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Background: Behavioral or mental health disorders are common in children, adolescents, and young adults. Medication use is increasingly common, with few data describing drug-drug combinations in ambulatory settings. The objectives of this study were to describe the pharmaco-epidemiology of behavioral and mental health (BMH) medications among children, adolescents, and young adults in New York Medicaid and assess the prevalence of contraindicated drug pairs within this population. Methods: This observational cross-sectional study evaluated New York State Medicaid managed care and fee-for-service enrollees under 21 years of age dispensed BMH medications in 2014. Main outcomes included number of members with prescriptions filled; number filling > 1 medication prescription concurrently for ≥ 30 days (polypharmacy), and number and nature of potentially contraindicated drug pairs. Results: Of 2,430,434 children, adolescents, and young adults, 422,486 (17.4%) had a visit associated with a BMH diagnosis and 141,363 (5.8%) received one or more BMH medications. With 84 distinct medications evaluated, polypharmacy was common, experienced by 53,388 individuals (37.8% of those with a prescription filled), generating 11,115 distinct drug combinations. 392 individuals filled prescriptions for a contraindicated pair of ≥ 2 BMH medications for 30 days or longer. With ≥ 1 day overlap, 651 were exposed to contraindicated medications. The most common contraindicated pairs increased potential risk for prolonged QT interval and serotonin syndrome (n = 378 and n = 250 patients, respectively). Most combinations involved ziprasidone (3247.1 per 10,000 ziprasidone prescriptions filled). Conclusions: With nearly 6% of members dispensed a BMH medication, contraindicated drug pairs were uncommon. However, any of those combinations represent a potential risk. Clinicians should attend to the balance of potential risks and benefits before contraindicated pairs are dispensed. The methodology described could serve as a basis for monitoring such rare instances and might reduce harm. [ABSTRACT FROM AUTHOR]

Abstract Background Behavioral or mental health disorders are common in children, adolescents, and young adults. Medication use is increasingly common, with few data describing drug-drug combinations in ambulatory settings. The objectives of this study were to describe the pharmaco-epidemiology of behavioral and mental health (BMH) medications among children, adolescents, and young adults in New York Medicaid and assess the prevalence of contraindicated drug pairs within this population. Methods This observational cross-sectional study evaluated New York State Medicaid managed care and fee-for-service enrollees under 21 years of age dispensed BMH medications in 2014. Main outcomes included number of members with prescriptions filled; number filling > 1 medication prescription concurrently for ≥ 30 days (polypharmacy), and number and nature of potentially contraindicated drug pairs. Results Of 2,430,434 children, adolescents, and young adults, 422,486 (17.4%) had a visit associated with a BMH diagnosis and 141,363 (5.8%) received one or more BMH medications. With 84 distinct medications evaluated, polypharmacy was common, experienced by 53,388 individuals (37.8% of those with a prescription filled), generating 11,115 distinct drug combinations. 392 individuals filled prescriptions for a contraindicated pair of ≥ 2 BMH medications for 30 days or longer. With ≥ 1 day overlap, 651 were exposed to contraindicated medications. The most common contraindicated pairs increased potential risk for prolonged QT interval and serotonin syndrome (n = 378 and n = 250 patients, respectively). Most combinations involved ziprasidone (3247.1 per 10,000 ziprasidone prescriptions filled). Conclusions With nearly 6% of members dispensed a BMH medication, contraindicated drug pairs were uncommon. However, any of those combinations represent a potential risk. Clinicians should attend to the balance of potential risks and benefits before contraindicated pairs are dispensed. The methodology described could serve as a basis for monitoring such rare instances and might reduce harm.

Postmenopausal Hispanic/Latina (N = 254) women with a body mass index (BMI) ≥ 25 kg/m2 were randomized to an intervention to reduce sitting time or a comparison condition for 12 weeks. The standing intervention group received three in-person health-counseling sessions, one home visit, and up to eight motivational interviewing calls. The heart healthy lifestyle comparison group (C) received an equal number of contact hours to discuss healthy aging. The primary outcome was 12-week change in sitting time measured via thigh-worn activPAL. Group differences in outcomes were analyzed using linear mixed-effects models. Participants had a mean age of 65 (6.5) years, preferred Spanish language (89%), BMI of 32.4 (4.8) kg/m2, and sat for an average of 540 (86) minutes/day. Significant between-group differences were observed in reductions of sitting time across the 12-week period [Mdifference (SE): C − 7.5 (9.1), SI − 71.0 (9.8), p < 0.01]. Results demonstrate that coaching models to reduce sitting are feasible and effective. [ABSTRACT FROM AUTHOR]

Interpersonal touch represents the primal sensory experience between humans, fostering social bonding from the cradle to the death bed. In recent decades “affective touch” has been intensely studied, stimulated by the discovery of a population of mechanosensitive unmyelinated C-tactile afferents in mammalian skin. A lack of touch in childhood is associated with negative consequences for psychosocial and physical health and the benefits of professional touch techniques in the prevention and treatment of various diseases have been shown over and over again in clinical studies. However, its application in mainstream clinical applications remains limited. To bridge the gap between recent discoveries in touch research and clinical medicine, we propose the establishment of a new discipline: ‘Touch Medicine’. Here, we unfold the potential of Touch Medicine by focusing on the treatment of depression, which in our view is primarily a disorder of the lived body. Controlled studies and systematic reviews have demonstrated the antidepressant, anxiolytic and analgesic effects of specific massage techniques. Underlying mechanisms of action are currently under investigation, ranging from interoceptive, endocrinological, to stress-related or psychological underpinnings. Touch Medicine represents a novel interdisciplinary field connected to various medical specialities such as neonatology, pediatrics, pain medicine, neurology, psychiatry, and geriatrics – but also clinical psychology and psychosomatic medicine might benefit from the integration of these findings into their daily practice. [ABSTRACT FROM AUTHOR]

