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Around 42% of individuals with cancer experience distress. Acceptance and commitment therapy (ACT) can reduce distress, but effects are small, and mechanisms unclear. This review aimed to identify associations between ACT processes and distress in cancer. Search terms included cancer, ACT processes, self-compassion, and distress. Six online databases and grey literature were searched until March 2022. Of 6555 papers screened, 108 studies were included with 17,195 participants. Five meta-analyses of 77 studies were conducted. Random effects meta-analyses of correlations revealed higher scores on flexible processes (acceptance, present moment awareness, self-compassion) were associated with lower distress (rpooled = -0.24, -0.39, -0.48, respectively); whilst higher scores on inflexible processes (experiential avoidance, cognitive fusion) were associated with higher distress (rpooled = 0.58, 0.57, respectively). Meta-analyses displayed moderate-to-high heterogeneity with most studies assessed as low risk of bias. Meta-regressions revealed no significant moderators (stage, time since diagnosis, gender and age). This review provides a theoretically aligned evidence base for associations between ACT processes and distress in cancer, supporting elements of ACT theory and providing targeted directions for intervention development. Due to limited evidence, future research should focus on self-as-context, values and committed action and conduct mediation analysis in controlled trials of ACT processes on distress in cancer. [ABSTRACT FROM AUTHOR]

Background: Psychological distress can cause burnout, which affects mental and physical well‐being. It is important to identify factors associated with psychological distress and physical discomfort and how nurses deal with these problems. Aim: The aim was to investigate distress, burnout and coping among community nurses (CN) and hospital nurses (HN). Approach and Methods: In this cross‐sectional study, 409 nurses completed three questionnaires: Perceived Stress Scale (PSS), Copenhagen Burnout Inventory (CBI) and Ways of Coping (WOC). Findings: Participants younger than 40 demonstrated significantly more distress and burnout than those older than 40 years. Participants who had moderate and high distress on the PSS were significantly more at risk for experiencing personal, work‐related and patient‐related burnout. A significant positive correlation was found between distress and behavioural escape‐avoidance, cognitive escape‐avoidance and distancing. Significant positive correlations were also seen between all the subscales of the CBI and behavioural escape‐avoidance, cognitive escape‐avoidance and distancing. Positive significant correlation was also obtained between staff resources and distress and personal‐related and work‐related burnout. Negative correlation was demonstrated between staff resources and patient‐related burnout. Participants with longer work experience were less likely to report moderate or high distress, and those who scored higher on personal burnout and behavioural escape‐avoidance were more likely to have moderate or high distress. Conclusion: The results of this study call for increased attention to the younger generation in the nursing profession. The results also validate the need to investigate further the correlation between distress, burnout and coping and how these issues might influence each other among nurses working in the community and hospitals. Findings should be taken with precaution, they do not describe in detail what underlying factors contribute to distress and discomfort found in this study, they do, however, indicate certain coping strategies nurses use to deal with distress and burnout. [ABSTRACT FROM AUTHOR]

Potholes are a significant hazard, causing severe damage to vehicles and potentially leading to fatal accidents. The automatic detection of potholes is crucial for timely maintenance and reducing these risks. This research evaluates the performance of three pre-trained Convolutional Neural Network models—ResNet 50, ResNet 18, and MobileNet—in classifying pavement images. Initially, the models distinguish between images containing potholes and those without (Potholes vs. Normal). Subsequently, they categorize pavement images into three classes: Small Pothole, Large Pothole, and Normal. Pavement images were captured from two different heights: 3.5 feet (waist height) and 2 feet. Among the models, MobileNet v2 demonstrated the highest accuracy of 98% for detecting potholes. For images taken at 2 feet, the classification accuracies for large potholes, small potholes, and normal pavement were 87.33%, 88.67%, and 92%, respectively. For images taken from waist height, the accuracies increased to 98.67%, 98.67%, and 100%, respectively. The study highlights the potential of these models in enhancing road safety through reliable and automated pothole detection, providing valuable insights for infrastructure maintenance. Article Highlights: Potholes are dangerous and can cause serious vehicle damage. Train CNN models for the classification of potholes These CNNs, for different sizes of potholes can be used for the rehabilitation of potholes. Among all CNN modes, MobileNet v2 achieves 98% accuracy in detecting the presence of a pothole. [ABSTRACT FROM AUTHOR]

The current research evaluates the Perfectionism Social Disconnection Model (PSDM) by considering the links between measures of trait perfectionism and perfectionistic self-presentation and measures of social support, loneliness, and distress in cross-sectional research. A particular focus is on perfectionism and levels of social support as assessed by the Social Provisions Scale. The current study also uniquely evaluates levels of perfectionism and perfectionistic self-presentation in undergraduate students, medical students, and law students. The results across samples provided evidence that loneliness mediates the link between interpersonal perfectionism and distress in keeping with the predictions of the PSDM. Correlational results found robust links between loneliness and low levels of social support. Moreover, socially prescribed perfectionism and perfectionistic self-presentation were associated negatively with social support, and this was especially evident in terms of the facet tapping the nondisclosure of imperfections. Group comparisons of perfectionism yielded few significant differences in accordance with expectations. Levels of perfectionism tended to be lower among medical students. However, the links between perfectionism and distress were clearly evident among undergraduates, medical students, and law students, thus attesting to the vulnerability of perfectionistic students in general. Overall, the results further confirm the relevance of perfectionism in distress among students and applicability of the PSDM in various types of students. [ABSTRACT FROM AUTHOR]

This study introduces an integrated approach to enhance county pavement management, emphasising operational efficiency in determining the Remaining Service Interval (RSI) for rigid and flexible pavements. It establishes a robust methodology for systematically processing raw county road data through dynamic segmentation and summarisation to create a structured pavement database. It also incorporates innovative approaches and input configurations in employing Artificial Neural Networks (ANNs) to predict current and future county pavement performance indicators, including International Roughness Index (IRI), rutting, transverse, and longitudinal cracks, even with limited data. Evaluation of the ANN models on independent county road databases exhibited high prediction accuracies (0.86 < R2 < 0.99), varying with specific performance indicators. The study results in an automation tool for expediting road performance estimation over multiple years. This tool seamlessly integrates the ANN models, empowering county engineers to make data-driven decisions and optimise resource allocation for effective pavement management, achieving significant cost savings. [ABSTRACT FROM AUTHOR]

Background: Patients with head and neck cancer (HNC) often demonstrate stress, distress, anxiety, depression, and are at risk for suicide. These affect their quality of life (QoL) but less attention has been given to psychological variables that may impact response to treatment. Objectives: This study aims to systematically review publications during 2013–2023 to collate evidence on the effects of psychological variables on HNC treatment outcomes. Methods: We searched Ovid Medline, PubMed, Scopus, and Web of Science for articles that examined psychological factors related to treatment outcomes in patients with HNC. Results: There were 29 studies (5 before treatment, 2 during, 17 after, and 5 covering the whole management trajectory) including 362,766 patients. The psychological factors were either behavioral (adjustment and coping strategy, unrealistic ideas, self-blame), cognitive (elevated risk of psychiatric co-comorbidity), or emotional (distress, depression, anxiety, nervousness, and fear of disfigurement and complications). It was found that there was a relationship between depression and decreased survival in patients with HNC. Pretreatment pain was an independent predictor of decreased survival in a large sample of patients. The distress level was approximately 54%, emotional problems ranged between 10 and 44%, while financial difficulties were identified in 54% of the patients. Sixty-nine percent of patients were reported to have used at least one cost-coping strategy within 6 months after treatment initiation. During post-treatment period, depression increased from 15% at the baseline to 29%, while the fear of recurrence was found among at least 35% of patients. Discussion and Conclusion: Several psychological factors predict QoL and survival among HNC survivors. Distress encompasses depression and anxiety, and physical burden from HNC diagnosis and treatment. Routine screening and early interventions that target distress could improve HNC survivors' QoL. A systematic and standardized measurement approach for QoL is warranted to homogenize these findings and to understand the underlying relationships. [ABSTRACT FROM AUTHOR]

