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Background: Digital devices have become very important in education. Students are increasingly spending their time on screen for education and other use. However, prolonged screen exposure has led to increasing complaints of digital eye strain, an emerging public health concern. Methods: A cross-sectional study was conducted among 165 undergraduate medical students in a tertiary care centre. A pilot studied; semi-structured questionnaire was used for data collection. Data was entered in Microsoft excel and analysed. Results: The prevalence of digital eye strain among undergraduate medical students was found to be 52.7%. Most common symptom noted were Headache (68.5%), Itching (60.6%), tearing of eyes (58.1%). There was a significant association between the duration of mobile screen usage (>4 hours) and digital eye strain (p value=0.0303). Conclusions: Digital eye strain is a common health concern among medical students. Higher the hours of mobile screen use, greater is the risk of digital eye strain.

In April 2026, US President Donald Trump signed an executive order fast-tracking access to psilocybin and ibogaine for the treatment of serious mental illness. This follows decades in which psychedelics had been vilified as a group of drugs entirely lacking in therapeutic potential, associated with counter-cultural groups such as hippies, and whose use was both criminalised and widely stigmatised. Our central questions are: How have the substances, practices, understandings and relationships that comprise psychedelic use developed, and shifted, over time? And how might we best understand the overall structure and dynamics of such changes? We argue that the recent psychedelic renaissance cannot be understood as the simple ‘discovery’ of a therapeutic potential that previously lay dormant in the substances themselves. It is better grasped as a part-process of longer-term informalisation processes, bound up with shifting balances of power between established and outsider groups and with the changing behavioural and emotional standards – the social canons – through which psychedelic use has become refigured. Drawing on the figurational sociology of Norbert Elias and relational work on substance use and health, we trace the shift in psychedelics from counter-cultural sacrament to therapy and technology of the self. Through dialogue with a multimodal, multi-source evidential base, we develop the concept of ‘pharmaceuticalisation from below’ to characterise both the contemporary uptake of psychedelics and the broader figurational dynamics this expresses.

Stress is an important physiological and psychological reaction which, when prolonged, has a negative impact on the health and well-being of humans. Traditional stress assessment methods tend to be subjective and are not scalable in real-time. In this research, a lightweight machine learning framework to predict stress from easily measurable environmental and activity-related features, temperature, humidity, and steps, is introduced. The proposed method is different from the approach that depends on complex physiological signals and uses minimal non-invasive inputs that can be applied in the wearable and IoT field. The stress level is considered as the target variable, and all the features used as input variables are independent from each other to prevent data leakage. There are several machine learning and deep learning models and their performances are measured, such as LightGBM, Support vector machine (SVM), AdaBoost, Gated Recurrent Unit (GRU). Bayesian hyperparameter optimization is used to improve the performance of the model and guarantee strong generalization. Experimental results show that LightGBM outperforms the other models, giving an accuracy of 97% and a balanced precision, recall and F1 score of 95%. The results demonstrate promising predictive performance on the evaluated dataset. However, since the model was validated on a relatively small publicly available dataset, further evaluation using larger and more diverse real-world datasets is required before practical deployment.

BACKGROUND: Understanding prescription trends and costs of psychotropic drugs is essential to inform mental healthcare policy and practice. However, comprehensive national evidence across psychotropic drug classes is limited, and little is known on how prescription volumes changed during the COVID-19 pandemic. AIMS: We examined prescription trends and costs of psychotropic drugs in the UK and assessed changes in prescription volumes following the onset of the COVID-19 pandemic. METHOD: We analysed national Prescription Cost Analysis data from 2013 to 2023, for six major psychotropic drug classes. Annual prescription volumes, total costs and average costs per drug were estimated. Linear regression was used to assess temporal trends and changes in prescription volume during the pandemic years. Costs were adjusted for inflation to 2023 prices. RESULTS: Between 2013 and 2023, psychotropic prescriptions grew 4% (95% CI 3.9-4.2) annually. Prescriptions for antidepressants, antipsychotics, stimulants and anti-dementia drugs increased, but not for hypnotics and anxiolytics and drugs used in substance dependence. In contrast, total costs declined by approximately £328 million, and the average cost per drug dropped from £11 to £5.9. Prescription volume remained unchanged during the pandemic years, except for anti-dementia medications, which showed an annual reduction of 17.2% (95% CI 7.8-26.6) relative to the underlying temporal trend during the study period. CONCLUSIONS: Our observed rising prescription trend is consistent with global evidence on availability and use of psychotropic drugs. Furthermore, we found a decrease both in total drug costs and average costs per drug.

