This study aimed to examine the association between physical activity and individuals’ health status, healthcare utilization, socio-demographic characteristics, and health behaviors in a large representative sample from Northern Greece. A cross-sectional study was conducted involving 1227 participants (47.4% males, mean age 49.94 ± 14.87 years) from Thrace, Greece, selected through a two-stage stratified sampling method. According to the Greek version of IPAQ, participants were classified as inactive/insufficiently active, sufficiently and highly active. Data on socio-demographic, lifestyle, and health-related variables were collected through structured interviews. Multivariate logistic regression analysis was performed to determine the independent effect of physical activity on subjects’ characteristics using SPSS ver. 19. Half of the participants (49.8%) were inactive/insufficiently active, 418 participants (34.1%) were sufficiently active, and 198 participants (16.1%) were highly active. In univariate analysis, smoking (p < 0.001), higher coffee consumption (p = 0.002), higher adherence to Mediterranean diet (p < 0.001), napping during the day (p = 0.017) and short sleep duration (p < 0.001) were associated with lower prevalence of high activity. In adjusted analyses, sufficiently active participants had a lower risk for bad self-rated health (aOR = 0.63), hypertension (aOR = 0.41), dyslipidemia (aOR = 0.42), diabetes (aOR = 0.53), obesity (aOR = 0.61), cardiovascular diseases (aOR = 0.43), anxiety (aOR = 0.65), depression (aOR = 0.56), daily sleepiness (aOR = 0.62), poor sleep quality (aOR = 0.71), as well as for primary (aOR = 0.54) and secondary (aOR = 0.40) healthcare utilization compared to inactive participants. Higher-intensity physical activity did not enhance these beneficial effects of sufficient activity on subjects’ characteristics. Physical inactivity significantly compromises health across multiple domains. Promoting even moderate-intensity physical activity may reduce chronic disease burden and healthcare utilization.

Introduction Despite evidence supporting child and adolescent cognitive behavioural therapy (CBT) globally, interventions remain largely unavailable within public systems. This gap requires implementation models integrating development, training, and scalability research within real-world settings and changes in management structures. Here we developed and implemented manualised psychotherapeutic protocols through a national capacity-building initiative in Greece. Methods We designed a structured implementation pathway conducted through the Child and Adolescent Mental Health Initiative (CAMHI), a public-private partnership involving clinical and academic institutions across Greece: (1) pre-implementation research through national reviews and national surveys of health professionals; (2) co-development and iterative pilot implementation of evidence-based interventions through supervised practice within the National Health System; and (3) dissemination research supporting scalability and institutionalisation within public structures. Results Pre-implementation research identified gaps in the availability of clinical protocols in Greek services; a survey of 120 psychologists and psychiatrists indicated the need for psychotherapeutic training. Three evidence-based protocols were co-developed: CBT for anxiety (6 to 12 years), CBT for depression (12 to 17 years), and behavioural parent training (BPT) for disruptive behaviour (4 to 14 years). During a three-stage pilot, 45 clinicians delivered interventions to 140 cases (anxiety n=52; depression n=25; BPT n=63); 117 (83.5%) completed treatment. Significant symptom reductions were observed for anxiety (d=-2.92; RCADS25), depression (d=-1.79, RCADS25), and disruptive behaviour (d=-2.3, SNAPIV), with 63%, 38% and 44% showing reliable improvement at the treatment endpoint. A train-the-trainer model is under implementation for national scale-up. Institutionalisation includes integration into child and adolescent psychiatry curricula. Sustainability safeguards were established through Law 5015.2023, with the Ministry of Health assuming operations by 2027. Discussion Pilot results demonstrate the feasibility of evidence-based psychotherapeutic interventions embedded within real-world child and adolescent services in Greece. Integrated implementation approaches provide a viable pathway for developing, refining, and scaling clinical manuals within public health provision. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This study was funded by the Stavros-Niarchos Foundation (SNF) as part of the Child and Adolescent Mental Health Initiative (CAMHI) in Greece ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Each regional hub secured ethical approval from its respective local ethics board, with amendments approved as necessary to accommodate additional trainers. In Athens, approvals were granted by the 1st Health District of Attica via the Scientific Council of "Agia Sofia" Children's General Hospital (27761/04.12.2023; 20381/12.08.2024). In Thessaloniki, approval was obtained from the 3rd Health District of Macedonia through the Scientific Councils of Hippokrateio Hospital (52297/17.11.2023) and Papanikolaou Hospital (925/28.11.2023; 1218/10.09.2024). Approval for the Ioannina hub was provided by the Administrative Board of the University General Hospital of Ioannina (36/19.12.2023). In Crete, the 7th Health District granted approval through the Scientific Council of the University General Hospital of Heraklion (36515/31.10.2023). Finally, in Alexandroupolis, approvals were issued by the Administrative Board of the University General Hospital of Alexandroupolis (54805/09.11.2023; 55388/04.11.2024). I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors

