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Introduction: Climate change is the public health crisis of our time, with young people particularly at risk. Climate change has been associated with increased prevalence of psychiatric disorders. Psychological concerns pertaining to the Earth's future have also been cited as contributing to negative emotions now termed ‘climate distress’. While previous reviews have addressed the various ways climate change affects pediatric mental health, this scoping review aims to specifically explore pediatric climate distress and its implications for clinical practice. Methods: 2548 articles were extracted from multiple databases, titles, abstracts, and full texts were screened blinded and in duplicate using the web-based platform Covidence. Quantitative and qualitative original research papers published in English between January 1, 2000 and April 29, 2024 that studied pediatric climate distress were included. Results: Forty-two articles met the inclusion criteria, along with 10 additional grey literature sources. Among quantitative studies, 81 % found that 50 % or more of respondents reported negative climate emotions and 86 % of qualitative studies reported that “all” or “most” respondents expressed negative climate emotions. Additionally, 63 % of studies measuring distress severity reported high distress levels. Therapeutic interventions addressing climate distress were found to be effective and were categorized thematically into three groups: Education-Emotion Focused, Nature-Engagement Based, and Activism-Civic Related. Conclusions: This review shows that while there is a growing body of literature that illustrates how young people have negative emotions pertaining to climate change, there is need for increased diagnostic and therapeutic approaches to clinically address these growing challenges.

Purpose or Objective: The aim of this study was to explore the potential relationship between the time estimation and psychological distress in patients with solid tumors prior to starting radiotherapy. Materials and Methods: In this multicenter study were included a total of 344 patients with solid tumors (197 with and 147 without metastatic disease). The time estimation was assessed by evaluating each subjects prospective estimation of how fast 1 min passed compared to the actual time. The median value (35sec) of subjective perception of time was used to group cases into two categories for experience of time. We used the National Comprehensive Cancer Network Distress Thermometer at the beginning of treatment to determine the levels of distress, where it measures distress on a scale from 0 to 10. Patients scoring 4 or above (73.5 %) were regarded as having high levels of distress. Results: The time estimation distributions significantly changed according to the level of distress. ROC analysis revealed that at the optimal cut off value of time estimation, patients with low and high distress levels can be discriminated with an AUC = 0.80 (95 % CI: 0.75– 0.85, p

Diabetes Mellitus (DM), particularly Type 2 Diabetes Mellitus (T2DM), is one of the most prevalent non-communicable chronic diseases and poses significant challenges for the healthcare sector and the community. Distress in patients with T2DM leads to severe physical and mental consequences. This study aims to analyze the relationship between distress and the nutritional status of T2DM patients. A cross-sectional descriptive study was conducted on 203 T2DM patients at the National Hospital of Endocrinology from October to December 2022. Of the participants, 54.2 % were female with an average age of 62.1 (±12.4). The waist circumference (WC) and waist-to-hip ratio (WHR) were significantly different between genders (p

Research indicates that hearing loss significantly contributes to tinnitus, but it alone does not fully explain its occurrence, as many people with hearing loss do not experience tinnitus. To identify a secondary factor for tinnitus generation, we examined a unique dataset of individuals with intermittent chronic tinnitus, who experience fluctuating periods of tinnitus. EEGs of healthy controls were compared to EEGs of participants who reported perceiving tinnitus on certain days, but no tinnitus on other days.. The EEG data revealed that tinnitus onset is associated with increased theta activity in the pregenual anterior cingulate cortex and decreased theta functional connectivity between the pregenual anterior cingulate cortex and the auditory cortex. Additionally, there is increased alpha effective connectivity from the dorsal anterior cingulate cortex to the pregenual anterior cingulate cortex. When tinnitus is not perceived, differences from healthy controls include increased alpha activity in the pregenual anterior cingulate cortex and heightened alpha connectivity between the pregenual anterior cingulate cortex and auditory cortex. This suggests that tinnitus is triggered by a switch involving increased theta activity in the pregenual anterior cingulate cortex and decreased theta connectivity between the pregenual anterior cingulate cortex and auditory cortex, leading to increased theta-gamma cross-frequency coupling, which correlates with tinnitus loudness. Increased alpha activity in the dorsal anterior cingulate cortex correlates with distress. Conversely, increased alpha activity in the pregenual anterior cingulate cortex can transiently suppress the phantom sound by enhancing theta connectivity to the auditory cortex. This mechanism parallels chronic neuropathic pain and suggests potential treatments for tinnitus by promoting alpha activity in the pregenual anterior cingulate cortex and reducing alpha activity in the dorsal anterior cingulate cortex through pharmacological or neuromodulatory approaches.

Although many breast cancer survivors adjust to cancer treatment and survivorship, a sizable subgroup of women do not do so, resulting in psychological distress. Over time, this psychological distress can contribute to immune dysfunction and accompanying worsened physical symptoms as women navigate survivorship. Dr. Kiecolt-Glaser's work and mentorship has been integral to our understanding of breast cancer survivors' immune risks, and how behavioral factors may enhance these risks. As a postdoctoral fellow in the Stress and Health Lab, under Dr. Kiecolt-Glaser's mentorship, my research focused on understanding how distress is associated with immune functioning and physical health in breast cancer survivors. In this paper, we highlight Dr. Kiecolt-Glaser's influence on our careers as a strong female research and mentor, the work completed under her mentorship, and how the field of psychoneuroimmunology can continue to expand her research to better understand how distress in the cancer context confers long-term health risks.

Background: Long COVID, an emerging public health issue, is characterized by persistent symptoms following SARS-CoV-2 infection. This study aims to explore the relationship between post-COVID-19 symptomatology and patient distress employing Latent Class Analysis to uncover symptom co-occurrence patterns and their association with distress. Methods: A cross-sectional study was conducted using an online survey among 240 participants from a university and affiliated hospital of southern Taiwan. The survey quantified distress due to persistent symptoms and assessed the prevalence of Long COVID, symptom co-occurrence, and latent symptom classes. Latent Class Analysis (LCA) identified distinct symptom patterns, and multiple regression models evaluated associations between symptom patterns, distress, and demographic factors. Results: The study found that 80 % of participants experienced Long COVID, with symptoms persisting for over three months. Individuals with multiple COVID-19 infections showed a significant increase in general (β = 1.79), cardiovascular (β = 0.61), and neuropsychological symptoms (β = 2.18), and higher total distress scores (β = 6.35). Three distinct symptomatology classes were identified: ''Diverse'', ''Mild'', and ''Severe'' symptomatology. The ''Mild Symptomatology'' class was associated with lower distress (−10.61), while the ''Severe Symptomatology'' class showed a significantly higher distress due to symptoms (13.32). Conclusion: The study highlights the significant impact of Long COVID on individuals, with distinct patterns of symptomatology and associated distress. It emphasizes the cumulative effect of multiple COVID-19 infections on symptom severity and the importance of tailored care strategies.