The WHO Adolescent Well-being Framework identifies agency and resilience as a central domain of adolescent well-being, yet its expression from a health promotion perspective remains insufficiently understood. Although previous research has often focused on specific behaviours or isolated factors, less attention has been given to how interconnected personal and relational resources coexist as patterns reflecting the WHO domain of agency and resilience. This study explored such patterns among young Swedish persons aged 15–18 years and examined gender differences across these patterns. A cross-sectional survey was conducted among 419 students in Swedish upper secondary schools. Agency and resilience were operationalised through measures of salutogenic health, positive youth development (PYD), playfulness, goal orientation, and physical activity. A person-oriented cluster analysis was used to identify patterns of interconnected resources, and gender differences between patterns. Three distinct resource patterns were identified: a low-resource group (26%), a high-resource group (28%), and an asymmetric-resource group (47%), characterised by relatively favourable intrapersonal resources alongside lower relational PYD resources. Girls were significantly overrepresented in both the low-resource and asymmetric-resource groups. Together, these findings suggest that young persons with seemingly favourable individual resources may nevertheless exhibit underlying vulnerabilities when resources are considered as interconnected patterns rather than isolated characteristics. This perspective contributes to the empirical understanding of the WHO domain of agency and resilience and may inform person-centred, relational approaches to promoting young persons’ well-being.

Background: Insomnia is an important public health concern and may be particularly relevant among security personnel because of irregular work schedules, occupational demands, sustained vigilance, and inadequate rest. This study was conducted to determine the prevalence of insomnia and its association with selected sociodemographic and health-related factors among security personnel in a tertiary care government hospital in south India. Methods: A cross-sectional study was conducted among 100 security personnel. Sociodemographic characteristics, including age, gender, income, education, and marital status, and health-related characteristics, including body mass index, diabetes, and hypertension, were assessed using a structured questionnaire. Insomnia was assessed using the Insomnia Severity Index (ISI). Associations between insomnia and selected variables were examined using the chi-square test. Results: Sub-threshold insomnia was present in 32% of participants, while no cases of moderate or severe insomnia were identified. Significant associations were observed between insomnia and gender (p=0.019) and income level (p=0.020). No significant associations were observed with age, education, marital status, or metabolic health status. Self-reported Diabetes and Hypertension were present in 10% and 4% of participants, respectively, while 74% were classified as obese. Conclusions: Although moderate or severe insomnia was not observed, nearly one-third of security personnel had sub-threshold insomnia. Workplace-based sleep hygiene interventions may be beneficial, particularly among women and lower-income employees. Further studies incorporating objective sleep assessments and detailed evaluation of shift schedules are warranted.

Background: Rural women in India are often confronted with situations that make it difficult for them to access formal mental health services such as inaccessibility, internalized stigma, believing that suffering is due to external causes and gender inequalities. These barriers delay receiving formal care for mental health and make these women resort to informal ways of coping such as community support and local faith healers. Methods: This study aimed to explore the informal coping strategies and beliefs around mental health among 100 rural women over the age of 18 years residing in Amroha district of Uttar Pradesh, India. Being a qualitative study, the method employed for the survey was focused group discussions and the participants were included through a convenience snowball sampling. The discussions were held in Hindi language for the ease of the participants and were recorded for analysis which was done through a thematic analysis approach. Results: The results highlighted six broad themes: (1) burden of responsibilities and emotional burnout, (2) physiological manifestations of psychological distress, (3) normalization of chronic stress, (4) psychological distress arising from marital conflict and gender-based adversity, (5) reliance on spiritual and informal coping strategies in place of formal mental healthcare, and (6) emotional suppression and silent tolerance. Conclusions: The findings suggest the urgent need to design culturally aligned psychotherapeutic interventions that focus on creating awareness through psychoeducation that could reduce stigma as well as helping rural women deal with their unmet mental health challenges.