Research in psychology and medicine has linked mental health disorders, and particularly bipolar disorder (BD), to employment in creative professions. Little is known, however, about the mechanisms for this link, which could be due to biology (primarily through a person's genes) or environmental (through socioeconomic status). Using administrative data on mental health diagnoses and occupations for the population of Denmark, we find that people with BD are more likely to be musicians than the population, but less likely to hold other creative jobs. Yet, we also show that healthy siblings of people with BD are significantly more likely to work in creative professions. Notably, people from wealthy families are consistently more likely to work in creative professions, and access to family wealth amplifies the likelihood that siblings of people with BD pursue creative occupations. Nevertheless, family wealth explains only a small share of the correlation between BD and creative employment. [ABSTRACT FROM AUTHOR]

High-quality eye-tracking data are crucial in behavioral sciences and medicine. Even with a solid understanding of the literature, selecting the most suitable algorithm for a specific research project poses a challenge. Empowering applied researchers to choose the best-fitting detector for their research needs is the primary contribution of this paper. We developed a framework to systematically assess and compare the effectiveness of 13 state-of-the-art algorithms through a unified application interface. Hence, we more than double the number of algorithms that are currently usable within a single software package and allow researchers to identify the best-suited algorithm for a given scientific setup. Our framework validation on retrospective data underscores its suitability for algorithm selection. Through a detailed and reproducible step-by-step workflow, we hope to contribute towards significantly improved data quality in scientific experiments. [ABSTRACT FROM AUTHOR]

Aim of the study: The study aimed to clarify the relationships between experienced nature connectedness (NC) and depression, anxiety and stress levels with mediating role of coping strategies. Subject or material and methods: Study group included 81 young adults (Mean = 28.02; SD 8.22) who completed questionnaires measuring nature connectedness, coping strategies, well-being, and mental illness. To verify whether the associations between connectedness to nature (measured by CNS) and mental health status (stress, anxiety and depression measured by DASS-21) are mediated by coping strategies parallel mediation analysis was employed. Following three coping strategies as mediators were tested: problem-focused coping strategy, emotion-focused coping strategy, avoidant-focused coping strategy. Results: Results showed a significant mediation of the association between nature connectedness and mental health via coping strategies. The study indicated that: 1) NC was indirectly related to stress and depression through its relationship with the problem-focused coping; 2) NC was neither directly nor indirectly associated with anxiety symptoms. Discussion: The health and wellbeing benefits of contact with nature are becoming increasingly recognized in psychology and medicine. Nevertheless, until now researchers haven't clearly recognized underlying mechanisms of nature-related mental health well-being. Presented study indicate one of the key pathways of associations. Conclusions: The findings support thesis that nature connectedness seems to be a mental health protective factor. [ABSTRACT FROM AUTHOR]

Abstract Background Childhood cancer survivors (CCS) are subject to a substantial burden of treatment-related morbidity. Engaging in health protective behaviors and eliminating risk behaviors are critical to preventing chronic diseases and premature deaths. This study is aimed to provide updated information on currently smoking, physical inactivity, binge drinking patterns and associated factors among CCS using a nationwide dataset. Methods We constructed a sample of CCS (cancer diagnosis at ages

The reported benefits of nature contact on human health and well-being have prompted the rise of nature prescriptions with health professionals recommending nature exposure. Due to the success of nature prescriptions and calls for greater reciprocity between people and the planet, this essay proposes to leverage health behavior promotion strategies to integrate planetary health prescriptions (Earth RX) into existing nature prescription frameworks with a vision to counsel patients on both the health and well-being benefits of nature contact as well as earth-sustaining behaviors, all of which fosters a compassionate interdependence between personal and planetary well-being. The essay emphasizes the importance of co-designed stakeholder collaboration for program success, addressing factors such as trust, perceived benefits, and accessibility. Finally, this essay concludes that integrating Earth RX in nature prescription programs strategically aligns with the principles of integrative health, acknowledging the reciprocal relationship between human health and well-being and planetary well-being. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Languages for Specific Purposes is the property of University of Oradea, Faculty of Economic Sciences and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Anxiety disorders in dogs are ever-growing and represent an important concern in the veterinary behavior field. These disorders are often disregarded in veterinary clinical practice, negatively impacting the animal's and owner's quality of life. Moreover, these anxiety disorders can potentially result in the abandonment or euthanasia of dogs. Growing evidence shows that the gut microbiota is a central player in the gut-brain axis. A variety of microorganisms inhabit the intestines of dogs, which are essential in maintaining intestinal homeostasis. These microbes can impact mental health through several mechanisms, including metabolic, neural, endocrine, and immune-mediated pathways. The disruption of a balanced composition of resident commensal communities, or dysbiosis, is implicated in several pathological conditions, including mental disorders such as anxiety. Studies carried out in rodent models and humans demonstrate that the intestinal microbiota can influence mental health through these mechanisms, including anxiety disorders. Furthermore, novel therapeutic strategies using prebiotics and probiotics have been shown to ameliorate anxiety-related symptoms. However, regarding the canine veterinary behavior field, there is still a lack of insightful research on this topic. In this review, we explore the few but relevant studies performed on canine anxiety disorders. We agree that innovative bacterial therapeutical approaches for canine anxiety disorders will become a promising field of investigation and certainly pave the way for new approaches to these behavioral conditions. [ABSTRACT FROM AUTHOR]