Introduction: Having a grandchild who survived childhood cancer might affect grandparents’ mental health. We aimed to A) describe the psychological distress of grandparents of childhood cancer survivors (CCS) and compare their distress to the Swiss general population, and B) explore the associations between the psychological distress of grandparents with person-, child-, and cancer-related characteristics. Methods: This is a cross-sectional study conducted in Switzerland. Grandparents were identified from families of eligible CCS (cancer diagnosis before 18 years old; 3–10 years after diagnosis). A subsample of a representative sample for the Swiss general population was used for comparison similar in age, gender and language region. The Brief Symptom Inventory-18 (BSI-18) was administered to assess psychological distress on three domains: somatization, depression, anxiety; and a Global Severity Index [GSI]. We ran Chi-squared and t-tests to compare grandparents and comparisons, and univariable, multivariable and multilevel regressions to analyze associations. Results: In total, 122 grandparents (60.7% female, mean age=72.8; SD=6.8) and 354 comparisons participated (55.4% female; mean age=65.7; SD=5.5). Grandparents reported average distress levels and their scores did not differ significantly from the comparison sample (all p>.05). Grandparents with worse health perception described more psychological distress (somatization: β=6.86, p

Persons with sickle cell disease exhibit high levels of distress, which has been documented with validated measures. However, there has been little qualitative investigation of the sources of distress in the lives of persons with sickle cell or the strategies they use to manage different sources of distress. Our study sought to: (1) identify sources of distress for persons with sickle cell, (2) explore management strategies for different sources of distress, (3) inform content development of the future mobile phone application, and (4) incorporate patient voices in the design and development phases of the future mobile phone application. In this manuscript, we present findings for the first objective. Using convenience sampling, we recruited participants with sickle cell (n = 11) from a home visit program at The Ohio State University Wexner Medical Center between February and July 2021. One team member conducted one-on-one semi-structured interviews with participants. We coded and analyzed all transcripts. Participants identified clinical encounters in the emergency department and intermediate care center to manage acute pain flares as the most profound source of distress. Our analysis identified four themes: (1) Pain has performative features, (2) Stigma and racism surround care, (3) Sickle cell is a neglected disease, and (4) Participants lack control over their pain management plan. Researchers may wish to consider how these settings can foster distress, and providers may wish to adopt participant recommendations to reduce distress associated with seeking pain treatment in acute care settings.

Background: Visits to an outpatient cancer clinic represent a challenging situation for patients, which can trigger anxiety and helplessness in those affected. It is important to identify patients with high psychological distress as early as possible in order to provide them with supportive psychological interventions. The aim of this study was to validate the Distress Thermometer (DT), a widely used screening for distress, in a cohort of patients with musculoskeletal tumors and to explore associations between distress, treatment satisfaction and health literacy. Methods: All patients presenting to a University outpatient clinic for musculoskeletal cancers were asked to complete a set of questionnaires including the DT), the Hospital Anxiety and Depression Scale (HADS) as a comparison scale, the Patient Satisfaction with Comprehensive Cancer Care (SCCC) and European Health Literacy Survey Questionnaire (HLS-EU-Q16).To assess the sensitivity and specificity of the DT in a cohort of patients with musculoskeletal tumors, we compare the performance of the DT in relation to an established screener for anxiety and depression using receiver operating characteristics (ROC) analyses. Results: A total of 120 patients (age 58 ± 18, 51% female) were analyzed. Patients reported a mean DT of 5.0 (SD 2.3, range, 0 to 10). Eighty-six patients (71.7 %) had a DT score ≥ 5 indicating moderate or severe psychological distress.The mean total HADS score (scale 0 to42 points) was 11.7 (SD 7.6, range, 0 to 32) with a HADS score of ≥ 15 in 29.2% of patients. The DT correlated moderately with anxiety and depression (HADS total r = 0.48, p

In the current research we investigated how people deal with decisions in which they have to reject others, something that is unavoidably part of many selection procedures. Integrating insights derived from research on social exclusion and dehumanization, we argued that when people need to reject others, they dehumanize them. To study the association between dehumanization and rejecting in a real-life setting, we conducted two field studies, in which we examined the selection process in student houses, where residents can accept some prospective members, but have to reject others. As predicted, our findings showed that when people need to reject targets, they subtly dehumanize them. Moreover, dehumanizing rejected targets was related to lower rejection aversion. This suggests that when people dehumanize those they have to reject, rejection is easier.

Background: Combined Orthopaedic Infectious Disease Clinics facilitate care for prosthetic joint infection (PJI) patients similar to multidisciplinary care in cancer centers. The National Comprehensive Cancer Network developed a standardized distress thermometer (DT) to measure distress in cancer patients. We propose using this tool to assess distress in PJI patients. Methods: In this pilot study, a retrospective review of patients treated in our combined clinic over 2 years was conducted. In addition to providing information surrounding their treatment, patients completed a questionnaire and DT, adapted with permission from the National Comprehensive Cancer Network. DT scores were compared to a chronologically collected matched aseptic control group. Results: There were 122 patients in the septic group and 40 patients in the aseptic group. On a scale of 0-10 (10, the highest level of distress), the septic group reported a mean DT score of 6.18 (±3.2), which was significantly higher than the aseptic mean score of 3.33 (±2.06) [P < .0001]. Over 75% of patients in the septic group reported a DT score ≥4, the cutoff used in most cancer centers to warrant additional support. Twenty-one percent of the septic group (26/122) reported extreme distress (defined as a score ≥10) compared to 0/40 of aseptic patients. Conclusions: Patients treated for PJI experience significantly higher levels of distress compared to aseptic revision patients. More attention is needed to measure and clinically address distress. Improved screening for distress would allow us to provide more comprehensive care and possibly improve compliance, outcomes, and resources available for the treatment of PJI patients.

The aim of this study was to examine the factors associated with mental health outcomes in school staff during the second year of the COVID-19 pandemic. Adapting the Transactional Model of Stress and Coping, we tested whether school staff who lived with others and adopted healthier behaviours (e.g., diet, physical activity) would be more likely to manage pandemic stressors, altering mental health outcomes. The current study included 2,343 school staff (60% teachers) from the greater Vancouver area in British Columbia, Canada, who completed the online questionnaire between February 3 and June 18, 2021 as part of a longitudinal study of COVID-19 impacts on schools. Results showed that participants’ perceived risk of getting COVID-19 was associated with poorer mental health among both male and female school staff. Furthermore, when perceived risk of COVID-19 was low, living with others reduced the negative impact of pandemic stressors on anxiety symptoms and dispositional optimism among female school staff. We detected no influence of health behaviours on the associations between stressors and mental health. Favorable health behaviours were also associated with lower anxiety and psychological distress among female school staff. These findings underlie the importance of proactive prevention and intervention strategies to address the mental health of school staff.

Objectives: Nowadays, the number of older people is increasing rapidly, both in absolute figures and as a proportion of the population, which makes the maintenance of psychological well-being among aging population imperative. Neuropsychological distress may promote cognitive impairment and impact on the health of older people, which makes accurate assessment of distress an important clinical and research issue. The Kessler Psychological Distress Scale (K-10) is a widely used instrument used to measure individual distress. However, the ability of K-10 to distinguish between enduring and dynamic distress symptoms, and the generalizability of its scores, have not been investigated in older populations using appropriate methodology. Method: Generalizability theory (G-theory) was applied to differentiate enduring and dynamic distress and examine the reliability of K-10 in a sample of 201 adults (43% males) aged 70 to 90 years old who participated in Sydney Memory and Ageing Study. The data were collected biennially over ten years. Results: The K-10 scale showed strong reliability (Ga=0.81, Gr=0.89) in assessing enduring distress and its assessment scores were generalizable across occasions and older adults. Most of distress symptoms represented by K-10 items were enduring. Limitations: Generalizability of these findings may be limited to older adults. Conclusions: The K-10 appears more suitable to evaluate enduring distress in aging populations over time, which is important for interventions targeting older adults’ mental health given its scores will likely capture enduring changes in neuropsychological health before and after interventions.

