Search

BACKGROUND: Occupational health factors such as shift work, sleep, fatigue, and work environment jeopardise the health and safety of gas station workers. This calls for new research to investigate how the working environment and characteristics impact the occupational health of workers at gas stations. However, minimal research has been conducted in this field, especially those involving psychological and behavioural factors, occupational stress, and so forth. OBJECTIVE: This review was performed to investigate the present condition of the occupational risk of gas station workers in this safety-critical position. METHODS: Five databases (Web of Science, ScienceDirect, PubMed, Google Scholar, and PsycINFO) were searched for relevant peer-reviewed studies. Results were selected according to these criteria: studies on fatigue, shift work, sleep, and physical and mental health of gas station employees; published on or before November 11, 2021; papers in English. RESULTS: Twenty studies were considered for the final analysis. The results showed that shift work at gas stations leads to psychological and physiological problems. The psychological consequences included anxiety, stress, and depression, while the physiological consequences included biochemical changes and lifestyle consequences. CONCLUSION: Shift work and the specific working environment of gas station employees adversely affect their sleep, stress levels, physical and mental health, and turnover intention. This systematic review allowed us to consider the occupational risk factors that can lead to sickness or accidents and contribute to reducing these risk factors. Realistic countermeasures ought to be established and interventions must be explored to mitigate risks to life, property, and the environment in operating gas stations. [ABSTRACT FROM AUTHOR]

Background: People experiencing cognitive concerns and symptoms of depression or anxiety are at risk for Alzheimer's disease and dementia. We know physical activity can benefit cognition but understanding how to best support engagement is an ongoing challenge. Evidence-based conceptual models of factors underpinning physical activity engagement in target populations can inform intervention tailoring to address this challenge. Objective: This study (part of a pragmatic physical activity implementation trial) aimed to develop a specified model of physical activity engagement in people experiencing depressive or anxiety symptoms and cognitive concerns, to enable optimized dementia risk reduction intervention tailoring. Methods: We employed a qualitative design, triangulating data from three sources: semi-structured individual interviews with people experiencing cognitive concerns and mild to moderate depressive or anxiety symptoms; review of published evidence; and the Capability, Opportunity and Motivation system of behavior, an existing behavioral science model. Findings were integrated to develop a contextualized model of mechanisms of action for optimizing engagement. Results: Twenty-one participants were interviewed, and 24 relevant papers included. Convergent and complementary themes extended understanding of intervention needs. Findings highlighted emotional regulation, capacities to enact intentions despite barriers, and confidence in existing skills as areas of population-specific need that have not previously been emphasized. The final model provides specificity, directionality, and linked approaches for intervention tailoring. Conclusion: This study demonstrated that people experiencing cognitive concerns and symptoms of depression or anxiety require different interventions to improve physical activity engagement. This novel model can enable more precise intervention tailoring, and, ultimately, benefits for a key at-risk population. [ABSTRACT FROM AUTHOR]

Psychological stress, a state of mental strain caused by mentally or physically threatening situations, plays a significant role in Parkinson’s disease (PD). Motor symptoms worsen during acute stress and common non-motor symptoms in PD, such as anxiety and depression, are linked to chronic stress. Although evidence in humans is lacking, animal models of PD suggest that chronic stress can accelerate dopaminergic cell death. This suggests that stress-reducing interventions have not only symptomatic, but perhaps also disease-modifying effects. Our objective was to identify the most promising strategies for stress-reduction in PD and to analyze their potential value for disease-modification. An unstructured literature search was performed, primarily focusing on papers published between 2020–2023. Several large clinical trials have tested the efficacy of aerobic exercise and mindfulness-based interventions on PD symptoms. The evidence is promising, but not definitive yet: some exercise trials found a reduction in stress-related symptoms, whereas others did not or did not report it. In the majority of trials, biological measures of stress and of disease progression are missing. Furthermore, follow-up periods were generally too short to measure disease-modifying effects. Hence, mechanisms underlying the intervention effects remain largely unclear. These effects may consist of attenuating progressive neurodegeneration (measured with MRI-markers of substantia nigra integrity or cortical thickness), or a strengthening of compensatory cerebral mechanisms (measured with functional neuroimaging), or both. Lifestyle interventions are effective for alleviating stress-related symptoms in PD. They hold potential for exerting disease-modifying effects, but new evidence in humans is necessary to fulfill that promise. [ABSTRACT FROM AUTHOR]