Introduction: Generating oral care and hygiene habits from an early age is critical in the development and growth of the child. Professionals such as pediatricians, nurses, and doctors have close contact with pregnant women and infants. Knowledge and attitudes towards oral health are essential in preventing oral diseases and their social impact on people's quality of life. Objective: To determine the knowledge and attitudes about early childhood oral health of pediatricians, doctors, nurses, and nursing assistants in a social enterprise in Cali, Colombia. Method: A descriptive study was conducted in 38 health-providing institutions in seven communes and two rural areas of Cali, applying a structured questionnaire-type instrument with 27 questions. Results: Seventy-four professionals participated; 35.8% presented regular knowledge about oral health, in addition to 87.8% with a good attitude towards the subject. Conclusions: The attitude towards health care and hygiene in childhood among health personnel in Cali, Colombia, is good. However, health personnel's knowledge of the topics could be improved. More similar studies are needed in other Colombian regions. [ABSTRACT FROM AUTHOR]

Heart diseases are potentially fatal pathologies considered a risk factor for anxiety disorders. This paper aims to present a systematic literature review on anxiety in cardiology. Five databases were selected: Scielo, PsycINFO, Web of Science, and PubMed. The descriptors "cardiologia" and "ansiedade" and their equivalents in English, "anxiety" and "cardiology" were used. The inclusion criteria were papers published in Portuguese, English, or Spanish between 2017 and 2021. Twenty-six studies were selected, and four topics stood out: socio-demographic profile, anxiety and cardiac rehabilitation, anxiety-related risk and protective factors, and anxiety and depression. The results indicate that healthy anxiety levels play a protective role in promoting patient self-care. However, maladaptive anxiety levels hinder patients from coping with the disease. [ABSTRACT FROM AUTHOR]

Heart diseases are potentially fatal pathologies considered a risk factor for anxiety disorders. This paper aims to present a systematic literature review on anxiety in cardiology. Five databases were selected: SciElo, PsycINFO, Web of Science, and PubMed. The descriptors "cardiologia" and "ansiedade" and their equivalents in English, "anxiety" and "cardiology" were used. The inclusion criteria were papers published in Portuguese, English, or Spanish between 2017 and 2021. Twenty-six studies were selected, and four topics stood out: socio-demographic profile; anxiety and cardiac rehabilitation; anxiety-related risk and protective factors; and anxiety and depression. The results indicate that healthy anxiety levels play a protective role in promoting patient self-care. However, maladaptive anxiety levels hinder patients from coping with the disease. [ABSTRACT FROM AUTHOR]

Introduction: Bedwetting is a frequent reason to visit pediatric, infant psychiatry, psychology and family medicine services, with more percentage in 5 years children, followed by 7 and 9 years children, in that order. Objective: To determine the construct validity of the hypnotherapeutic algorithm for patients with monosymptomatic bedwetting. Methods: A complex investigation of 97 patients was carried out, who were assisted in the Therapeutic Hypnosis Clinic of the University of Medical Sciences in Santiago de Cuba, from February, 2021, to July, 2022 which was structured in 3 methodological phases of construct validation to continue the phase IV of hypnotherapeutic algorithm content validation, on the base of 2 quasi-experiments without control group and a quasi-experiment with non equivalent control group of the second phase of this investigation. Results: The factorial analysis on the study of main components was possible, because the factors 1, 2 and 3 should stay, which was expressed in the sedimentation graph and in the explained total variance, through the percentages accumulated in the initial auto values and the sum of saturations to the square of extraction and rotation with 64.24%. Conclusions: The construct validation of the designed algorithm showed relevancy, given by the suitability of the factorial analysis and the Bartlett test of spherical form. [ABSTRACT FROM AUTHOR]

Copyright of Psicooncologia is the property of Universidad Complutense de Madrid and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Aim of the study was to explore the relationship between emotional dimensions of hypertensive patients and the self‐care skills; we tried to draw the psychological aspects could impact the health management in hypertension analyzing the effect of emotional regulation on self‐care skills: our scope was to highlight the psychological dynamics into behavioral medicine approach. Methods: In an observational study design, patients were collected. Patients with diagnosis of hypertension were recruited in primary care setting. Inclusion criteria included patients older than 18 years, with known and medically treated primary hypertension undergoing antihypertensive medication. Results: Statistical analysis was carried out based on the data of 28 primary hypertensive patients (seven females, 21 males, mean age ± SD: 49.8 ± 7.8 years mean; clinic blood pressure: mean systolic blood pressure: 137.2 ± 13.1 mmHg, mean diastolic blood pressure: 82.1 ± 9.9 mmHg). Mean duration of hypertension in the sample was 13.1 years (±8.2 years). Correlations among the main variables of interest showed a positive and significant relationship between emotional dysregulation indexes, psychological distress, and self‐care domains: awareness resulted negatively and significantly correlated to self‐efficacy; nonacceptance, goals and impulse indexes seemed positively and significantly correlated to anxiety and depression; finally, stress was correlated positively and significantly to awareness and impulse. Conclusions: Evidencing the role of emotion dysregulation on self‐care skills and psychological outcomes, and specifically highlighting the impact of emotion dysregulation on self‐care, our findings could inform the development and implementation of psychological interventions aimed at promoting psychological well‐being and healthy behavior by focusing on the promotion of emotion regulation strategies, to reduce the risk for co‐morbidity and/or severe cardiovascular diseases. [ABSTRACT FROM AUTHOR]