BACKGROUND:Children's health-related quality of life (HRQoL) has been associated with both individual and family-related factors, including internalizing symptoms and parental psychological well-being. Although previous research has highlighted the role of parental mental health, evidence from non-clinical community samples remains limited, particularly when parent-proxy reports are used. METHODS:A cross-sectional study was conducted among 242 parents of children aged 8-12 years in Northern Greece. Parents completed proxy measures of children's HRQoL and internalizing symptoms, as well as self-reported measures of their own HRQoL and anxiety. Nonparametric tests were used for bivariate analyses, and multiple linear regression was applied to identify independent predictors of children's HRQoL. RESULTS:Higher parental mental HRQoL was positively associated with children's HRQoL (ρ = 0.213, p = 0.031), while parental anxiety (trait anxiety: ρ = -0.204, p = 0.004; state anxiety: ρ = -0.314, p < 0.001) and parent-reported child internalizing symptoms (depression: ρ = -0.369, p < 0.001; anxiety: ρ = -0.322, p < 0.001) were negatively associated with HRQoL; however, in the multivariable model, only parental mental HRQoL (B = 0.344, p = 0.020) and parental education (B = -2.944, p = 0.044) remained significantly associated with parent-proxy child HRQoL, explaining 29.2% of the variance in children's HRQoL (R2 = 0.292). CONCLUSIONS:The findings suggest that parent-proxy child HRQoL is associated with parental psychosocial functioning in this community-based sample. Parental mental HRQoL was the strongest independent correlate of parent-proxy child HRQoL. However, given the exclusive use of parent-proxy reports and the convenience-based sample, these findings should be interpreted cautiously, as shared method variance, rater-related effects, and limited generalizability may have contributed to the observed associations. Further multi-informant and longitudinal studies conducted in more diverse populations are warranted.

BACKGROUND/OBJECTIVES:Perceived stress and sleep quality are increasingly recognized as important determinants of emotional eating (EE), particularly among university students who are frequently exposed to academic pressures, psychosocial challenges, and lifestyle disruptions. Both stress and sleep quality are closely interconnected, with elevated stress contributing to sleep disturbances and poor sleep further exacerbating psychological distress. The present study aims to simultaneously examine the independent contributions of perceived stress and sleep quality to EE while accounting for other relevant sociodemographic, lifestyle, and anthropometric factors. METHODS:This cross-sectional study was conducted among 1297 university students recruited from 10 geographical regions of Greece. Data on sociodemographic characteristics, academic profile, lifestyle behaviors, and anthropometric parameters were collected using standardized and validated assessment instruments. Perceived stress was measured using the Perceived Stress Scale (PSS), while sleep quality was evaluated with the Pittsburgh Sleep Quality Index (PSQI). Emotional eating was assessed using the Emotional Eating subscale of the Three-Factor Eating Questionnaire-Revised 18 (TFEQ-R18), and participants were subsequently classified into tertiles corresponding to low, moderate, and high levels of emotional eating. RESULTS:Perceived stress was independently associated with EE in the multivariable analysis. Compared with students reporting low levels of stress, those experiencing high perceived stress exhibited almost threefold greater odds of being classified in higher emotional eating categories (OR = 2.86; p = 0.0001). Likewise, participants with moderate perceived stress were approximately twice as likely to demonstrate elevated emotional eating levels relative to their low-stress counterparts (OR = 2.01; p = 0.0001). Sleep quality was also independently associated with EE after adjustment for potential confounding factors. Specifically, students characterized by inadequate sleep quality had more than three times the likelihood of belonging to higher emotional eating categories compared with those reporting satisfactory sleep quality (OR = 3.08; p = 0.0001). The multivariable model demonstrated good fit (Likelihood Ratio Test, p < 0.001), and the proportional odds assumption was satisfied (p = 0.46). CONCLUSIONS:These findings underscore the important role of psychological distress and sleep health in EE behavior, independent of other sociodemographic, academic, lifestyle, and anthropometric factors. Given the observed associations, interventions incorporating stress-management and sleep-improvement components may represent promising approaches for addressing emotional eating among university students; however, longitudinal and intervention studies are needed to establish causality. Future longitudinal and intervention studies are needed to establish causality among perceived stress, sleep quality, and emotional eating.