Objective: To evaluate a facilitated, 90-min session, delivered for four weeks, Online Carer Wellbeing and Connection Program in Victoria, Australia. Methods: One hundred and three carers took part in the evaluation. Eighty-six completed both pre- and post-program surveys evaluating program impacts on psychological distress, perceived loneliness, and social support. Qualitative interviews were conducted (n = 76) post-program for experiential data. Findings: Paired samples t-tests showed significant decreases between pre- and post-program for psychological distress (M = 25.10, SD = 7.08; M = 22.00, SD = 6.57; t(85) = 4.88, p = 0.000), perceived loneliness (M = 6.69, SD = 1.89; M = 6.14, SD = 1.76; t(85) = 3.45, p = 0.000) and perceived social support (M = 8.31, SD = 2.48; M = 8.83, SD = 2.21; t(85) = −2.54, p = 0.013). Thematic analysis identified positive experiences and the mechanisms of action (or the ingredients for program success) as: 1. Delivery by a trained facilitator; 2. Provision of respite for person being cared for during meetings; 3. Technical assistance; 4. Online modality; 5. Inclusivity; 6. Diversity of experience; 7. Shared understanding; 8. Safety; 9. Emotional release; 10. Reflection, and; 11. Self-care practices. Innovation: A model illustrating the mechanisms of action based on the findings of the mixed-methods evaluation is presented to support wider implementation and translation. Conclusion: The online program effectively reduced psychological distress and loneliness and improved carer wellbeing.

Background: The impact of the COVID-19 pandemic on mental health has been widely reported. Yet, little remains known about the psychological mechanisms associated with changes in mental well-being during the currently ongoing pandemic. Methods: Here, we use a network analysis to unravel complex relationships between COVID-19 related stressors and emotional states during the initial phase of the COVID-19 (April 2020). Adults living in the Netherlands and Belgium (N = 1145, age 16 and older) (repeatedly) completed an online survey (approximate survey completion rate = 66.2%) about COVID-19 (over a 5-day maximum sampling period). Results: Partial correlations and contemporaneous networks illustrated that worries about the impact of the COVID-19 pandemic were primarily associated with distress and mood ratings, which were subsequently associated with other indicators of well-being. Temporal network analysis revealed that COVID-19 worries were selectively associated with the reciprocal interplay between high distress and low positive mood (https://osf.io/vtdkr/). Limitations: Short-term temporal intervals were evaluated. A small percentage of participants completed the survey repeatedly (35.63% of the total sample), yielding to a relatively small sample size for repeated measures online research. The sample was self-selected. Conclusion: These results may point to potential mechanisms by which initial worries about the COVID-19 pandemic may have impacted psychological well-being.

International evidence on the effect of minimum wages on mental health has been mixed. Estimation has used different types of variation in the minimum wage. In some countries such as the UK, the minimum wage is set nationally. In the United States, it is largely set subnationally. The resulting across state and time variation has recently been used to estimate that minimum wage increases have a positive effect on mental health. We exploit similar and substantial subnational level variation for Canada, using a longitudinal health survey panel available from 1994 to 2011. Using difference-in-difference and triple difference methods with individual fixed effects, we find that minimum wage increases are associated with modest reductions in distress and depression symptoms, largely for males.

Background: India's National Mental Health Survey (NMHS) reports a treatment gap for common mental disorders of over 85 percent, which they attribute to lack of awareness and access to psychiatric services in India. Interventions aiming to close that treatment gap through task-sharing have gained significant traction in India, but have met with mixed success, particularly in long-term perspective. Aims: We critically examined the assumptions embedded in the NMHS report that the mental health treatment gap results from people in India lacking access and awareness to psychiatric services in a medium-sized Indian city. Method: We conducted qualitative interviews with a community-based sample of 66 adult women in Mysuru city, Karnataka about the causes of distress in their lives, their understandings of distress, and their care-seeking behaviors. The overall aim was to assess their familiarity with psychiatry and their relative willingness to engage with it. Results: Women were familiar with psychiatric models of mental illness and with the psychiatric services available in their community. They recommended these services for hypothetical others but uniformly refused them for their own distress, even when this distress was severe. Women reported fears of stigma, doubts about psychiatric effectiveness, and connected their distress to social and structural causes rather than medical causes. They therefore did not perceive that clinical care could help them resolve their distress. Conclusions: Cultural mismatch appeared to be responsible for at least a part of women's lack of use of psychiatry in the research context. We conclude with a set of recommendations addressing how future research and intervention could modify task-sharing approaches to incorporate culturally relevant conceptions of distress and its appropriate management, instead of relying solely on standard psychiatric approaches.

Diabetes-related distress (DRD) is a psychological syndrome with worsened prognosis in uncontrolled diabetic patients. The current study aimed to assess the factors contributing to DRD among the Lebanese population using the Diabetes Distress Scale (DDS-17) score and its sub-scores. A cross-sectional analysis was conducted between March and September 2021 enrolling. 125 diabetic from six Lebanese governorates through an online survey. The survey included two parts: the first section gathered sociodemographic data sociodemographic and socioeconomic data and the second one focused on assessing the Diabetes Distress Scale (DDS-17) score. Participants 30 years old and above had higher emotional distress compared to younger patients, (65.2 % versus 45.5 %). Those with a primary educational level showed significantly higher emotional distress than those with a secondary and tertiary level of education (72.5 %, versus 66.7 % and 46.4 %). Participants who were treated with both insulin and non-insulin medications or had a diastolic blood pressure of more than 90 mmHg showed significantly moderate to high distress (63.6 % or 53.8 %). Participants who lived in rural areas showed higher distress (35.6 %). Obese and overweight had significant moderate to high distress (64.1 %, and 48.0 %). The same results were found in non-married (divorced or widowed) and married participants (76.9 % and 51.3 %). The association between medical history with total distress showed that participants with glycemic store HbA1c of more than 6.5 followed by those who had HbA1c between 5.7 and 6.4 showed moderate to high total distress (45.9 % and 40.0 %). It is concluded that the prevalence of DRD is high in Lebanon, more common among rural residents, and among participants high HbA1c, low educational level, unmarried and on complex treatment regimens. Screening for DRD and providing better support can optimize clinical outcomes.

The present research article provides data about the differences in post-traumatic stress symptoms, and defense mechanisms based on the levels of perceived stress (low, average, high), using a large national sample of 1100 Italian individuals, collected during the first wave of the COVID-19 pandemic. Participants completed an online survey through the Google Form platform, where the Ten-Item Perceived Stress Scale, Impact of Event Scale – Revised, and Forty Item Defense Style Questionnaire were included. First, the cut-offs of the perceived stress scale were calculated by determining the 25th and 75th percentile scores for the sample of this survey. Then, MANOVA analyses were performed, together with ANOVAs and the Bonferroni Post hoc analyses as a follow-up. The dataset (.xlsx) includes the survey scores, while the tables and figures provide the analysed data, where the differences are shown. This data article may provide useful bases for future research on perceived stress and for suggesting associated factors on which focus clinical intervention and preventive programs.