Weight loss, through a reduction in energy intake and increase in energy expenditure, can reduce diabetes risk in people with prediabetes. However, lifestyle change can be challenging even with positive intentions. The Health Action Process Approach (HAPA) theoretical framework bridges the intention-behavior gap by targeting planning behaviors and strengthening efficacious beliefs for behavioral change. In the current trial, an adaptive design was employed to examine differences in HAPA measures (i.e., planning and self-efficacy) regarding the target behaviors of dietary intake and physical activity (PA). Adults ≥ 21 years old with overweight or obesity and prediabetes (n = 185) received the standard Group Lifestyle Balance (GLB) intervention during the first month of treatment. Weight loss responders (lost > 2.5% of weight) at week five remained in GLB during weeks 5-16; slow responders (lost ≤ 2.5%) were stratified to the adaptive GLB Plus (GLB+) intervention during weeks 5-16. GLB+ augmented self-regulatory skills and practices consistent with HAPA. We conducted mixed model analyses with a group-by-time interaction for fixed effects at four months. GLB experienced greater improvement in behavioral intention for both diet and PA, planning behaviors (action and coping planning) for diet, and self-efficacy beliefs (action and maintenance self-efficacy) for PA compared to GLB+ (all ps < .0125). However, GLB+ also experienced statistically significant improvement in planning and self-efficacy and in energy intake and food group servings (all ps < .01). Whereas an adaptive intervention can be advantageous in improving HAPA measures and food choices, greater focus on increasing PA is needed. Additional research may help to determine effective PA strategies.

This document is an editorial published in Frontiers in Psychiatry, discussing the second volume of a community series in psychocardiology that explores the brain-heart interface. The editorial highlights the connection between mental processes and cardiovascular health, emphasizing the need for further investigation in this area. The second volume includes studies on the influence of adverse childhood experiences on adult mental and cardiovascular health, the impact of depression on heart disease, the determinants of severe QTc prolongation in the elderly, the role of post-traumatic stress disorder in heart disease, the association between relationship status and mental health in adults with congenital heart disease, coping style in women with atrial fibrillation, and the benefits of psychosocial interventions for heart failure patients. The editorial concludes by emphasizing the importance of integrating psychosocial perspectives into cardiovascular care to improve outcomes and quality of life for patients. [Extracted from the article]

This document is an editorial from the journal "Brain Sciences" discussing the influence of stress on the nervous system and its impact on anxiety and affective disorders. The editorial highlights the prevalence of anxiety disorders and their effect on quality of life, particularly in young adults. It explores the interrelations between environmental stress factors, such as psychological and biological stressors, substance misuse, and their effects on brain structure and function. The editorial also discusses the shared clinical features and underlying mechanisms of anxiety and mood disorders, as well as the role of stress in modern society. It introduces a special issue that includes nine manuscripts covering various aspects of stress and its interactions with affective disorders. The manuscripts explore topics such as suicide risk assessment, immune regulatory mechanisms, genetic factors, diagnostic validity in psychiatry, and neuroimaging as a tool for treatment response monitoring. The editorial emphasizes the need for multidisciplinary perspectives in psychiatry and the importance of considering social and cultural influences in diagnostic frameworks. Overall, the articles in this special issue provide insights into the mechanisms and pathways of anxiety and affective disorders in relation to stress. [Extracted from the article]

Animal behavior is closely linked to the process of evolution of nervous tissues that move towards the cephalic region, promoting the creation of a central nervous system with greater proximity to the sense organs, providing an increasing increase in sensory and cognitive functionalities. The functional analysis of animal behavior establishes a relationship between a certain action and changes that occur in the surrounding environment or within the individual. Changes in these factors may occur incidents, where the veterinarian must have an understanding of all the factors involved in order to contribute to the solution of this triggered behavioral pathology.

Climate change poses serious threats to public health and is exacerbating health inequities. Policy changes are essential to mitigate climate change impacts on human and planetary health. The purpose was to describe recommendations by the Policy and Advocacy Subgroup of the Society of Behavioral Medicine (SBM) Climate Change, Behavior Change and Health Presidential Working Group (PWG). The Policy and Advocacy subgroup was comprised of experts in public health, climate policy, and health behavior change, who worked together to identify priorities and develop recommendations. We worked under the premise that building political will for climate policy action is the most urgent goal, and we recommended promotion of citizen advocacy for this purpose. Because citizen advocacy is a set of behaviors, SBM members can use behavioral science to identify and scale up interventions, working collaboratively with communities targeted for marginalization. Recommendations for SBM included establishing an organizational home for climate and health work, providing training and resources, engaging in climate advocacy as an organization, and networking with other organizations. Recommendations for a proposed SBM Climate and Health Committee, Council, or Special Interest Group included developing trainings and resources, seeking opportunities for networking and collaborations, and identifying a research agenda. Individual behavior changes are insufficient to address climate change; policy actions are needed. SBM and similar organizations can support their members to work in developing, evaluating, and scaling up advocacy interventions for action on climate policy to magnify the power of the health and medical sectors to protect planetary and human health.

Climate change is the greatest threat to global health in human history. It has been declared a public health emergency by the World Health Organization and leading researchers from academic institutions around the globe. Structural racism disproportionately exposes communities targeted for marginalization to the harmful consequences of climate change through greater risk of exposure and sensitivity to climate hazards and less adaptive capacity to the health threats of climate change. Given its interdisciplinary approach to integrating behavioral, psychosocial, and biomedical knowledge, the discipline of behavioral medicine is uniquely qualified to address the systemic causes of climate change-related health inequities and can offer a perspective that is currently missing from many climate and health equity efforts. In this article, we summarize relevant concepts, describe how climate change and structural racism intersect to exacerbate health inequities, and recommend six strategies with the greatest potential for addressing climate-related health inequities.