Abstract Background Health professionals in Greece face barriers in assessing child and adolescent mental health conditions due to the lack of instruments with evidence of validity in local samples. This study addresses this gap by evaluating the psychometric properties and establishing common norms for six globally recognized mental health tools in Greece: the Child and Adolescent Trauma Screen-2 (CATS-2), Pediatric Symptoms Checklist-17 (PSC-17), Revised Children’s Anxiety and Depression Scale-25 (RCADS-25), Swanson, Nolan, and Pelham Scale (SNAP-IV), Modified Checklist for Autism in Toddlers-Revised (MCHAT-R/F), and Child Autism Spectrum Test (CAST). Methodology We drew on a nationwide Greek survey comprising 1,756 caregivers and 1,201 children and adolescents (age groups: 1 to 18 years). Using Item Response Theory, we assessed internal consistency and factor models according to Consensus-based Standards for the Selection of Health Measurement Instruments’ (COSMIN) criteria for unidimensionality, local independence, monotonicity, and global model fit. Normative references were calculated using standardized metrics recommended by the Patient-Reported Outcomes Measurement Information System (PROMIS). Results Final sample sizes ranged from 1,356 (PSC-17, caregiver version) to 198 (CATS-2, caregiver version). Internal consistency was rated as good to excellent across all scales. Factor analyses supported all scales except the ones assessing autism spectrum disorder: MCHAT-R/F (failing monotonicity) and CAST (failing monotonicity and unidimensionality). Local normative references were usually consistent with international samples. Conclusion This toolkit provides essential evidence-based resources for child and adolescent mental health in Greece, offering a scalable model for other underserved settings. Further research with national probabilistic samples is recommended to enhance risk stratification accuracy.

Background/Objectives: The Mediterranean diet (MD) constitutes one of the most broadly studied dietary patterns, which has been linked to the prevention of non-communicable diseases and mental health disorders. University students, a population exposed to significant psychosocial stressors and lifestyle changes, may particularly benefit from healthy eating patterns such as the MD. This study was designed to examine the potential associations of MD adherence with symptoms of depression and anxiety among Greek university students. Methods: A cross-sectional study was initially conducted among 7160 active university students from ten diverse geographic regions in Greece. After the enrollment procedure and the application of relevant exclusion criteria, 5191 university students (52.0% female; mean age: 21.3 ± 2.4 years) constituted the study population. MD adherence was assessed using the KIDMED index, while depressive and anxiety symptoms were evaluated using the Beck Depression Inventory-II (BDI-II) and State–Trait Anxiety Inventory (STAI-6), respectively. Sociodemographic and anthropometric data were collected for all the enrolled university students. All the questionnaires were completed by face-to-face interviews with expert personnel. Results: Students with low adherence to the MD were significantly more likely to report symptoms of depression (OR = 2.12; p ˂ 0.001) and anxiety (OR = 2.27; p ˂ 0.001) and to be overweight or obese (OR = 2.45; p ˂ 0.001) after adjustment for multiple confounding factors. Low MD adherence was also associated with male gender (OR = 0.73; p ˂ 0.01), living alone (OR = 0.78; p ˂ 0.01), smoking (OR = 0.75; p ˂ 0.01), low physical activity (OR = 1.84; p = 0.001), and poorer academic performance (OR = 0.83; p ˂ 0.01). Conclusions: Low adherence to the MD is significantly associated with increased likelihood of depression, anxiety, and excess body weight among university students in Greece. These findings underscore the importance of promoting healthy dietary habits and related lifestyle behaviors in young adult populations as a potential strategy for mental health prevention and intervention. Due to the presence of several limitations in the present study, future longitudinal and interventional studies should be performed to confirm the present findings.