Three years after the SARS-CoV-19 pandemic, a chronic post-COVID syndrome "LONG COVID" persists, causing fatigue and shortness of breath, along with distress, anxiety, and depression. Aim: To assess the impact of physical activity on the management and rehabilitation of LONG COVID, as well as to investigate the persistence of LONG COVID symptomatology in individuals over 40 years, beyond the pandemic. Methods: A total of 1004 participants (aged 53.45 ± 11.35) were recruited through an online snowball sampling strategy to complete a web-based survey. The following questionnaires were administered: Physical Activity Scale for Elderly (PASE), Shortness of Breath Questionnaire (SOBQ), Patient Health Questionnaire-9 item (PHQ-9), Generalized Anxiety Disorder 7-item (GAD-7), and Fatigue Scale for Motor and Cognitive Functions (FSMC). Results: Significant gender differences were discovered, with women reporting higher symptoms than men (p < 0.001). Significant age differences were also found, with participants under 55 showing higher values than those over 55 (p < 0.001). No significant differences were found between aerobic and mixed physical activity (p > 0.05) while significant results emerged between physical activity groups and the no activity group (p < 0.001). The low-frequency group reported higher symptoms than the high-frequency group (all ps < 0.001). Conclusion: Regardless of the type of physical activity performed, our survey identified the frequency of training as a crucial factor to overcome LONG COVID symptoms; the challenge lies in overcoming the difficulties due to the persistent feelings of inefficiency and fatigue typical of those who have contracted the infection. [ABSTRACT FROM AUTHOR]

Abstract Background Previous studies had found the effects of stress on eating behaviors. The aim of this study was to explore the effects of perceived stress on dietary quality by sexes in Chinese adults. Methods The study population consisted of individuals aged 18 to 59 years participating in the China Health and Nutrition Survey. Perceived stress levels were measured using the 10-item Perceived Stress Scale (PSS-10), with scores ranging from 0 to 40. Dietary quality was evaluated by Chinese Dietary Guidelines Index (CDGI) ranging 0-110. Using a two-level mixed effects model with community as level 2 and individual as level 1, the study analyzed the impact of PSS-10 scores on CDGI. Additionally, a two-level mixed effects structural equation model was employed to explore the effects of distress factor scores and coping stressor factor scores on dietary quality among different sexes within the population. Results This study involved in 2515 males and 3165 females, and the average age was 45.9 ± 9.6.The PSS-10 score and CDGI were 14.6 ± 5.1 and 44.8 ± 11.6, separately. After adjusting for confounders, there were no effects of PSS-10 score, distress factor score, and coping stressors factor score on CDGI in males. After adjusting for confounders, CDGI in the highest tertile of PSS-10 score group was 1.64 lower than that in the lowest tertile group in females(P = 0.001). The distress factor score was not associated with CDGI (standardized β=-0.164, P = 0.488), while the coping with stressors factor score was significantly negative with CDGI (standardized β=-0.834, P

Abstract Mast cells are commonly found in pancreatic ductal adenocarcinoma (PDAC), yet their role in the disease remains uncertain. Although mast cells have been associated with depression in several diseases, their connection to PDAC in this context remains unclear. This study explored the correlation between mast cells and psychosocial stress in patients with PDAC. Prior to surgery, 40 patients with PDAC (n = 29 primary resected, n = 11 neoadjuvant treated) completed four questionnaires assessing stress and quality of life. Immunostaining was performed on the resected tumor tissue. Spearman analysis was employed to correlate mast cells with distress and neuropeptides serotonin and beta-endorphin serum and tissue levels. Patients with PDAC exhibited elevated levels of distress and worry. Lower number of mast cells within the tumor correlated with greater psychological burden. Among primary resected patients, mast cell count moderately correlated with joy and inversely with worries. Following neoadjuvant chemotherapy, strong inverse correlation was observed between anxiety, depression, and mast cell quantity. No correlation was found between mast cells and serotonin or beta-endorphin levels. In summary, mast cell presence inversely correlates with psychosocial stress, suggesting a link between immune cells and psychological well-being in pancreatic cancer. Targeting mast cells might offer therapeutic avenues for addressing cancer-induced depression and anxiety.

Background. Diabetes-related distress (DRD) is a psychological syndrome with worsened prognosis in uncontrolled diabetic patients. Risk of DRD progression is increased with uncontrolled diabetes, development of complications, concomitant medical conditions, and complicated treatment regimens. In addition to the di­sease burden, there are other factors that increase the risk of DRD such as lower level of education, younger age, se­dentary lifestyle, unhealthy diet, and poor self-care behavior. The current study purposed to assess the factors contributing to DRD among the Ukrainian population using the Diabetes Distress Scale (DDS-17) score and its sub-scores. Materials and methods. A cross-sectional analysis was conducted between January and June 2024 enrolling 125 diabetic patients from five Ukrainian regions. The survey included two parts: the first section gathe­red sociodemographic data and the second one focused on assessing the DDS-17 score. Results. Participants aged 46 years old and above had higher emotional distress compared to younger patients. Those with a primary educational level showed significantly higher emotional distress than those with a secondary level of education. Participants who were treated with both insulin and non-insulin medications or had a diastolic blood pressure of more than 90 mm Hg showed significant moderate to high distress. Participants who lived in rural areas showed higher distress. Obese and overweight people had significant moderate to high distress. The association between medical history with total distress showed that participants with glycated hemoglobin (HbA1c) of more than 8.0 followed by those who had HbA1c between 7.1 and 8.0 showed moderate to high total distress. Conclusions. It is concluded that the prevalence of DRD is high in Ukraine, more common among rural residents, and among participants with high HbA1c, low educational level and those on complex treatment regimens. Screening for DRD and providing better support can optimize clinical outcomes.

The purpose of this study was to identify the correlates of depressive symptoms and the prevalence of depression, distress, and demoralization among patients with cancer in Taiwan in relation to their sociodemographics. A cross-sectional study design with convenience sampling was used to recruit 191 consecutive patients with cancer from the Cancer Center of a teaching hospital in northern Taiwan. Multiple linear regression was applied to analyze the determinants of depressive symptoms. The prevalence rates of depression (including suspected cases), distress, and demoralization were 17.8%, 36.1%, and 32.5%, respectively. The regression model explained 42.2% of the total variance, with significant predictors including marital status, life dependence, comorbidity, demoralization, and distress. The results demonstrated that higher levels of distress and demoralization were associated with more depressive symptoms. Demoralization and distress played vital roles in moderating depressive symptoms among patients with cancer. Nursing interventions should integrate appropriate mental health services, such as alleviating distress and demoralization, to prevent the occurrence of depression in patients with cancer.

Background: Different clinical manifestations were revealed by the distinct waves of the coronavirus. The pandemic had a multifaceted impact on mental health, sleep patterns, and associated fear. MATERIALS AND METHODS: It was an observational online survey using by using Google Forms in the city of Chandigarh between April 2020 and April 2021 across three waves of the coronavirus outbreak (first wave from March 2020 to May 2020, second wave from June 2020 to January 2021, and third wave from February 2021 to April 2021). Fear of coronavirus disease (COVID), preventive behaviors, insomnia-related problems, and impact of the event were assessed by using standardized scales. Results: The participants who were infected during the first phase exhibited significantly higher levels of distress, loss of control over their reactions, increased fear of coronavirus and sleep problems, and also greater adherence to preventive behaviors compared to those who were infected during the second and third waves. A tendency to emerge post-traumatic stress disorder (PTSD) was seen in 68 (58.1%) of the participants (Peritraumatic Distress Inventory (PDI) score >14) and 34 (29.1%) of all the participants (PDI score >23). Overall, 66 (56.4%) participants reported having insomnia. About 24 people (20.5%) had clinical concerns about PTSD, 20 people (17.1%) had probable PTSD diagnoses, and 16 people (13.7%) experienced a severe coronavirus disease 2019 (COVID-19) pandemic impact on their lives. Conclusion: The first wave of COVID-19 had a greater psychological impact than subsequent waves. Further research must fill important gaps in our knowledge of the clinical range and long-term effects.