PURPOSE Patient outcomes can improve when primary care and behavioral health providers use a collaborative system of care, but integrating these services is difficult. We tested the effectiveness of a practice intervention for improving patient outcomes by enhancing integrated behavioral health (IBH) activities. METHODS We conducted a pragmatic, cluster randomized controlled trial. The intervention combined practice redesign, quality improvement coaching, provider and staff education, and collaborative learning. At baseline and 2 years, staff at 42 primary care practices completed the Practice Integration Profile (PIP) as a measure of IBH. Adult patients with multiple chronic medical and behavioral conditions completed the Patient-Reported Outcomes Measurement Information System (PROMIS-29) survey. Primary outcomes were the change in 8 PROMIS-29 domain scores. Secondary outcomes included change in level of integration. RESULTS Intervention assignment had no effect on change in outcomes reported by 2,426 patients who completed both baseline and 2-year surveys. Practices assigned to the intervention improved PIP workflow scores but not PIP total scores. Baseline PIP total score was significantly associated with patient-reported function, independent of intervention. Active practices that completed intervention workbooks (n = 13) improved patient-reported outcomes and practice integration (P = .05) compared with other active practices (n = 7). CONCLUSION Intervention assignment had no effect on change in patient outcomes; however, we did observe improved patient outcomes among practices that entered the study with greater IBH. We also observed more improvement of integration and patient outcomes among active practices that completed the intervention compared to active practices that did not. Additional research is needed to understand how implementation efforts to enhance IBH can best reach patients. [ABSTRACT FROM AUTHOR]

Background: Chronic insomnia is the most prevalent sleep disorder among military service members, and it compromises readiness, performance, and physical and mental health. Cognitive behavioral treatment for insomnia (CBTI) is the standard of care for the treatment of insomnia recommended by the VA/DoD Clinical Practice Guideline, the American Academy of Sleep Medicine, and the American College of Physicians. CBTI is highly effective but has limited scalability. It is often unavailable in clinical settings where service members receive sleep care. Digital technologies offer unique opportunities to scale and broaden the geographic reach of CBTI services and support increased patient access and engagement in behavioral sleep care. This study aims to evaluate the impact and acceptability of digital CBTI hubs to augment military treatment facilities' capabilities in behavioral sleep medicine. Methods: This is a multi-site, non-inferiority randomized clinical trial designed to compare the effects of in-person (face-to-face or virtual) insomnia care as usual at three military sleep clinics versus CBTI delivered remotely and asynchronously through digital CBTI hubs. Digital CBTI hubs are led by licensed, certified clinicians who use NOCTEM's® evidence-based clinical decision support platform COAST™ (Clinician Operated Assistive Sleep Technology). Changes in insomnia severity and daytime symptoms of depression and anxiety will be compared at baseline, at 6–8 weeks, and at 3-month follow-up. Patient satisfaction with insomnia care as usual versus digital CBTI hubs will also be examined. We hypothesize that digital CBTI hubs will be non-inferior to insomnia care as usual for improvements in insomnia and daytime symptoms as well as patient satisfaction with insomnia care. Discussion: Digital technology has a high potential to scale CBTI accessibility and delivery options required to meet the insomnia care needs of military service members. Digital CBTI hubs using COAST offer a novel approach to broaden service members' access to CBTI and to serve as an augmentation strategy for existing sleep services at military treatment facilities. The pragmatic approach leveraging technology in this trial has the potential to rapidly inform clinical practice within the Defense Health Agency as well as other healthcare systems. Trial registration: ClinicalTrials.gov NCT05490550. Registered on 14 July 2023. [ABSTRACT FROM AUTHOR]

Pediatric oncological pain (OP) is a common condition in children with cancer, resulting in postural changes in the head and spine, which significantly impact their quality of life. Osteosarcoma is the most prevalent type of pediatric tumor affecting head and spine districts. Its exact cause is still unknown, although it may be attributed to DNA mutations in bone cells, either inherited or acquired after birth; it often leads to bone and muscle pain and discomfort. This can initiate a harmful cycle, including mood disorders like anxiety and depression and maladaptive thoughts. Conducting a thorough functional assessment of children with OP is crucial, involving clinical and psychological evaluations and multidisciplinary rehabilitative approaches. A physical evaluation of the head and spine primarily focuses on assessing motor abilities through inspection of joint mobility, muscle strength, palpation, reflexes, and sensitivity. This narrative review considered randomized clinical trials, observational and cohort studies, and case reports; studies that did not meet inclusion criteria were excluded; 41 studies were selected for this review. A team of healthcare professionals, including orthodontists, physiat­rists, pediatricians, oncologists, and psychologists, collaboratively manage children with OP, aiming to minimize the physical and mental disability caused by OP. It is based on education, exercise therapy, and psychological approaches. Education should include proper ergonomic postural guidance for sitting and standing, pain education (neuroscience education), and management of mood disorders and maladaptive thoughts (cognitive-behavioral education). Exercise therapy should focus on active postural correction, including exercises to counteract forward head posture, hyperkyphosis, and sway­back; strengthening exercises for spinal deep muscles; segmental stretching involving limbs and back muscles; and functional exercises. Psychological therapy, particularly cognitive-behavioral therapy, involves cognitive restructuring, time-based activity pacing, relaxation techniques, and adaptive coping strategies. This review pro­vides a comprehensive overview of the clinical postural assessment of the head and spine, which is essential for planning effective multidisciplinary rehabilitative treatments.

