domains Framework.ResultsClinicians endorsed EW's holistic intent but reported variable understanding, discipline-specific role ambiguity, administrative burden, and fragmented primary care as barriers, particularly in the context of frailty and multimorbidity. Facilitators included documentation prompts, multidisciplinary collaboration, and targeted training.ConclusionsAllied health clinicians support EW principles but emphasise the need for organisational investment, practical training, streamlined documentation, and stronger primary-care links. Findings highlight the importance of age-sensitive adaptation of EW to ensure equitable physical health care for older adults with MI.