The Anxiety, Depression and Mood Scale (ADAMS), a mental health screening tool developed for individuals with intellectual disabilities, has yet to be evaluated in adults with Down syndrome. We included the ADAMS in a Dementia Protocol.

We reviewed the charts of 71 adults with Down syndrome seen in a specialty clinic and collected ADAMS data from our quality improvement project. We evaluated the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of the ADAMS at five cutoff points to identify optimal screening thresholds for adults with Down syndrome.

Cutoff points set at two points below the 75th percentile scores of the original ADAMS publication presented optimal sensitivity of 81.82%, specificity of 82.93%, PPV of 72.00% and NPV of 89.47%.

For adults with Down syndrome, we suggest alternate thresholds, generally two points below the original ADAMS thresholds, to adequately capture mental health concerns.

There is an increasing number of studies in the literature on the prevalence of attention-deficit/hyperactivity disorder (ADHD), indicating its high prevalence. This study sought to investigate the reliability of the ADHD Rating Scale-5 (ADHD-RS-5) for adolescents in Saudi Arabia as a valid screening tool for this age group. Furthermore, it aimed to calculate the cutoff score for screening for ADHD in the Saudi environment to provide a reliable tool that helps specialists assessing for ADHD among adolescents.This study applied a descriptive approach to verify the reliability of the ADHD-RS-5 in the Saudi environment. The sample consisted of 477 parents and 1284 teachers of Saudi and non-Saudi adolescents (aged 13 to below 20 years) residing in Riyadh, Makkah, and the Eastern Province. Both forms of the ADHD-RS-5 (home and school) were applied to the sample under supervision of the Saudi ADHD Society. Data were analyzed using IBM SPSS Statistics (version 26), JASP (version 0.18.3.0), and MedCalc statistical software (version 22.030).Confirmatory factor analysis results revealed acceptable goodness-of-fit indicators for the home and school forms of the ADHD-RS-5. Pearson's correlation coefficients for both forms were found to be positive and statistically significant (p > 0.001); the coefficient values ranged between 0.669 and 0.921 for the home form and between 0.795 and 0.954 for the school form. In addition, Cronbach's α coefficient values ​​for inattention, hyperactivity, impairment, and the scale's total score for the home form were 0.919, 0.913, 0.952, and 0.952, respectively, while for the school form were 0.955, 0.944, 0.969, and 0.981, respectively. Cronbach's α coefficient values ​​were close to the values ​​of the McDonald's ω for the home form (0.920, 0.914, 0.953, and 0.965, respectively) and for the school form (0.955, 0.939, 0.968, and 0.977, respectively). These results indicate that the ADHD-RS-5, both home and school forms, and its subscales have good Cronbach's α and McDonald's ω coefficients. The findings also showed that the prevalence of ADHD among adolescents in Saudi Arabia was 5.03% based on the home form and 5.92% based on the school form. The cutoff value to screen for ADHD in adolescents in the Saudi environment for the home form was > 30, with a sensitivity of 91.67% (95% confidence level [CL] = 73-99), a specificity of 86.98% (95% CL = 83.5-89.9), and 81.29% accuracy. However, the cutoff score in the school form was > 28, with a sensitivity of 94.74% (CL = 81.1-98.5), a specificity of 89.65% (CL = 87.8-91.3), and 86.46% accuracy.The current findings suggest that the Arabic version of the ADHD-RS-5-AR has strong psychometric properties, with good indicators of internal consistency and reliability. This study provides valuable information for the national ADHD survey planned to be carried out in 2024-2025. It will also support the preventive efforts in Saudi Arabia and Saudi Vision 2030 in achieving its goals related to the quality of life and well-being of community members of all ages as well as the goals of sustainable development.

Neurofilament light(NfL) and glial fibrillary acidic protein(GFAP) are associated with disease activity in multiple sclerosis(MS), however use in monitoring remains limited. The ability of these biomarkers to detect disease activity upon treatment discontinuation was studied.

Long-term stable relapse-onset MS patients were to continue or discontinue their first-line disease-modifying therapy(DMT) to study the safety of DMT discontinuation(DOT-MS trial NCT04260711). "Significant" disease activity was defined as clinical relapse, ≥3 new lesions or ≥2 contrast-enhancing lesions. MRI and sampling were performed at baseline, month 3, 6, 12, 18 and 24. Associations of delta biomarker levels and NfL z-score(age and body mass index derived) with "significant" disease activity were tested. Cut-off values for biomarkers to detect disease activity were calculated.

45(50.5%) participants discontinued their DMT. Eight(all discontinued DMT) had "significant" disease activity, which was associated with an increase in NfL levels(OR:1.13 [1.03-1.33], p = 0.04) and NfL z-scores(OR:2.17 [0.98-5.22], p = 0.06), but not with GFAP(p = 0.52). Delta NfL had the highest ability to detect "significant" disease activity(AUC:0.88 [0.76-0.99]), with the best calculated cut-off of 46.4% increase(AUC:0.68, sensitivity 0.57, specificity 0.96).

