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In response to identified deficits in the provision of health care to female patients, we sought to improve healthcare workers' gender awareness- conceptualized as gender-role ideology, sensitivity, and knowledge related to female patients-through the application of a brief computerized educational intervention. This study, conducted in the Veterans Affairs (VA) health-care setting, involved a pretest-posttest equivalent control group design. We evaluated hypotheses using random coefficients regression, a technique that offers a number of advantages relative to repeated-measures ANOVA. Findings revealed significant improvements in sensitivity and knowledge for participants in the treatment condition compared to the control condition. With several exceptions, the intervention was similarly effective across employee groups. Copyright © 2008 SAGE Publications Ltd. [ABSTRACT FROM AUTHOR]

This study aimed to provide preliminary evidence for, and explore potential antecedents and correlates of, a phenomenon observed in aging combat veterans termed late-onset stress symptomatology (LOSS). LOSS is a hypothesized phenomenon among older veterans who (a) experienced highly stressful combat events in early adulthood; (b) functioned successfully throughout their lives, with no chronic stress-related disorders; but (c) begin to register increased combat-related thoughts, feelings, reminiscences, memories, or symptoms commensurate with the changes and challenges of aging, sometimes decades after their combat experiences. Using a qualitative focus group methodology with 47 World War II, Korean Conflict, and Vietnam War veterans, the authors obtained preliminary evidence for the presence of LOSS as defined, identified some of its features, revealed some normative late-life stressors that may precipitate LOSS, and uncovered potential intrapersonal risk and resilience factors for LOSS. The authors present illustrative quotations from the group discussions and discuss the implications and future directions of this research. [ABSTRACT FROM AUTHOR]

The study aimed to compare the quality of life (QoL) in two communities with different exposures to conflict and investigate the inter-relationship between posttraumatic stress disorder (PTSD), social support, and QoL. This is a cross-sectional with 413 participants. Study instruments included the PTSD module of the Composite International Diagnostic Interview (CIDI), the World Health Organization Quality of Life BREF (WHOQoL-BREF), and the Multidimensional Scale of Perceived Social Support (MSPSS). The family domain of social support was protective of both PTSD and QoL. Except for the relationship between community's location and the physical subscale of the QoL, a hierarchical regression analysis showed that all the independent variables were significantly associated with the QoL domains. Direct exposure to crises impaired QoL more than areas indirectly exposed. PTSD and the family domain of social support play a significant role in the QoL outcome. This suggests that therapeutic intervention to improve QoL should target these key variables. [ABSTRACT FROM AUTHOR]

Excessive sugar intake poses a significant risk factor for non-communicable diseases. A positive healthy eating (PHE) intervention was developed to promote low-sugar dietary practices in families. The PHE intervention capitalized on positive psychological constructs to overcome barriers to health behavior change by helping families associate feelings of joy, gratitude, and savoring with healthy eating. In a cluster randomized controlled trial, 1983 participants from 1467 families were recruited in Hong Kong. PHE included a core and booster session. Data were collected at pre-intervention, post-intervention, and at 1-month and 3-month follow-up. Compared to the control, PHE showed greater increase in intention to change at post-intervention, engagement in low-sugar dietary practices individually and with family members at 3-month follow-up, and greater reduction in sugar-sweetened beverage intake at 1-month and 3-month follow-up. Intentions to change mediated PHE's effects on low-sugar dietary practices. Focus group interviews revealed the behavior-change process and family quality of life. [ABSTRACT FROM AUTHOR]

Background: Diabetes mellitus is associated with higher risk of target lesion failure (TLF) after percutaneous coronary intervention. We studied the 5-year outcome in patients with diabetes mellitus treated with biodegradable polymer stents. Methods: The SORT OUT VII was a randomised trial comparing the ultrathin sirolimus-eluting Orsiro stent (O-SES) and the biolimus-eluting Nobori stent (N-BES) in an all-comer setting. Patients (n = 2525) were randomised to receive O-SES (n = 1261, diabetes: n = 236) or N-BES (n = 1264, diabetes: n = 235). Endpoints were TLF (a composite of cardiac death, target-lesion myocardial infarction (MI), target lesion revascularization (TLR)), definite stent thrombosis and a patient related outcome (all-cause mortality, MI and revascularization) within 5 years. Results: Patients with diabetes mellitus had higher TLF (20.6% vs 11.0%, (Rate ratio (RR) 1.85 95% confidence interval (CI): (1.42-2.40) and patient related outcome (42.0% vs 31.0%, RR 1.43 95% CI: (1.19-1.71)) compared to patients without diabetes. Among patients with diabetes mellitus, TLF after 5 years did not differ between O-SES and N-BES (21.2% vs 20.0%), RR 1.05 95% CI: (0.70-1.58), p = 0.81). Cardiac death, MI, TLR, and definite stent thrombosis did not differ between the groups. Conclusion: In patients with diabetes mellitus, 5-year outcomes were similar among patients treated with biodegradable polymer O-SES or N-BES. Clinical trial registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01879358. [ABSTRACT FROM AUTHOR]

Consumer society has gradually disconnected consumers from the origin of their consumption, the real needs it truly satisfies, and its social and ecological impact. This research aims to study the phenomenon of consumer reconnection, through which consumers try to experience meaning by becoming mindful of their consumption experiences. We focus specifically on the consumption practice of mindful eating. Using an interpretative approach, we show how the reconnection process unfolds around three dimensions: self, nature, and society. We highlight the tensions related to reconnection in everyday life and examine the coping strategies that emerge to reduce these tensions. Finally, we discuss the implications in terms of education, health, and marketing practices. [ABSTRACT FROM AUTHOR]