Introduction: Lockdown during the initial wave of the COVID-19 pandemic and isolation were discovered to have a negative psychological influence on the general population’s mental health and wellbeing. Aim: This study aims to Trace and compares the impact of the COVID-19 pandemic on mental health in terms of psychological well-being (PWB), distress and family functioning during the first and second wave. Materials and Methods: A convenient purposive sampling method was used to conduct an online survey during the first COVID wave (May 2020–July 2020) in India, and the same demographic group was re-contacted (March 2021–May 2021) during the second wave. The institute ethical committee was consulted in advance for approval, and participants’ digital consent was obtained. The first and second waves of the COVID-19 epidemic in India were evaluated using the PWB scale, the depression anxiety stress scale 21, and the brief family relationship scale. Results: Among all individuals, there was a 25.4%, 39.3%, and 30% prevalence of stress, anxiety, and depression, respectively in our study. Participant’s well-being and family relationships were negatively impacted by anxiety and depression. Older participants reported more favorable relationships and higher levels of well-being than younger participants did. Women scored significantly lower on psychological well-being measures and much higher on stress, anxiety, and depression measures than men. Conclusion: The first wave, which has contributed to a significant increase in psychiatric morbidity, affected the general population at a moderate intensity. The present study’s findings may be useful for developing policies, intervention programs, and offering psychosocial help to the community.

Moral injury is a psychological wound resulting from deep-rooted traumatic experiences that corrode an individual’s sense of humanity, ethical compass, and internal value system. Whether through witnessing a tragic event, inflicting injury on others, or failing to prevent a traumatic injury upon others, moral injury can have severe and detrimental psychological and psychosomatic outcomes that may last a lifetime. Post-traumatic experiences do not have to be a permanent affliction, however. From moral injury can come post-traumatic growth—the recovery from trauma in which personal betterment overshadows moral injury. Moral injury may lead to substantial personal growth, improved capacity and resilience. Based on these observations, it seems that from struggles and darkness, there can be positivity and hope. This review will summarize the current concepts of post-traumatic growth and consider potential mechanisms leading to resilience and recovery through post-traumatic growth. These considerations are gaining more importance in light of a growing number of existential threats, such as violent conflicts, natural disasters and global pandemics.

Abstract Breast cancer impacts the psychological well-being of women, leaving them at risk of developing depression, anxiety, and other stress-related disorders. The Depression Anxiety Stress Scales (DASS-21) is a widely used measure, although empirical evidence regarding its psychometric properties in the breast cancer population is limited. The purpose of this study was to conduct an exhaustive analysis of the psychometric properties of the DASS-21 in a sample of Spanish women diagnosed with breast cancer. Participants were 289 breast cancer patients who completed the DASS-21 and other questionnaires measuring life satisfaction, positive and negative affect, flourishing, perceived stress, and breast cancer-specific stressors. In terms of validity evidence based on the internal structure of the DASS-21, adequate fit indices were obtained for the model based on three first-order factors (depression, anxiety, stress) and one second-order factor (general psychological distress). Reliability coefficients (McDonald’s omega) ranged from .84 to .95. Validity evidence based on relationships with other variables was also provided by moderate and strong correlations with well-being indicators and stress measures. The results support the use of the DASS-21 for measuring general psychological distress in the breast cancer context, where it may provide useful information for the design of psychological interventions with patients.

Aims: Diabetes distress (DD) refers to the emotional and behavioural challenges associated with managing this demanding chronic disease over time. DD is alarmingly common and it has a significant impact on self‐management behaviours and clinical outcomes. Thus, there is growing recognition that DD is a pressing problem that deserves careful attention in clinical care. Translating the application of validated DD assessment and intervention protocols from the research to the clinical setting, however, presents challenges that require a reconsideration of some common assumptions about what DD is, how prevalent it is, how it presents itself clinically, how it might best be assessed and by whom. Methods: We employed data from six large‐scale studies using five common DD measures. Using these data, we review and challenge several common assumptions about DD. Results: These data suggest that, because of its relative ubiquity, DD should not be viewed as a 'co‐morbidity' or 'complication' of diabetes and it should not be seen as a mental health/illness 'condition'. Furthermore, we argue that DD assessment should: (1) be accepted as a standard part of comprehensive diabetes care, (2) occur regularly using broad rather than brief screening measures and (3) be addressed directly by diabetes clinicians, rather than exclusively by behavioural specialists. Conclusions: The results form the basis of a series of suggestions to enhance the translation, adoption and implementation of DD knowledge derived from the research setting directly into the real world of clinical care. [ABSTRACT FROM AUTHOR]

Children with negative procedural experiences have an increased risk of fear and distress, with psychological consequences for subsequent procedures and future healthcare behaviors. Gaining control and feeling trust are important aspects for children to decrease fear. To enable professionals providing personal care during medical procedures, a systematic, evidence-based approach that supports children in expressing their preferences is needed. This study will gain insight into the experiences and needs of professionals involved in small invasive medical procedures to meet the coping strategies and preferences of children undergoing these procedures. A qualitative design was used to gain insight into professionals' perspectives. Data were collected through online focus groups with various professionals involved in medical procedures, such as anesthetists, laboratory staff, nurses, and pediatricians. Five interdisciplinary focus groups, with a total of 32 participants, were held. One overarching theme was revealed: "Balancing between different actors within the context of the hospital." Professionals reported they had to deal with different actors during a medical procedure: the child, the parent, the colleague, and themselves. Each actor had its own interests. They were aware of the child and parents' priority to gain control and feel trust. Nevertheless, they perceive organizational and personal aspects that hinder addressing these needs. Conclusion: To provide personalized care, professionals experience balancing between the needs and interests of diverse actors during medical procedures. The findings underscore the importance of a policy supporting HCPs in integrating patient-centered care into practice through practical tools and training initiatives such as scenario training. What is Known: • Unresolved pain and stress arising from medical procedures can have significant short- and long-term impacts on children. Empowering children to gain control and fostering a sense of trust are crucial factors in reducing fear associated with medical procedures. • Children and parents expect to receive child-tailored care from professionals including respect for their own, unique needs, and boundaries. Professionals should build trustful relationships and provide appropriately tailored autonomy around medical procedures. What is New: • Healthcare professionals vary in their awareness of children's needs during a medical procedure. Beside this, the organizational dynamics of the hospital, along with the presence of actors such as the child, parent, colleague, and oneself, collectively influence the conduct of medical procedures. • Providing person-centered care during medical procedures can present challenges. The results highlight the significance of a policy to assist healthcare professionals in incorporating patient-centered care into their practice through practical tools and a culture of self-reflections regarding patient-centered values. [ABSTRACT FROM AUTHOR]

This paper examines the relationship between market participants' sentiment regarding distress in the real estate market, captured through internet search queries, and the U.S. commercial real estate market. We use Google search frequency to construct a measure of market perception of distress, the Market Distress Perception Index (MDP Index), and determine the extent to which this index can help predict future private commercial real estate returns in the U.S. The results show that our pessimistic sentiment index predicts returns of commercial real estate up to three quarters in advance. These results hold at the national, regional, and state levels and are robust across various model specifications. The predictability of the sentiment index is especially pronounced during recessionary periods. We also analyse different property sectors and find that the inverse relationship between the MDP Index and future private commercial real estate returns persists across all sectors except the industrial sector. The relationship is strongest for the office sector. [ABSTRACT FROM AUTHOR]