This study aimed to understand the impact of body mass index on distress, depression, self-esteem, and satisfaction with life amongst recreational athletes from random intermittent dynamic type sports. A cross-sectional study design was selected with 440 recreational athletes to conduct this study. The mean age was 20.34 ± 1.33 years, height was 157.27 ± 5.93 cm, weight was 57.31 ± 13.02 kg, and BMI was 25.82 ± 6.64 kg/m2. All the athletes voluntarily participated in this study. Psychological distress was measured with the K10 questionnaire; depression was measured with the PHQ-9 self-reported questionnaire. The Rosenberg self-esteem scale measured self-esteem, and Diener's satisfaction with life scale measured satisfaction with life. The data collection was conducted in the classroom setting. It took 12–15 min to complete the survey. The descriptive statistics were calculated, and the ordinal-scale, qualitative variables and frequency distributions for different categories were determined. The Chi-Square (two-tails) test was applied to find the relationship between the variables. The significant level was set at 0.05 level. The result showed that body mass index was significantly related to distress (X2 = 27.59, p = .001) and life satisfaction (X2 = 45.14, p = .001). Whereas depression (X2 = 15.46, p = .148) and self-esteem (X2 = 12.02, p = .212) showed an insignificant relationship with body mass index among recreational athletes from random intermittent dynamic sports. The study highlighted the health implications of psychological distress, depression, self-esteem, and satisfaction with life with body mass index among recreational athletes from random intermittent dynamic sports. Future studies are needed to understand better the interaction between psychological variables and body mass index level.

Objective: To compare the impact of the coronavirus disease 2019 (COVID-19) pandemic on the psychological health of patients with infertility who have become pregnant with that of women who have not. Design: Prospective cohort study conducted from April 2020 to June 2020. The participants completed three questionnaires over this period. Setting: A single large, university-affiliated infertility practice. Patients: A total of 443 pregnant women and 1,476 women still experiencing infertility who completed all three questionnaires. Interventions: None. Main Outcome Measures: Patient-reported primary stressor over three months of the first major COVID-19 surge; further data on self-reported sadness, anxiety, loneliness, and the use of personal coping strategies. Results: Pregnant participants were significantly less likely to report taking an antidepressant or anxiolytic medication, were less likely to have a prior diagnosis of depression, were more likely to cite COVID-19 as a top stressor, and overall were less likely to practice stress-relieving activities during the first surge. Conclusions: Women who became pregnant after receiving treatment for infertility cited the pandemic as their top stressor and were more distressed about the pandemic than their nonpregnant counterparts but were less likely to be engaging in stress-relieving activities. Given the ongoing impact of the pandemic, patients with infertility who become pregnant after receiving treatment should be counseled and encouraged to practice specific stress-reduction strategies.

Introduction: Depression and burnout are highly overlapping constructs, according to many correlational, factor, network, and mixture analysis studies. However, the latent correlation between the unique factors of burnout and depression might be confounded by a general factor of distress, and acquiescence (i.e., the tendency to agree more than disagree when responding to self-report items). In the current study, we performed an in-depth investigation on the latent structure of burnout and depression controlling for a general factor and acquiescence, and using a combination of random-intercept bifactor, network, and latent profile analysis. Method: Participants were 584 nurse professionals (79% nurse technicians and assistants, 21% nurses), with ages ranging from 20 to 65 years (M = 35.41; SD = 9.54), who responded to measures of depression symptoms, burnout, and work stress. Results: Results revealed a latent overlap between depression and burnout, even once acquiescence (r = .74), and a general factor was accounted for (r = .57). Burnout and depression indicators formed a coherent network of associated symptoms, with fatigue and lack of energy acting as bridge symptoms. The latent profile analysis yielded five classes that once again suggested a high dependence between burnout and depression. Discussion: We conclude that controlling for acquiescence and a general factor does not eliminate the high overlap between burnout and depression, that fatigue symptoms bear clinical importance as a trigger to more severe mental suffering in occupational settings, and that burnout involves a continuum of work stress.

Breast cancer is one of the most diagnosed cancer in women worldwide and lymphedema is one of the most common late and chronic adverse effects of breast cancer treatment. Lymphedema symptoms are essential signs of early-stage of lymphedema as they often precede changes in limb size or girth or a lymphedema diagnosis. Therefore, to achieve early detection and prevent lymphedema progression, it is important to promote patient selfcare in terms of the awareness symptoms identification. To this purpose Breast Cancer and Lymphedema Symptom Experience Index (BCLE SEI Esp) scale was used.Between October 2018 and June 2020, we collected data from 286 lymphedema and non-lymphedema patients post-breast cancer treatment on sociodemographic information, lymphedema symptoms, daily living-function and psychosocial distress, women and the data comparison between lymphedema and non-lymphedema patients were provided in this publication.This dataset can be used as a reference in clinical settings or in clinical studies or as an instructional tool to teach breast cancer patients and clinicians to be aware of lymphedema symptoms and to help clinicians and patients to achieve early identification of lymphedema symptoms and the impacts of lymphedema symptoms in women´s life and to develop future research, for example, to develop predictive algorithms.

Background: College students experience high stress levels during emergency remote classes in the COVID-19 pandemic. However, it is not clear whether this is due to the summation effect of both stressors (classes and pandemic). Therefore, the aim of this study was to investigate predictors of stress in college students before and during remote classes five months after the beginning of the COVID-19 pandemic. Methods: The study was conducted before (BRC, July-August 2020) and during remote classes (DRC, October-November 2020). The sample consisted of 177 individuals (80 in BRC, 97 in DRC). Students were asked to self-collect saliva for cortisol analysis at each moment of the study, and to fill out a form to characterize the individual and assess the chronotype (Morningness-Eveningness Questionnaire), sleep quality (Pittsburgh Sleep Quality Index) and the stress (Perceived Stress Scale–10). Results: There was no difference between the evaluated periods for cortisol, perceived stress or sleep quality. Predictors for cortisol levels were gender, academic semester, chronotype, sleep quality and sadness due to pandemic (p

This article draws on the journal entries of 62 healthcare professionals (HCP) in the United States and Canada who participated in the Pandemic Journaling Project (PJP) during 2020–2021. The HCP in this article represented healthcare fields including medicine, nursing, physical therapy, social work, and clinical psychology. In their journal entries, HCP provided accounts of witnessing the death and bereavement of their patients and loved ones; experiencing their own loss of loved ones and important milestones; facing isolation from their networks and places of meaning; and juggling increasing workloads and caregiving activities. I illustrate how these four areas were impacted by guilt, duty, ethical deliberations, and gender disparities. I argue that HCP face an accumulation of distress when they witness grief and face loss without space to process these experiences.

Context: The Bereaved Family Survey is an important method for evaluating the quality of palliative care., Objectives: To examine the distress and benefits of bereaved families of patients with or without cancer, who participated in a Bereaved Family Survey, and identify factors associated with distress and benefits., Methods: We conducted a nationwide cross-sectional, self-reported questionnaire mail survey among the bereaved families of patients who died of cancer, heart disease, cerebrovascular disease, pneumonia, or kidney failure. Participants answered questions on a four-point Likert scale measuring the distress and benefit associated with participating in the Bereaved Family Survey. We conducted a qualitative analysis of responses to open-ended questions about the distress and benefits of participating in the survey to comprehensively examine the distress and benefits of participating in the survey., Results: Questionnaires were distributed to 115,816 eligible bereaved family members between February 2019 and February 2020; 62,576 (54.0%) family members returned valid responses. Distress and benefits accounted for 51.4% and 49.3%, respectively. The results of the binomial logistic analysis for distress were significantly higher among cancer patients (p<0.001-0.003), 20-39-year-old patients (p<0.001), female bereaved family members (p<0.001), and bereaved family members with poor mental health statuses (p<0.001). Factors related to "benefit" were significantly higher among over-80-year-old bereaved family members (p<0.001), higher care evaluation scale (CES) scores (p<0.001), and higher good death inventory (GDI) scores (p<0.001)., Conclusion: Bereaved family members experience both distress and benefits. There is need to devise ways to reduce distress and increase its benefits to continue assessing the quality of palliative care., Competing Interests: Disclosure and Conflicts of interest The authors have no potential conflicts of interest to declare., (Copyright © 2024. Published by Elsevier Inc.)