Mental health systems face a persistent gap in accessible, continuous, and person-centred support. Conversational AI can expand access to psychoeducation, emotional check-ins, self-management, and service navigation, but may also introduce risks of digital exclusion, cultural mismatch, privacy concerns, unsafe advice, and overreliance on automation. This paper develops a conceptual framework integrating Orange Technology, which promotes emotional wellbeing, cultural sensitivity, social connectedness, and resilience, with empathetic AI for mental health support. An integrative literature review examined peer-reviewed systematic reviews and WHO and UN guidance published from 2021 to 2026. Evidence suggests that conversational AI can improve depression, distress, anxiety, and engagement, although effects are heterogeneous and may decline over time. Personalization and empathic interaction may enhance engagement, while the framework's effects on community resilience, cultural sensitivity, and community resource integration require further empirical validation. The framework therefore positions AI as a supportive, human-in-the-loop layer rather than a replacement for clinicians, families, peers, or communities. It connects emotional sensing, empathetic dialogue, personalized support, escalation pathways, community connection, inclusive access, and governance, while aligning mental health innovation with SDG 3, 9, and 17.

ABSTRACT Type 2 diabetes mellitus is a chronic metabolic disease with a rapidly increasing prevalence worldwide and is frequently accompanied by microvascular complications, particularly diabetic neuropathy. Diabetic neuropathy often presents with sensory symptoms such as pain, paresthesia, and numbness, which tend to worsen at night and may interfere with sleep quality. Disturbed sleep in patients with type 2 diabetes mellitus can adversely affect daily functioning, glycemic control, and overall quality of life. However, previous studies examining the relationship between diabetic neuropathy and sleep quality have reported inconsistent findings. This study aims to determine the relationship between the occurrence of diabetic neuropathy and sleep quality among patients with type 2 diabetes mellitus at RS Siti Khodijah Sepanjang. This study employed an analytical observational design with a cross-sectional approach. Data were collected using primary data from questionnaires and secondary data from medical records of patients with type 2 diabetes mellitus. Diabetic neuropathy was assessed based on clinical evaluation, while sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). The findings demonstrate an association between the occurrence of diabetic neuropathy and impaired sleep quality in patients with type 2 diabetes mellitus. Patients experiencing diabetic neuropathy tended to have poorer sleep quality, characterized by prolonged sleep latency, reduced sleep efficiency, increased sleep fragmentation, and shorter sleep duration. Diabetic neuropathy is associated with decreased sleep quality in patients with type 2 diabetes mellitus. These findings highlight the importance of considering sleep quality as part of comprehensive management in patients with diabetic neuropathy to improve overall health outcomes. Keywords: Type 2 Diabetes Mellitus, Diabetic Neuropathy, Sleep Quality, PSQI. ABSTRAK Diabetes melitus tipe 2 merupakan penyakit metabolik kronis dengan prevalensi yang terus meningkat dan sering disertai komplikasi mikrovaskular, salah satunya neuropati diabetik. Neuropati diabetik ditandai dengan gejala sensorik seperti nyeri, kesemutan, kebas, dan rasa terbakar yang umumnya memberat pada malam hari sehingga berpotensi mengganggu kualitas tidur. Gangguan kualitas tidur pada pasien diabetes melitus tipe 2 dapat berdampak negatif terhadap aktivitas harian, kontrol glikemik, dan kualitas hidup. Namun, hasil penelitian sebelumnya mengenai hubungan neuropati diabetik dengan kualitas tidur masih menunjukkan ketidakkonsistenan. Penelitian ini bertujuan untuk mengetahui hubungan antara kejadian neuropati diabetik dengan kualitas tidur pada pasien diabetes melitus tipe 2 di RS Siti Khodijah Sepanjang. Penelitian ini menggunakan desain observasional analitik dengan pendekatan cross-sectional. Data diperoleh dari data primer berupa kuesioner serta data sekunder dari rekam medis pasien diabetes melitus tipe 2. Kejadian neuropati diabetik dinilai melalui evaluasi klinis, sedangkan kualitas tidur diukur menggunakan Pittsburgh Sleep Quality Index (PSQI). Hasil penelitian menunjukkan adanya hubungan antara kejadian neuropati diabetik dengan penurunan kualitas tidur pada pasien diabetes melitus tipe 2. Pasien dengan neuropati diabetik cenderung mengalami kualitas tidur yang lebih buruk, ditandai dengan latensi tidur yang memanjang, efisiensi tidur yang menurun, fragmentasi tidur yang meningkat, serta durasi tidur yang lebih pendek. Terdapat hubungan antara kejadian neuropati diabetik dengan kualitas tidur pada pasien diabetes melitus tipe 2. Oleh karena itu, aspek kualitas tidur perlu dipertimbangkan dalam manajemen komprehensif pasien neuropati diabetik guna meningkatkan luaran kesehatan secara keseluruhan. Kata Kunci: Diabetes Melitus Tipe 2, Neuropati Diabetik, Kualitas Tidur, PSQI.