La société de consommation a progressivement déconnecté les consommateurs de l'origine de leur consommation, des besoins qu'elle assouvit réellement, et de son impact social et écologique. La présente recherche vise à étudier le phénomène de « reconnexion » par lequel les consommateurs essaient de retrouver du sens à travers la conscientisation de leurs expériences de consommation. Dans ce but, nous nous focalisons sur la pratique de l'alimentation en pleine conscience. En utilisant une approche interprétative, nous montrons comment le processus de reconnexion se déploie autour de trois dimensions : soi-même, la nature et la société. Nous mettons en lumière les tensions liées à l'intégration de la reconnexion dans la vie quotidienne, et nous étudions les stratégies d'adaptation qui émergent pour réduire ces tensions. Enfin, nous discutons les implications en termes d'éducation, de santé et de pratiques marketing. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of this retrospective study is to further the limited body of evidence regarding the effects of a group-based boxing intervention for those with Parkinson's disease (PD). Design: A retrospective cohort study was performed analyzing data collected on outcome measures at 6-month intervals up to 2 years. Individuals participated in the standardized "Rock Steady Boxing" (RSB) program for up to 24 months. Every 6 months, measures were taken of balance (Fullerton Advanced Balance [FAB] Scale), functional mobility (Timed-Up and Go [TUG]), lower extremity strength (30-second Chair Stand [30CST]), and gait speed (10 Meter Walk Test [10MWT]). Methods: Statistical significance (P <.05) was determined by a two-tailed t test. Data were collected from RSB-affiliated programs at 4 locations across the southeastern United States. Current and/or past participants in RSB with baseline and at least one subsequent outcome measure were included, resulting in 68 participants (54 male, 14 female, and mean age of 71.2 years ± 8.56 standard deviation). Results: Statistically significant improvements in FAB scale, TUG, and 30CST over time were found at both 6- and 12-month time points. Significant changes continued through 18 months for FAB and 30CST. No significant changes in 10MWT were observed; however, a moderate effect size was observed at the 1-year point. Conclusions: Participants with PD were able to achieve statistically significant improvements in standard measures of functional mobility, balance, and strength within the timeline of this study. Limitations include the retrospective nature, an inability to monitor adherence, and lack of control over pharmaceutical or other interventions. [ABSTRACT FROM AUTHOR]

Drawing on the cognitive psychology of entrepreneurship, bounded rationality and role congruity perspectives, we investigate the moderating role of the assertiveness of women business owners in the relationship between their business performance and subsequent family-to-business instrumental support. Previous research has generally examined the family support women receive while running their businesses as an antecedent of firm performance. In this article, we reverse the order of these factors and investigate whether the past performance of a woman-led firm is a precursor of family support. Based on results of a longitudinal study of women business owners in Denmark, we found that the higher the assertiveness, the weaker the link between past performance and instrumental family support for businesses. [ABSTRACT FROM AUTHOR]

Background: Whenever possible, a person should die where they feel it is the right place to be. There is substantial global variation in home death percentages but it is unclear whether these differences reflect preferences, and there are major limitations in how the place of death is classified and compared across countries. Objectives: EOLinPLACE is an international interdisciplinary research project funded by the European Research Council aiming to create a solid base for a ground-breaking international classification tool that will enable the mapping of preferred and actual places towards death. Design: Mixed-methods observational research. Methods and analysis: We combine classic methods of developing health classifications with a bottom-up participatory research approach, working with international organizations representing patients and informal carers [International Alliance of Patients' Organizations (IAPO) and Eurocarers]. First, we will conduct an international comparative analysis of existing classification systems and routinely collected death certificate data on place of death. Secondly, we will conduct a mixed-methods study (ethnography followed by longitudinal quantitative study) in four countries (the Netherlands, Portugal, Uganda and the United States), to compare the preferences and experiences of patients with life-threatening conditions and their families. Thirdly, based on the generated evidence, we will build a contemporary classification of dying places; assess its content validity through focus groups with patients, carers and other stakeholders; and evaluate it in a psychometric study to examine construct validity, reliability, responsiveness, data quality and interpretability. Ethics: Approved by the ethics committee of the University of Coimbra, Faculty of Medicine (CE-068-2022) and committees in each of the participating countries. Discussion: The findings will provide a deeper understanding of the diversity in individual end-of-life pathways. They will enable key developments such as measurement of progress towards achievement of preferences when care can be planned. The project will open new directions in how to care for the dying. Trial registration: Research Registry UIN 9213. [ABSTRACT FROM AUTHOR]

This case study delves into the experiences of a women's basketball team situated in Shenzhen, South China, comprised primarily of members of sexual minority groups. Utilizing qualitative research methods, including interviews and observation of team dynamics, this research examines how lesbian and bisexual female basketball players navigate societal norms and negotiate their sexual identities. It also highlights the team's unique strategies for dealing with social interactions, group membership, and power dynamics in resisting heteronormative norms. Team B exemplifies a form of queer resistance in Chinese society and sports that is distinct from the Western pride movements and political advocacy. This strategy involves avoiding confrontation and integrating the nonheteronormative subculture into mainstream sports and society to gain support from families, the general public, and local communities, thereby promoting sports inclusivity and gaining social recognition. This study argues, from a post-structural feminist perspective, that participation in a gender-inclusive sports group provides sexual minority individuals with a unique social position and an empowering means of destabilizing power relations and reducing sexual identity tensions. In addition, it demonstrates the capacity of sports subcultures to foster collective agency and resilience in the face of dominant cultural norms, despite the constraints posed by the unaltered macro-level structure of gender. This case study provides valuable insights into how gender-inclusive sports groups can challenge and reshape preconceived notions of gender and sexuality in Chinese society while serving as a platform for queer resistance. [ABSTRACT FROM AUTHOR]