ABSTRACT This study aims to analyze the effects of multimodal environmental modification (MEMO) of cats with recurrence of lower urinary tract signs (LUTS). Treatment of FLUTD included pharmacological treatment, dietary management, and multimodal environmental modification approaches. Twenty client-owned indoor-housed cats with recurrence of lower urinary tract signs had been covered in this observation. Diagnosis of lower urinary tract was made primarily based on the cat's clinical signs, results of laboratory parameters, urinalysis and ultrasonographic examination. Cats were divided into two groups as cefovecin (8 mg/kg sc, single time use) + meloxicam (0.1mg/kg q24h, 3 days) + dry food including l-tryptophan and milk protein hydrolysate to dissolve struvite stones (Group 1) and cefovecin + meloxicam + dry food including l-tryptophan and milk protein hydrolysate to dissolve struvite stones + multimodal environmental modification (Group 2). Clinical and urinary parameters are scored as 0, 1, 2, 3 or 4 points on initial, third, seventh days. Scores of clinical parameters were significantly different between (p

This article discusses the meditational processes in Vijnana Bhairava in the context of mental health. It explains that mental health, from a yogic perspective, encompasses a state of mind-intellect-ego complex and an inwardly tranquil state of being. Vijnana Bhairava is a school of yoga that focuses on achieving unity and absolute blissfulness. The article also mentions practical techniques in Vijnana Bhairava that aim to achieve universal consciousness and improve mental health. Additionally, it provides summaries of other studies that highlight the benefits of yoga in managing various health conditions. [Extracted from the article]

BACKGROUND: There is a need to identify factors outside of abnormal reflux that contribute to gastroesophageal reflux disease (GERD). Esophageal hypervigilance is a psychological process impacting symptom experience in esophageal disease. However, little is known about the presence of hypervigilance in GERD phenotypes, especially in those with abnormal acid exposure or symptom index scores. The primary aim was to assess differences in self-reported esophageal hypervigilance across different GERD presentations. The secondary aim was to evaluate esophageal hypervigilance as a predictor of symptom severity. METHODS: We conducted retrospective data analyses on a cohort of adult patients with reflux symptoms that underwent 96-hour wireless pH monitoring from 9/2015 to 9/2017. Patients were stratified into groups based on the number of days they exhibited positive acid exposure time (AET; 0 days, 1-2 days, 3+ days), and symptom index scores (SI; 0 days, 1-day, 2+ days). Esophageal hypervigilance and anxiety, and symptom frequency and severity were assessed between groups. KEY RESULTS: A total of 123 AET cases and 116 SI cases were included for analysis. Esophageal hypervigilance and anxiety scores did not significantly differ based on the number of days of positive AET (p = 0.311) or SI (p = 0.118). Symptom severity and perceived symptom frequency differed between groups. Hypervigilance significantly predicted symptom severity, when controlling for symptom-specific anxiety. CONCLUSIONS: Esophageal hypervigilance is persistent across patients with reflux, irrespective of acid burden and symptom index, and significantly predicts symptom severity. Hypervigilance should be considered as an independent factor contributing to esophageal symptom perception.

Interest and incentives are increasing around strategies whereby the health care sector can better identify and address patients' social and economic needs in the context of primary care delivery. This interest is likely to accelerate during the economic recession following the OVID-19 pandemic. Yet effective and sustainable strategies for integrating social care practices (eg, patient-facing social risk screening and activities to address identified needs) have not been clearly established. Lessons learned from more than 2 decades of research on behavioral health integration could be applied to efforts to integrate social care into primary care. In this article, we synthesize learnings from primary care and behavioral health care integration, and translate them into organizing principles with the goal of advancing social care integration practices to improve the health of both patients and communities.

Abstract Background Terror management theory (TMT) posits that people manage death-related anxiety through the meaning provided by their cultural world-views and the sense of personal value provided by self-esteem. While a large body of research has supported the core propositions of TMT, little research has focused on its application to individuals with terminal illness. If TMT can help healthcare providers better understand how belief systems adapt and change in life-threatening illness, and the role they play in managing death-related anxiety, it may provide guidance on how to improve communication around treatments near the end of life. As such, we set out to review the available research articles that focus on describing the relationship between TMT and life-threatening illness. Methods We reviewed PubMed, PsycINFO, Google Scholar, and EMBASE through May 2022 for original research articles focused on TMT and life-threatening illness. Articles were only deemed appropriate for inclusion if direct incorporation of the principles of TMT were made in reference to a population of interest whom had life-threatening illness Results were screened by title and abstract, followed by full review of candidate articles. References were also scanned. Articles were assessed qualitatively. Results Six relevant and original research articles were published which provide varied levels of support for TMT’s application in critical illness, each article detailed evidence of ideological changes consistent with what TMT would predict. Building self-esteem, enhancing the experience of life as meaningful, incorporating spirituality, engaging family members, and caring for patients at home where meaning and self-esteem can be better maintained are strategies supported by the studies and serve as starting points for further research. Conclusion These articles suggest that applying TMT to life-threatening illness can help identify psychological changes that may effectively minimize the distress from dying. Limitations of this study include a heterogenous group of relevant studies and qualitative assessment.