Background and Objectives: Rates of obesity have been consistently increasing in recent years across all age groups, with a notable rise among young people. Obesity represents a persistent inflammatory condition and a key contributor to various chronic health problems, such as cardiovascular disorders, metabolic abnormalities, cancer, and psychological conditions. The move from high school to university is a transitional phase accompanied by specific pressures that can affect both body weight control and mental health in students. This cross-sectional investigation aimed to investigate potential associations between excess weight and the presence of depressive and anxiety symptoms in university populations. Methods: This cross-sectional analysis included 5298 students enrolled at universities across ten geographic areas of Greece. Participants filled out questionnaires concerning demographic information and lifestyle behaviors. Levels of depression and anxiety were measured using the Beck Depression Inventory (BDI-II) and the short form of the State Anxiety Inventory (STAI-6), respectively. Measurements of height and body weight were obtained to compute Body Mass Index (BMI). Results: The presence of overweight or obesity among students was significantly and independently related to female sex, urban residence, living independently, tobacco use, and lower academic performance (p = 0.0103, p = 0.0102, p = 0.0203, p = 0.0075, and p = 0.0168, respectively). Individuals reporting insufficient physical activity had 85% higher odds of being overweight or obese (p = 0.0068). Similarly, participants experiencing depressive or anxious symptomatology had more than double odds of excess body weight compared with those without such symptoms (p = 0.0015 and p = 0.0012, respectively). Furthermore, poor Mediterranean diet adherence was linked to more than a twofold increase in the odds of overweight or obesity (p = 0.0005). Conclusions: These findings offer considerable evidence that symptoms of depression and anxiety may serve as significant contributors to the development of overweight and obesity among university students. Additional longitudinal studies are strongly encouraged to substantiate these observations.

To improve access to mental health care for children and adolescents, it is necessary to identify the barriers faced by their caregivers. The aim of this study is to identify these barriers in Greece and to investigate the reliability and validity of the modified version of the Barriers to Access to Care Evaluation scale (BACE) - the BACE Proxy Report (BACE-PR). A total of 265 caregivers who reported that their offspring had mental health difficulties completed the BACE-PR. Descriptive statistics were used to identify the major barriers to accessing care. Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA) were used to investigate the factor structure of the instrument. Item parameters were assessed via Item Response Theory. Interpretability was assessed by linking summed scores to IRT-based scores. Caregivers reported care costs, their willingness to resolve problems on their own, and their own concern that their children might be seen as weak, as the major barriers to services access. Obsessive compulsive symptoms and self-harm were the conditions for which caregivers reported the highest level of barriers. EFA and CFA suggested that a one-factor solution fit the data well (RMSEA = 0.048, CFI = 0.991, TLI = 0.990). Internal consistency was found to be high (ω = 0.96). Average z-scores provided five meaningful levels of caregivers’ perceived barriers compared to the national average. Caregivers face a variety of barriers to access mental health care for their children, and this could partly explain the treatment gap in the Greek mental health sector. Our study provides evidence for the reliability and validity of the BACE-PR scale, which can aid to identify caregiver-perceived barriers and to design interventions to improve access to mental health care.

Parenting practices are vital in a child’s development. The modified Block “Child Rearing Practices Report” has been used to assess these practices, allowing further analysis combining other parental characteristics. This study aimed to validate the measure in a Greek sample and explored the associations between parenting practices, styles, and parental characteristics. The sample consisted of 547 parents of pre-school children. The psychometric properties of the Q-short Child Rearing Practices Report (CRPR) provide evidence for its feasibility as an assessment tool for parenting approaches. Two factors of parenting practices were validated from the CRPR Greek version. Authoritative style predicted nurturing approaches. Authoritarian and strict styles indicated restrictive practices among mothers, as fathers adopted permissive and strict styles. The higher the mother’s educational level was, the lower the restrictive behaviors she exhibited toward the child. These links may enrich the existing scientific evidence on the effects of parenting styles in parenting practices and allow cross-cultural comparisons.

Background/Objectives: Social cognition impairment is common in multiple sclerosis (MS) and could implicate the well-being of patients by promoting difficulties in social interactions. This study investigated the relationship between social cognition and quality of life (QoL) in patients with MS (PwMSs). Methods: In total, 100 PwMSs, enrolled as per distinct criteria, underwent neuropsychological assessment using validated questionnaires and scales. To assess QoL, Multiple Sclerosis Quality of Life-54 (MSQOL-54) questionnaires, both physical and mental, were utilized. The components of social cognition were evaluated using the Reading the Mind in the Eyes Test (RMET) and the Faux Pas task. The type of MS and years since diagnosis were also recorded. Results: The RMET score (β = 0.336; p = 0.001) and years since diagnosis (β = −0.225; p = 0.017) emerged as significant predictors of physical QoL, whereas the Faux Pas score did not significantly predict MSQOL-54_PHYSICAL scores (p = 0.451). Both Faux Pas (β = 0.247; p = 0.015) and RMET scores (β = 0.221; p = 0.028) showed a positive association with MSQOL-54_MENTAL scores. The years since diagnosis did not significantly predict the mental component of QoL (p = 0.635). Conclusions: Social cognition deficits are crucial for the social functioning of patients with MS, inevitably affecting both physical and mental aspects of QoL.