This article uses a global multilevel sample to advance our understanding of the gender gap in youth entrepreneurship by investigating the joint moderating influence of in-group support and national embeddedness values on young women's entrepreneurial activity relative to that of young men. Based on a mixed embeddedness theoretical lens, our moderation analysis demonstrates the importance of in-group support in narrowing the gender gap in youth entrepreneurship. Moreover, in-group support enhances young women's entrepreneurship vis-à-vis that of young men primarily in countries with strong embeddedness values. Our findings contribute to the entrepreneurial gender gap literature as well as to the comparative entrepreneurship literature, by providing evidence of the joint role of micro-level and macro-level cultural layers in reducing the entrepreneurial gender gap. Implications for theory, practice and policy are provided. [ABSTRACT FROM AUTHOR]

Introduction: Engaging in meaningful activities contributes to health and well-being. Therefore, it is important to measure this with reliable and valid evaluation tools. The Engagement in Meaningful Activities Survey (EMAS-VL) has been cross-culturally validated in Flemish and the psychometric properties determined. Method: The adaptation process followed the guidelines 'Translation and Adaptation of Instruments' and 'Cross-Cultural Adaptation of Self Report'. A forward and backward translation was performed. Three authors of the original EMAS were in close contact. Pretesting and cognitive interviews were performed on a sample of 10 chronically ill individuals. Psychometric analysis of survey data, collected during the COVID-19 lockdown (N = 1938 Belgian adults, Flemish speaking), was performed. Internal consistency, factorial validity and construct validity were examined. Results: The adaptation process involved an accurate analysis of the items of the EMAS by the expert panel and EMAS authors. The EMAS-VL showed high reliability (Cronbach's α = 0.91). Exploratory factor analysis discerned an interpretable two-factorial structure of the EMAS-VL. As hypothesized, moderate associations were found between GHQ-12 (r = −0.57) and CD-RISC (r = 0.50) so the EMAS-VL possesses satisfactory construct validity as well. Conclusion: EMAS-VL is shown to be a reliable and valid instrument for evaluating meaning in activities in Flanders. [ABSTRACT FROM AUTHOR]

Aims: The harms arising from psychoactive drug use are complex, and harm reduction strategies should be informed by a detailed understanding of the extent and nature of that harm. Drug harm is also context specific, and so any comprehensive assessment of drug harm should be relevant to the characteristics of the population in question. This study aimed to evaluate and rank drug harms within Aotearoa New Zealand using a multi-criteria decision analysis (MCDA) framework, and to separately consider harm within the total population, and among youth. Methods: Two facilitated workshops involved the separate ranking of harm for the total population, and then for youth aged 12–17, by two expert panels. In the total population workshop, 23 drugs were scored against 17 harm criteria, and those criteria were then evaluated using a swing weighting process. Scoring and weighting were subsequently updated during the youth-specific workshop. All results were recorded and analysed using specialised MCDA software. Results: When considering overall harm, the MCDA modelling results indicated that alcohol, methamphetamine and synthetic cannabinoids were the most harmful to both the overall population and the youth, followed by tobacco in the total population. Alcohol remained the most harmful drug for the total population when separately considering harm to those who use it, and harm to others. Conclusions: The results provide detailed and context-specific insight into the harm associated with psychoactive drugs use within Aotearoa New Zealand. The findings also demonstrate the value of separately considering harm for different countries, and for different population subgroups. [ABSTRACT FROM AUTHOR]

The feeling of well-being differs across cultural contexts and can be understood from the perspective of personal value priorities. This study uses a multilevel model with a sample of 324,204 people from 31 European countries and shows that the values conformity, tradition, benevolence, self-direction, and hedonism exert a positive average influence, whereas universalism and power exert a negative average influence on subjective well-being. Comparing similar value-outcome relationships in multiple countries simultaneously reveals that the geographical boundaries of a country strongly influence the kind of role values play, with very different and sometimes opposing effects across countries. The study also considers how subjective well-being is related to the fit of personal value priorities with the prevailing values in the environment. While value incongruency is negatively related to well-being in Cyprus, Germany, Spain, Greece, Lithuania, and Ukraine, it has a positive effect in other countries in the eastern and northern parts of Europe. [ABSTRACT FROM AUTHOR]

Background: The use of ketamine, a controlled dissociative anesthetic, has become more widespread in recent years with recreational/nonmedical use increasing and ketamine becoming more widely available in clinics to treat depression. Aims: We examined recent trends in adverse effects related to ketamine use. Methods: US National Poison Control data were examined, focusing on ketamine exposures among those aged ⩾13 between 2019 and 2021 (n = 758). We examined quarterly trends in exposure and delineated correlates of patients experiencing a major adverse effect or death. Results: The number of reported exposures increased 81.1% from 2019 Quarter 1 through 2021 Quarter 4, from 37 to 67 (p = 0.018). The majority of patients were male (57.1%), and the plurality of cases involved intentional misuse or "abuse" (39.5%), followed by suspected suicide attempt (19.7%) and unintentional exposure (18.9%). A fifth (19.6%) experienced a major adverse effect or death. A third (33.4%) co-used other drugs; the drugs most commonly co-used were benzodiazepines (14.6%), alcohol (10.3%), and opioids (8.7%). Co-use of gamma- hydroxybutyrate (GHB; adjusted prevalence ratio (aPR) = 3.43, 95% confidence interval (CI): 1.57–7.46) and opioids (aPR = 2.44, 95% CI: 1.46–4.08) was associated with increased risk for a major adverse effect or death, as was injection-only administration (aPR = 2.68, 95% CI: 1.21–5.92). Conclusions: Although still rare, poisonings involving ketamine have increased in recent years. Polydrug use—particularly with opioids or GHB—appears to be a particular risk factor for more serious adverse effects. As prevalence of use increases, it is important to monitor adverse effects and co-occurring behaviors to inform timely prevention and harm reduction as needed. [ABSTRACT FROM AUTHOR]