Background: Anxiety and depression during the postpartum period can have a significant impact on mothers’ perceived sense of responsive caregiving, causing considerable distress. This association may be affected by mothers’ perception about social support. In the context of low-and-middle-income countries where prevalence rates of maternal mental illnesses are high and access to health care services is limited, informal supports become more relevant. Aim: The study aims to understand the lived experience of mothers who had postpartum depression or anxiety and their perceived distress related to infant care giving. It also explores the role of social support in the motherhood experience. Methods: Six mothers with postpartum depression or anxiety were interviewed to understand their experience of postpartum depression and/or anxiety and their perceptions about social support. The interviews were analyzed using a reflexive thematic analysis approach. Results: The thematic analysis revealed four themes, namely, (a) uncertainty and helplessness, (b) misattunement with the immediate family, (c) personal strength rooted in the family support system, and (d) other means of coping. Mothers with postpartum anxiety and depression can have emotional, informational, and tangible social support needs in the context of uncertainty and helplessness, which are associated with different challenges and barriers for infant care in the Indian context. Conclusion: Support from family members is viewed as a pillar of comfort and recovery for the mothers. At the same time, if it is not adequately attuned to the needs of the mother, it can become a major source of distress.

Abstract Accuracy of memory is critical in legal and clinical contexts. These contexts are often linked with high levels of emotional distress and social sources that can provide potentially distorting information about stressful events. This study investigated how distress was associated with susceptibility to misinformation about a trauma analogue event. We employed an experimental design whereby in Phase 1, participants (N = 243, aged 20–72, 122 females, 117 males, 4 gender diverse) watched a trauma film (car crash) and heard an audio summary that contained misinformation (misled items), true reminders (consistent items), and no reminders (control items) about the film. Participants rated their total distress, and symptoms of avoidance, intrusions, and hyperarousal, in response to the film. They then completed cued recall, recognition, and source memory tasks. One week later in Phase 2, participants (N = 199) completed the same measures again. Generalised linear mixed models were used. A significant misinformation effect was found, and importantly, participants with higher distress levels showed a smaller misinformation effect, owing to especially poor memory for consistent items compared to their less distressed counterparts. Distress was also associated with improved source memory for misled items. Avoidance of the film’s reminders was associated with a smaller misinformation effect during immediate retrieval and a larger misinformation effect during delayed retrieval. Findings suggest that distress is associated with decreased susceptibility to misinformation in some cases, but also associated with poorer memory accuracy in general. Limitations are discussed, and the need for further research is highlighted.

Abstract The influence of naps on tinnitus was systematically assessed by exploring the frequency, clinical and demographic characteristics of this phenomenon. 9,724 data from two different tinnitus databases (Tinnitus Hub: n = 6115; Tinnitus Research Initiative (TRI): n = 3627) were included. After separate analysis of the databases, these results were then compared with each other. In the Tinnitus Hub survey database, a total of 31.1% reported an influence on tinnitus by taking a nap (26.9% in the TRI database), with much more frequent worsening after a nap than improvement (23.0% a little or a lot worse; TRI: 17.7% worse; 8.1% a little or a lot better; TRI: 9.2% better). The influence of napping on tinnitus was associated in both databases with other clinical features, such as the dependence of tinnitus on night quality, stress and somatosensory maneuvers. The present study confirms the clinical observation that more tinnitus sufferers report worsening after a nap than tinnitus sufferers reporting an improvement. It was consistently shown that tinnitus sufferers reporting nap-induced modulation of tinnitus also report more frequently an influence of night sleep on their tinnitus. Further clinical and polysomnographic research is warranted to better understand the interaction between sleep and tinnitus.

Abstract Background Now affecting one in six couples in Canada, infertility is defined as a lack of conception after 12 or more months of regular, unprotected heterosexual intercourse. Infertility is associated with immense psychological burden, particularly for individuals assigned female at birth. Yet existing psychological interventions are not specialized to this population and have been shown to be only marginally effective at relieving distress related to infertility. Thus, a new online self-directed psychological intervention was co-created with a panel of women experiencing infertility, and ultimately consisted of six 10-min video modules addressing the cognitive, emotional, and interpersonal aspects of infertility-related distress. Methods In the current study, 21 women experiencing reduced quality of life related to infertility were recruited to participate in a one-arm pre-post pilot testing the feasibility, acceptability, and preliminary efficacy of the program. Participant adherence and retention were monitored, and participants rated the credibility of the program and the helpfulness of each module as well as provided feedback on the content and format of the program. Pre-to-post changes in fertility quality of life, anxious symptoms, depressive symptoms, and relationship satisfaction were examined. Results The program modules were highly rated by participants, with average helpfulness ratings ranging from 7.5 to 8.2/10. Two participants became pregnant and therefore stopped prematurely, 79% of the remaining participants completed all six modules, and participants reported completing 52.8 (SD = 82.0) min of homework per week. Participants perceived the intervention as highly credible and generally approved of the format, length, and speed; however, 68% of participants had recommendations for additional content to be included in the intervention. While relationship satisfaction did not change significantly over time, large pre-to-post improvements in fertility quality of life, depression, and anxiety were observed (p

Abstract Background Digital health technologies such as sensor systems are intended to support healthcare staff in providing adequate patient care. In the Department of Palliative Medicine (University Medical Center Freiburg), we developed and implemented a noninvasive, bed-based sensor system in a pilot study. The aim was to detect distress in patients who were no longer able to express themselves by monitoring heart and respiratory rates, vocalizations, and movement measurements. The sensor system was intended to supplement standard care, which generally cannot guarantee constant monitoring. As there is a lack of data on how healthcare professionals experience such a techno-digital innovation, the aim of this study was to explore how the multiprofessional palliative care team who piloted the sensor system perceived its potential benefits and limitations, and how they experienced the broader context of healthcare technology and research in palliative care. Methods We conducted a qualitative interview study with 20 members of the palliative care team and analyzed the recorded, verbatim transcribed interviews using qualitative content analysis. Results The sensor system was described as easy to use and as helpful support for patients, care staff, and relatives, especially against the backdrop of demographic change. However, it could not replace human interpretation of stress and subsequent treatment decisions: this remained the expertise of the nursing staff. A potential reduction in personnel was expected to be a risk of a digital monitoring system. The special conditions of research and digital health technologies in an end-of-life context also became clear. Specifically, healthcare staff were open to health technologies if they benefited the patient and were compatible with professional nursing and/or palliative care attitudes. Additionally, a patient-protective attitude and possible interprofessional differences in priorities and the resulting challenges for the team became apparent. Conclusions A potential digital solution for distress monitoring was considered useful by palliative care practitioners. However, interprofessional differences and compatibility with existing palliative care practices need to be considered before implementing such a system. To increase user acceptability, the perspectives of healthcare professionals should be included in the implementation of technological innovations in palliative care.

Introduction: Psychological distress has been defined as a state of emotional suffering with predominant symptoms of depression and anxiety. Given the state of poor awareness of psychological morbidities in general population, the associated stigma as well as the lack of training among primary health-care professionals in identifying psychological morbidities has led to poor detection rates. We therefore conducted this study to estimate the psychological distress among outpatient department attendees at a rural health center in Goa, using the World Health Organization Self-Reporting Questionnaire (WHO-SRQ)-20 screening questionnaire and to identify some associated factors. Methodology: A hospital-based cross-sectional study was conducted in a rural area. Systematic sampling technique was used to include 300 study participants aged 18 years and above. Psychological distress was measured using the 20-point WHO-SRQ. Those identified as having psychological distress were reconfirmed by the Hamilton Depression Rating Scale (HAM-D) under supervision by a trained psychiatrist. Data were later entered into Google Sheets and analyzed using IBM-SPSS 24. Results: Around 7.7% of the participants had psychological distress. Female sex, marital status, education level, type of family, and alcohol use were significantly associated with psychological distress. Confirmation of diagnosis by the HAM-D indicated 21 of the 23 participants identified by WHO-SRQ had definitive psychological distress. Conclusion: WHO-SRQ is a simple screening tool which can be routinely used to effectively screen for psychiatric morbidities at primary care level.

