Neuropsychiatric symptoms (NPS) are common in dementia and may hinder differential diagnosis between behavioral variant frontotemporal dementia (bvFTD) and Alzheimer's disease (AD). Despite investigations of NPS and social cognition, particularly Theory of Mind (ToM) and emotion recognition, their precise, differential impact on social cognition in bvFTD versus AD remains less characterized. This study examined NPS in bvFTD and their association with social cognition, comparing results to AD. Patients with bvFTD (n=13) and AD (n=18) were assessed using neuropsychiatric and cognitive batteries measuring depression, anxiety, mania, and psychosis. Social cognition was evaluated with the Mini-Social and Emotional Assessment (mini-SEA), including the Faux-Pas test (ToM) and the Facial Emotion Recognition Test (FERT). The groups did not differ in sex, education, or disease duration. Compared to AD, bvFTD patients had higher manic symptoms (p<0.001) and schizophrenia spectrum symptoms, particularly in negative (p<0.001) and resistance/hostility (p=0.034) symptoms. In bvFTD, depressive (p=0.020) and anxious (p=0.045) symptoms positively correlated with the Faux-Pas test, while positive psychotic symptoms correlated negatively (p=0.005). In AD, obsessive-compulsive (p=0.013) and disorganized psychotic symptoms (p=0.009) negatively correlated with the Faux-Pas test, while manic symptoms negatively correlated with the FERT (p=0.033). bvFTD patients displayed more schizophrenic and manic symptoms than AD, with NPS impacting social cognition differently in each condition. Sintomas neuropsiquiátricos (SNP) são comuns na demência e podem dificultar o diagnóstico diferencial entre a variante comportamental da demência frontotemporal (DFTvc) e a doença de Alzheimer (DA). Embora os SNP e a cognição social — especificamente a Teoria da Mente (ToM) e o reconhecimento de emoções — tenham sido investigados, o impacto distinto desses SNP na cognição social, na DFTvc em comparação com a DA, permanece pouco caracterizado. Este estudo examinou os SNP na DFTvc e sua associação com a cognição social, comparando os resultados com a DA. Pacientes com DFTvc (n=13) e DA (n=18) foram avaliados por meio de baterias neuropsiquiátricas e cognitivas que mensuraram depressão, ansiedade, mania e psicose. A cognição social foi avaliada com a Mini-Social and Emotional Assessment (mini-SEA), incluindo o teste de Faux-Pas (ToM) e o Teste de Reconhecimento de Emoções Faciais (FERT). Os grupos não diferiram quanto a sexo, escolaridade ou duração da doença. Em comparação à DA, os pacientes com DFTvc apresentaram sintomas maníacos mais elevados (p<0,001) e sintomas do espectro da esquizofrenia, particularmente sintomas negativos (p<0,001) e de resistência/hostilidade (p=0,034). Na DFTvc, sintomas depressivos (p=0,020) e ansiosos (p=0,045) correlacionaram-se positivamente com o teste de Faux-Pas, enquanto sintomas psicóticos positivos correlacionaram-se negativamente (p=0,005). Na DA, sintomas obsessivo-compulsivos (p=0,013) e sintomas psicóticos desorganizados (p=0,009) correlacionaram-se negativamente com o teste de Faux-Pas, ao passo que sintomas maníacos correlacionaram-se negativamente com o FERT (p=0,033). Pacientes com DFTvc exibiram mais sintomas esquizofrênicos e maníacos do que aqueles com DA, e os SNP impactaram a cognição social de maneira diferente em cada condição.
Social media is increasingly used by patients, caregivers, and clinicians to access and share cancer-related information. This study examined how individuals use social media for lung cancer education and their preferences. A cross-sectional survey was conducted on Instagram using interactive story features (polls, open-response questions) over three weeks (August to September 2025). Voluntary participation implied consent. Respondents provided demographic data and responses about social media use, content preferences, trust, and impact. Among 182 respondents, 37% were patients, 31% caregivers, 23% clinicians, and 9% others; most were female (78%), ages 25-44 years (65%) and living in North America (75%). Social media use for lung cancer information was common, particularly on Instagram, with 66% following cancer-related accounts. Respondents preferred content from patients/survivors and practicing clinicians. Short videos/reels, patient stories, and infographics were the most favored formats, with 97% reporting diagrams/animations improved understanding; 93% reported trust in social media content and that posts improved clarity on cancer types and treatments; 70% self-reported that social media influenced a behavior and 67% reported it increased confidence in discussing care. Open response answers highlighted social media as a source of education, hope, peer connection, empowerment, and timely updates, and interest in future content on emerging therapies, conference insights, care navigation, survivorship, and personalized topics. Respondents frequently sought information from clinicians, with concise visual formats, and reported tangible benefits for confidence and health behaviors. Social media may offer a scalable platform for delivering real-time education on lung cancer.