Health shocks—such as new diagnoses of chronic disease—can disrupt daily life and create potential “teachable moments” for behavioral improvement. Yet, existing evidence on post-diagnosis behavior change remains mixed and largely limited to high-income countries. This study addresses a major empirical gap by examining whether chronic disease diagnoses are associated with measurable within-person changes in health behaviors among middle-aged and older adults in Thailand, a rapidly aging middle-income society. We analyzed four waves (2015–2022) of the Health, Aging, and Retirement in Thailand (HART) survey. The analytic sample comprised adults aged ≥45 years with no baseline diagnosis of cancer, diabetes, or cardiovascular disease (N = 2,891; 9,577 person-wave observations). Self-reported physician-diagnosed conditions were used to construct disease-status indicators. Behavioral outcomes included smoking, current alcohol use, sufficient physical activity (≥150 minutes/week), normal body mass index (BMI) (18.5–23), and waist obesity (sex-specific cutoffs). Individual fixed-effects linear probability models with survey-wave fixed effects and adjustment for time-varying covariates (log income, activities of daily living [ADL] score, and marital status) estimated within-person associations, with standard errors clustered at the individual level. Disease-specific models and models including interactions with sex assessed heterogeneity. In pooled analyses, the disease-status indicator was not significantly associated with smoking, alcohol use, physical activity, BMI, or waist obesity. In contrast, a diabetes diagnosis was associated with a reduction of 3.6 percentage-point in current alcohol use, and both diabetes and cancer diagnoses were associated with reductions in frequent drinking. Models including interactions with sex suggested larger diagnosis-associated reductions in selected alcohol-use outcomes among men, although statistical evidence varied by outcome and disease type. Among middle-aged and older Thai adults, chronic disease diagnoses were associated with selective, rather than comprehensive, changes in health behaviors. Diagnosis alone is insufficient to support changes across multiple health behaviors, underscoring the need for structured post-diagnosis counselling, follow-up, and gender-sensitive secondary prevention in aging middle-income populations.