Abstract This study aimed to investigate distress levels, using the distress thermometer (DT), and the factors associated with distress in postoperative patients with pancreatobiliary cancer. This study retrospectively investigated 155 patients who underwent surgery for pancreatobiliary cancer between December 1, 2019 and September 30, 2021. The DT and problem list were used to measure distress. Descriptive statistics, t-test, and multivariate logistic regression analysis were used to analyze the data. Of the 155 patients, 16.8% (n = 26) and 83.2% (n = 129) were in the mild-distress and moderate-to-severe distress groups, respectively. The average DT score was 6.21; that for the mild-distress and moderate-to-severe distress groups was 2.46 and 6.97, respectively. More patients in the moderate-to-severe distress group reported having problems of “sadness” (χ2 = 4.538, P

Abstract Recent clinical trials have found that the serotonergic psychedelic psilocybin effectively alleviates anxiodepressive symptoms in patients with life-threatening illnesses when given in a supportive environment. These outcomes prompted Canada to establish legal pathways for therapeutic access to psilocybin, coupled with psychological support. Despite over one-hundred Canadians receiving compassionate access since 2020, there has been little examination of these ‘real-world’ patients. We conducted a prospective longitudinal survey which focused on Canadians who were granted Section 56 exemptions for legal psilocybin-assisted psychotherapy. Surveys assessing various symptom dimensions were conducted at baseline, two weeks following the session (endpoint), and optionally one day post-session. Participant characteristics were examined using descriptive statistics, and paired sample t-tests were used to quantify changes from baseline to the two-week post-treatment endpoint. Eight participants with Section 56 exemptions (four females, Mage = 52.3 years), all with cancer diagnoses, fully completed baseline and endpoint surveys. Significant improvements in anxiety and depression symptoms, pain, fear of COVID-19, quality of life, and spiritual well-being were observed. Attitudes towards death, medical assistance in dying, and desire for hastened death remained unchanged. While most participants found the psilocybin sessions highly meaningful, if challenging, one reported a substantial decrease in well-being due to the experience. These preliminary data are amongst the first to suggest that psilocybin-assisted psychotherapy can produce psychiatric benefits in real-world patients akin to those observed in clinical trials. Limited enrollment and individual reports of negative experiences indicate the need for formal real-world evaluation programs to surveil the ongoing expansion of legal access to psychedelics.

Abstract Breast cancer is the most commonly diagnosed cancer among women worldwide. Breast cancer patients experience significant distress relating to their diagnosis and treatment. Managing this distress is critical for improving the lifespan and quality of life of breast cancer survivors. This study aimed to assess the level of distress in breast cancer survivors and analyze the variables that significantly affect distress using machine learning techniques. A survey was conducted with 641 adult breast cancer patients using the National Comprehensive Cancer Network Distress Thermometer tool. Participants identified various factors that caused distress. Five machine learning models were used to predict the classification of patients into mild and severe distress groups. The survey results indicated that 57.7% of the participants experienced severe distress. The top-three best-performing models indicated that depression, dealing with a partner, housing, work/school, and fatigue are the primary indicators. Among the emotional problems, depression, fear, worry, loss of interest in regular activities, and nervousness were determined as significant predictive factors. Therefore, machine learning models can be effectively applied to determine various factors influencing distress in breast cancer patients who have completed primary treatment, thereby identifying breast cancer patients who are vulnerable to distress in clinical settings.

Abstract Introduction Improving the quality of life (QOL) is the most important goal of early diagnosis and treatment in patients with type 2 diabetes (T2D). Numerous studies have indicated the positive effects of health literacy, social support and self-care behaviors and the negative effects of diabetes distress and burnout on the QOL of patients with T2D. Understanding these factors is crucial for people with diabetes. However, no study has investigated the simultaneous effects of these variables on QOL. In this study, our goals were to find out how these variables are related to each other, in addition, which variables play the role of mediating variables, and finally, what is the cumulative effect of these variables in predicting the QOL of patients with T2D. So, this study aimed to examine the relationship between diabetes health literacy (DHL), distress, burnout, social support, complications of diabetes, self-care behaviors, and QOL among patients with T2D by application Path analysis method. Methods In this study 929 participants were entered to study by cluster sampling method and finally, data were analyzed among 820 participants. Data were gathered by self-report and with seven tools of Demographic section, DHL Scale, Diabetes distress scale, Diabetes Burnout scale, Diabetes Self-Management Questionnaire (DSMQ), Perceived social support, Diabetes Quality of Life (DQOL) Questionnaire. The software’s of SPSS version 24 and AMOS version 24 were used for analysis. Results The variables of DHL, social support, diabetes distress, and complications of diabetes predicted 38% variance in diabetes burnout (R2 = 0.38). Greatest impact on diabetes burnout was related to diabetes distress (estimate total effect = 0.539). The variables of DHL, social support, diabetes distress, complications of diabetes, and diabetes burnout predicted 24% variance in self- care behaviors (R2 = 0.24). Greatest impact on self- care behaviors was related to DHL (estimate total effect = 0.354). The variables of DHL, social support, diabetes distress, diabetes burnout, complications of diabetes, and self- care behaviors predicted 49% variance in DQOL (R2 = 0.49). Greatest impact on DQOL was related to variables of diabetes distress (estimate total effect = -0.613), DHL (estimate total effect = 0.225), diabetes burnout (estimate total effect = -0.202), complications of diabetes (estimate total effect = − 0.173), social support (estimate total effect = 0.149), and self -care (estimate total effect = 0.149), respectively. Conclusion To improve QOL in patients with T2D, health care providers must develop interventions that increase DHL of diabetic. Because DHL can decrease distress and burnout, enhance self -care skills, create supportive networks, and ultimately improve QOL in patients with type 2 diabetes.

This study focused on the TALK Debrief Experience in the prehospital personnel (n = 1521) of a western Spanish healthcare region during the COVID-19 Pandemic. The study aimed to apply the TALK clinical debriefing intervention to out-of-hospital clinical staff during pandemics; identify their emotions, thoughts, coping strategies, and solution proposals; determine their demands for improving well-being and coping ability; and disseminate valuable knowledge for addressing trauma in similar situations. The study employed a qualitative methodology within a participatory action research (PAR) framework, conducting group discussions (n = 375) and employing the TALK clinical debriefing method as the guiding framework for the sessions. The discussion group meetings were facilitated by psychologists (n = 67) who had received training in this intervention technique. Various emotions were identified during the sessions, including fear of contagion, lack of control and security, work-related stress, and ethical dilemmas. Proposed solutions and coping strategies addressed increased security measures, promotion of social distancing, stress and anxiety management, and clarity in procedures and provision of protective equipment. The study also highlighted additional demands such as the need for clear information, psychological support, and changes in work practices like reducing strenuous shifts. In conclusion, despite study limitations, such as the lack of long-term follow-up, it emphasized the importance of comprehensively addressing well-being and working conditions during health crises.

