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☐ ☆ ✇ BMJ Open

Sustaining community self-help groups beyond donor support: lessons from a qualitative study of self-help groups, including persons affected by leprosy and disability in rural India

Por: Darlong · J. · Charles · M. V. · Ilozumba · O. · Govindasamy · K. · Shrivastva · A. · Choudhury · S. · Sartori · J. · Lindenmeyer · A. · Lilford · R. J. · Griffiths · F. — Enero 9th 2026 at 14:17
Introduction

Leprosy remains a significant public health challenge in many low and middle-income countries, including India. People affected by leprosy face multifaceted challenges: physical, psychological, social and economic. In response, donors support self-help groups (SHGs) to improve health, social integration and economic circumstances for marginalised people, including those with leprosy. This study aims to assess the sustainability of SHGs in India after the withdrawal of donor support by examining whether they remain functional and exploring the key factors, barriers and facilitators that influence their long-term social and economic viability.

Objectives

To examine the functionality of SHGs after withdrawal of donor support, and to explore the factors, barriers and facilitators influencing their long-term social and economic sustainability.

Methods

Using qualitative methods, we conducted semistructured interviews with 40 key informants associated with five SHGs formed under the Self-Help Community Development Project implemented in an endemic state of India and funded by The Leprosy Mission Trust India.

Study design

It was an exploratory qualitative study using interviews with SHG members and key informants, situated within the self-help community-based project.

Results

While some SHGs demonstrated resilience and adaptability, others faced challenges such as internal discord, loss of members to migration and lack of access to government schemes. Thematic analysis revealed key drivers and barriers to sustainability and realising the benefits of SHGs, highlighting variations in leadership, governance, economic performance and social engagement across groups.

Discussion and conclusion

SHGs are often sustained after the funding and managerial donor support have been withdrawn. The findings emphasise the importance of strong leadership, community support and external facilitation in sustaining SHGs and enhancing their impact on marginalised populations. This study contributes to understanding the role of SHGs in addressing the socioeconomic challenges faced by individuals affected by leprosy and offers insights for improving their long-term viability.

☐ ☆ ✇ PLOS ONE Medicine&Health

EEG difference in the Higuchi fractal dimension of wakefulness and sleep from birth to adolescence

by Francesco Colussi, Jacopo Favaro, Claudio Ancona, Edoardo Passarotto, Maria Federica Pelizza, Eleonora Lorenzon, Simone Ruzzante, Stefano Masiero, Giorgio Perilongo, Giovanni Sparacino, Irene Toldo, Stefano Sartori, Maria Rubega

Brain maturation from birth to adolescence involves profound transformations in neural dynamics, which can be studied in a minimally invasive manner using quantitative EEG. Most of the results published in the literature are based on spectral analysis approaches, which are extremely effective in detecting and assessing EEG rhythms. However, some aspects of EEG dynamics can only be investigated using nonlinear approaches, the use of which is still relatively unexplored in the pediatric population. The aim of the present paper is to assess the EEG differentiation of wakefulness from deep sleep (quiet sleep in neonates, stage N3 in older children) and its maturation across a wide developmental window (0–17 years) using the fractal dimension. Specifically, Higuchi fractal dimension (HFD) algorithm is used to analyse both wakefulness and sleep EEG recordings collected from 63 infants (aged 0-1 year) and 160 children (aged 2-17 years). To ensure methodological consistency, a data-driven criterion for the selection of HFD user parameters is implemented to enhance reproducibility. Our results show that HFD during wakefulness increases during the first year of life, followed by a stabilization or slight decrease in later years. In contrast, HFD during sleep exhibits a more stable profile, with only a mild increase over development. These findings are consistent with known neurodevelopmental processes—including synaptogenesis, pruning, and white matter maturation—and support the interpretation of HFD as a sensitive marker of large-scale integrative brain dynamics. These physiological trajectories of HFD both in wakefulness and sleep could be used as reference for future clinical applications in pediatric neurology and developmental monitoring.
☐ ☆ ✇ BMJ Open

Psychological distress and well-being in university and high school students: a cross-sectional study in Italy

Por: Nose · M. · Turrini · G. · Muriago · G. · Badino · M. · Cristofalo · D. · Sartori · R. · Tedeschi · F. · Barbui · C. — Agosto 19th 2025 at 15:52
Objective

Adolescence is a transitional period marked by psychosocial changes that can impact well-being. Mental disorders before university are linked to dropout and lower employment rates, affecting long-term outcomes. This study examines the psychological well-being of Italian students aged 18–25, exploring factors related to distress.

Design

Cross-sectional survey.

Setting

High schools and university in Verona, northern Italy.

Participants

A total of 1766 students (88.96% university students and 11.04% high school students in their final year) were recruited. Inclusion criteria were being enrolled in high school or university in Verona, aged 18–25, with adequate Italian language proficiency and informed consent. No exclusion criteria were applied.

Primary and secondary outcome measures

Primary outcomes were levels of psychological distress (Kessler Psychological Distress Scale-10-item - Kessler-10), anxiety and depression (Patient Health Questionnaire Anxiety and Depression Scale - PHQ-ADS) and well-being (WHO-Five Well-Being Index - WHO-5). Secondary analyses examined the association of these outcomes with sociodemographic and educational variables.

Results

Most participants (88.6%) reported psychological distress (mean K-10=22.95, SD=6.64). Mild symptoms of anxiety and depression were reported by 47.1% and 43.3% of participants, respectively. Only 16.5% reported high psychological well-being. Female and non-binary students had worse mental health outcomes than males (p value

Conclusions

Psychological distress, anxiety and depression are widespread among Italian students. Gender, academic stage and living situation significantly impact mental health outcomes. The findings emphasise the need for targeted mental health interventions, particularly for non-binary and female students, as well as those in advanced academic years.

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