Background: Young adults' extensive use of smartphones has resulted in several health concerns and one of which is Text Neck Syndrome. Prolonged neck flexion during smartphone use can lead to neck pain, disability and functional limitations. The study focused on determining the prevalence and knowledge regarding Text Neck Syndrome and identify predicting factors associated with the condition. Methods: A cross-sectional study was carried out among 240 undergraduate students selected using convenience method of sampling from four colleges in East Khasi Hills, Meghalaya. A standardized questionnaire with questions on demographics, participant behaviour and understanding of text neck syndrome was used to gather data. Two standardized tools neck disability index and the smartphone addiction scale-short version were used with prior permission to assess neck disability and smartphone addiction.8,9 Results: The results demonstrated that, prevalence of Text Neck Syndrome among the participants discovered to be 35.8% (95% CI:29.8%–42.3%) and 41.0% participants had smartphone addiction. Majority (71.7%) participants had adequate knowledge regarding Text Neck Syndrome and smartphone addiction was identified as a significant independent predictor of Text Neck Syndrome, with 2.2 times higher odds of developing the condition. Additionally, there was a significant positive correlation found between smartphone addiction and neck disability. Conclusions: Text Neck Syndrome is a prevalent health issue among undergraduate students in Meghalaya, affecting more than one-third of the study population. Although most of the participants had adequate knowledge regarding text neck syndrome, the occurrence of the syndrome suggests the need of targeted educational, ergonomic and behavioural interventions among young adults.

Background Insomnia and poor sleep are highly prevalent among university students and are linked to impaired mental and physical health, reduced cognitive functioning, and lower academic performance. Existing interventions for insomnia include cognitive behavioural therapy for insomnia (CBT-I), mindfulness, and sleep hygiene. CBT-I is widely recognised as effective but remains difficult to access for the general population and lack scalability, long-term follow-up, and feasibility in non-clinical settings. Pragmatic, group-based approaches that can be delivered within the university and are tailored to help students develop self-endorsed routines and competencies for better sleep, creating sustainable changes that extend beyond the program period, is needed. Methods This study is a pragmatic, two-arm randomised controlled trial evaluating the effectiveness of a group-based sleep program for university students with insomnia symptoms. A total of 118 full-time students aged 18–30 meeting diagnostic criteria for chronic insomnia disorder will be randomized (1:1) to either the intervention or a wait-list control group. The intervention comprises 12 weekly 90-minute group sessions followed by nine monthly follow-up meetings, facilitated by trained coaches. The program integrates core elements of CBT-I with motivational and coping strategies, delivered in an interactive and peer-supported format. The primary outcome is change in insomnia severity measured by the Bergen Insomnia Scale. Secondary outcomes include subjective and objective sleep measures, mental health, cognitive performance, academic attainment, health behaviours, physical fitness, and biological markers. Assessments will be conducted at baseline, post-program (12 weeks), and 12 months. A mixed methods process evaluation will assess fidelity, acceptability, mechanisms of impact, and contextual influences. Discussion This trial will be among the first pragmatic evaluations of a structured, group-based sleep intervention tailored to university students with insomnia. Key strengths include the randomised controlled design, comprehensive outcome assessment, 12-month follow-up, and embedded process evaluation. If effective, the program could provide a feasible, scalable, and cost-effective model to improve sleep and therein health, and academic performance in young adults in higher education.

Background: Examination periods can coincide with psychological stress, sleep difficulties, and uncertainty about academic performance. Students may continue to feel tense while waiting for results or further assessment, particularly when they are unsure how well they answered the examination questions. Objective: To describe students’ reported stress and sleep difficulties before and after examinations at Gori State University and European University, and to explore themes appearing in anonymous open-ended questionnaire responses. Methods: The study is described as a comparative questionnaire study involving 50 students, with 25 participants from each university. Anonymous questionnaires were administered before and after an examination. The questionnaire asked about stress, sleep, feeling tired or sleepless, waiting for further assessment or results, and students’ perceptions of how they had answered the test. Results: The preliminary account supplied for this draft indicates that sleep difficulty associated with stress and concern while waiting for further assessment were recurring concerns in open-ended responses. The initial estimate was approximately 5% of students reporting satisfaction with their answers. With 50 participants, the closest possible whole-person counts are 2 students (4%) or 3 students (6%); the original questionnaires must be checked to establish which count is correct. No further frequency estimates or statistical tests are reported because participant-level data were not provided for analysis. Conclusion: Anonymous pre- and post-examination questionnaires may help educators identify students’ concerns about sleep, stress, and uncertainty. Findings should be interpreted as preliminary until response counts, scoring procedures, ethics information, and the exact number of students reporting satisfaction are verified.

