How left-behind experience moderates the impact of impulsivity on non-suicidal self-injury among Chinese senior high school students: the mediating role of self-control.

Stroke in young adulthood presents a distinct and growing public health challenge, with implications that extend far beyond the acute clinical episode. Unlike older adults, younger individuals who experience a stroke are often in the midst of their most economically and socially productive years. The definition of young stroke is highly variable in the current literature with young stroke being defined with multiple age cutoffs: 40, 45, 50 and up to 65 years (). Consequently, stroke-related impairments in this population can have profound and lasting effects on physical function, mental wellbeing, and participation in daily life, including employment and social roles (; ). Although advancements in acute stroke care have improved survival rates, many young stroke survivors face persistent difficulties in mobility, mood, cognition, and overall quality of life long after hospital discharge (; ). An emerging but underrecognized factor that may influence post-stroke outcomes in this demographic is hearing loss. Hearing loss, which affects an estimated 15% of adults in the United States and often begins in early to mid-adulthood, is associated with increased risk of depression, cognitive decline, and social withdrawal (; ). Among stroke survivors, hearing loss may exacerbate communication challenges, hinder engagement in rehabilitation, and intensify emotional distress—yet it remains rarely screened for or addressed in post-stroke care pathways (). The intersection of stroke and hearing loss is particularly important to consider in younger populations, where the implications for long-term disability, social integration, and economic productivity are especially pronounced. Despite this potential impact, limited research has systematically explored how hearing status may influence the health trajectories of young adults with stroke. Furthermore, employment status—both as an outcome and as a social determinant of health—remains an underexamined factor in the context of post-stroke recovery in this age group. Return to work is not only an indicator of functional recovery, but also a contributor to improved psychological wellbeing and financial independence (; ). However, individuals with stroke and comorbid sensory impairments may face additional barriers to re-employment, compounding the risk of long-term disability.