Prenatal stress is increasingly recognized as a critical factor influencing fetal brain development, with potential long-term risks for neurodevelopmental and psychiatric disorders. This review explores the effects of prenatal stress on the fetal brain, with particular emphasis on sex differences and the interplay between genetic, epigenetic, and environmental factors. The activation of the hypothalamic–pituitary–adrenal (HPA) axis in response to maternal stress leads to increased levels of glucocorticoids, which can cross the placenta and alter fetal brain structure and function. Key regions affected include the prefrontal cortex, hippocampus, and amygdala, which are crucial for emotional regulation, memory, and cognitive function. Sex differences play a significant role in fetal stress responses, with males exhibiting greater vulnerability to adverse prenatal conditions. Studies suggest that male fetuses exposed to high maternal cortisol levels exhibit alterations in brain connectivity, increased amygdala volume, and heightened stress reactivity, whereas female fetuses may show adaptive mechanisms that confer resilience. Additionally, maternal nutritional status influences fetal neurodevelopment, with both undernutrition and obesity contributing to structural and functional changes in the fetal brain. Advances in neuroimaging techniques, including high-resolution magnetic resonance imaging (MRI) and placental diffusion imaging have provided valuable insights into how prenatal stress affects fetal brain connectivity. Epigenetic modifications, such as DNA methylation and histone modification, are implicated in the long-term programming of stress responses. Furthermore, early-life interventions, including maternal social support and mindfulness-based therapies, may mitigate the adverse effects of prenatal stress on offspring neurodevelopment. Given the profound impact of prenatal stress on fetal brain development, early identification of at-risk populations and the implementation of targeted interventions are crucial. Future research should integrate findings from neuroscience, genetics, and endocrinology to develop preventive strategies that improve neurodevelopmental outcomes and reduce the burden of stress-related disorders in later life.

Background/Objectives: The COVID-19 pandemic has led to detrimental effects on diverse aspects of the mental and physical health of the general population worldwide. The elderly are more susceptible to COVID-19 infection compared to younger age groups. In this aspect, the purpose of the current survey is to evaluate the effect of the COVID-19 pandemic on the interrelationships among the sociodemographic and anthropometric characteristics, depressive behavior, quality of life, cognition status, physical activity and nutritional status of older adults. Methods: The present study constitutes a comparative, cross-sectional study of 4162 older adults (mean age ± standard deviation: 72.13 ± 8.1 years and 75.22 ± 8.2 years in the pre- and post-COVID-19 periods, respectively, and a male/female ratio of almost 1:1). We used validated questionnaires to assess depression, cognition function, quality of life, physical activity and nutritional status of the elderly in the pre-Covid and post-Covid periods. Relevant questionnaires were also used for collecting sociodemographic data, while anthropometric data were measured using standard protocols. Results: The present study finds that the COVID-19 pandemic influenced, in an independent manner, residence location, smoking status, overweight/obesity and abdominal obesity, depressive behavior, quality of life, cognition behavior, physical activity levels and nutritional status of the elderly. The COVID-19 pandemic was also related to employment and living status as well as family economic status. Nevertheless, the above three relationships were insignificant in the multivariate analysis. Conclusions: The COVID-19 pandemic exerted deleterious effects on several aspects of the mental and physical health of the elderly, which appeared to strongly persist in the post-Covid period. Future prospective population-based and well-organized surveys should be conducted to establish whether there is a causality long-term effect of the COVID-19 pandemic on diverse aspects of the mental and physical health of the elderly.