Biomarkers, ranging from molecules to behavior, can be used to identify thresholds beyond which performance of mission tasks may be compromised and could potentially trigger the activation of countermeasures. Identification of homologous brain regions and/or neural circuits related to operational performance may allow for translational studies between species. Three discussion groups were directed to use operationally relevant performance tasks as a driver when identifying biomarkers and brain regions or circuits for selected constructs. Here we summarize small-group discussions in tables of circuits and biomarkers categorized by (a) sensorimotor, (b) behavioral medicine and (c) integrated approaches (e.g., physiological responses). In total, hundreds of biomarkers have been identified and are summarized herein by the respective group leads. We hope the meeting proceedings become a rich resource for NASA's Human Research Program (HRP) and the community of researchers. [ABSTRACT FROM AUTHOR]

Evaluation of the effectiveness of integration of depression and alcohol use disorder care into primary health care in low- and middle-income countries (LMICs) is limited. The authors aimed to quantify the effectiveness of integrating mental health care into primary care by examining depression and alcohol use disorder outcomes. The study updates a previous systematic review summarizing research on care integration in LMICs. Following PRISMA guidelines, the authors included studies from the previous review and studies published from 2017 to 2020 that included adults with alcohol use disorder or depression. Studies were evaluated for type of integration model with the typology developed previously. A meta-analysis using a random-effects model to assess effectiveness of integrated interventions was conducted. Meta-regression analyses to examine the impact of study characteristics on depression and alcohol use disorder outcomes were conducted. In total, 49 new articles were identified, and 74 articles from the previous and current studies met inclusion criteria for the meta-analysis. Overall random effect sizes were 0.28 (95% CI=0.22–0.35) and 0.17 (95% CI=0.11–0.24) for studies targeting care integration for depression or for alcohol use disorder, respectively, into primary care in LMICs. High heterogeneity within and among studies was observed. No significant association was found between country income level and depression and alcohol use outcomes. However, differences in effect sizes between types of integration model were statistically significant (p<0.001). Integration of mental health care into primary health care in LMICs was found to improve depression and alcohol use disorder outcomes. This evidence should be considered when designing interventions to improve mental health screening and treatment in LMICs. [ABSTRACT FROM AUTHOR]

Activity recognition using data collected with smart devices such as mobile and wearable sensors has become a critical component of many emerging applications ranging from behavioral medicine to gaming. However, an unprecedented increase in the diversity of smart devices in the internet-of-things era has limited the adoption of activity recognition models for use across different devices. This lack of cross-domain adaptation is particularly notable across sensors of different modalities where the mapping of the sensor data in the traditional feature level is highly challenging. To address this challenge, we propose ActiLabel, a combinatorial framework that learns structural similarities among the events that occur in a target domain and those of a source domain and identifies an optimal mapping between the two domains at their structural level. The structural similarities are captured through a graph model, referred to as the dependency graph, which abstracts details of activity patterns in low-level signal and feature space. The activity labels are then autonomously learned in the target domain by finding an optimal tiered mapping between the dependency graphs. We carry out an extensive set of experiments on three large datasets collected with wearable sensors involving human subjects. The results demonstrate the superiority of ActiLabel over state-of-the-art transfer learning and deep learning methods. In particular, ActiLabel outperforms such algorithms by average F1-scores of 36.3 % , 32.7 % , and 9.1 % for cross-modality, cross-location, and cross-subject activity recognition, respectively. [ABSTRACT FROM AUTHOR]

Background: The number of preliminary studies conducted and published has increased in recent years. However, there are likely many preliminary studies that go unpublished because preliminary studies are typically small and may not be perceived as methodologically rigorous. The extent of publication bias within preliminary studies is unknown but can prove useful to determine whether preliminary studies appearing in peer-reviewed journals are fundamentally different than those that are unpublished. The purpose of this study was to identify characteristics associated with publication in a sample of abstracts of preliminary studies of behavioral interventions presented at conferences. Methods: Abstract supplements from two primary outlets for behavioral intervention research (Society of Behavioral Medicine and International Society of Behavioral Nutrition and Physical Activity) were searched to identify all abstracts reporting findings of behavioral interventions from preliminary studies. Study characteristics were extracted from the abstracts including year presented, sample size, design, and statistical significance. To determine if abstracts had a matching peer-reviewed publication, a search of authors' curriculum vitae and research databases was conducted. Iterative logistic regression models were used to estimate odds of abstract publication. Authors with unpublished preliminary studies were surveyed to identify reasons for nonpublication. Results: Across conferences, a total of 18,961 abstracts were presented. Of these, 791 were preliminary behavioral interventions, of which 49% (388) were published in a peer-reviewed journal. For models with main effects only, preliminary studies with sample sizes greater than n = 24 were more likely to be published (range of odds ratios, 1.82 to 2.01). For models including interactions among study characteristics, no significant associations were found. Authors of unpublished preliminary studies indicated small sample sizes and being underpowered to detect effects as barriers to attempting publication. Conclusions: Half of preliminary studies presented at conferences go unpublished, but published preliminary studies appearing in peer-reviewed literature are not systematically different from those that remain unpublished. Without publication, it is difficult to assess the quality of information regarding the early-stage development of interventions. This inaccessibility inhibits our ability to learn from the progression of preliminary studies. [ABSTRACT FROM AUTHOR]

