Hypertension remains a major global public health concern. Emerging evidence suggests that sleep duration may play a significant role as a modifiable risk factor; however, findings across studies have been inconsistent. This study aims to examine the association between sleep duration and hypertension in a cohort of adults residing in southern Iran. This population-based study was conducted among adults aged 35-70 years from the Bandare-Kong Non-Communicable Diseases (BKNCD) Cohort, part of the Prospective Epidemiological Research Studies in Iran (PERSIAN). Blood pressure was measured using a standardized protocol, and hypertension was defined as systolic blood pressure (SBP) ≥ 140 mmHg and/or diastolic blood pressure (DBP) ≥ 90 mmHg or the use of antihypertensive medication. Sleep duration was self-reported through a structured questionnaire. Logistic and Cox regression models were applied to assess the association between sleep duration and hypertension. Analyses were performed using R software, with p-values < 0.05 considered statistically significant. A total of 3,737 participants were included in the analyses, among whom 1,332 individuals without hypertension at baseline were followed for six years. At baseline, logistic regression analysis showed that women under the age of 50 who reported sleeping less than 7h per night had 1.82 times higher odds of having hypertension compared to those who slept 7-8h per night (OR = 1.82; 95% CI: 1.31-2.15; p = 0.042). Among participants aged 50 years and older, both women and men with short sleep duration (< 7h/night) had significantly increased odds of hypertension compared to their counterparts who slept 7-8h per night (women: OR = 2.68; 95% CI: 1.52-3.88; p < 0.001; men: OR = 2.35; 95% CI: 1.45-4.00; p = 0.003). Furthermore, Cox proportional hazards modeling indicated that individuals with either short (< 7h) or long (> 8h) sleep duration had a 1.91-fold increased risk of developing hypertension over the study period compared to those with normal sleep duration (7-8h/night) (HR = 1.91; 95% CI: 1.84-3.50; p = 0.041). Both short sleep duration (< 7h/night) and long sleep duration (> 8h/night) were associated with an increased risk of hypertension. These findings highlight the importance of adequate sleep as a potential modifiable factor in hypertension prevention. Future research is warranted to further explore the combined impact of sleep duration and sleep quality on the development of hypertension.

Portugal has made significant progress over the last 40years in the response against the Human Immunodeficiency Virus (HIV) infection and the Acquired Immunodeficiency Syndrome (AIDS). However, as of 2021, it remained one of the three Western European countries with the highest rates of new HIV infections and AIDS cases. Initially shaped by HIV exceptionalism, Portugal began transitioning to a universal testing strategy in 2011. This study provides a historical and policy review of the evolution of HIV testing in Portugal, focusing on alignment with international guidelines and national implementation outcomes. We conducted a narrative policy review covering the period from 1998 to 2024. Our analysis drew on scientific literature, national health plans, surveillance reports, and international guidelines. Documents were selected through structured searches in multiple academic databases and government repositories using relevant Portuguese and English search terms. Thematically coded findings were mapped chronologically and assessed against evolving WHO and CDC recommendations. Portugal gradually moved from a targeted testing approach to a more comprehensive, universal strategy. Key policy shifts occurred in 2011 and 2017, accompanied by an expansion of testing modalities, including self-testing and community-based testing. Despite these developments, implementation has been uneven. The lack of standardized protocols, limited integration into primary healthcare, and regional disparities tied to a contract-based health system have contributed to inconsistent service delivery. Additionally, testing uptake among older adults, migrants, and other key populations remains suboptimal. The COVID-19 pandemic temporarily disrupted testing services but also accelerated the use of self-testing strategies. Portugal's experience illustrates the challenges of operationalizing universal HIV testing within a hybrid public-private healthcare system. Although policies increasingly reflect international best practices, structural barriers continue to hinder equitable implementation. To close existing testing gaps, Portugal must strengthen implementation by standardizing procedures, improve disaggregated data collection in monitoring systems, and ensure greater integration of HIV testing in primary healthcare. Enhanced outreach to underserved populations will be critical to achieving national and international HIV prevention targets. This paper offers a historical and policy perspective to inform more equitable and effective national testing strategies.