Mental disorders in children and adolescents are widespread and can have lasting effects on their emotional, social, and academic growth. The present meta-analysis examines the global prevalence of mental disorders, revealing significant regional variability. The present systematic review and meta-analysis of the literature used the PRISMA-2020 statement and the protocol was registered and is publicly available in PROSPERO. Data were retrieved from different databases, specifically PubMed, Google Scholar, Scopus, and PsycINFO. The search for relevant studies, and the quality assessment of the included studies was carried out independently by two researchers, while discrepancies were resolved through discussion with the third researcher, who verified the assessments and contributed to the consensus. The study included 37 original research articles with a total number of 1,599,337 participants who were diagnosed with mental disorders by DSM or ICD. The results showed extreme heterogeneity. In Asia, the prevalence was 14.53

Background/Objectives: Emotional eating may be a consequence of acquired cue reactivity, a lack of control, or an inaccurate link between episodic overeating and negative affect, according to a new analysis of its standard measurement. This study was a controlled trial, which was designed to investigate the effect of personalized nutritional psychoeducation on emotional eating behavior. Methods: This study enrolled 95 participants (62 control group and 33 intervention group) who were randomized to treatment and assessed at 3-month follow-up. Over a period of 3 months, six thematic individual sessions were conducted with a frequency of every 15 days for the participants in the intervention group. The Three-Factor Eating Questionnaire (TFEQ) was used to assess feeding patterns and the manifestation of emotional food consumption in response to emotion. Results: At baseline, it appears that gender is positively related to TFEQ Emotional Score (β: 1.77 (random error: 0.57, p-value: 0.003). BMI (β: −0.11 (random error: 0.04, p-value: 0.003) and waist circumference are negatively related to the TFEQ Emotional Score. Conclusions: Although this study confirmed significant associations of emotional eating and gender, BMI, and waist circumference, the nutritional psychoeducation-based intervention did not exert the expected effects on emotional eating. More high-quality clinical trials need to further be designed to improve emotional eating behavior by applying relevant nutritional psychoeducation-based interventions.

Background: Depression constitutes a major public health issue, being one of the leading causes of the burden of disease worldwide. The risk of depression is determined by both genetic and environmental factors. While genetic factors cannot be altered, the identification of potentially reversible environmental factors is crucial in order to try and limit the prevalence of depression. Aim: A cross-sectional, questionnaire-based study on a sample from the multicultural region of Thrace in northeast Greece was designed to assess the potential association of depression with several sociodemographic characteristics, lifestyle, and health status. The study employed four machine learning (ML) methods to assess depression: logistic regression (LR), support vector machine (SVM), XGBoost, and neural networks (NNs). These models were compared to identify the best-performing approach. Additionally, a genetic algorithm (GA) was utilized for feature selection and SHAP (SHapley Additive exPlanations) for interpreting the contributions of each employed feature. Results: The XGBoost classifier demonstrated the highest performance on the test dataset to predict depression with excellent accuracy (97.83%), with NNs a close second (accuracy, 97.02%). The XGBoost classifier utilized the 15 most significant risk factors identified by the GA algorithm. Additionally, the SHAP analysis revealed that anxiety, education level, alcohol consumption, and body mass index were the most influential predictors of depression. Conclusions: These findings provide valuable insights for the development of personalized public health interventions and clinical strategies, ultimately promoting improved mental well-being for individuals. Future research should expand datasets to enhance model accuracy, enabling early detection and personalized mental healthcare systems for better intervention.

Background Differences in walking patterns have been observed by clinicians working with children with Autism Spectrum Disorders (ASD). Different gait parameters have been studied and emerged through the recent years. The purpose of this review is to summarize the gait patterns that have been studied during the last decade in children with ASD. Methods Pubmed, Scopus, PsycINFO, and Google Scholar databases were screened for publications examining differences in gait patterns in children with ASD. Included articles were written in English, published during the last decade (2013-2024), regarding childhood age of participants and examining gait patterns in children with ASD. Initial database search retrieved 289 studies and 17 were included in this review. Gait parameters, including spatiotemporal parameters (stride length, stride width, and cadence), joint mobility parameters (knee flexion, ankle flexion, and dorsiflexion), stability, asymmetry, and toe-walking are the main parameters which were further investigated. Results Study selection process, study and participants’ characteristics, diagnostic scales, scales for mobility assessment and methods utilized for gait assessment were descripted for each study. Gait parameters are affected in children with ASD. Specifically, greater stride width, increased gait variability and decreased stability during walking are the most consistent findings across the studies. For many variables, such as stride length, cadence, symmetry, and joint mobility parameters, the results are still inconclusive and further research is needed. Conclusion Existing research is limited in its ability to draw firm conclusions. Small sample size, methodological differences and group deviation consist the main limitations regarding the generalizability of the results. Therefore, scientific interest should focus more on mobility variations in children with ASD in the future.