ObjectiveProviding behavioral health interventions via smartphones allows these interventions to be adapted to the changing behavior, preferences, and needs of individuals. This can be achieved through reinforcement learning (RL), a sub-area of machine learning. However, many challenges could affect the effectiveness of these algorithms in the real world. We provide guidelines for decision-making.Materials and methodsUsing thematic analysis, we describe challenges, considerations, and solutions for algorithm design decisions in a collaboration between health services researchers, clinicians, and data scientists. We use the design process of an RL algorithm for a mobile health study "DIAMANTE" for increasing physical activity in underserved patients with diabetes and depression. Over the 1.5-year project, we kept track of the research process using collaborative cloud Google Documents, Whatsapp messenger, and video teleconferencing. We discussed, categorized, and coded critical challenges. We grouped challenges to create thematic topic process domains.ResultsNine challenges emerged, which we divided into 3 major themes: 1. Choosing the model for decision-making, including appropriate contextual and reward variables; 2. Data handling/collection, such as how to deal with missing or incorrect data in real-time; 3. Weighing the algorithm performance vs effectiveness/implementation in real-world settings.ConclusionThe creation of effective behavioral health interventions does not depend only on final algorithm performance. Many decisions in the real world are necessary to formulate the design of problem parameters to which an algorithm is applied. Researchers must document and evaulate these considerations and decisions before and during the intervention period, to increase transparency, accountability, and reproducibility.Trial registrationclinicaltrials.gov, NCT03490253.

Translational sleep science has become a critical and fundamental focus in the field of behavioral medicine. This is the second issue in the special series of the International Journal of Behavioral Medicine focused on the physiological, psychological, social, and environmental concomitants of sleep and human health. The articles included in this issue draw further attention to the range and significance of sleep as a marker of health status and as a target of behavioral intervention. The research included in this series highlights the pervasive manner in which sleep health is intrinsically connected to health risk, behavior, and outcomes. The next decade promises to further behavioral medicine approaches to improving the provision of care and the overall public health through the implementation of translational sleep science research.

Personality traits are important predictors of health behaviors, healthcare utilization, and health outcomes. However, we know little about the role of personality traits for emergency department outcomes. The present study used data from 200 patients (effective Ns range from 84 to 191), who were being discharged from the emergency department at an urban hospital, to investigate whether the Big Five personality traits were associated with post-discharge outcomes (i.e., filling prescriptions, following up with primary care physician, making an unscheduled return to the emergency department). Using logistic regression, we found few associations among the broad Big Five domains and post-discharge outcomes. However, results showed statistically significant associations between specific Big Five items (e.g., responsible) and the three post-discharge outcomes. This study demonstrates the feasibility of assessing personality traits in an emergency medicine setting and highlights the utility of having information about patients personality tendencies for predicting post-discharge compliance.

Health Psychology has received numerous papers over the past several months on topics related to the COVID-19 pandemic. Many of them concern depression, anxiety, stress, or other forms of distress in the general population or in health care workers. We have received far fewer papers on COVID-related health behaviors and health communications-factors that have played central roles in the spread of the pandemic and that are major topics in health psychology. Our experience is consistent with the published scientific literature on the pandemic. A Medline search that we conducted in late September yielded over 23,000 English-language articles pertaining to COVID-19. Over 1,400 of them concerned topics that are within the scope of Health Psychology. As shown in Table 1, COVID-related mental disorders comprised the largest category. Many other studies concerned other forms of stress or emotional distress. At least 248 articles addressed the profound ethnic and racial disparities in COVID-19 infection and death rates and in access to health care that are accentuating longstanding health inequities; 22 (9%) of these articles addressed behavioral or psychosocial aspects of COVID-19 health disparities. Thus, the literature on the behavioral and psychosocial aspects of the pandemic has been dominated, so far at least, by research on stress or distress. Fewer reports have been published so far on critical COVID-related health behaviors, health communication, or health disparities. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Background: Terror management theory (TMT) posits that people manage death-related anxiety through the meaning provided by their cultural world-views and the sense of personal value provided by self-esteem. While a large body of research has supported the core propositions of TMT, little research has focused on its application to individuals with terminal illness. If TMT can help healthcare providers better understand how belief systems adapt and change in life-threatening illness, and the role they play in managing death-related anxiety, it may provide guidance on how to improve communication around treatments near the end of life. As such, we set out to review the available research articles that focus on describing the relationship between TMT and life-threatening illness. Methods: We reviewed PubMed, PsycINFO, Google Scholar, and EMBASE through May 2022 for original research articles focused on TMT and life-threatening illness. Articles were only deemed appropriate for inclusion if direct incorporation of the principles of TMT were made in reference to a population of interest whom had life-threatening illness Results were screened by title and abstract, followed by full review of candidate articles. References were also scanned. Articles were assessed qualitatively. Results: Six relevant and original research articles were published which provide varied levels of support for TMT's application in critical illness, each article detailed evidence of ideological changes consistent with what TMT would predict. Building self-esteem, enhancing the experience of life as meaningful, incorporating spirituality, engaging family members, and caring for patients at home where meaning and self-esteem can be better maintained are strategies supported by the studies and serve as starting points for further research. Conclusion: These articles suggest that applying TMT to life-threatening illness can help identify psychological changes that may effectively minimize the distress from dying. Limitations of this study include a heterogenous group of relevant studies and qualitative assessment. [ABSTRACT FROM AUTHOR]

Behavioral medicine research from across the globe has been catalyzed by the quest to understand the interactions between psychological, social, and physiological factors underlying disparities in human health. A more complete biopsychosocial model increasingly integrates advanced clinical and laboratory assessments of relevant environmental chemicals, biological mediators of inflammation, cardiometabolic and endocrine markers, infectious disease exposure, and genetic polymorphisms determined from saliva specimens. The overarching aims are to identify mechanisms, decode moderating processes that translate adversity into risk, and verify the impact of clinical intervention. This special issue of the International Journal of Behavioral Medicine highlights novel contributions of salivary bioscience with emphasis on research utilizing varied research designs (i.e., experimental, longitudinal, dyadic), incorporating a broad array of salivary analytes, and investigating the influence of psychological and social factors on human health.