Social innovation in education remains under-researched despite its growing importance in addressing educational challenges in Latin America. Whilst innovation in education can encompass systemic reforms or incremental classroom changes, social innovation specifically involves novel partnerships, institutions, methods, and collaborative arrangements amongst communities, schools, local governments, and non-governmental organizations, emphasizing societal participation through co-creation processes. This paper addresses the research question: How do social actors construct and sustain social innovations in education through networks, partnerships, and community participation? Drawing on fieldwork conducted in Brazil and Mexico between 2013 and 2014 and a follow-up interview in 2023, this study employs case study methodology examining three long-standing educational innovations: City School-Apprentice and Campos Salles School in São Paulo, Brazil, and the Institute of Educational Innovation in Chiapas, Mexico. The analysis suggests that, in the cases examined, social innovations emerged through iterative processes involving collective action, sustained relationship-building, and collaborative governance at the micro level. The findings show how locally rooted networks developed connections to wider institutional structures, under conditions that varied considerably between the two national contexts. The paper's primary contribution lies in offering an empirically grounded sociological account of social innovation in education in two contrasting Latin American contexts. This study shows the influence of diverse stakeholders on the implementation of educational innovations in environments with limited resources. It also emphasizes the transformative potential of grassroots innovation, civil society involvement, and community-centred approaches to educational change in Latin America.
Appearance anxiety for social media users (AASMU) is emotional distress linked to social media use (SMU), negatively affecting mental and physical health. However, little is known about the dynamic relationship between AASMU and SMU, and effective interventions. Study 1 used Ecological Momentary Assessment (EMA) with 206 participants completing daily surveys for 20 days. Dynamic structural equation modeling (DSEM) revealed that AASMU tended to persist from 1 day to the next (β = 1.45) and that higher levels of AASMU and SMU often occurred together on the same day (β = 2.57). A higher level of self-compassion (SC) or a healthier lifestyle moderated this relationship, providing resilience against SMU's negative effects (β = -0.40 or -0.41). Study 2 utilized an ecological momentary intervention (EMI) with 200 participants, where the intervention group read SC statements daily. Results showed a significant reduction in both the mean level (β = -0.05) and intra-individual variability of AASMU in the intervention group (β = -0.11), suggesting SC-based EMI is an effective approach to reducing AASMU.
Hikikomori is a condition characterized by remaining predominantly at home for at least 6 months, with marked social withdrawal and functional impairment. In prolonged cases, reduced self-care and physical comorbidities are common; however, access to necessary medical care is often limited. When a distrust of medical services and the refusal of psychiatric care are pronounced, psychiatric interventions alone may be insufficient. In such cases, it is important to use general medical care as an entry point to subsequent psychiatric and community-based support. We herein report a case of hikikomori for more than 15 years in a man in his 50s. He first presented to general medical services after developing wound myiasis. Thereafter, while receiving physical treatment, he received stepwise support in a psychiatric ward, including support for hygiene behaviors, family support, and discharge planning. His resistance to bathing and grooming gradually decreased. After discharge, he moved into supported housing and began attending a supported employment program. During the 3-month follow-up, no recurrence of hikikomori was observed. This case shows that in patients with long-term hikikomori for whom psychiatric interventions alone are difficult, a structured support process that links general medical, psychiatric, and community care in a stepwise manner may facilitate social reintegration. The process may be conceptualized in terms of the entry point, transition phase, and outcome.