Background Sleep problems are common among university students due to academic stress, lifestyle factors, and psychological distress and may adversely affect physical and mental health, academic performance, and social functioning. Mindfulness-based interventions (MBIs) have increasingly been used as a non-pharmacological approach to improve sleep health; however, previous findings remain inconsistent, and evidence specifically addressing sleep quality in university students remains limited. This study aimed to systematically evaluate the effects of MBIs on sleep quality in university students and explore factors that may account for variations in intervention effects. Methods We searched seven databases—PubMed, Web of Science, EBSCO, the Cochrane Library, Scopus, Embase, and ScienceDirect—from inception to June 26, 2026. Randomized controlled trials (RCTs) evaluating MBIs for sleep quality in university students were included. Two reviewers independently conducted study selection, data extraction, and risk-of-bias assessment using the RoB 2 tool. Meta-analysis was conducted in Stata 17.0 using a random-effects model. Subgroup analyses, sensitivity analyses, publication bias assessment, and GRADE assessment were also performed. Results Ten RCTs involving 638 university students were included, with 335 participants in the intervention groups and 303 in the control groups. MBIs significantly improved sleep quality [SMD = −0.97, 95% CI (−1.43, −0.51), p < 0.001], although substantial heterogeneity was observed ( I 2 = 85.1%). Subgroup analyses revealed statistically significant between-group differences with respect to sleep-outcome measurement instrument ( p = 0.001), intervention type ( p = 0.009), and session duration ( p = 0.030), indicating that these variables may partially account for the observed heterogeneity. Sensitivity analyses supported the robustness of the pooled results. Egger’s test revealed no evidence of significant publication bias ( p = 0.270). The certainty of the evidence was rated as low according to the GRADE framework. Conclusion MBIs may improve sleep quality in university students. However, given the substantial heterogeneity and low certainty of evidence, further high-quality RCTs are needed to confirm these findings. Systematic review registration CRD420261458068, https://www.crd.york.ac.uk/PROSPERO/view/CRD420261458068 .

The Ig Nobel Prize, a spoof on Nobel Prize, has long performed a valuable service to science.It honours achievements that make people laugh and then think [1].Global Health, after several decades of earnest endeavour, would seem ready for similar recognition.I therefore propose, with all due humility, the establishment of an Ig Nobel Prize for Global Health.There is, of course, no intention to mock Global Health, which is too noble, and the inequalities it seeks to address too consequential.But, like most human enterprises, Global Health has acquired its own vocabulary, rituals, paradoxes and unintended ironies.The proposed Ig Nobel Prize for Global Health would therefore recognise such phenomena for their ability to make us laugh first, think second, and perhaps recognise a little of ourselves in the process.Five examples readily come to mind.