Background: Despite the growth of psychedelic research, psychedelic-assisted group psychotherapy (PAGP) has received little attention in comparison to individual psychedelic-assisted psychotherapy models. Methods: In this article, we aim to discuss the therapeutic potential of PAGP, as well as outline existing models and the challenges of this approach. Using Irvin Yalom's 11 therapeutic factors of group therapy as a basic framework, we analyse current literature from clinical studies and neurobiological research relative to the topic of PAGP. Results: We argue that combining psychedelic substances and group psychotherapy may prove beneficial for increasing group connectedness and interpersonal learning, potentially enhancing prosocial behaviour with direct opportunities to practice newly acquired knowledge about previously maladaptive behavioural patterns. Challenges regarding this approach include a more rigid therapy structure and potential loss of openness from patients, which may be ameliorated by adequate therapeutic training. Conclusion: We hope for this article to support clinical research on PAGP by presenting a therapeutic framework and outlining its mechanisms and challenges. [ABSTRACT FROM AUTHOR]

This paper reflects on the value of diary methods in the context of a qualitative, longitudinal narrative inquiry exploring the higher education decision-making of further education students in England. Event-based diaries were used alongside interviews and focus groups over a 14-month period to gain in-depth insights into the reasons and influences informing their decision-making trajectories. I explore the challenges, successful approaches and advantages of employing diary methods with young people in this context. Challenges consisted of maintaining participant engagement, which was overcome by combining methods and incorporating a reactive co-participatory element. Yet, a number of advantages emerged from participants' engagement with diary keeping which enhanced the richness of the data; this inspired deeper reflections on decision-making and influences and provided a private space for participants to disclose personal difficulties that could not be obtained via interviews. [ABSTRACT FROM AUTHOR]

We set out to understand how role-making works and what roles employees and leaders play in this process. Employees often make changes to their work roles, such as by negotiating their job responsibilities and seeking challenging tasks. In this study, we suggest that role-making behaviours influence and are influenced by the dyadic relationship between leaders and employees, otherwise known as leader–member exchange (LMX). We collected three waves of survey data from a sample of Chinese employees who were recent college graduates (n = 203). The results from cross-lagged panel analyses showed that (1) LMX and job-change negotiation were reciprocally related to each other and (2) initial LMX was associated with increased challenge-seeking behaviours, although these behaviours did not lead to greater LMX later on. In addition, we found evidence that when employees experienced a high level of emotional ambivalence (a conflicting, mixed and complex emotional state), the direct and reciprocal relationships between LMX and role-making behaviours were weakened. Our findings advance the understanding of the development of leader–employee relationships in the workplace and have implications for strengthening employee perceptions of high-quality relationships with their leaders by making changes to their workplace roles. [ABSTRACT FROM AUTHOR]

Informal caregivers can experience various demands when providing care and support for People with Parkinson's disease (PwP) in their own homes. The outbreak of SARS-CoV-2 and public health strategies employed to mitigate the spread of COVID-19 have presented challenges to the general populace on a global basis. The present study used a qualitative research design to explore how the COVID-19 pandemic has impacted informal caregivers in their role of providing care for PwP in their own homes. A series of 1:1 semi-structured interviews were conducted with 11 informal caregivers of PwP (M age = 72.64 years, SD = 8.94 years). A thematic analysis indicated that 1) vulnerabilities to COVID-19, 2) home maintenance & activities of daily living and 3) engagement with healthcare services were 3 themes that provided indications on how the COVID-19 pandemic impacted informal caregivers of PwP. The present study provides illustrations of how being an informal caregiver of PwP and being identified as high risk to COVID-19 can present challenges to the process of caring for loved ones who are also vulnerable to SARS-CoV-2. The results of the present study highlights the necessity to develop strategies to ensure that informal caregivers have the necessary resources to provide care for PwP in their homes and also maintain their own well-being in the post COVID-19 era. [ABSTRACT FROM AUTHOR]

Objective: To explore the knowledge and attitudes of psychiatrists about psychedelics therapies. Method: Access to a cross-sectional survey was distributed to psychiatrists through social media channels. Attitudes and knowledge about psychedelic therapies were recorded using Likert scales and ranking questions. Results: Fifty-eight complete responses were collected (44 fully trained +14 trainee RANZCP members). Greater than 85% of respondents agreed there is a shortfall in effective psychiatric treatments, and greater than 65% agreed that psychedelic therapies might address this shortfall. The psychiatrists did not consider themselves knowledgeable about psychedelic therapies, with 60% showing interest in further training on this topic. About 70% of the sample hold various concerns about psychedelic therapies, and more believe that the prescription of psychedelics should be limited to psychiatrists in the future. Conclusion: Considering these results in the context of a rapidly changing landscape relating to psychedelic research and regulations, we suggest there is scope to develop up-to-date education about psychedelics for psychiatrists. [ABSTRACT FROM AUTHOR]

Throughout life, one may witness grand views, scenes accompanied by intense affect and a sense of awe or wonder. The awe-inspiring things in these experiences vary considerably from suns in sunsets to glowing visages in holy visions to juices in simple tangerines. For different people, different views along the broad spectrum of these affectively intensive grand-view experiences can produce meaning in life, the influential facet of wellbeing identified by positive psychologists but poorly differentiated from meaning-making in other senses. This paper lays out a theory of semiotic vista to organize such disparate signification events and their use of both linguistic and non-linguistic signs. Using the examples of accounts of mountain hiking experiences, mindfulness meditation experiences, and supernatural encounters, I describe semiotic vista as a transitional mode of semiotic viewing in which agents re-interpret multiple signifiers of ordinary phenomena (objects) as valorized components of novel contexts, typically in association with intense affective experience. The vista mode is heavily facilitated by the (re)generation of at least two primary types of first-order indexical interpretants which occur in these contexts and of their attendant second-order indexicality which (semi)permanently re-contextualizes the objects originally referenced in the same view. I also briefly touch on how this process relates to storytelling and audience reactions. This analysis has implications for wellbeing, positive affect generation, and ideological enregisterment. [ABSTRACT FROM AUTHOR]

