This study employs a longitudinal network approach to investigate the dynamic relationships between COVID-19-related stressors and depressive symptoms among Canadian adults and to explore any sex and age differences in these associations.

The study utilised data from the Canadian Longitudinal Study on Ageing (CLSA), a large, national, long-term study of Canadian adults aged 45 years and older. Depressive symptoms were measured using the Centre for Epidemiologic Studies Depression Scale (CES-D), and COVID-19-related stressors were evaluated using a standardised stress inventory adapted for the pandemic context. The cross-lagged panel network analysis (CLPN) was employed to examine the temporal relationships and dynamic interactions between depressive symptoms and COVID-19-related stressors.

Significant variations in network structures and strengths were identified across demographic groups. Individuals aged between 45 and 65 years and females exhibited stronger connections between COVID-19-related stressors and depressive symptoms. Central symptoms such as “feeling unhappy” were consistent across groups, while “feeling depressed” was more central among males and “increased verbal or physical conflict” among females. Additionally, health-related stressors and family separation emerged as critical bridge symptoms for males and individuals under 65 years, respectively.

Both cross-sectional and longitudinal relationships, and directionality between COVID-19-related stressors and depressive symptoms across sex and age groups were identified. The findings of the study highlight that dedicated mental health intervention and prevention efforts are warranted to ameliorate the negative impact of stressors on depressive symptoms.

Mental health awareness efforts are increasing, especially for ADHD. There is growing evidence that such efforts may also cause unnecessary self-diagnosis and worsening symptoms for some disorders; however, there are no validated approaches to avoid these potential harms without reducing the awareness efforts themselves. We developed a multifaceted intervention, called nocebo education. The intervention was based on the principles of the nocebo effect, where negative expectations may cause symptom misattribution and worsening. We tested whether teaching about the nocebo effect could mitigate the potential false self-diagnosis and symptom worsening from ADHD awareness.

In a double-blind randomized controlled trial with a week-long follow-up (NCT06638411), 215 healthy young adults (77% women) were randomized to participate in a group workshop on either ADHD awareness, ADHD combined with nocebo education, or control (sleep). We measured changes in self-diagnosis and ADHD symptoms immediately after the workshop (self-diagnosis), and 1-week later (self-diagnosis and symptoms).

ADHD group reported substantially higher self-diagnosis scores immediately $ ({\beta}_{\mathrm{standardised}}=0.80\;\left[0.58,1.02\right],p<.001 $) and 1 week after the workshop $ (\beta =0.50\;\left[0.28,0.72\right],p<.001 $) compared to controls. These effects persisted despite no changes in reported symptoms. Nocebo education halved the false self-diagnosis scores immediately after the workshop ($ \beta =0.45\;\left[0.23,0.67\right],p<.001 $) and eliminated the false self-diagnosis entirely at follow-up $ (\beta =0.16\;\left[-0.06,0.38\right],p=.08 $).

We show that being exposed to ADHD awareness reliably increases false self-diagnosis among healthy young adults for at least one week; a brief nocebo education intervention is efficacious in substantially reducing and later eliminating it. Nocebo education is a promising adjunct for balanced awareness efforts that could be applied in various contexts.

This study aims to provide an overview of evidence on factors affecting Mediterranean diet (MD) adherence across socio-ecological levels (individual, interpersonal and environmental) in Mediterranean countries, which can be target points for future interventions to promote MD adherence.

A systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines and registered in the Prospero database (CRD42020189337). Literature was searched in PubMed, Web of Science and PsycINFO.

The MD is one of the healthiest dietary patterns, reducing risk of chronic disease while promoting better health outcomes. However, adherence to the MD remains challenging, even in Mediterranean countries.

Healthy adults aged 18 years and older, living in a Mediterranean country.

A total of thirty-seven cross-sectional studies were included, with 190 to 13 262 participants. Most studies (30/37) were conducted in European Mediterranean countries, primarily Italy (n 14), Spain (n 9) and Greece (n 6). All studies involved community-based samples; two studies included only women. Individual-level determinants were the most frequently examined. Higher socio-economic status, regular breakfast consumption, being unemployed, a job seeker or retired were linked to better MD adherence. Socio-cognitive and interpersonal factors were underexplored. At the environmental level, COVID-19 confinement boosted adherence, whereas the effects of economic crises were inconsistent. Effect sizes were mostly very small to small, and findings are based on low-quality studies.

This systematic review highlighted several socio-economic and environmental factors potentially influencing MD adherence. However, more robust research is needed to better understand socio-cognitive and ecological factors.

To provide an up-to-date review of existing and current literature in the field of radiological and nuclear disasters to support the needs of research applications for health care and public health preparedness and response.

A systematic literature search using 4 databases to identify articles which included a multitude of topics relevant to preparedness for nuclear and radiological disasters. One hundred articles that met inclusion criteria were summarized into 7 themes addressing medical and health care preparedness for nuclear and radiological events.

The review generated evidence supporting and defining various measures health care and government entities can take to improve nuclear and radiological disaster readiness and responsiveness in health systems. Strengthening preventive measures and policies, prehospital and hospital mechanisms, training and education, regional collaboration, communication, and infrastructure support were the main gaps identified.

An overarching concern regarding the inadequacies of the modern health care system’s radiological disaster preparedness was a clear-cut conclusion from the literature. The major challenges and proposed solutions for public safety to the growing threat of radiologic disasters were identified.

Primary care serves as the foundation of a well-functioning healthcare system and is critical for ensuring equitable access, early disease management, and cost-effective service delivery. In China, reforming primary-level healthcare institutions has become a national priority to achieve universal health coverage. Understanding the service users’ perspectives is essential to align primary care services with population health needs and improving trust in grassroots healthcare providers.

To evaluate satisfaction and unmet service needs among primary care users in Jiangsu Province, China.

A cross-sectional survey using structured questionnaires was given to 424 residents in urban and rural Jiangsu Province to measure satisfaction with primary hospitals, doctors, service preferences, and perceived gaps. Data was analyzed using descriptive statistics and chi-square tests to identify regional differences.

The primary care utilisation rate among respondents was 73.3%. While 75.2% reported satisfaction with medical expenses at primary-level facilities, significant urban-rural and regional differences were observed in service awareness, health policy knowledge, and perceived quality of doctor-patient communication. Primary care doctors received the highest ratings for using “easy-to-understand language”(mean score 4.13 ± 0.821) but lower scores for “professional competence” and “treatment effectiveness” (both 3.91). Rural inhabitants expressed high demand for services like management of common diseases (65.8%) and routine health examinations (52.4%), but highlighted shortages in advanced diagnostic tools (e.g., CT scans, endoscopy). Most inhabitants (67.2%) felt that primary care providers require improvement, particularly in clinical competency and communication.

The findings highlight areas for targeted policy interventions to improve primary care service delivery and capacity-building of primary care doctors in Jiangsu Province.