Background Helping professionals face elevated risks of compassion fatigue and burnout, yet the daily processes through which emotional transformation occurs during therapeutic interventions remain poorly understood. This study examined how participants’ daily reflections shifted across the Emotion-Focused Training for Helping Professions (EFT-HP), analyzed through three complementary theoretical frameworks: Emotion-Focused Therapy's inner dialogue model (self-criticism, self-compassion, self-protection), Compassion-Focused Therapy's three-systems framework (threat, drive, soothing), and Ekman's basic emotion theory (primary emotions). Method Two hundred twenty-five helping professionals (88.0% female; M age = 38.7 years) from healthcare, social work, psychology, and education began the 14-day online EFT-HP intervention. Primary analyses focused on the 146 participants who completed at least 9 of the 14 days (completers), whose daily written reflections yielded 7,307 coded reflection units. Reflections were analyzed with directed content analysis and frequency quantification, applying non-exclusive, AI-assisted coding within three theoretical frameworks—EFT inner-dialogue categories, CFT emotion-regulation systems, and Ekman's discrete emotions—with a verbatim textual evidence excerpt retained for every assigned code. Results Across the intervention, participants’ reflections shifted from threat- and self-criticism-related content toward soothing and self-compassion. Within the EFT inner-dialogue framework, Self-Compassion was the most frequent category (17.9% of units) and was sustained throughout (Day-13 peak 30.8%), while Self-Criticism fell from 14.3% on Day 1 to 3.9% on Day 14 (73% relative decrease) and Self-Protection peaked on Day 6 (11.3%). Within the CFT emotion-regulation framework, the soothing system was the most frequently coded system overall (31.8% of units), followed by drive (20.4%); over the 14 days the threat system declined from 35.4% on Day 1 to 7.0% on Day 14 (80% relative decrease). Within Ekman's discrete-emotion framework, specific emotions were named less frequently: Fear declined from 2.7% to 0.8%, Anger peaked on Day 6 (15.0%), Joy rose to a Day-13 peak (14.8%), and Love was comparatively prominent (11.9% overall, Day-5 peak). Conclusions Across the 14-day intervention, participants’ daily reflections showed substantial shifts in emotional content, characterized by marked self-criticism and threat reduction alongside sustained self-compassion and soothing activation. Triangulated findings across three analytical frameworks: EFT inner dialogue, CFT emotion systems, and Ekman's primary emotions, are consistent with the emotional-transformation processes proposed by EFT-HP and with findings from previous controlled trials. Because the three frameworks were applied to the same reflection data, their convergence reflects analytic (theoretical) triangulation rather than independent confirmation.

Aim and background: Sleep is a biological necessity essential for physical and mental well-being, yet many young adults, particularly college students, experience sleep disruptions due to major life changes and poor sleep hygiene.This study aimed to identify the determinants of insomnia among undergraduate female students in a rural area of Haryana.Materials and methods: A mixed-method study was conducted between May 2024 and May 2025 involving 340 undergraduate female students.Quantitative data were collected using a semi-structured socio-demographic questionnaire and the insomnia severity index (ISI).Qualitative insights were gathered through in-depth interviews (IDI) with 15 students identified with clinically significant insomnia.Statistical analysis was performed using SPSS software version 26, with significance set at p < 0.05.Results: The prevalence of clinically significant insomnia in the cohort was 5.6% (n = 19).Quantitative analysis revealed that the participant's state of origin was the only statistically significant socio-demographic determinant (p = 0.031).Students from states other than Haryana reported a significantly higher insomnia prevalence (12.5%) compared to those from Haryana (4.2%).Factors such as age, socio-economic status, and type of occupancy showed no significant correlation.Qualitative themes highlighted academic performance, overuse of electronic devices, social environment, and psycho-social stress as primary triggers.Conclusion: While the prevalence of insomnia is relatively low, it is significantly driven by academic transitions, excessive screen time, and communal living challenges.A notable awareness-action gap exists, as students recognize the importance of sleep but prefer self-management or mindfulness over professional clinical help.

Background Trans, non-binary and gender diverse (TNBGD) sexual function has historically been narrowly defined as physical capacities following medical and surgical gender affirming (GA) interventions; and this population's sexual health has been researched more in terms of external influences considered risky rather than being founded in individuals' desires and needs. This can produce discrepancies between services and people who access them. This study explores the service-related barriers, facilitators and compensatory strategies for TNBGD people seeking healthcare related to sexual function. Methods Based on qualitative interview data from n = 19 TNBGD adults in the UK, the dataset was deductively analyzed using Levesque's framework of healthcare access. Results TNBGD people face barriers in distance and transport to appropriate sexual health services, overlaps between sexual healthcare and GA services, and limits in professionals' TNBGD specific knowledge and cultural competence. To navigate these TNGBD people pursued independent knowledge acquisition, were selective during clinical interactions and access, and sought to meet their needs outside clinical settings. The analytical themes demonstrate varied barriers and their interrelatedness. For example, acceptability of a service was informed by the appropriateness of clinician's knowledge and interactions. In turn, TNBGD people's anticipation of un (der) met needs motivated compensatory measures, such as seeking information online or from peers before approaching formal services or sometimes instead of approaching them. Conclusions Healthcare services' design and delivery can present significant barriers to TNBGD adults seeking healthcare to support their sexual function. Providers' ways of interacting may offset some of the barriers and TNBGD adults may deploy strategies that enable them to access care that leads to satisfactory health outcomes. However, while significant barriers persist, TNBGD adults are liable to have unmet needs and consequent health inequalities.