Because psychedelics have been found to increase psychological traits like openness, mental flexibility, and interpersonal perceptiveness, some researchers believe that psychedelics could help individuals cope with the psychological effects of discrimination. However, it is still unclear whether psychedelic use can help manage the internalized stigma that deters formal mental health treatment. This study investigates the impact of six measures of psychedelic use (MDMA, psilocybin, DMT, ayahuasca, peyote/mescaline, and LSD) on psychological distress (Kessler Psychological Distress Scale) and internalized stigma. The study used data from the National Survey of Drug Use and Health (NSDUH) from 2008 to 2019, with a sample size of 458,372 participants. Ordinary least square regression models were conducted using Stata 18. Gender analysis found that among men, ayahuasca use was linked to reduced stigma perception associated with higher distress. For women, DMT use was linked to reduced stigma perceptions when experiencing higher distress. However, results find that individuals who have used MDMA and psilocybin reported heightened perceptions of stigma associated with increased psychological distress. Among women, MDMA and psilocybin use was associated with a higher perception of stigma when they experienced distress. These findings suggest that, overall, psychedelics may not reduce the impact of distress on the perception of stigma, especially for women.

Background. Timely and accurately conducted introduction of demoralization into the differential diagnostics make it possible to define objective and subjective factors essential to demoralization, which constitute actual psychological state of a patient. It also helps to differentiate these factors from variety of syndrome signs and, therefore, to stabilize individual mental condition by making therapeutic interventions more targeted. Objectives. The aim is to elicit specific features of and to discern criteria for distinction of the notion of demoralization from variety of other concepts frequently used in clinical psychologist’s activity to describe pathological mental states that patients with severe somatic disease may have. Results. Based on the comparison of the demoralization concept and mental distortions frequent in a clinic of severely ill somatic patients, essential and pivotal sings of the phenomenon of demoralization are shown. The epidemiological data on occurrence and intensity rates, as well as demoralization comorbidity to a number of disturbed mental activity symptoms and states amid patients with different somatic nosology are given. Conclusions. As a psychological state, demoralization can be diagnosed among either inpatients or outpatients. It might also present itself singularly or be comorbid to any mental distortion yet maintaining its seminal qualities, such as distress, subjective incompetence experience and preservation of motivation. Discrimination of demoralization state might have both therapeutic and prognostic value.

The sudden shift to remote learning during the Covid-19 pandemic has brought much distress to teachers. Since the teachers are considered as the major force that facilitates the learning process, their well-being should be given importance. The study used a survey research design to determine the level of distress among private school teachers in San Pablo City, Philippines, using the Covid-19 Peritraumatic Distress Index (CPDI). It also analyzed the sources of distress and examined the different coping strategies the teachers are using to mitigate the distress related to remote learning. Results show that the majority of the respondents are experiencing distress, with most having mild-moderate distress, followed by severe distress. Preparation of learning materials, internet connectivity problems, limited teacher-student interaction, assessment of student's learning, tracking student's progress, inconducive working environment, and inadequate technical skills were identified as sources of distress. Most respondents prefer coping strategies that would promote their overall wellness and those activities that avoid the source of distress. These findings have implications for school owners and administrators, policymakers, and curriculum developers in addressing the needs of teachers by providing programs that would help them cope with the distress related to remote learning.

The purpose of this study was to analyze the influence of socio-demographic characteristics on feeding habits of inhabitants of Katagum local government Area of Bauchi state, Nigeria. The two nominal independent variables used in the descriptive survey are income level, and culture/ethnicity. This study employed the descriptive survey design. The population of the study was drawn from three districts council of Katagum local Government Area in Bauchi State Nigeria. Three hundred and ninety nine (399) respondents was conveniently selected using stratified random sampling and convenient sampling techniques, the instrument used for collecting data for this study was questionnaire named Socio-demographic characteristics data (SDCDQ) and food frequency list (FFL), data collected was statistically analyzed using descriptive and inferential statistics. The result revealed that income level was not significantly influenced by the feeding habit of the Katagum inhabitants, which implies that there is no significant difference between feeding habit and income level. The findings further discovered that culture/ethnicity shows there is no significant difference between feeding habit and culture/ethnicity; the study concludes that the inhabitant feeding habit was not influenced by their various cultures. Based on these findings it was recommended among others that the government should ensure food self-sufficiency and provide necessary infrastructure to stimulate economic activities, enhance incomes and improve living conditions of the poor.

Road traffic accidents are the primary source of injuries and fatalities worldwide, accounting for 20–50 million long term disabilities and 1.25 million deaths annually. Pavement conditions rank as the second most common cause of traffic accidents. The combined effects of environmental factors and traffic loads lead to pavement discomfort. Ensuring proper pavement design and maintenance can assist in lowering accident rates and preventing long-term disability associated with drivers. Physical maintenance procedures like overlays, seal coatings, patching, and filling joints are carried out in practice; nevertheless, they only offer temporary fixes by treating the symptoms rather than the underlying issue. An alternative method for road pavement maintenance is using polyurethane to improve the properties of asphalt due to the excellent properties of polyurethane. This study conducts a systematic review of the polyurethane asphaltic characteristics and performance based on the previous study by researchers. It is found that the pavement maintenance work using polyurethane is able to sustain longer periods and is moisture resistant due to its excellent bonding with the existing pavement material.

Latar belakang. Respiratory Distress Syndrome merupakan penyebab gangguan pernapasan, sering terjadi pada bayi baru lahir dan juga menjadi penyebab paling umum terjadinya morbiditas dan mortalitas pada neonatus. Salah satu komplikasi yang sering terjadi adalah Acute Kidney Injury. Tujuan. Penelitian ini bertujuan untuk menganalisis hubungan antara Respiratory Distress Syndrome dengan kejadian Acute kidney injury pada neonatus di Rumah Sakit dr. Zainoel Abidin Banda Aceh. Metode. Penelitian ini menggunakan pendekatan analitik obervasional dengan desain cross-sectional. Data dikumpulkan dari pasien yang dirawat dalam periode Januari 2021-Desember 2021. Sampel penelitian adalah populasi terjangkau yang memenuhi kriteria inklusi dan eksklusi. Besar sampel penelitian adalah total populasi. Penelitian bersifat retrospektif dengan variabel dependen dan independen yang diamati secara sekaligus. Hasil. Selama penelitian berlangsung didapatkan 50 sampel yang memenuhi kriteria inklusi dan eksklusi penelitian, jumlah neonatus berjenis kelamin laki-laki (50%) sebanding dengan perempuan (50%). Usia neonatus terbanyak pada kelompok 3 hari yakni 36 subjek (72%). Mayoritas jenis persalinan dijumpai pada kelompok sectio caesarea yakni 45 subjek (90%). Kelompok usia gestasi 34-36 minggu (preterm) terbanyak yakni 32 subjek (64%). Subjek kelompok Berat badan lahir 1000-7 berhubungan dengan kejadian Acute Kidney Injury. Mayoritas subjek penelitian dengan Respiratory Distress Syndrom tidak dijumpai Acute Kidney Injury, sebanyak 39 subjek (78%) dengan hasil normal. Kesimpulan. Pada penelitian ini didapatkan terdapat hubungan antara Respiratory Distress Syndrom dengan kejadian Acute Kidney Injury (p

Latar belakang. Respiratory Distress Syndrome adalah masalah serius yang menyebabkan morbiditas dan mortalitas tinggi pada bayi prematur. Beberapa faktor risiko, antara lain, jenis kelamin laki-laki, ibu dengan diabetes melitus, ketuban pecah dini, hipertensi, usia ibu

* Background Digital addictions are a major problem worldwide, which has increased considerably during the COVID-19 pandemic. In this scenario, two important impact factors to explain this problem are stress and anxiety because of COVID-19. The objective of this research was to determine the impact of distress and anxiety due to COVID-19 on digital addictions. Methods cross-sectional, explanatory study. A total of 802 students from public and private universities residing in the city of Lima and Callao (Peru), with a mean age of 21.68 (SD = 3.11), selected by convenience sampling, participated in the study. The MULTICAGE CAD-4 questionnaire, the distress scale, and the COVID-19 worry scale were applied. Results two models examined with structural equation modeling showed good fit indices (CFI and TLI > .95, RMSEA and SRMR < .06). The first model shows that the latent variables distress and anxiety due to COVID-19 have direct effects on digital addictions as a general construct (R 2 = 22%). The second model shows that the exogenous latent variables (stress and anxiety) have direct effects of different magnitudes on each digital technology, so the variance explained on smartphone addiction was higher (R 2 = 25%) with respect to internet (R 2 = 19%) and video game addiction (R 2 = 6%). It was also found that for every male, there are two females with high levels of distress and anxiety. Regarding the problematic use of smartphones and internet, there is a prevalence of 40% regardless of sex; but as for the problematic use of video games, there is a marked difference between males (18.8%) and females (2.7%). Conclusion the distress and anxiety caused by COVID-19 have a direct impact in aggravating digital addictions.