Objective: When patients with non-traumatic lower extremity conditions express concerns regarding symptoms of the contralateral lower extremity they may be communicating fear of painful movement. Among people seeking specialty care for unilateral non-traumatic lower extremity conditions, we studied the relationship between magnitude of incapability and pain intensity in the contralateral and ipsilateral limbs and thoughts and feelings about sensations., Methods: Patients seeing a musculoskeletal specialist for any unilateral non-traumatic lower extremity condition were enrolled. We used multivariable analysis to identify aspects of unhelpful thinking and feelings of distress associated with contralateral and ipsilateral pain intensity and magnitude of capability accounting for demographic factors., Results: Greater pain intensity in the contralateral limb, greater pain intensity in the ipsilateral limb, and higher magnitude of incapability were all associated with greater distress regarding symptoms., Conclusions: When patients voice concerns about pain in the contralateral limb, they may be signaling feelings of worry or despair regarding symptoms., Practice Implications: Concerns about pain in the contralateral limb can prompt clinicians to explore feelings of worry or despair regarding symptoms, an important and modifiable aspect of musculoskeletal illness., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background: Evidence suggests that disabled people have worse mental health than non-disabled people, but the degree to which disability contributes to mental health is unclear., Objective: This paper uses 2021 National Health Interview Survey (NHIS) data to estimate the association between disability and depression and anxiety diagnoses as well as psychological distress among adults., Methods: We calculated disability population prevalence and mental health diagnoses and associated symptoms among 28,534 NHIS respondents. Logistic regressions estimated the odds of depression or anxiety diagnoses and recent psychological distress, controlling for disability and mental health diagnoses. We measured disability using binary and continuum measures of functional disability with the Washington Group Short Set on Functioning., Results: Disabled people have significantly greater odds of both depression and anxiety diagnoses compared to non-disabled people. Those with high functional disability have 552 % greater odds of an anxiety diagnosis (95 % CI: 5.61-7.58; p < 0.01) and 697 % greater odds of a depression diagnosis (95 % CI: 6.97-9.12; p < 0.01) compared to those with no functional disability. Similarly, those with any level of functional disability are more likely to have elevated psychological distress in the past 30 days compared to those with no functional disability., Conclusions: Findings support the idea that mental health is worse for disabled people compared to non-disabled people, with increasing functional disability associated with worse mental health. This suggests that mental health is not being adequately addressed for those with the greatest functional disability. Future work should seek to better understand the systemic causes of disparities., Competing Interests: Declaration of competing interest The authors have no conflicts of interest to declare., (Copyright © 2024 Elsevier Inc. All rights reserved.)

For diabetic patients it is crucial to constantly monitor blood glucose levels to mitigate complications due to hyperglycaemia, including neurological issues and cognitive impairments. This activity leads to psychological stress, called "diabetes distress," a problem for most patients living with diabetes. Diabetes distress can exacerbate the hyperglycaemia effects on brain and negatively impact the quality of life, but the underlying mechanisms remain poorly explored. We simulated diabetes distress in adult zebrafish by modelling hyperglycaemia, through exposure to dextrose solution, along with chronic unpredictable mild stress (CUMS), and evaluated brain redox homeostasis by assessing reactive oxygen species (ROS) content, the antioxidant system, and effects on mitochondrial biogenesis and fission/fusion processes. We also evaluated the total, cytosolic and nuclear content of nuclear factor erythroid 2-related factor 2 (NRF2), a critical regulator of redox balance, in the whole brain and total NRF2 in specific brain emotional areas. The combined CUMS + Dextrose challenge, but not the individual treatments, reduced total NRF2 levels in the entire brain, but strongly increased its levels in the nuclear fraction. Compensatory upregulation of antioxidant genes appeared inadequate to combat elevated levels of ROS, leading to lowering of the reduced glutathione content and total antioxidant capacity. CUMS + Dextrose treatment also upregulated transcription factors implicated in mitochondrial biogenesis and dynamics with a predominance of fission, which is consistent with increased oxidative stress. In conclusion, this study highlights the close interplay between hyperglycaemia and psychological distress causing overriding oxidative stress in the brain, rendering the organism vulnerable to the development of disease complications., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Introduction: The brain is a frequent site of metastases in NSCLC, and screening for asymptomatic brain metastases (BM) is increasingly advised in NSCLC guidelines. An asymptomatic BM diagnosis may trigger anxiety for future neurologic problems and can negatively affect quality of life of patients and their relatives. Therefore, we performed this qualitative study. Methods: Three focus group discussions were organized with patients with NSCLC and asymptomatic BM (N = 3–4 per group) and separately with their relatives, to explore this psychosocial impact. Two researchers independently performed an inductive content analysis. Results: A total of 10 patients and 10 relatives participated in six focus groups. A diagnosis of BM caused feelings of distress and anxiety in both patients and relatives. These feelings diminished over time in case of a tumor responding to systemic therapy. The diagnosis of BM was not perceived as more distressful than other metastases, and scan-related anxiety was not experienced. Although magnetic resonance imaging screening and follow-up were thought of as burdensome, follow-up was valued. The coping strategies of both groups seemed related to personality and to the efficacy of the given systemic therapy. Relatives appreciated peer support of other relatives during the focus groups, and they seemed open for future psychological support. Conclusions: Asymptomatic BM diagnosis can cause anxiety and distress, but this diminishes over time with effective systemic treatment. Although patients perceive magnetic resonance imaging as burdensome, they value follow-up screening and imaging. Relatives highly appreciated peer support, and psychological distress of relatives should not be overlooked.

In March 2020, the World Health Organization (WHO) characterized the outbreak of the coronavirus disease 2019 (COVID-19) as a pandemic. The aim of this study was to evaluate the psychological impact of the COVID-19 pandemic on cancer patients undergoing radiotherapy.Were enrolled 210 patients in treatment and in follow-up who had access to the Radiation Oncology Department of the Campus Bio-Medico University Hospital Foundation between April and May 2020. The sample was subjected to structured interview and validated questionnaires. 37% of patients showed significant levels of distress; depressive symptoms were reported by 22.4% of patients and 99% of sample had clinically significant anxiety symptoms. All patients anxiety worsened during the COVID-19 pandemic (p=< 0.001). Patients on active treatment had higher levels of distress (3.5 vs 2.6; p = 0.04) and anxiety (3.5 vs 2.6; p = 0.04). Lung cancer patients appeared to be more afraid of COVID-19 than other patients (24.2 vs 22.2). This study highlights the presence of clinically significant anxiety in 99% of sample. This conclusion reflects the condition of emotional distress present during the pandemic which makes it necessary to treat patients in a multidisciplinary perspective that includes psychological support in the care plan.

Objective: This study aimed to investigate the current prevalence and determinants of psychological distress and the association of distress with general information, character strengths, medical coping, and social support in Chinese adolescents and young adults (AYAs) aged 15–39 years with cancer. Methods: A multicenter survey was carried out. Eight hundred and nine patients completed the Chinese version of the National Comprehensive Cancer Network distress thermometer (DT), the three-dimensional inventory of character strengths, the medical coping modes questionnaire, and the Social Support Rating Scale. Results: The current prevalence of psychological distress in Chinese AYAs with cancer was 83.4'. Binary logistic regression analysis showed that gender, age, educational level, marriage, monthly income, exercise intensity, cancer classifications, treatments, self-control, confrontation, avoidance, and subjective support were all associated with distress. AYA cancer patients who were female, younger, or divorced or had a lower monthly income, education level, or exercise intensity were more likely to have higher level of distress. Compared to AYAs with other cancer classifications, patients with digestive system malignancies, breast cancers, and head and neck malignancies had a higher prevalence of distress. Patients receiving chemotherapy or radiotherapy were more likely to be distressed. The higher the self-control, confrontation, avoidance, and subjective support scores were, the lower the prevalence of distress was among AYA cancer patients. Conclusions: The prevalence of psychological distress in AYA cancer patients was relatively high. Potential interventions targeting exercise intensity, character strengths, medical coping, and social support may decrease the prevalence of psychological distress in this patient population.