Aim and background: Excessive daytime sleepiness (EDS) is reported far less often than poor nocturnal sleep quality in Indian medical students.We aimed to estimate EDS prevalence and its independent correlates (primary), and to compare these with poor sleep quality correlates in the same cohort and relate both to examination performance (secondary).We hypothesized that sleep hygiene behavior, not global sleep quality category, would dominate.Materials and methods: Prospective cross-sectional study of 354 of 450 eligible MBBS students (78.7%) at a Southern Indian college, sampled by stratified proportional randomization.Under supervised standardized administration, they completed the Epworth Sleepiness Scale (ESS; EDS >10), Pittsburgh Sleep Quality Index (PSQI), and Sleep Hygiene Index (SHI), with screen time, stress, mood, lifestyle, clinical covariates, and the latest university examination percentage.Excessive daytime sleepiness correlates were examined by logistic regression with a pre-specified confounder-adjusted sensitivity model.Results: Excessive daytime sleepiness affected 21.5% [95% confidence interval (CI) 17.5-26.0],more often among poor than good sleepers (27.7% vs 18.6%).Adjusted [area under the receiver operating characteristic curve (AUC) 0.773, 0.714-0.832],only poorer sleep hygiene remained independent [odds ratio (OR) 1.12 per point, 1.07-1.18],unchanged after adjustment for all measured confounders (1.12, 1.06-1.17).Examination percentage did not differ by sleep status (67.33 ± 5.16 vs 68.07 ± 5.72; p = 0.229); academic stage and sex, not sleep, predicted marks (R² = 0.152).Conclusion: In this cross-sectional sample, EDS was associated more closely with sleep hygiene behavior than with global sleep quality category, and the two had distinct correlation profiles.Screening for sleepiness alongside sleep quality, and addressing bedtime device use, merit consideration in student health services.These are associations only; no direction of effect can be inferred.Clinical significance: Measuring EDS alongside global sleep quality identifies a partly distinct at-risk group, for whom brief counselling on bedtime device use may be more specific than generic sleep hygiene advice.

Introduction In Japan, noriuchi refers to a collaborative gambling practice in which multiple players pool money used for betting and later split the final net profit or loss. This cross-sectional online study aimed (a) to estimate the prevalence of noriuchi among adult Japanese gamblers and (b) to examine how the frequency of noriuchi participation relates to gambling involvement and problem gambling severity. Methods In February 2022, an online survey was administered via Rakuten Insight, Inc. to adults aged 20 years or older. Participants were eligible if they reported gambling at least monthly in at least one of nine gambling activities during the past 12 months ( N = 2,000). Noriuchi participation frequency was assessed on a four-point scale (never, less than monthly, monthly or more, weekly or more). Outcomes included monthly gambling days, monthly gambling expenditure, and problem gambling severity measured with the Japanese version of the Problem Gambling Severity Index (PGSI). Results Overall, 498 participants (24.9%) reported noriuchi experience in the past 12 months; among them, 198 (39.76%) met the PGSI criterion for problem gambling. After adjustment for demographic covariates, noriuchi participation was associated with greater problem gambling severity across several gambling activities. Associations with monthly gambling days and expenditure were more limited and varied across gambling activities, with significant increases primarily observed among those engaging in noriuchi weekly for certain gambling activities. Discussion These findings suggest that noriuchi is associated with problem gambling severity, whereas its associations with gambling frequency and individual gambling expenditure are less consistent.