NfL may be useful to identify, but not predict, disease activity after DMT discontinuation in MS. GFAP levels were not discriminatory for disease activity.

Xingfu (), a Chinese term, holds meanings that transcend Western concepts of happiness; it is modern and highly valued in China. Despite its centrality to China's national discourse on xingfu, there are no validated tools for measuring perceived xingfu, particularly in Hong Kong's unique sociopolitical context. Postpandemic recovery efforts and widening socioeconomic disparities in Hong Kong highlight the urgency of understanding indicators such as perceived xingfu.

This study aimed to develop and validate the first single-item measure of perceived xingfu and examine its association with health-related and socioeconomic factors among Hong Kong Chinese adults, addressing gaps in culturally tailored assessment.

Our cross-sectional online survey included 5070 Hong Kong Chinese adults in 2023. Perceived xingfu was measured using a novel, single-item, 11-point scale from 0 to 10, with higher scores indicating better perceived xingfu. Two-week test-retest showed high reliability (intraclass correlation coefficient of 0.78). We used regression models to analyze associations between perceived xingfu score and high perceived xingfu (defined as ≥7) with mutually adjusted study variables; all estimates were weighted based on 2022 Hong Kong population data.

The mean perceived xingfu score was 6.3 (SD 2.2). Perceived xingfu score was associated with happiness (r=0.85), perceived mental health (r=0.65), and adversity coping capability (r=0.50) and negatively associated with perceived stress (r=-0.56), past 7-days loneliness (r=-0.52), anxiety symptoms (r=-0.45), and depressive symptoms (r=-0.52). Female sex (β=0.69, adjusted odds ratio [aOR] 2.11), older age (β=0.46, aOR 2.67), having post-secondary education or above (β=0.19, aOR 1.35), higher monthly household income (≥ HKD60,000: β=0.99, aOR 3.04), living in owned properties (β=0.27, aOR 1.57), being retired (β=0.56, aOR 1.18), and excellent versus poor self-rated health (β=3.84, aOR 40.72) were associated with higher perceived xingfu score or high perceived xingfu (all Ps or Pstrend<0.001).

This study pioneers the perceived xingfu measurement in a Chinese population using a concise, validated tool. Significant socioeconomic disparities and health associations highlight perceived xingfu's relevance to policy priorities, including equitable resource allocation and health support. Our single-item perceived xingfu tool offers practical utility for population surveillance and cross-cultural comparisons. Future research should explore longitudinal trends and integrate perceived xingfu into public health frameworks.

The goal of the Immigrant Wellbeing Project (IWP) study is to test a transdisciplinary ecological approach to reducing Latinx immigrants' mental health disparities by adapting and integrating a multilevel community-based advocacy, learning, and social support intervention into existing efforts at four community partner organizations that focus on mental health, education, legal issues, and community mobilization for Spanish-speaking immigrants. This protocol paper describes a study designed to advance the science of multilevel interventions and health equity through the conceptualization of the IWP intervention model as one component of complex processes and interventions that aim to create sustainable change at multiple levels. After completing in-depth qualitative interviews with 24 Latinx immigrants to elucidate their mental health needs, stressors, political/economic/social context, and local solutions, and a process of community engagement and intervention adaptation, a mixed methods strategy with data collected from 60 participants at four timepoints over 12 months will be used to test the impact of the 6-month intervention on reducing psychological distress, increasing protective factors, and achieving system-level changes in policies and practices that impact Latinx immigrants' well-being. Mechanisms of change will be explored by testing mediating relationships between protective factors and distress. Qualitative data will explore feasibility, acceptability, and participants' experiences; document multilevel changes and the context of implementation; and inform interpretation of quantitative data. Data on quality of community partnerships and their relationship to multilevel outcomes will also be examined. This paper describes the theoretical foundation, research design, qualitative and quantitative analysis plans, and innovations of the study.

The growth hormone (GH)/insulin-like growth factor (IGF-1) axis determines optimal growth and affects metabolism and energy homeostasis. Pregnancy-associated plasma protein-A2 (PAPPA2) regulates bioactive IGF-1 availability and patients with PAPPA2 deficiency have impaired growth and glucose metabolism. This axis is altered in metabolic disturbances such as obesity and anorexia nervosa in a sex-specific manner, but the mechanisms involved are not completely understood. Here we evaluated how Pappa2 deficiency affects energy homeostasis, focusing on male and female differences.

Growth and energy homeostasis were determined in male and female Pappa2^ko/ko mice and control Pappa2^wt/wt littermates, as well as their response to recombinant human (rh)PAPPA2, rhIGF-1 and rhIBFBP5. Effects of a high-carbohydrate diet (HCHD) on glucose tolerance, fuel partitioning, de novo lipogenesis and energy homeostasis were determined.