Cardiovascular health remains susceptible to inaccurate information, which can harm health outcomes. This scoping review addresses a gap in comprehensive analyses by synthesising evidence on the prevalence, spread, impact and correction strategies related to cardiovascular health misinformation across diverse populations and settings. Following Joanna Briggs Institute guidelines, we searched MEDLINE, EMBASE, Global Index Medicus, Web of Science. A dual-reviewer process, using Covidence, screened articles in two phases (title/abstract, full-text) based on predefined inclusion criteria. Data extraction was performed by two reviewers, and results were synthesised narratively, presented by tables and figures. From 6348 screened articles, 22 were included. The review reveals widespread misinformation concerning smoking, nutrition, blood pressure, weight management, alcohol consumption and diabetes care. Specific examples include misleading claims about e-cigarette safety and the downplaying of alcohol's harms. A substantial proportion of social media posts falsely discourage salt reduction (reaching 1.5 million followers) and a significant number of diet/exercise vlogs (36.7%) and YouTube videos on myocardial infarction (one-third) contain inaccuracies, often originating from unreliable sources. Instagram, Facebook, YouTube and X were identified as key platforms for dissemination. This review demonstrates that cardiovascular health misinformation is widespread and shaped by both platform dynamics and user-level factors. Addressing this challenge requires coordinated strategies that strengthen digital literacy, enhance visibility of evidence-based content and reduce the reach of misinformation. Collaborative efforts between public health agencies, clinical institutions and technology platforms are essential to ensure that trustworthy cardiovascular disease-related information reaches the public.
Residency orientation provides a unique opportunity to introduce an interdisciplinary group of resident physicians to locally relevant social determinants of health (SDOH). To compare residents' ability to address SDOH before and after an orientation workshop and describe the feasibility and acceptance of utilizing authentic patient narratives in teaching SDOH. All incoming residents at the University of New Mexico in 2 consecutive academic years (AY 2023-2024 and 2024-2025) participated in the workshop. Large group lectures complemented small-group case-based exercises on recognizing and addressing SDOH. In the second year, video excerpts of real patients narrating their experiences with health care were incorporated. A post-session survey measured self-reported ability to recognize and address SDOH. One hundred seven of 164 (65%) residents in AY 2023-2024 and 91 of 173 (53%) residents in AY 2024-2025 completed the survey. Both sessions demonstrated statistically significant (P<.001) improvement in resident self-reported ability to: (1) recognize SDOH (pre- and post-workshop mean scores 8.32 [SD 1.17] vs 6.83 [SD 1.89] in AY 2023-2024; 8.67 [SD 1.06] vs 6.97 [SD 2.06] in AY 2024-2025), and (2) address SDOH (7.98 [SD 1.37] vs 6.32 [SD 1.96]; 8.48 [SD 1.28] vs 6.99 [SD 2.00]). Patient videos supported learning, demonstrated by an increase in effect size (Cohen's d 0.1 vs 1.04). Twelve to 18 hours were needed to develop workshop materials, with an additional 6.5 hours required for administrative and facilitator time. A workshop during graduate medical education orientation introducing SDOH using authentic patient narratives increased residents' self-reported ability to address SDOH specific to their new patient populations.
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Sickness behavior comprises a coordinated constellation of motivational, cognitive, and social alterations that emerge during systemic inflammation. Although reductions in locomotion, feeding, and social engagement have been extensively characterized, how inflammation affects ultrasonic vocal communication-an ethologically relevant index of social motivation in rodents-remains insufficiently understood. Here, we investigated how systemic immune activation alters male-female social communication in mice by jointly assessing ultrasonic vocalizations (USVs) and approach behavior. Sexually experienced male mice received an intraperitoneal injection of lipopolysaccharide (LPS), and their interactions with a novel estrous female were evaluated 24 h later by quantifying USVs and approach behavior. LPS administration robustly suppressed both the total number of USVs and the duration of male approach behavior, indicating a pronounced reduction in social motivation. Beyond this quantitative suppression, LPS also induced qualitative changes in vocal output, including shifts in the proportional use of specific USV subtypes and alterations in acoustic features such as sound pressure. These findings demonstrate that USVs capture multiple dimensions of inflammation-induced disruption of social communication, reflecting not only diminished motivation to engage socially but also changes in the structure of communicative signals themselves. By revealing that systemic immune activation reshapes both social approach behavior and vocal communication patterns, this study establishes USV analysis as a sensitive and translationally relevant behavioral readout for probing neuroimmune mechanisms underlying the social and communicative disturbances characteristic of sickness behavior. More broadly, our results highlight the utility of vocal communication analyses for elucidating how inflammatory processes perturb social circuits and communicative function in health and disease.