Objective: Serotonergic psychedelics are re-emerging as potential novel treatments for several psychiatric disorders including major depressive disorder. The Canadian Network for Mood and Anxiety Treatments (CANMAT) convened a task force to review the evidence and provide a consensus recommendation for the clinical use of psychedelic treatments for major depressive disorder. Methods: A systematic review was conducted to identify contemporary clinical trials of serotonergic psychedelics for the treatment of major depressive disorder and cancer-related depression. Studies published between January 1990 and July 2021 were identified using combinations of search terms, inspection of bibliographies and review of other psychedelic reviews and consensus statements. The levels of evidence for efficacy were graded according to the Canadian Network for Mood and Anxiety Treatments criteria. Results: Only psilocybin and ayahuasca have contemporary clinical trials evaluating antidepressant effects. Two pilot studies showed preliminary positive effects of single-dose ayahuasca for treatment-resistant depression (Level 3 evidence). Small randomized controlled trials of psilocybin combined with psychotherapy showed superiority to waitlist controls and comparable efficacy and safety to an active comparator (escitalopram with supportive psychotherapy) in major depressive disorder, with additional randomized controlled trials showing efficacy specifically in cancer-related depression (Level 3 evidence). There was only one open-label trial of psilocybin in treatment-resistant unipolar depression (Level 4 evidence). Small sample sizes and functional unblinding were major limitations in all studies. Adverse events associated with psychedelics, including psychological (e.g., psychotomimetic effects) and physical (e.g., nausea, emesis and headaches) effects, were generally transient. Conclusions: There is currently only low-level evidence to support the efficacy and safety of psychedelics for major depressive disorder. In Canada, as of 2022, psilocybin remains an experimental option that is only available through clinical trials or the special access program. As such, Canadian Network for Mood and Anxiety Treatments considers psilocybin an experimental treatment and recommends its use primarily within clinical trials, or, less commonly, through the special access program in rare, special circumstances. [ABSTRACT FROM AUTHOR]

The Observable Well-being in Living with Dementia-Scale was developed to address conceptual and methodological issues in current observational scales for music therapy. Creative interventions may receive lowered scores, as existing instruments rely heavily on verbal behavior. Methods were (1) Systematic review of observational instruments: (2) field work with music therapy and sociable interactions to operationalize the items; (3) field testing assessing feasibility and preliminary psychometric properties; (4) focus groups with experts to investigate content validity; (5) final field test and revision. 2199 OWLS-ratings were conducted in 11 participants. Hypotheses of construct validity and responsiveness were supported (r =.33 −.65). Inter-rater reliability was good (84% agreement between coders, Cohen's Kappa =.82), and intra-rater reliability was excellent (98% agreement, Cohen's Kappa =.98). Focus groups with 8 experts supported the relevance of the items and suggested further refinements to increase comprehensiveness. The final field-tested OWLS showed improved inter-rater reliability and usability. [ABSTRACT FROM AUTHOR]

Perinatal depression/anxiety is a significant concern for mothers of children with Down syndrome. This is influenced by the way the Down syndrome diagnosis is shared with parents. This study examined social media posts from mothers regarding experiences of the birth of their child with Down syndrome. Forty-three total stories were coded using thematic content analysis. Results highlighted the experiences of mother's who received a diagnosis of Down syndrome for their newborn. Two themes were found with relevant subthemes (i.e., receiving the diagnosis-mother's intuition, confirmation of the diagnosis, influence of potential health concerns, initial emotions, impact of the medical professional; Processing the diagnosis-life-altering, child not meeting expectations, reframing the diagnosis, impact of partner and others). Findings highlight the need for medical personnel to understand this identity-changing process, as perinatal depression/anxiety looks different for these mothers. There is also a need to help them engage in services accordingly. [ABSTRACT FROM AUTHOR]

Background: Determining when athletes are able to return to sport after sports-related concussion (SRC) can be difficult. Hypothesis: A multimodal algorithm using cognitive testing, postural stability, and clinical assessment can predict return to sports after SRC. Study Design: Prospective cohort. Level of Evidence: Level 2b. Methods: Athletes were evaluated within 2 to 3 weeks of SRC. Clinical assessment, Immediate Post Concussion and Cognitive Testing (ImPACT), and postural stability (Equilibrate) were conducted. Resulting data and machine learning techniques were used to optimize an algorithm discriminating between patients ready to return to sports versus those who are not yet recovered. A Fisher discriminant analysis with leave-one-out cross-validation assessed every combination of 2 to 5 factors to optimize the algorithm with lowest combination of type I and type II errors. Results: A total of 193 athletes returned to contact sports after SRC at a mean 84.6 days (±88.8). Twelve subjects (6.2%) sustained repeat SRC within 12 months after return to sport. The combination of (1) days since injury, (2) total symptom score, and (3) nondominant foot tandem eyes closed postural stability score created the best algorithm for discriminating those ready to return to sports after SRC with lowest type I error (13.85%) and type II error (11.25%). The model was able to discriminate between patients who were ready to successfully return to sports versus those who were not with area under the receiver operating characteristic (ROC) curve of 0.82. Conclusion: The algorithm predicts successful return to sports with an acceptable sensitivity and specificity. Tandem balance with eyes closed measured with a video-force plate discriminated athletes ready to return to sports from SRC when combined in multivariate analysis with symptom score and time since injury. The combination of these factors may pose advantages over computerized neuropsychological testing when evaluating young athletes with SRC for return to contact sports. Clinical Relevance: When assessing young athletes sustaining an SRC in a concussion clinic, measuring postural stability in tandem stance with eyes closed combined with clinical assessment and cognitive recovery is effective to determine who is ready to successfully return to sports. [ABSTRACT FROM AUTHOR]