The supportive care of people with cancer cachexia is a rapidly evolving field. In the past decade, multimodal treatments have been developed and new multidisciplinary cachexia clinics have been established across the world. This scoping review examines the extent to which psychosocial support has become part of the multimodal management of cancer cachexia. The review draws on a systematic search of Medline, Embase, CINAHL, PsycINFO, and the Cochrane Library for publications about people who have cancer cachexia and receive multimodal interventions. Search limits were the English language, date range January 2013 to March 2021, and adults 18 years and older. The search found 19 papers about multimodal interventions for either cancer cachexia or its defining feature involuntary weight loss that included a psychosocial component. This review found three different ways a psychosocial component of a multimodal intervention can help patients: (1) enable adherence to multimodal therapies; (2) aid emotional adaptation and coping; and (3) treat comorbid anxiety and depression. Recognizing these three different functions of psychosocial support is important because they have different mechanisms of action. Behavioral change techniques are important for enabling adherence, education in coping methods is important to alleviate stress, and cognitive reframing for the treatment of anxiety and depression. The analysis reveals that multimodal interventions for cancer cachexia with a psychosocial component can either focus on physical health or have a more holistic focus. Holistic care is considered the best practice in cancer nursing. Thus multimodal interventions that can address not only physical health problems, but psychosocial issues are consistent with high-quality nursing care.

This study examined adrenocortical responses in the days following the Pulse nightclub massacre on June 12, 2016, among emerging adults in Northern California (N = 202; M = 23.18 years, SD = 2.56; 25% LGBQ-Latinx, 25% LGBQ-White, 25% Straight-Latinx, and 25% Straight-White) between June 13—August 12, 2016. As predicted, participants tested more proximally to the massacre had higher waking cortisol (intercepts) and flatter diurnal cortisol output (slopes), indicative of time-dependent adrenocortical arousal across the day. The effect of days post-massacre on waking cortisol was moderated by daily distress, with days since the Pulse massacre predicting waking cortisol significant only for participants reporting lower distress; participants who reported feeling higher daily distress had elevated waking cortisol across the testing period. These findings were independent of weekly personal stressors, and consistent across participants’ demographic and identity characteristics. The violent attack at the Pulse nightclub was connected to increased waking cortisol and diurnal cortisol production for several days after the massacre, in a distal population exposed to the massacre vicariously, and especially for individuals not experiencing other, personal stressors. Heightened physiological responses to violent crimes support policy efforts to protect vulnerable communities, including violence prevention, gun control, and community-based trauma response services for those directly and indirectly affected by gun violence.

Background: The COVID-19 pandemic has led to psychological distress among community samples and university students. Some coping behaviors and cognitive appraisals allow individuals to experience positive psychological growth amid such a crisis (Folkman et al. 1986). In the event of continuing waves of COVID-19 infection and future viral outbreaks, understanding the relationships between coping behaviors, stress appraisals, and COVID-related distress and growth can empower public health officials and university leadership to mitigate negative consequences and encourage growth. Methods: 774 undergraduate students completed online self-report measures of coping (Brief COPE; emotion, problem, avoidant), stress appraisal (SAM; threat/centrality, challenge/self-efficacy, uncontrol, other-control), neuroticism (NEON), health anxiety (SHAI), and COVID-19 exposure/impact (C-PIQ; distress and growth). Hypotheses were examined via simple regressions and interactions. Results: Increased utilization of avoidant coping was associated with high levels of distress regardless of whether it was perceived as threatening or not. Emotion-focused and problem-focused coping strategies were associated with more growth, whereas avoidant coping was associated with less growth. Higher emotion-focused coping and challenge appraisal together predicted the most growth. Limitations: Cross-sectional design precludes the tracking of distress and growth over time; this study relied on self-report data. Conclusions: These results underscore the impact of stress appraisals on the mental health of students navigating the COVID-19 pandemic. Findings may inform public health messaging–or have clinical implications, as successful interventions exist for improving coping strategies and stress appraisals.

Background: The COVID-19 pandemic had led to severe education disruption in many countries, including for medical students (MS). We aimed to evaluate MS mental health in France and search for a difference depending on studies’ years and clinical activities. Methods: In a cross-sectional, survey-based study during the first confinement, 668 (8.35%) MS were compared to 7 336 non-medical students (non-MS) (91.65%). The PHQ-9 (≥ 10), the GAD-7 (≥ 8), and the IES-R (≥ 26) were collected to assess depressive, anxiety, and distress symptoms. Multivariable logistic regression analyses were performed. Results: MS reported significant psychological distress (depressive symptoms: 38.17%, anxiety: 38.77% and distress: 36.83%). Compared to non-MS, they reported less significant depressive (OR, 0.80; 95% CI, 0.67–0.91; P = .007) and distress symptoms (OR, 0.73; 95% CI, 0.62–0.87; P

This study investigated how the carbon dioxide (CO2) concentration within a chamber affects the efficacy of CO2 euthanasia and how the efficacy of CO2 induction methods changes as birds age. In experiment 1, pairs of broiler chicks (n = 192; 0, 3, and 6 D of age) were immersed into a chamber prefilled with 70, 80, 90, or 100% CO2. For experiment 2, 3- and 6-day-old broiler chicks (n = 88) were immersed in pairs into 100% CO2 or exposed to CO2 gradual fill in a chamber with a displacement rate of 28% chamber volume per minute. Latency to performance of headshaking (HS) and gasping (GS) as potential indicators of distress, loss of posture indicative of insensibility, and the cessation of rhythmic breathing (CRB) and cessation of movement (COM) as the indicators of death were monitored (live focal sampling/video recordings). The duration and frequency of HS and GS were assessed. For both experiments, behavior data were analyzed for CO2 method and age (4 × 3 factorial). Age and CO2 concentration interacted for latency to CRB and COM, with longer latencies for 0-day-old chicks immersed into 70% CO2 than other concentrations and ages. CO2 concentration did not affect latency to HS, GS, or loss of posture but affected CRB and COM, with latencies longest for 70% and shortest for 90 and 100% CO2. Newly hatched chicks had a longer latency to CRB and COM and longer duration and frequency of distress behaviors than older chicks. At all ages, initiation of all behaviors occurred later with gradual fill compared to immersion. There was an increased duration and frequency of distress behaviors with gradual induction compared with immersion. Overall, immersion into 90 to 100% CO2 resulted in the shortest time to insensibility and death, with a decreased duration and frequency of distress behaviors. Chicks immersed into 70% CO2 had the longest duration of GS and time to death. Age affects the efficacy of CO2 euthanasia, with increasing age decreasing time to death and the duration and frequency of distress behaviors.