This review deals with the questions why humans want to live with other animals and how this is at all possible. In fact, it has become common sense that living and working with companion animals entails major benefits for human wellbeing and health, albeit with the caveat that the positive experience of private keepers and practitioners in pedagogy and therapy is not always backed by scientific scrutiny. The present focus is on relevant aspects of the "Darwinian continuum," which provides humans and other animals with a shared social toolbox, including brain, physiology and behavioral organization. It is discussed why domesticated animals are particularly suitable companions, why dogs are a special case, and why anthropomorphizing other animals may be as much an asset as a burden. In fact, living with companion animals is a human universal, which seems basically motivated by biophilia (the human-typical interest in nature and animals), and by striving for social homoeostasis (for social contexts supporting wellbeing and health). Between-species socializing is possible because of common phylogeny and functional convergence, resulting in matching social mindsets and behavioral systems. It is based on shared principles of behavioral organization, of thinking and decision making, on shared neuronal, physiological and psychological mechanisms, on virtually identical basic affects, and on the shared stress and calming systems. Finally, the social toolbox shared between humans and other animals also suggests a relatively moderate socio-cognitive gap between humans and other animals.
Headache disorders involve complex interactions between neurobiological, psychiatric, behavioral, and social factors. Despite robust evidence of psychiatric comorbidity and psychosocial influences, these dimensions remain inadequately integrated into clinical practice and conceptual models. This review synthesizes evidence linking psychiatric factors with headache disorders and proposes Headache Psychiatry as a unified, integrative framework, operationalized through the Psychocephalology model. We conducted a structured narrative review across PubMed, PsycINFO, and Web of Science (1990-2025), examining psychiatric comorbidity, emotion regulation, stress physiology, pain neuroscience, and psychosocial determinants in headache disorders. The Psychocephalology framework synthesizes findings across five interconnected domains: neurobiological mechanisms, pain-processing dynamics, emotion regulation, stress-behavioral factors, and social-contextual influences. Strong bidirectional associations exist between headache and depression, anxiety, trauma exposure, and sleep disturbance. Emotion dysregulation, catastrophizing, and maladaptive coping predict chronification and disability. Neural pain-emotion circuits show heightened activity in chronic migraine. Stress physiology, HPA axis dysregulation, and behavioral patterns are associated with chronic headache. Women experience disproportionate burden due to hormonal fluctuations, perinatal transitions, and role-related stress. Headache Psychiatry, operationalized through the Psychocephalology framework, offers a biopsychosocial model that bridges fragmented disciplines. Clinical implementation requires routine psychiatric screening, multidisciplinary teams, integrated behavioral-pharmacological treatments, and specialized attention to perinatal mental health. This approach enables personalized, context-sensitive care and may prevent transition from episodic to chronic headache.
School dropout is the premature interruption or extended completion of education, posing significant challenges for both individuals and educational systems worldwide. This study explores how psychosocial factors influence the intention to dropout of school among 2,646 students from 13 secondary schools in Italy. By assessing individual (e.g., personality, behavior, mental health) and environmental (e.g., family, school context) factors, the study seeks to understand the role of psychological distress in dropout intentions. Specifically, individual factors were measured through the Youth Self-Report, Bergen Social Media Addiction Scale, Internet Gaming Disorder Scale, Eating Attitude Test, Hikikomori Questionnaire, and Big Five Inventory-10. Environmental factors were measured using the Word Health Organization Quality of Life, Parental Bonding Inventory, and the Questionnaire de dépistage d'élèves à risque de décrochage scolaire. Socio-demographic factors and social desirability bias (using the Impression Management scale from the Balanced Inventory of Desirability Responding) were also measured. Multiple linear regression analyses, controlling for gender, socioeconomic status, age, and social desirability, revealed family supervision as a crucial protective factor against dropout. Conversely, attention-related issues such as impulsivity and difficulty concentrating were strong predictors of dropout intentions, indicating their detrimental effect on academic performance and study habits. These findings highlight the importance of family involvement and mental health support to reduce dropout rates. Addressing both environmental and psychological factors is critical for promoting student retention and academic success.