Children's independent mobility (CIM) represents their freedom to travel in their neighborhood without adult supervision. Secular declines in CIM coincided with a major increase in mental health problems among children. We investigated relationships between two indicators of CIM and parent-perceived child distress in a national longitudinal study involving 2,291 Canadian parents of 7- to 12-year-olds at baseline (December 2020) with up to four follow-ups, every six months. We assessed mobility licenses (i.e. children's permission to do certain activities on their own) with 6 items, and home range (i.e. how far [in minutes] children can roam with friends and/or siblings) with a 4-point item. We used generalized estimating equations controlling for children's age and gender, household income, study wave, school attendance, and COVID-19 isolation in the week preceding the survey. At each successive time point, 51.8%, 44.0%, 43.2% and 42.4% of children experienced clinically elevated distress. Compared to children allowed to roam <5 min, children allowed to roam 5–15 min (OR = 0.76; 95% CI: 0.67–0.88) or >15-minutes (OR = 0.61; 95% CI: 0.51–0.72) had lower odds of elevated distress. However, CIM licenses were not associated with distress. Our findings underscore the need to support extending children's home range. [ABSTRACT FROM AUTHOR]

The influence of naps on tinnitus was systematically assessed by exploring the frequency, clinical and demographic characteristics of this phenomenon. 9,724 data from two different tinnitus databases (Tinnitus Hub: n = 6115; Tinnitus Research Initiative (TRI): n = 3627) were included. After separate analysis of the databases, these results were then compared with each other. In the Tinnitus Hub survey database, a total of 31.1% reported an influence on tinnitus by taking a nap (26.9% in the TRI database), with much more frequent worsening after a nap than improvement (23.0% a little or a lot worse; TRI: 17.7% worse; 8.1% a little or a lot better; TRI: 9.2% better). The influence of napping on tinnitus was associated in both databases with other clinical features, such as the dependence of tinnitus on night quality, stress and somatosensory maneuvers. The present study confirms the clinical observation that more tinnitus sufferers report worsening after a nap than tinnitus sufferers reporting an improvement. It was consistently shown that tinnitus sufferers reporting nap-induced modulation of tinnitus also report more frequently an influence of night sleep on their tinnitus. Further clinical and polysomnographic research is warranted to better understand the interaction between sleep and tinnitus. [ABSTRACT FROM AUTHOR]

Background: Now affecting one in six couples in Canada, infertility is defined as a lack of conception after 12 or more months of regular, unprotected heterosexual intercourse. Infertility is associated with immense psychological burden, particularly for individuals assigned female at birth. Yet existing psychological interventions are not specialized to this population and have been shown to be only marginally effective at relieving distress related to infertility. Thus, a new online self-directed psychological intervention was co-created with a panel of women experiencing infertility, and ultimately consisted of six 10-min video modules addressing the cognitive, emotional, and interpersonal aspects of infertility-related distress. Methods: In the current study, 21 women experiencing reduced quality of life related to infertility were recruited to participate in a one-arm pre-post pilot testing the feasibility, acceptability, and preliminary efficacy of the program. Participant adherence and retention were monitored, and participants rated the credibility of the program and the helpfulness of each module as well as provided feedback on the content and format of the program. Pre-to-post changes in fertility quality of life, anxious symptoms, depressive symptoms, and relationship satisfaction were examined. Results: The program modules were highly rated by participants, with average helpfulness ratings ranging from 7.5 to 8.2/10. Two participants became pregnant and therefore stopped prematurely, 79% of the remaining participants completed all six modules, and participants reported completing 52.8 (SD = 82.0) min of homework per week. Participants perceived the intervention as highly credible and generally approved of the format, length, and speed; however, 68% of participants had recommendations for additional content to be included in the intervention. While relationship satisfaction did not change significantly over time, large pre-to-post improvements in fertility quality of life, depression, and anxiety were observed (p <.001; Cohen's ds = 0.9–1.3). Conclusions: This self-directed intervention was well received and has the potential to be highly effective in reducing infertility-related distress, informing future development and optimization. Trial registration: ClinicalTrials.gov, NCT05103982. [ABSTRACT FROM AUTHOR]

Simple Summary: Behavioral training is an internationally accepted and recommended tool in enhancing the welfare of captive animals, facilitating their habituation to unfamiliar environments, and promoting cooperation with routine care procedures. Long-tailed monkeys were previously reported to be fearful and difficult to train. Moreover, wild long-tailed monkeys from monkey–human conflict areas can add more challenges; their prior experience with humans can either facilitate or complicate training processes. This project aimed to apply behavioral training techniques, established for captive-born primates, to test whether wild long-tailed monkeys could be trained to cooperate with routine and animal-care procedures and to determine the time required for each training exercise. Additionally, cortisol levels, a key indicator of stress, were monitored to evaluate the animals' stress responses, providing an additional metric for determining the success of training. This study offers the first validation of a primate behavioral training program wild long-tailed macaques, contributing valuable insights into the refinement of welfare practices for this specific population. Owing to their similarities to humans in various aspects, non-human primates (NHPs) serve as valuable translational models that has greatly contributed to scientific advancements. However, working with untrained NHPs can cause stress and increase the risk of injuries to both animals and care staff, compromising both animal welfare and occupational safety. Behavioral training, that benefits from animals' learning abilities to gain their cooperation during husbandry and veterinary procedures, is a well-established method to mitigate these risks. Cynomolgus monkeys, in particular, are known for being despotic, fearful, and challenging to train. Moreover, our first-generation breeders were wild-sourced from human–macaque conflict areas in Thailand. These macaque populations are accustomed with human contact; hence, their prior experience can either work for or against behavioral shaping plans. Establishing a training program with realistic expectations would benefit both the animals and trainers. In this study, six cynomolgus monkeys were selected based on temperament, then underwent a pilot training program that included basic husbandry and veterinary procedures. Over 256 training sessions with gradual shaping plans, all six monkeys went through all training steps, with progress varying considerably among individuals. Cortisol levels were measured to monitor stress responses, revealing a notable sex difference: female monkeys generally complied more easily with the trainer but exhibited a stronger cortisol increase compared to males. This study proposed a behavioral training program grounded in three essential components: temperament assessment, behavioral shaping plans, and the cortisol-based criteria for evaluating training success. [ABSTRACT FROM AUTHOR]