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This study aims to examine the relationship between active coping and hope during the COVID-19 pandemic and investigate the underlying mechanism based on meaning making theory. We conducted a two-wave survey and recruited 521 Chinese adults (aged 18–65). Results show that all three active coping strategies (personal hygiene practice, support seeking, and positive reappraisal) at T1 was positively associated with T2 hope. Importantly, T2 meaning in life serves as a mediator between T1 active coping and T2 hope. Our findings suggest that active coping could be an effective approach to maintain mental health by making meaning and promoting hope. [ABSTRACT FROM AUTHOR]

Background: The benzodiazepine drug alprazolam, a fast-acting tranquiliser, cannot be prescribed on the National Health Service in the United Kingdom. Illicit alprazolam supply and consumption have increased. Concern about increasing numbers of alprazolam-related fatalities started circulating in 2018. However, statistics on this issue are very limited. This study examined patterns in such mortality in Scotland.Methods: Statistics on deaths where alprazolam was mentioned in the 'cause of death' were obtained from official mortality registers. Anonymised Scottish case-level data were obtained. Data were examined in respect of the characteristics of decedents and deaths using descriptive statistics.Results: Scotland registered 370 deaths in 2004-2020; 366 of these occurred in 2015-2020: most involved males (77.1%); mean age 39.0 (SD 12.6) years. The principal underlying cause of death was accidental poisoning: opiates/opioids (77.9%); sedatives/hypnotics (15.0%). Two deaths involved alprazolam alone. Main drug groups implicated: opiates/opioids (94.8%), 'other benzodiazepines' (67.2%), gabapentinoids (42.9%), stimulants (30.1%), antidepressants (15.0%). Two-thirds (64.2%) involved combinations of central nervous system (CNS) depressants.Discussion: Alprazolam-related deaths are likely due to an increasing illicit supply. The fall in deaths in 2019-2020 is partially due to increased use of designer benzodiazepines. Treatment for alprazolam dependence is growing. Clinicians need to be aware of continuing recreational alprazolam use. When such consumption occurs with CNS depressants, overdose and death risks increase.Conclusions: More awareness of alprazolam contributing to deaths, especially in conjunction with other CNS depressants, is needed by consumers and clinicians. Improved monitoring of illicit supplies could identify emerging issues of medicines' abuse. [ABSTRACT FROM AUTHOR]

Background: Psilocybin-containing mushrooms are used for recreational, spiritual, self-development and therapeutic purposes. However, physiologically relatively nontoxic, adverse reactions are occasionally reported. Aims: This study investigated the 12-month prevalence and nature of magic mushroom-related adverse reactions resulting in emergency medical treatment seeking in a global sample of people reporting magic mushroom use. Methods: We use data from the 2017 Global Drug Survey – a large anonymous online survey on patterns of drug use conducted between November 2016 and January 2017. Results: Out of 9233 past year magic mushroom users, 19 (0.2%) reported having sought emergency medical treatment, with a per-event risk estimate of 0.06%. Young age was the only predictor associated with higher risk of emergency medical presentations. The most common symptoms were psychological, namely anxiety/panic and paranoia/suspiciousness. Poor 'mindset', poor 'setting' and mixing substances were most reported reasons for incidents. All but one respondent returned back to normality within 24 h. Conclusions: The results confirm psilocybin mushrooms are a relatively safe drug, with serious incidents rare and short lasting. Providing harm-reduction information likely plays a key role in preventing adverse effects. More research is needed to examine the detailed circumstances and predictors of adverse reactions including rarer physiological reactions. [ABSTRACT FROM AUTHOR]

While it is well-established that entrepreneurs benefit from social support, little is known about how and when instrumental and emotional support from household members facilitate entrepreneurial action and persistence. Through a longitudinal, qualitative study, we develop a conceptual framework that shows how social support from the household becomes an integral part of the everyday activities of entrepreneurs. In contrast to the perception of social support as static, our findings illustrate it as a dynamic, ongoing process which is core to business start-up and growth over time. We also challenge the perspectives that households are simply repositories of resources and entrepreneurs passive recipients of support by demonstrating that social support is necessarily interactive, whereby entrepreneurs and households play a collaborative role in entrepreneurship. Finally, we join the debate concerning mechanisms of social support by suggesting that the main effect model and buffering hypothesis are not contradictory, but are instead interdependent. [ABSTRACT FROM AUTHOR]

This study proposes that chief executive officers who have received over their tenure a greater sum of total compensation relative to the market's going rate become overconfident. We posit that this happens because historically overpaid chief executive officers perceive greater self-worth to the firm whereby such self-serving attribution inflates their level of self-confidence. We also identify chief executive officer- and firm-level cues that can influence the relationship between chief executive officers' historical relative pay and their overconfidence, suggesting that chief executive officers' perceived self-worth is more pronounced when chief executive officers possess less power and when their firm's performance has improved upon their historical aspirations. Using a sample of 1185 firms and their chief executive officers during the years 2000–2016, we find empirical support for our predictions. Findings from this study contribute to strategic leadership research by highlighting the important role of executives' compensation in creating overconfidence. [ABSTRACT FROM AUTHOR]