Urinary incontinence (UI) is a common yet underrecognized condition among women and is associated with substantial physical, psychological, and social consequences. Despite its significant impact on quality of life, many affected women do not seek medical care because of embarrassment, stigma, or misconceptions regarding the condition. Limited data are available regarding the burden of UI and its effect on the quality of life among women in Saudi Arabia.  To assess the prevalence of urinary incontinence and evaluate its impact on quality of life among women in Saudi Arabia.  A descriptive cross-sectional study was conducted among women residing in Saudi Arabia using a structured self-administered electronic questionnaire. Adult women aged 18 years and older were included, while pregnant women and those with neurological disorders affecting bladder function were excluded. Data collected included sociodemographic characteristics, obstetric and medical history, urinary incontinence characteristics, quality of life impact, and health-seeking behavior. Quality of life was assessed using Likert-scale responses across multiple domains. Data were analyzed using the Statistical Package for the Social Sciences (SPSS), version 26 (IBM Corp., Armonk, New York, USA), and associations between urinary incontinence and selected variables were evaluated using the chi-square test, with a p-value of less than 0.05 considered statistically significant.  A total of 442 women participated in the study. Urinary incontinence was reported by 40.3% (n = 178) of participants, while 59.7% (n = 264) reported no symptoms. Stress urinary incontinence was the most common subtype, reported by 38.2% (n = 68) of affected women, followed by mixed urinary incontinence in 32.6% (n = 58) and urge urinary incontinence in 23.6% (n = 42). The prevalence of UI increased with age, reaching 61.1% (n = 44) among women aged 50 years or older. Moderate to severe impairment in overall quality of life was reported by 61.8% (n = 110) of affected participants. Emotional well-being was moderately to severely affected in 65.2% (n = 116), while daily activities were moderately to severely affected in 61.8% (n = 110). Despite the significant burden, only 36.0% (n = 64) of affected women sought medical advice, whereas 64.0% (n = 114) did not seek healthcare. The most common barriers to seeking care were embarrassment, reported by 36.8% (n = 42), and the belief that UI is a normal condition, reported by 29.8% (n = 34).  Urinary incontinence is highly prevalent among women in Saudi Arabia and is associated with considerable impairment in quality of life. The condition particularly affects emotional well-being, daily functioning, and social participation. Despite its impact, healthcare-seeking behavior remains low because of social and cultural barriers. Increased awareness, early screening, and targeted public health interventions are essential to improve recognition, management, and quality of life outcomes among affected women.
This study examines the effects of an integrated intervention combining inclusive children's literature and creative drama on the empathic tendencies of fourth-grade primary school students. Although the individual contributions of inclusive literature, creative drama, and empathy development have been documented separately in the literature, no prior study has examined how cognitive empathy initiated through inclusive narratives can be transformed into emotional and behavioral outcomes through drama-based experiences within a unified pedagogical framework. This study addresses that gap by both testing this theoretical proposition empirically and proposing an integrated model for multidimensional empathy education. Drawing on a multidimensional model of empathy (cognitive, affective, and behavioral) and grounded in developmental psychology and social-cognitive frameworks, particularly theory of mind and prosocial development, the study was conducted in the context of Turkish primary education, where inclusive policies are increasingly implemented yet remain insufficiently supported by evidence-based pedagogical models. A quasi-experimental pretest-posttest control group design was employed with 57 students enrolled in a public primary school in Türkiye. The experimental group participated in an eight-week structured intervention based on inclusive children's literature and creative drama, while the control group continued with regular classroom practices. As a methodological limitation, the intervention was implemented by different teachers across the experimental and control groups, which may have introduced teacher-specific variables that could not be fully controlled. Data were collected using the Empathic Tendency Scale, a validated instrument assessing multidimensional empathy constructs. The results revealed that, after controlling for baseline scores, the experimental group demonstrated significantly higher posttest scores in overall empathic tendency compared to the control group, with a large effect size. Multivariate analyses further indicated that the intervention had significant effects across all subdimensions of empathy. While the effect on cognitive empathy was moderate, the effects on emotional and behavioral empathy were large, suggesting that the integration of drama-based experiential learning plays a critical role in transforming cognitive understanding into affective engagement and prosocial behaviors. The results support the theoretical proposition that inclusive literature functions as a cognitive stimulus, whereas creative drama acts as a pedagogical mechanism that operationalizes empathy by embedding it in lived experience. By integrating inclusive education, children's literature, and creative drama within a unified framework, this study contributes to the literature by offering a novel and empirically tested model for fostering empathy in primary education. Future research should further examine the longitudinal stability of these effects, their transfer to real-life social behaviors, and their replicability across larger and more diverse samples.