Background: Digital health technologies such as sensor systems are intended to support healthcare staff in providing adequate patient care. In the Department of Palliative Medicine (University Medical Center Freiburg), we developed and implemented a noninvasive, bed-based sensor system in a pilot study. The aim was to detect distress in patients who were no longer able to express themselves by monitoring heart and respiratory rates, vocalizations, and movement measurements. The sensor system was intended to supplement standard care, which generally cannot guarantee constant monitoring. As there is a lack of data on how healthcare professionals experience such a techno-digital innovation, the aim of this study was to explore how the multiprofessional palliative care team who piloted the sensor system perceived its potential benefits and limitations, and how they experienced the broader context of healthcare technology and research in palliative care. Methods: We conducted a qualitative interview study with 20 members of the palliative care team and analyzed the recorded, verbatim transcribed interviews using qualitative content analysis. Results: The sensor system was described as easy to use and as helpful support for patients, care staff, and relatives, especially against the backdrop of demographic change. However, it could not replace human interpretation of stress and subsequent treatment decisions: this remained the expertise of the nursing staff. A potential reduction in personnel was expected to be a risk of a digital monitoring system. The special conditions of research and digital health technologies in an end-of-life context also became clear. Specifically, healthcare staff were open to health technologies if they benefited the patient and were compatible with professional nursing and/or palliative care attitudes. Additionally, a patient-protective attitude and possible interprofessional differences in priorities and the resulting challenges for the team became apparent. Conclusions: A potential digital solution for distress monitoring was considered useful by palliative care practitioners. However, interprofessional differences and compatibility with existing palliative care practices need to be considered before implementing such a system. To increase user acceptability, the perspectives of healthcare professionals should be included in the implementation of technological innovations in palliative care. [ABSTRACT FROM AUTHOR]

Although substantial advances have been made in the field, only scant research has been conducted on substance use among women. In the current study (n = 132), we examined possible intermediate processes that could underline the high comorbidity between substance use disorders (SUDs), compulsive sexual behavior (CSBD), and risky sexual behaviors (RSB) among women: emotion regulation, distress, and perceived social support (PSS). Results indicate that women with SUDs have more prevalent RSB and higher CSBD symptoms than healthy controls. Using a model with SUD as a dependent measure, intermediate factors as mediators, and CSBD and RSB as outcomes, we found that women with SUDs had more significant sensations of distress and lowered PSS than healthy controls. However, only distress mediated the association between SUDs, CSBD, and RSB. The findings provide insights into the intermediate processes that intertwined addictive behaviors and an opportunity for developing novel and successful treatments for women. [ABSTRACT FROM AUTHOR]

At any given moment, a notable proportion of parents worldwide have at least one child serving in the military. The aim of this study is to assess the prevalence of depression, anxiety, and stress in the sample of parents of Israeli soldiers and to assess the difference in this prevalence by type of service (combat vs. non‐combat) and other demographic characteristics of parents and soldiers. A cross‐sectional study of a convenience sample of 202 Israeli parents who were interviewed during January‐September 2023. Depression Anxiety Stress Scale (DASS‐21) was used to measure the emotional states of depression, anxiety, and stress (with cut‐off points of ≥5, ≥4, and ≥8, respectively). Having depression, anxiety, or stress was defined as psychological distress. Parents' demographics and child's service characteristics were included in the multivariable logistic regression model, with psychological distress as a dependent variable. Almost a quarter (22.8%) of parents experienced distress, defined as having high depression, anxiety, or stress score. In a multivariable model, combat service (vs. non‐combat) was significantly associated with distress: parents of combat soldiers were four times more likely to report distress than parents of non‐combat soldiers (OR = 3.9; 95% CI: 1.3–11.8). Highly classified service preventing the child from sharing information with the parents was significantly associated with distress (OR = 2.6; 95% CI: 1.2–5.3). Most distressed parents (78.3%) did not seek professional help, with the vast majority of those seeking assistance were female. Given the substantial proportion of parents suffering from mental distress found in this study, especially parents of combat soldiers and those serving in highly classified positions, healthcare professionals should be aware of parents' difficulties, be proactive in gathering information about their mental well‐being, and be prepared to provide professional help. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to evaluate the prevalence of anxiety and depression traits in Italian patients with metabolic dysfunction-associated steatotic liver disease (MASLD), and the possible relation with the severity of liver disease. Methods: Demographic, anthropometric, clinical and laboratory parameters were collected in patients referred to a metabolic unit for a comprehensive evaluation of possible liver disease. Hepatic steatosis and fibrosis were evaluated by surrogate biomarkers. Imaging (controlled attenuation parameter-CAP and vibration-controlled transient elastography-VCTE). Beck depression inventory (BDI) and state-trait anxiety inventory-Y (STAI-Y) were used to define depressive/anxiety states; calorie intake and lifestyle were self-assessed by questionnaires. Results: The whole sample comprised 286 patients (61.9% females; mean age 52.0 years; BMI, 34.6 kg/m2); 223 fulfilled MASLD criteria. BDI and trait anxiety scores were lower in the MASLD cohort, and the prevalence of both moderate/severe depression and severe trait anxiety was reduced compared with non-MASLD cases, despite VCTE-diagnosed fibrosis F3–F4 present in over 15% of cases. However, after correction for demographic and anthropometric confounders, MASLD was not associated with a lower risk of moderate/severe depression or severe anxiety trait (odds ratio, 0.34; 95% confidence interval, 0.12–1.01 and 0.79, 0.27–2.34). Additional adjustment for the severity of fibrosis did not change the results. No differences in state anxiety were observed. Conclusion: The risk of anxiety and depression in MASLD is not different from that generated by diabetes and obesity per se. MASLD patients do not perceive liver disease as a specific source of psychological distress, possibly as a consequence of the unawareness of progressive liver disease. [ABSTRACT FROM AUTHOR]

Background: Anxiety and depression during the postpartum period can have a significant impact on mothers' perceived sense of responsive caregiving, causing considerable distress. This association may be affected by mothers' perception about social support. In the context of low-and-middle-income countries where prevalence rates of maternal mental illnesses are high and access to health care services is limited, informal supports become more relevant. Aim: The study aims to understand the lived experience of mothers who had postpartum depression or anxiety and their perceived distress related to infant care giving. It also explores the role of social support in the motherhood experience. Methods: Six mothers with postpartum depression or anxiety were interviewed to understand their experience of postpartum depression and/or anxiety and their perceptions about social support. The interviews were analyzed using a reflexive thematic analysis approach. Results: The thematic analysis revealed four themes, namely, (a) uncertainty and helplessness, (b) misattunement with the immediate family, (c) personal strength rooted in the family support system, and (d) other means of coping. Mothers with postpartum anxiety and depression can have emotional, informational, and tangible social support needs in the context of uncertainty and helplessness, which are associated with different challenges and barriers for infant care in the Indian context. Conclusion: Support from family members is viewed as a pillar of comfort and recovery for the mothers. At the same time, if it is not adequately attuned to the needs of the mother, it can become a major source of distress. [ABSTRACT FROM AUTHOR]

As outcomes for breast cancer patients improve, addressing the side effects and distress of treatment can optimize survivorship. Although distress in breast cancer is well known in literature, there is a lack of information on how these concerns change through the phases of the cancer care continuum. Therefore, this study investigates the longitudinal trajectory of worry in patients with nonmetastatic breast cancer. Female patients with newly diagnosed stage I-III breast cancer comprised a mixed-methods, longitudinal study at a cancer center from June 2019 to June 2023. Patients completed an open-ended survey regarding their top three concerns. Responses were obtained before surgery and two weeks, three, six, nine months, and one year postoperatively. Responses were qualitatively coded and analyzed to determine themes of cancer-related distress. Participants (n = 262) were aged an average 57.53 y (±12.54), 65.8% had stage I disease at diagnosis, and 91.1% were White. Responses revealed that patients' top three sources of concerns varied by treatment phase. Overall, patients were worried about their cancer diagnosis and the risk of recurrence. Preoperatively, patients were worried about treatment timeline, while postoperative concerns transitioned to physical appearance and surgical side effects. Breast cancer patients consistently reported worries about cancer diagnosis, recurrence, and metastasis as well as the side effects and fear of treatments. However, patient worry appeared to be intrinsically linked with their treatment phase. Therefore, support and interventions should be catered to reflect the changing patterns of patients' sources of distress to optimize breast cancer patients' quality of life. • Sources of breast cancer patients' worry appear to be linked with treatment phase. • Distress interventions should be tailored to specific treatment phase. • Setting realistic expectations about postoperative pain to reduce distress. [ABSTRACT FROM AUTHOR]