Background and purpose: To evaluate longitudinal patient-reported distress in cervical cancer patients treated with definitive chemoradiation (CRT). Materials and methods: Between 2011 and 2016, consenting cervical cancer patients treated with definitive CRT who completed ≥ 2 revised Edmonton Symptom Assessment System (ESAS-r) questionnaires at clinical visits, including baseline, were included. A linear mixed model was used to assess the longitudinal trend in ESAS-r. A minimal clinically important difference (MCID) for total ESAS-r score was defined as a change of 3-points for improvement and 4-points for deterioration. The proportion of patients with an MCID over time was described using moving averages. To test for changes, mixed effects logistic models were fitted, each of which included patient-specific random intercepts and random slopes. Results: 67 patients were eligible for analysis (736 ESAS-r assessments). Median (range) follow-up was 24 months (range: 15–45) and compliance at 12 months was 60% (40/67). There was a significant decrease in ESAS-r scores over time. Baseline ESAS-r was strongly predictive of ESAS-r at follow-up (p

In this paper, we compared five crack detection algorithms using terrestrial laser scanner (TLS) point clouds. The methods are developed based on common point cloud processing knowledge in along- and across-track profiles, surface fitting or local pointwise features, with or without machine learning. The crack area and volume were calculated from the crack points detected by the algorithms. The completeness, correctness, and F1 score of each algorithm were computed against manually collected references. Ten 1-m-by-3.5-m plots containing 75 distresses of six distress types (depression, disintegration, pothole, longitudinal, transverse, and alligator cracks) were selected to explain variability of distresses from a 3-km-long-road. For crack detection at plot level, the best algorithm achieved a completeness of up to 0.844, a correctness of up to 0.853, and an F1 score of up to 0.849. The best algorithm’s overall (ten plots combined) completeness, correctness, and F1 score were 0.642, 0.735, and 0.685 respectively. For the crack area estimation, the overall mean absolute percentage errors (MAPE) of the two best algorithms were 19.8% and 20.3%. In the crack volume estimation, the two best algorithms resulted in 19.3% and 14.5% MAPE. When the plots were grouped based on crack detection complexity, in the ‘easy’ category, the best algorithm reached a crack area estimation MAPE of 8.9%, while for crack volume estimation, the MAPE obtained from the best algorithm was 0.7%.

Background: Long COVID, an emerging public health issue, is characterized by persistent symptoms following SARS-CoV-2 infection. This study aims to explore the relationship between post-COVID-19 symptomatology and patient distress employing Latent Class Analysis to uncover symptom co-occurrence patterns and their association with distress., Methods: A cross-sectional study was conducted using an online survey among 240 participants from a university and affiliated hospital of southern Taiwan. The survey quantified distress due to persistent symptoms and assessed the prevalence of Long COVID, symptom co-occurrence, and latent symptom classes. Latent Class Analysis (LCA) identified distinct symptom patterns, and multiple regression models evaluated associations between symptom patterns, distress, and demographic factors., Results: The study found that 80 % of participants experienced Long COVID, with symptoms persisting for over three months. Individuals with multiple COVID-19 infections showed a significant increase in general (β = 1.79), cardiovascular (β = 0.61), and neuropsychological symptoms (β = 2.18), and higher total distress scores (β = 6.35). Three distinct symptomatology classes were identified: "Diverse", "Mild", and "Severe" symptomatology. The "Mild Symptomatology" class was associated with lower distress (-10.61), while the "Severe Symptomatology" class showed a significantly higher distress due to symptoms (13.32)., Conclusion: The study highlights the significant impact of Long COVID on individuals, with distinct patterns of symptomatology and associated distress. It emphasizes the cumulative effect of multiple COVID-19 infections on symptom severity and the importance of tailored care strategies., Competing Interests: Declaration of Competing Interest The authors have no competing interest to declare., (Copyright © 2024. Published by Elsevier Ltd.)

The psychological effects of staged nasal reconstruction with a forehead flap were prospectively investigated. Thirty-three patients underwent nasal reconstruction with forehead flaps between March 2017 and July 2020. Three questionnaires were used to assess psychosocial functioning before surgery (time 1), 1 week after forehead flap transfer (time 2), 1 week after forehead flap division (time 3), and after refinement procedures (time 4). The patients were categorized into three groups according to the severity of nasal defects. Between- and within-group comparisons were conducted. All patients reported increased satisfaction with their appearance during nasal reconstruction. For most patients, levels of distress and social avoidance were highest before reconstruction (time 1). Both levels decreased as reconstruction advanced, and were significantly improved by times 3 and 4. The stage of reconstruction had a greater effect on these levels than did severity of nasal defect. Nasal reconstruction with forehead flap is beneficial physically and psychologically. Psychological evaluation before and after surgery facilitates patient-surgeon interactions and further enhances outcomes., Competing Interests: Declaration of competing interest None., (Copyright © 2024 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.)

Background: Healthcare services have responded to the challenges of service delivery during COVID-19 with telehealth and hybrid models of care. However, there is limited understanding of the experiences of care amongst people affected by cancer and how their experiences may change and evolve against the shifting landscape of COVID-19 incidence, mortality, vaccination and refinements in service delivery. Objectives: This study explores the experiences of cancer care amongst people affected by cancer in Ireland during the COVID-19 pandemic. This paper presents the results of the initial cross-sectional semi-structured interviews and the longitudinal qualitative research design which will be employed in this study. Design: A longitudinal descriptive qualitative study. Setting: Ireland Participants: People living with and after cancer or caring for someone with cancer during the COVID-19 pandemic. Methods: Participants were recruited to the study via social media advertisements and consented to participate in up to three semi-structured interviews between January and July 2021. Initial semi-structured interviews were conducted with 16 participants in January 2021. Participants completed measures of resilience (2-item Connor‐Davidson Resilience Scale) and distress (The National Comprehensive Cancer Network Distress Thermometer). Interviews were recorded, transcribed and analysed thematically. Results: Participants reported low levels of distress and moderate to high levels of resilience on average. Three themes were generated from analysis of the first phase of cross-sectional interviews. Participants described a counterbalance of being cautious of infection and keeping safe through prevention and shielding strategies. Although hospitals felt safe and were working efficiently, some participants felt COVID-19 had compromised person-centredness and empathy in care. While participants valued the measures taken to minimize infection risk, substitution of face-to-face appointments with telehealth services and attending essential face-to-face appointments alone restricted participants' access to professional and social support. Despite this, many participants felt public health measures to reduce transmission of COVID-19 had created a sense of not missing out, feeling safe and reduced difficult social interactions requiring explanation of their diagnosis. Conclusions: There is an opportunity to learn from the experiences of healthcare delivery from the perspectives of people affected by cancer during the COVID-19 pandemic. The results highlight the complexities and dualities of living with, after or caring for someone with cancer during the COVID-19 pandemic. Opportunities for longitudinal qualitative research to explore the evolving experiences, concerns and persistent and emerging unmet information and clinical needs within the rapidly changing socio-political, socio-cultural and healthcare contexts of the COVID-19 pandemic are highlighted.