Extant research has identified that employee political skill exerts a positive influence on the formation of high-quality leader-member exchange (LMX), thereby impacting career outcomes. However, the boundary conditions that moderate this relationship, especially from an integrated career capital and social exchange perspective, remain underexplored. Grounded in these two theoretical perspectives, we argue that task performance, as human capital, enables political skill, conceptualized as social capability or relational competence, to translate into high-quality LMX as realized relational social capital. Specifically, we propose that task performance strengthens the political skill-LMX link, which in turn enhances promotability. Analyses of 200 supervisor-subordinate dyads support our hypotheses. These results yield substantive implications for organizational behavior theory and managerial practice.
Mental health risk among urban older adults has become an important public health and social policy issue in the context of rapid population aging in China. Existing studies have often focused on single factors and have lacked an integrated analysis of multi-level determinants within a unified theoretical framework. This study examined the associations of ecological system factors with mental health risk among urban older adults. Data were drawn from the 2020 China Longitudinal Aging Social Survey (CLASS). Guided by Bronfenbrenner's ecological systems theory, this study constructed an analytical framework covering the micro-, meso-, exo-, macro-, and chrono-system levels. Ordered logistic regression, stepwise cumulative regression, bootstrap mediation analysis, and robustness tests were used to examine the associations of social support, activity participation, community environment, institutional environment, and risk events with mental health risk, as well as subgroup heterogeneity. Higher levels of social support and more frequent activity participation were associated with higher mental health risk. Better community and institutional environments were associated with lower mental health risk, whereas risk events were significantly associated with higher risk. Mediation analysis suggested that activity participation was indirectly associated with mental health risk through risk events, while the association between community environment and mental health risk was attenuated after risk events were taken into account. Heterogeneity analysis showed substantial differences across gender, age, income, and educational groups. Mental health risk among urban older adults was closely related to multi-level ecological factors. Policy efforts should focus on improving the quality of support, strengthening community services and institutional protection, and adopting stratified interventions for different groups. Given the cross-sectional design, the findings should be interpreted as associations rather than causal relationships.
Emotional intelligence (EI) has emerged as a critical neurocognitive construct linking affective processing, social behavior, and adaptive functioning. This integrative narrative review synthesizes multidisciplinary findings to map the biological underpinnings of EI across genetic, epigenetic, neuroanatomical, and neurophysiological domains. Drawing on evidence from neuroimaging, molecular genetics, neurochemistry, and brain connectivity studies, the review suggests EI as a product of dynamic interactions between prefrontal-limbic circuits, neurotransmitter systems, and environmentally sensitive regulatory mechanisms. Key brain structures, including the prefrontal cortex, amygdala, anterior cingulate cortex, and insula, operate within coordinated networks that support the recognition, regulation, and social cognition of emotions. Neurotransmitters such as dopamine, serotonin, oxytocin, and gamma-aminobutyric acid (GABA) modulate the emotional reactivity and cognitive control essential to EI. Epigenetic modifications further explain the lifelong plasticity of emotional capacities in response to experience. Anchored in the process model of emotion regulation and the social brain hypothesis, this review provides a cohesive neuroscientific framework for EI. It outlines its translational implications in education, healthcare, and affective computing. By consolidating current advances, this review may help inform precision interventions and policy initiatives aimed at enhancing emotional resilience, empathy, and psychological well-being.