Objective: To assess the effectiveness of Wii sports-based strategy training on risk of falling, falls and quality of life in adults with idiopathic Parkinson's disease. Design: Single blind, Randomised comparative trial. Setting: Hospital and home Subjects: Diagnosed as idiopathic Parkinson's disease, Hoehn-Yahr stage 2.5 to 4, history of at least 3 falls in the last 3 months. Intervention: Experimental group participated in 30–40 min of Wii training, 3 session/week for 12 weeks and control group participated for the same duration in traditional balance training. During each session both the group received 30 min of conventional physiotherapy. Outcomes: Number of fallers, Fall rate, Berg balance scale, Timed up and go test, Parkinson's disease questionnaire 39, at baseline, 12th and 36th week after baseline. Results: We randomised 192 participants. Participant's characteristics were similar between Wii and control group at base line, in age 69.7 ± 10, 68.5 ± 9.8, disease severity 3.43 ± 0.56, 3.42 ± 0.59, and fall rate 10.47 ± 15.78, 11.80 ± 18.95 (in mean ± SD). At 12th week 28%(27), 51%(49) & 36th week 45%(42), 60%(57) in Wii-group, control group fell at least once, respectively. Wii group improved more than control group at 12th, 36th week in number of fallers (−23%, p < 0.001) (−15%, p < 0.039), fall rates −2.635(−5.38 to 0.112), −1.476(−5.09 to 2.142) (difference in mean, Confidence Interval) and bodily discomfort component of PDQ 39. Conclusion: A 12 weeks exercise training using the Wii sports-based strategy decreases the number of fallers, fall rate, measures of risk of falling but did not alter the quality of life in adults with idiopathic Parkinson's disease. [ABSTRACT FROM AUTHOR]

Adherence to plant-rich diets remains low despite numerous health benefits accruing to such practices. We sought to distinguish college students who report high adherence to a plant-rich diet ("Sustainers") from those who are less successful ("Strivers"). Sustainers more strongly endorsed multiple ethical dietary motives and indicated stronger allegiance to their values compared to Strivers, who rated health reasons more highly. Sustainers scored better on seven factors relating to effective dietary goal pursuit. Results underscore the importance of motivational factors in the maintenance of plant-based eating. [ABSTRACT FROM AUTHOR]

Background: Many benefits and some harms associated with psychedelic use could be attributable to these drugs' acceptance/avoidance-promoting effects and corresponding changes in psychological flexibility. Underlying psychological mechanisms are insufficiently understood.Aim: The purpose of this study was the validation of a psychological model of acceptance/avoidance-promoting psychedelic experiences, which included the development of a theory-based self-report instrument: the Acceptance/Avoidance-Promoting Experiences Questionnaire (APEQ). Its two main scales, acceptance-related experience (ACE) and avoidance-related experience (AVE), represent the theorized model's core constructs. We aimed to test the model's central assumptions of complementarity (ACE and AVE may occur alternatingly but not simultaneously, and are therefore empirically independent), intertwinedness (subaspects within ACE and AVE are mutually contingent and therefore highly inter-correlated), context-dependence (ACE and AVE depend on context factors) and interaction (longer-term outcomes depend on the interplay between ACE and AVE).Method: A bilingual retrospective online survey including 997 English- and 836 German-speaking participants. Each participant reported on one psychedelic experience occasioned by lysergic acid diethylamide (LSD), psilocybin, mescaline, or ayahuasca.Results: Whereas ACE and AVE were found to be relatively independent aspects of participants' reported psychedelic experiences (complementarity), their subaspects were mostly distinguishable but strongly correlated among each other (intertwinedness). Therapeutic, escapist, and hedonic use motives were differentially associated with ACE and AVE (context-dependence), which were in turn associated with retrospective changes in psychological flexibility following participants' reported experiences. The positive association between ACE and increased psychological flexibility was significantly moderated by AVE (interaction).Conclusion: These results provide an initial validation of the APEQ and its underlying theoretical model, suggesting the two can help clarify the psychological mechanisms of psychedelic-induced benefits and harms. Both should be further investigated in prospective-longitudinal and clinical studies. [ABSTRACT FROM AUTHOR]

Background: Despite an increasing body of research highlighting their efficacy to treat a broad range of medical conditions, psychedelic drugs remain a controversial issue among the public and politicians, tainted by previous stigmatisation and perceptions of risk and danger.Objective: This narrative review examines the evidence for potential harms of the classic psychedelics by separating anecdotes and misinformation from systematic research.Methods: Taking a high-level perspective, we address both psychological and psychiatric risks, such as abuse liability and potential for dependence, as well as medical harms, including toxicity and overdose. We explore the evidence base for these adverse effects to elucidate which of these harms are based largely on anecdotes versus those that stand up to current scientific scrutiny.Results: Our review shows that medical risks are often minimal, and that many - albeit not all - of the persistent negative perceptions of psychological risks are unsupported by the currently available scientific evidence, with the majority of reported adverse effects not being observed in a regulated and/or medical context.Conclusions: This highlights the importance for clinicians and therapists to keep to the highest safety and ethical standards. It is imperative not to be overzealous and to ensure balanced media reporting to avoid future controversies, so that much needed research can continue. [ABSTRACT FROM AUTHOR]

Background: Classic psychedelics show promise in the treatment of mental health conditions; however, more scalable intervention protocols are needed to maximize access to these novel therapeutics. In this proof-of-concept study, perceptions of safety, subjective effects, and beliefs about the clinical utility of lysergic acid diethylamide (LSD) were evaluated among healthy participants (N = 31) administered 50 to 100 µg LSD in a treatment paradigm conceptualized as more scalable than traditional approaches to administering classic psychedelics.Methods: Semi-structured interviews assessed participants' expectations, experience, and thoughts on the safety and efficacy of the study design. These interviews were transcribed for thematic analysis relating to perceptions of safety, subjective effects, and beliefs about the clinical utility of LSD.Results: Most participants felt safe throughout the study, with a minority reporting concerns related to having a challenging experience that diminished over time. Participants attributed their feelings of safety to the study structure and support of their attendants, which allowed them to "let go" and immerse themselves in the experience without pre-occupation. Furthermore, participants reported transcendent, mystical-type experiences characteristic of classic psychedelics, with almost half highlighting the prominent role played by music during the acute period of drug action. Finally, participants endorsed support for the clinical utility of LSD in controlled environments, expressing the belief that LSD is safe and has the potential to help others.Conclusion: Findings provide preliminary support for the feasibility of this scalable interventional paradigm and set the stage for future critical research with clinical populations. [ABSTRACT FROM AUTHOR]