Introduction: Cancer patients who smoke report more stress and psychological distress than patients who do not smoke. It is unclear how these emotional symptoms may modify smoking behavior in cancer patients. We examined the influence of a smoking cessation intervention for cancer patients on stress and distress, and the effects of these symptoms on smoking abstinence. Methods: Mixed-methods secondary analysis of data from the Smokefree Support Study, a two-site randomized controlled trial examining the efficacy of Intensive (IT; n = 153) vs. Standard Treatment (ST; n = 150) for smoking cessation in newly diagnosed cancer patients. Stress coping, perceived stress, distress, and anxiety were self-reported at baseline, 3, and 6 months. Abstinence was biochemically-confirmed at 6 months. A subset of patients (n = 72) completed qualitative exit-interviews. Results: Patients were on average, 58 years old, 56% female, and smoked a median of 10 cigarettes/day. There were no significant treatment group × time interactions or main effects of treatment group on stress or distress measures (p’s > 0.05), however there were significant main effects of time suggesting symptom improvements on each measure in both study groups (p’s

Objectives: The present study examined the effects of a yoga and mindfulness-based programme on the autonomic nervous system of primary school children by using heart rate variability parameters. Design: A two-arm non-randomised controlled trial compared an integrated yoga and mindfulness-based programme (16 weeks) to conventional primary school lessons. Setting: Primary school classrooms and conference rooms. Interventions: Participants were allocated to a 16-week integrated yoga-based programme or conventional school lessons. A subgroup was randomised to receive 24h electrocardiogram-recordings. Main outcome measures: Heart rate variability indices were measured, both linear (time and frequency domain) and non-linear (symbolic dynamics, compression entropy), calculated from 30-minute extracts of Holter-electrocardiogram-recordings. Assessments were conducted at baseline and at the end of intervention. Results: 40 participants (42.5% female) were included into the analysis of HRV. No significant changes in heart rate variability parameters were observed between the groups after 16 weeks. In the intervention group, a trend towards increased parasympathetic activity could be seen over time, although not significantly enhanced compared to the control group. Conclusion: Results obtained here do not clearly show that children in German primary school settings benefit from an integrated yoga-based intervention. However, exploratory post-hoc analyses point interestingly to an increased nocturnal parasympathetic activity in the intervention group. Further studies are required with high-quality study designs, larger sample sizes and longer-term follow-ups.

Background: Old age is an inevitable developmental phenomenon and expected to affect psychology of geriatric people. As life expectancy continues to rise, one of the greatest challenges of public health is to improve the mental health and self-esteem. Aim: Study aimed to assess the effectiveness of psycho-education on psychological distress and self-esteem among elderly residing in selected old age home of Punjab, India. Methodology/design: A pre-experimental research approach with one group pre-test post-test design was used. Sixty resident elderly were selected randomly who received psycho educational intervention which comprised of 14 sessions and delivered on daily basis. Each session was 1 h duration. Psychological distress includes depressive symptoms, anxiety symptoms and stress. The socio-demographic profile sheet, DASS- 21 scale and Rosenberg self-esteem scale was used. Follow-up data was collected after one month. Results: Nearly 53.3% had severe depressive symptoms, 15% had severe anxiety, 75% had severe stress before intervention. Psycho-education training was highly effective in improving self esteem (t = −19.64, p=

Background: This paper evaluates the evolution of health-related and economic-related anxiety surrounding COVID-19 in the early stages of the pandemic. Methods: We merged two waves of data from a national survey administered first in late March 2020 (T1) and then a month later in late April/early May 2020 (T2). A moderated mediation model was estimated to predict changes in psychological distress. Results: Health-related anxiety and economic-related anxiety surrounding COVID-19 both predict psychological distress. Levels of distress were significantly higher at T2 compared to T1. Over this time period, anxieties evolved away from fear of the virus itself and toward its impact on the economy. Moreover, economic-related anxiety is especially pronounced for men. Limitations: Our measure of psychological distress is not a diagnostic instrument, although it meets diagnostic criteria. Moreover, the data do not necessarily provide unbiased population estimates. Conclusions: The sources of psychological distress associated with COVID-19 shifted away from early anxieties of physiological infection and toward an emerging fear of joblessness stemming from the economic anxiety of the lockdown. This research suggests that employed individuals, and especially men, may be at risk of psychological distress related to economic anxiety.

The COVID-19 pandemics caused an unprecedented mortality, distress, and globally poses a challenge to mental resilience. To our knowledge, this is the first study that aimed to investigate the psychological distress among the adult general population across 13 countries. This cross-sectional study was conducted through online survey by recruiting 7091 respondents. Psychological distress was evaluated with COVID-19 Peritraumatic Distress Index (CPDI). The crude prevalence of psychological distress due to COVID-19 is highest in Vietnam, followed by Egypt, and Bangladesh. Through Multivariate Logistic Regression Analysis, the respondents from Vietnam holds the highest level of distress, while the respondents from Sri Lanka holds the lowest level of distress with reference to Nepal.Female respondents had higher odds of having reported psychological distress, and those with tertiary education were less likely to report psychological distress compared to those with lower level of education. The findings indicate that psychological distress is varies across different countries. Therefore, different countries should continue the surveillance on psychological consequences through the COVID-19 pandemic to monitor the burden and to prepare for the targeted mental health support interventions according to the need. The coping strategies and social support should be provided especially to the lower educational attainment group.

Patients with hematologic malignancies experience high rates of depression. These patients are vulnerable to depression throughout the disease trajectory, from diagnosis to survivorship, and at the end of life. In addition to the distressing nature of depression, it has substantial downstream effects including poor quality of life, increased risk of treatment complications, and worse survival. Therefore, systematic screening for depression and integration of robust psychological interventions for affected patients is crucial. Although depression has been historically studied mostly in patients with solid malignancies, research focusing on patients with hematologic malignancies is growing. In this article, we describe what is known about depression in patients with hematologic malignancies, including its assessment, prevalence, risk factors, and implications. We also describe interventions to ameliorate depression in this population. Future research is needed to test effective and scalable interventions to reduce the burden of depression among patients with blood cancers., Competing Interests: Declaration of competing interest The authors have no competing interests to disclose., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objective: This study aimed to investigate the mediating effect of distress on the relationship between stigma and quality of life (QOL) in lung cancer patients, and to explore the moderated mediating effect of social support., Methods: A total of 184 individuals diagnosed with primary lung cancer participated in the study. Data on general and disease-related characteristics, stigma, distress, QOL, and social support were collected using a comprehensive structured questionnaire. Medical records were also utilized for an in-depth analysis of disease-related attributes. The data were meticulously analyzed using the SPSS PROCESS macro ver. 3.4 for detailed insights., Results: The findings elucidated a clear pathway whereby stigma negatively impacted patients' QOL through the mediating effect of distress. Interestingly, the extent of this impact was significantly influenced by the presence of friendship support, underscoring its unique moderated mediating role. Conversely, support from family and health care professionals did not demonstrate a significant influence in this context., Conclusions: These findings underscore the importance of addressing stigma and distress to improve the QOL of lung cancer patients. The study highlights the pivotal role of friendship support in moderating this relationship, suggesting the need for tailored interventions to strengthen social networks. These insights provide valuable guidance for developing more nuanced and effective patient support strategies in oncology care., (© 2024 The Author(s).)

Electroejaculation (EE) is stressful and probably painful; thus the administration of anaesthesia is recommended to decrease those negative effects. However, anaesthesia has a direct risk of provoking death, but sedation is less risky than anaesthesia. At the same time, α2-adrenergic agonists may improve semen quality. Therefore, the aim of the present study was to compare the physiological and behavioural responses indicative of stress and possibly pain, and the semen quality in electroejaculated untreated, anaesthetised or sedated goat bucks. Semen was collected from eight bucks using three different procedures in all them (EE in untreated bucks, EE under sedation or EE under general anaesthesia). The number of vocalizations during EE and the behavioural pattern before and after procedures were recorded. Pain visual analogue scale (VAS) score was also determined during EE. Rectal temperature, heart rate, serum cortisol concentration, biochemical and haematological parameters were measured before and after each procedure, and sperm characteristics were determined. Bucks vocalised more often when untreated than sedated or anaesthetised (P