Disability among women of reproductive age is a critical public health issue with significant social and economic implications. Understanding individual- and community-level determinants is essential for targeted interventions. This study examines the prevalence and determinants associated with disability among women aged 15-49 years in Somalia. Data from the Somalia Health and Demographic Survey (SHDS) were analyzed using STATA 17.0, employing a multivariable multilevel logistic regression model to assess individual- and community-level determinants of disability. Multicollinearity was assessed and found not to be a concern. The SHDS used a stratified two-stage cluster sampling design in which enumeration areas were selected with probability proportional to size, followed by systematic selection within each cluster, and inclusion of all eligible individuals, ensuring nationally representative data across population groups. Only statistically significant predictors were reported. Overall, 3.05% of women reported a disability. At the individual level, the odds of disability increased with older age (25-34 years: AOR = 1.42; 35-49 years: AOR = 2.17) and among women who were divorced (AOR = 2.34), abandoned (AOR = 4.99), widowed (AOR = 2.20), or never married (AOR = 3.36), while higher education (AOR = 0.51), larger household size (6-10 members: AOR = 0.71; ≥11 members: AOR = 0.67), higher wealth (highest quintile: AOR = 0.63), and health insurance coverage (AOR = 0.04) were protective. At the community level, rural residence (AOR = 0.45) and living in the southern areas (AOR = 0.75) were associated with lower odds of disability compared with urban and northern areas. The findings underscore the need for targeted, evidence-informed policies that address the determinants associated with disability among women of reproductive age in Somalia. Priority should be given to expanding access to education for women, improving health insurance coverage for disadvantaged and low-income groups, and reinforcing social protection systems for the marginalized groups. In addition, efforts should focus on improving the availability, accessibility, and quality of disability-related health services, with particular emphasis on urban areas and the northern areas, where the likelihood of disability was relatively higher compared with rural residence and the southern areas.
Family caregivers play a crucial role in supporting patients with mental disorders after hospital discharge. However, caregivers often experience difficulties related to limited information, caregiving burden, and restricted access to mental health services. This study aimed to explore the informational and skill-related needs of caregivers of psychiatric patients after hospital discharge and to develop a prototype chatbot-based consultation system tailored to these needs in Indonesia. An exploratory qualitative design guided by Social Cognitive Theory was employed to explore caregiver needs and support the development of a preliminary rule-based chatbot prototype. Data were collected through semi-structured interviews with eight participants (five mental health professionals and three family caregivers), supported by analysis of 67 anonymized WhatsApp consultation records and five discharge education documents. Data were analyzed using inductive thematic analysis following Braun and Clarke's framework and organized using NVivo. Trustworthiness was enhanced through triangulation, member checking, and peer debriefing. The identified themes were translated into chatbot features including psychoeducation, caregiving guidance, relapse support, and referral navigation, followed by expert validation involving six multidisciplinary experts. Thematic analysis identified nine domains of caregiver needs: patient condition understanding, treatment and medication management, home care practices, community support, caregiver burden and coping strategies, supporting health services, barriers in online consultation systems, expectations for digital media, and future challenges in chatbot implementation. Caregivers emphasized the need for continuous psychoeducation, clear guidance for relapse prevention, and accessible consultation channels after discharge. Based on these findings, the identified caregiver needs were translated into a preliminary rule-based decision tree chatbot prototype (KJOL-ITEUNGBOT) designed to support caregiving information and referral navigation. Family caregivers of psychiatric patients in Indonesia face complex informational and psychosocial challenges after hospital discharge. A chatbot-based consultation system may serve as a potentially useful tool for supporting caregiver access to information and post-discharge guidance. Future research should evaluate the usability, effectiveness, and scalability of the chatbot in broader clinical settings.
Disability in youth is an increasing global public health concern, with growing evidence linking disability to mental disorders and elevated healthcare needs. This study aimed to identify disability subtypes among Singaporean youth, examine sociodemographic factors, and assess their relationships with psychological distress and healthcare utilization. Data were drawn from the National Mental Health Youth Study (n = 2,600), a cross sectional epidemiological survey of Singapore residents aged 15-35 years. Latent class analysis was conducted using 12 indicator variables from the World Health Organization Disability Assessment Schedule 2.0. Multinomial and multivariable logistic regression models examined sociodemographic correlates and associations with psychological distress and healthcare utilization. A four-class solution best represented disability patterns: high difficulty (7.8%), moderate social and functional difficulty (13.8%), high physical and cognitive difficulty (6.7%), and no/low difficulty (71.7%). Youth in the high difficulty class were more likely to be of Malay and Indian ethnicity and have lower educational attainment. Compared with the no/low difficulty class, the high difficulty class had higher odds of moderate (OR=3.2) and severe/very severe depression (OR=4.1), as well as moderate (OR=2.2) and severe/very severe anxiety (OR=3.6). Youth in the high difficulty and moderate social and functional classes also had higher odds of hospital admissions, A&E visits, and contact with polyclinic and restructured hospital doctors. Distinct disability profiles among Singaporean youth are strongly linked to psychological distress and higher healthcare use, highlighting the need for earlier identification and targeted interventions to better support youths experiencing functional difficulties and psychological distress.