The bacterium Listeria monocytogenes (Lm) is widely distributed in the environment as a saprophyte, but may turn into a lethal intracellular pathogen upon ingestion. Invasive infections occur in numerous species worldwide, but most commonly in humans and farmed ruminants, and manifest as distinct forms. Of those, neuroinfection is remarkably threatening due to its high mortality. Lm is widely studied not only as a pathogen but also as an essential model for intracellular infections and host-pathogen interactions. Many aspects of its ecology and pathogenesis, however, remain unclear and are rarely addressed in its natural hosts. This review highlights the heterogeneity and adaptability of Lm by summarizing its association with the environment, farm animals, and disease. It also provides current knowledge on key features of the pathology and (molecular) pathogenesis of various listeriosis forms in naturally susceptible species with a special focus on ruminants and on the neuroinvasive form of the disease. Moreover, knowledge gaps on pathomechanisms of listerial infections and relevant unexplored topics in Lm pathogenesis research are highlighted. [ABSTRACT FROM AUTHOR]

Background: Suicide is one of the leading causes of death worldwide and rates within the United States have risen over the past two decades. Hence, there is a critical need for novel tools to treat suicidal ideation and related mental health conditions. 3,4-Methylenedioxymethamphetamine (MDMA)/ecstasy and classic psychedelics may be two such tools. Aims: The aim of this study was to assess non-causal associations between MDMA/ecstasy and classic psychedelic use and psychological distress and suicide risk. Methods: In this study, we examined the aforementioned associations among 484,732 adult participants in the National Survey on Drug Use and Health (2008–2019). Results: Lifetime MDMA/ecstasy use was associated with reduced odds of past year suicidal thinking (10% reduced odds; odds ratio (OR) = 0.90; 95% confidence interval, CI = (0.84–0.97); p < 0.01) and past year suicidal planning (OR = 0.88; 95% CI = (0.78–0.99); p < 0.05). Furthermore, lifetime psilocybin use was associated with reduced odds of past month psychological distress (OR = 0.78; 95% CI = (0.73–0.84); p < 0.001) and past year suicidal thinking (OR = 0.90; 95% CI = (0.83–0.96); p < 0.01). Finally, lysergic acid diethylamide (LSD) was associated with increased odds of past year suicidal thinking (OR = 1.07; 95% CI = (1.00–1.15); p < 0.05). Conclusion: MDMA/ecstasy and psilocybin use are associated with reduced odds of suicidal thinking and related outcomes—though experimental studies are needed to determine whether these associations are causal. These findings call for more research into the efficacy of MDMA/ecstasy and classic psychedelics for treating psychological distress and suicidal thoughts and behaviors, and for updated drug legislation that allows for further investigation into these substances. [ABSTRACT FROM AUTHOR]

Background: Microdosing psychedelics is the practice of taking small, sub-hallucinogenic doses of lysergic acid diethylamide or psilocybin-containing mushrooms. Despite its surging popularity, little is known about the specific intentions to start microdosing and the effects of this practice. Aims: First, we aimed to replicate previous findings regarding the subjective benefits and challenges reported for microdosing. Second, we assessed whether people who microdose test their substances before consumption. Third, we examined whether having an approach-intention to microdosing was predictive of more reported benefits. Methods: The Global Drug Survey runs the world's largest online drug survey. Participants who reported last year use of lysergic acid diethylamide or psilocybin in the Global Drug Survey 2019 were offered the opportunity to answer a sub-section on microdosing. Results: Data from 6753 people who reported microdosing at least once in the last 12 months were used for analyses. Our results suggest a partial replication of previously reported benefits and challenges among the present sample often reporting enhanced mood, creativity, focus and sociability. Counter to our prediction, the most common challenge participants associated with microdosing was 'None'. As predicted, most participants reported not testing their substances. Counter to our hypothesis, approach-intention – microdosing to approach a desired goal – predicted less rather than more benefits. We discuss alternate frameworks that may better capture the reasons people microdose. Conclusion: Our results suggest the perceived benefits associated with microdosing greatly outweigh the challenges. Microdosing may have utility for a variety of uses while having minimal side effects. Double-blind, placebo-controlled experiments are required to substantiate these reports. [ABSTRACT FROM AUTHOR]

In Finnish data from 1995-2000, 1006 fatal poisonings due to alcohol (ethanol), a single drug or both were statistically analysed in retrospect to evaluate the interaction between alcohol and drugs. In 53% of these cases, low concentrations of some common benzodiazepines were present. The median postmortem blood alcohol concentration (BAC) was 3.3‰ (w/w) in the 615 alcohol poisonings, but significantly lower, ranging from 1.3 to 1.7‰, when promazine, doxepin, amitriptyline or propoxyphene were found together with alcohol. When levomepromazine, temazepam or zopiclone were present, the median BAC was also significantly lower, 2.5-2.7‰. Citalopram and diltiazem did not exhibit a significant effect. The median BAC was significantly lower in cases with high concentrations than in those with low concentrations of a drug (excluding citalopram), suggesting a positive concentration-effect relationship. Fatal toxicity indices (FTIs) were calculated by relating the number of deaths caused by a drug to the corresponding sales figures. Promazine had an extremely high FTI, followed by levomepromazine, propoxyphene, doxepin and amitriptyline. The other drugs had relatively low FTIs. The results reflect not only the acute toxicity of a given drug alcohol combination but also the manners of use and abuse of these drugs. [ABSTRACT FROM AUTHOR]