The creation and implementation of suicide prevention measures requires an evaluation of the full range of potential risk factors. This study examined the associations between the total number of suicides in the season-specific context and various meteorological parameters in Lithuania as a country of the Boreal region. This study included data on 21,487 cases of suicide in Lithuania from 2001 to 2021. The data were collected from the Register of the Institute of Hygiene. The associations between weather variables and the daily number of suicides were evaluated using a multivariate Poisson regression. The rate ratio (RR) of suicide was observed to be highest in two summer months, June and July (1.35 and 1.36, respectively), compared to January, with the same tendency in both sexes and different ages. Elevated temperature was associated with a significantly higher RR of suicide in the general population, in men, and across all ages. Moreover, a higher number of sunny hours per day was also associated with higher RR in the whole sample, in both sexes and at the youngest and the oldest ages. Higher atmospheric pressure was found to be associated with lower suicide RR in the total sample, in men, and in the youngest and the middle age groups. An average relative humidity (RH) of 50% or more, compared to an average relative humidity < 50%, was associated with a significantly higher RR of suicide in the total sample and in the men's group. There is significant evidence of seasonal effects on suicide. Clinical services in Lithuania should be aware of the risk of suicide on the hot, long summer days, especially among men.

As societal pressures increase, many college students face social anxiety, especially those with adverse childhood experiences, which can lead to higher social anxiety in adulthood. Parental attachment and cyberbullying victimization may mediate this relationship, while resilience could alleviate the effects. This study, based on the stress-vulnerability model and attachment theory, investigates how adverse childhood experiences affect social anxiety among college students, with parental attachment and cyberbullying victimization as mediators and resilience as a moderator, forming a moderated chain mediation model. A random sample of 964 college students from various Chinese universities was selected. Standardized scales assessed parental attachment, cyberbullying victimization, resilience, adverse childhood experiences, and social anxiety. Structural equation modeling tested the proposed model, and multi-group analysis examined differences between single-parent and non-single-parent families. Adverse childhood experiences were significantly associated with higher social anxiety. Parental attachment and cyberbullying victimization played mediating roles, with resilience reducing the impact of adverse childhood experiences on social anxiety. In non-single-parent families, parental attachment more strongly protected against cyberbullying, whereas, in single-parent families, adverse childhood experiences had a more pronounced effect on cyberbullying victimization. This study reveals the psychological mechanisms through which adverse childhood experiences contribute to social anxiety in college students, offering new insights and practical recommendations for preventing and treating social anxiety in university settings.

Recurrent myocardial infarction (re-MI) remains a significant challenge in cardiovascular care, especially in low-income countries. Despite advancements in cardiac care, many patients with coronary artery disease (CAD) fail to follow the secondary prevention guidelines consistently. This study aims to determine the independent predictors of re-MI and inadequate adherence to secondary prevention strategies among adults with CAD in a rural cohort in South India. A nested case-control study with risk set sampling of controls was conducted from January 2022 to March 2022 within the ENDIRA (Epidemiology of Non-communicable Diseases In Rural Areas) Cohort in the rural part of Aluva municipality of Ernakulam district, Kerala, India. CAD patients aged 35-80years from the ENDIRA cohort who have had one or more episodes of myocardial infarction 28days post the index episode as confirmed by medical reports were selected as cases while those with no recurrent episodes were taken as controls. Descriptive analysis was conducted to characterise the study population and was expressed in frequencies and percentages. Regression models were used to determine the independent predictors of re-MI as well as inadequate adherence and was expressed using adjusted odds ratio along with 95% confidence intervals. The study included 187 cases and 436 controls. The independent predictors of recurrent myocardial infarction included poor socio-economic status (Adjusted Odds Ratio [AOR] 1.98; 95% confidence interval [CI] 1.34-2.91), > 5years since CAD diagnosis (AOR 1.53; 95% CI 1.06-2.22), previous history of CABG (AOR 1.75;95% CI 1.17-2.61), alcohol consumption (AOR 1.65; 95% CI 1.04-2.61), follow up under complementary and alternative medicine (AOR 2.04; 95% CI 1.03-4.01), distance to follow up hospital > 20 kms (AOR 1.85; 95% CI 1.09-3.12) and uncontrolled blood pressure (AOR 1.60; 95% CI 1.07-2.39). The CAD patients preferring private facilities for follow up were 43% less likely to develop recurrent myocardial infarction. (AOR 0.57; 95% CI 0.34-0.95). The determinants of recurrent myocardial infarction and inadequate adherence are multifactorial, encompassing socioeconomic, behavioural and health system factors. Strengthening equitable access to quality secondary prevention services, integrating social support, and improving continuity of cardiac care are essential to reduce recurrence and improve outcomes in rural India.