Pappa2^ko/ko mice had reduced body weight, bone length and lipid deposition associated with higher energy expenditure and intake. Male Pappa2^ko/ko mice had mild glucose intolerance, altered bone mineral properties and higher energy costs for locomotor activity possibly due to inefficient muscle mitochondrial activity; whereas female Pappa2^ko/ko mice had enhanced fatty acid oxidation on a normal diet, but not on a HCHD. All Pappa2^ko/ko mice had lower hepatic fat deposition associated with lower IGF-1 activity in the liver, while fatty acid metabolism dysregulation in adipose tissue was found only in females.

These data reinforce the importance of the GH/IGF-1 axis in metabolic control and emphasize the relevance of its fine-tuned control by Pappa2. Moreover, the differences between sexes in metabolic imbalances underscore the relevance of sex-specific strategies for treatment of metabolic imbalances.

Neglected tropical diseases affect more than one billion people worldwide, over 55 million of whom are in the Region of the Americas. These conditions can cause long-term disability and death, and disproportionately affect populations living in poverty. It is well known that adopting the gender perspective and incorporating intersectionality in the development of health programs can help reduce inequities. Based on this idea, this article suggests specific actions for the mainstreaming of gender and intersectionality. These actions include the collection of disaggregated data, the implementation of affirmative actions and inclusive communication, intersectional gender analysis, capacity building for health care providers, mental health and stigma management, and the implementation of a human rights-based approach. Adoption of the gender perspective with an intersectional approach is not only advisable but essential to achieving comprehensive person- and community-centered health care. Integration must occur from the strategic level through to the local level, to elucidate and tackle the barriers that people face in accessing health care as a result of their axes of identity. Community participation should be encouraged and capacity built both within health services and in communities themselves.

To understand the current status of Internet use among older adults in China and the impact of Internet use on the cognitive function status of older adults.

Using data from the China Health and Retirement Longitudinal Study (CHARLS) 2020, older adults aged ≥60 years and above were selected. Multiple linear regression was used to analyze the factors affecting Internet use on cognitive function of older adults, propensity matching score (PSM) kernel matching method was used to test the effect of Internet use on cognitive function of older adults, and two methods, proximity matching and radius matching, were used to validate the robustness of the study results.

A total of 5,987 older adults were selected in this study, with cognitive function scores clustered from 9.50 to 14.50. The results of multiple linear regression showed that Internet, age, literacy, home address, self-rated health, life satisfaction, IADL, depression, alcohol consumption, and social participation had an impact on cognitive function of older adults (p < 0.05). Among them, Internet use, high literacy, alcohol consumption, and social participation were protective factors for cognitive function in older adults. Age, living in rural areas, IADL disability, and depression are risk factors for cognitive function in older adults.

Cognitive function in older adults is influenced by individual characteristics, health status, and healthy lifestyles. The use of the Internet is conducive to enhancing cognitive function, promoting physical and mental health, and further realizing healthy aging in older adults.

The global challenge of closing the treatment gap highlights the need for innovative interventions. Problem Management Plus (PM+), developed by the World Health Organization (WHO), is an evidence-based brief psychological intervention designed to address this gap by involving non-specialist helpers. In this study, 'non-specialists' or 'helpers' are individuals without formal training in mental health, who have been trained in and have been delivering individual PM+ for more than 1.5 years. To enhance quality in mental health care, especially with non-specialists, WHO and the United Nations International Children's Emergency Fund (UNICEF) have launched the Ensuring Quality in Psychosocial and Mental Health Care (EQUIP) platform, an open-access resource for competency-based training. This study evaluates the acceptability and preliminary utility of EQUIP assessment tools. Thirteen helpers were assessed using the ENhancing Assessment of Common Therapeutic Factors (ENACT) and the PM+ assessment tool, culturally adapted and translated for Arabic-speaking helpers in Switzerland. The results indicate that the EQUIP tools can identify strengths and areas for improvement, provide valuable feedback for training, and thus have great potential for enhancing mental health care quality.

Approximately three million Venezuelan migrants (VMs) currently reside in Colombia. Many are in need of mental health services but face significant difficulties accessing services. To improve service access and engagement, we culturally adapted and pilot tested an evidence-based mental health intervention integrated within entrepreneurship training in a community setting for VM youth in Colombia. Using participatory research and qualitative methods approaches, we explored the program's acceptability, appropriateness and feasibility. We recruited and enrolled 67 VM youth (aged 18-30) living in Bogotá, Colombia, who participated in piloting the intervention. We conducted semi-structured interviews with a subset of these participants (n = 16) at post-intervention to explore the intervention's acceptability, appropriateness and feasibility. Two bilingual research assistants analyzed qualitative data using thematic network analysis. Findings suggested that VM youth viewed the integrated intervention as acceptable and appropriate, noting that it was helpful to have a "safe space" to discuss difficult emotions. They also noted challenges to engaging in the intervention, including transportation time and balancing other life responsibilities with intervention participation. Findings point to the importance of engaging community member participants in the adaptation and testing process of mental health interventions to increase intervention fit with the target population.