The COVID-19 pandemic profoundly impacted the mental and physical well-being of nurses, with distinct challenges faced by pediatric and general hospital nurses. This study aimed to compare the stressors and experiences of these two groups in Greece during and after the pandemic. A cross-sectional survey of 249 nurses (108 pediatric and 141 general) (response rate: 71.1%) was conducted using a 34-item questionnaire adapted from the Coronavirus Health and Impact Survey (CRISIS) tool. While the questionnaire did not include a single item labeled "stressors," it contained sections measuring workload, burnout, perceived emotional burden, exposure risks, and mental health impacts. These variables serve as indicators of stressors within the healthcare context. The findings revealed significant differences between the two groups. Previous research suggests that pediatric nurses experience unique stressors, including the dual burden of addressing the psychological needs of children while providing emotional support to anxious families. The need for child-centered communication and high-quality care further amplifies these demands. However, pediatric nurses demonstrated greater resilience, likely due to their emphasis on maintaining physical activity as a coping mechanism. On the other hand, general hospital nurses exhibited reduced social interactions and a higher degree of social isolation compared to pediatric nurses. Despite facing common challenges, the distinct stressors highlight the necessity for targeted interventions. Tailored support systems should address the specific psychological and physical demands of pediatric nurses while also mitigating burnout and enhancing resilience among general hospital nurses. These findings underscore the importance of implementing specialized mental health programs and workplace policies designed to address the unique challenges faced by pediatric and general hospital nurses. By addressing the distinct stressors experienced by each group, such initiatives can enhance resilience, reduce burnout, and promote overall well-being.

Classical psychedelics encompass psilocybin, lysergic acid diethylamide (LSD), N, N-dimethyltryptamine (DMT), and mescaline and are psychoactive substances that primarily function as agonists at the serotonin 5-hydroxytryptamine receptors (5-HT). In the immediate term, they modify perception, cognition, emotional state, social processing, and introspection, leading to a subjective mystical encounter. They also yield enduring effects by mediating neural plasticity. A renaissance in the potential benefits of using psychedelics, especially for psychiatric disorders, has led to clinical trials with adults. When considering a possible equivalent application of classical psychedelics for pediatric conditions, autonomy, beneficence, non-maleficence, and justice have to be contemplated, following the framework of Beauchamp and Childress. The purpose of this study was to provide a comprehensive review of the use of classical psychedelics, hence providing a balanced evaluation of the ethical considerations surrounding the administration of psychedelic compounds to pediatric populations. We summarized evidence indicating that classical psychedelics have shown efficacy in treating various disorders in adults, with ongoing research exploring their potential for additional conditions. While this suggests they could offer benefits for children, the current research remains preliminary, with uncertain outcomes and significant limitations. These factors highlight the ethical and practical challenges of applying such treatments to children, a particularly vulnerable population.

Minor neurocognitive disorders (NCDs) represent a transitional phase between normal cognitive aging and dementia, highlighting the importance of early interventions. This study assessed the efficacy of a structured 6-month computerized cognitive training (CCT) program in stabilizing cognitive decline among older adults with minor NCDs. One hundred participants were randomly assigned to an intervention group or a non-intervention group. The intervention group underwent weekly, personalized CCT sessions using the MeMo program, which targeted memory, attention, and adaptability. Cognitive performance was measured at baseline and after six months using the Cambridge Cognitive Examination (CAMCOG). Statistical analysis showed significant cognitive decline in the non-intervention group in orientation (p = 0.032), language expression (p = 0.008), praxis (p = 0.008), and memory (p = 0.01). In contrast, the intervention group showed no significant changes, except for a minor decline in perception (p = 0.003). These results suggest that CCT may help delay cognitive deterioration in minor NCDs. However, while cognitive decline was stabilized, no significant improvement was observed. Further research is recommended to investigate the long-term benefits and the transferability of cognitive gains. The findings support the use of CCT as a non-pharmacological health promotion strategy for enhancing cognitive resilience in aging populations. The novelty of this research lies in its focus on adaptive CCT as a non-pharmacological intervention, highlighting the potential role of neuroplasticity in delaying cognitive decline and offering new insights into personalized cognitive health strategies for aging populations.