High Blood Pressure (HBP) is one of the major significant medical concerns of many people around the globe today. HBP is so common symptom many people across the globe are experiencing, irrespective of age, gender, region, and religion. HBP prediction ahead of time can help the person to avoid the consequences such as heart stroke, kidney failure, eye damage, sexual dysfunction, and even death. HBP prediction in advance is a challenging issue as it is associated with many biopsychosocial factors. Heuristic and meta-heuristic-based Machine Learning Models (MLM) exclusively supervised machine learning techniques are becoming part and parcel of medical data diagnosis. However, the reliability of outcome, usability, and understandability of such stand-alone models in processing medical data in real-time are not up to the mark. To overcome such limitations, in this paper we proposed an intelligent majority voting and heuristic-based user-friendly hybrid classifier to predict HBP (An Intelli MOC). The model considers AA-AOC (Anger level, Anxiety level-Age, Obesity level, and Cholesterol level) of a person to predict the HBP of a person. The proposed model is said to be majority vote-based and hybrid as it considers the output of three classifiers and assigns the count for each decision class. The model is said to be heuristic-based as it uses a mathematical and Fuzzy approach in obtaining the fuzzified values of each attribute in AA-AOC. The experiments are conducted on real-time data set collected from a medical diagnostic center Doctor C, Hyderabad, India. The model is executed on 1200 data records, 65% of data is used to train the model and 35% of data is used to test the model. The output of the model proved that the proposed model outperformed in terms of accuracy, precision, recall, and F-measure compared with all available state-of-the-art, existing MLM. [ABSTRACT FROM AUTHOR]

This paper presents a mobile application supporting mental health combining techniques to detect different mental health disorder symptoms. It provides different interactions, using affirmations, emotions, based on unloading techniques such as writing, drawing, and monitoring associated emotions, providing modalities to save and track progress. [ABSTRACT FROM AUTHOR]

BACKGROUND: As interest in job-related psychology increased, the need to focus on understanding workplace stress was emphasized. Negative emotional states such as anxiety and stress permeate the organization and, if uncontrolled, can negatively impact the health and work performance of workers. Therefore, attempts to analyze various signals to understand human emotional states or attitudes may be important for future technological development. OBJECTIVE: The purpose of this study was to identify what biological variables can discriminate emotions that can significantly affect work results. METHODS: Databases (Embase, PsychINFO, PubMed, and CINAHL) were searched for all relevant literature published as of December 31, 2019. RESULTS: Brain activity (BA) and heart rate (HR) or heart rate variability (HRV) are adequate for assessing negative emotions, while BA, galvanic skin response (GSR), and salivary samples (SS) can confirm positive and negative emotions. CONCLUSION: In the future, researchers should study measurement tools and bio-related variables while workers perform tasks and develop intervention strategies to address emotions associated with work. This may enable workers to perform tasks more efficiently, prevent accidents, and satisfy clients. [ABSTRACT FROM AUTHOR]

BACKGROUND: Sedentary tasks contribute to the deterioration of health and the appearance of chronic diseases. Physical exercise can contribute to the development of health, although the characteristics of the most appropriate program are unknown. OBJECTIVES: This is the second paper of the PRODET® intervention trial evaluating the effect of a supervised group exercise intervention in the worksite based on aerobic capacity and strength lasting 12 weeks. METHODS: The sample was composed of 67 subjects (N = 67, mean age 34.31 years) and the study investigated a 12-week group physical exercise program in the workplace, two days per week with 50-minute sessions, which was supervised and based on aerobic endurance and strength. The 67 subjects were working-age office workers, deemed as sedentary and randomized into an intervention (N = 40) or control (N = 27) group. Outcomes work ability, depression, anxiety and job satisfaction were assessed with questionnaires pre-and post-test in both groups. RESULTS: The program showed effects on the mental factor of work ability (Z = 2.36, P = 0.019, η2 = 0.09). However, there were no significant differences in the rest of the results. CONCLUSIONS: The intervention had an impact on the mental factor of work ability in the workers whose occupations were based on sedentary tasks, and reinforcing this variable with an exercise program in the workplace could contribute to reducing the mental factor of work ability. [ABSTRACT FROM AUTHOR]

Individuals within the Arab world rarely access mental health services. One of the major reasons for this relates to the stigma associated with mental disorders. According to the World Health Organization (WHO), untreated and undiagnosed individuals living with moderate to severe mental health disorders are more likely to die 10-20 years earlier than the estimated life expectancy of the general population. Mental disorders also cause a large amount of costs to economies. Access to mental health services is out of reach for many individuals within in the Arab world due to insufficient planning, inadequate community resources, and military conflicts. Online mental health information and services are growing within the region; however, they are embedded and often sidelined within a wealth of other general health information. The purpose of this paper is to present the conceptual framework of the Mental Health Assistant (MeHA) digital platform being developed for the Arab world. The aim of this platform is to provide mental health information and educational resources through the use of a conversational agent, multi-media information, and to digitally connect patients with mental health service providers. The conceptual framework for the platform is based on mental health and information technology expert feedback, review of both academic and gray literature on mental health, and an examination of leading mental health digital platforms. As a result of this process, we developed a conceptual framework that will guide the development of the MeHA platform. [ABSTRACT FROM AUTHOR]

Conversational agents are being used to help in the screening, assessment, diagnosis, and treatment of common mental health disorders. In this paper, we propose a bootstrapping approach for the development of a digital mental health conversational agent (i.e., chatbot). We start from a basic rule-based expert system and iteratively move towards a more sophisticated platform composed of specialized chatbots each aiming to assess and pre-diagnose a specific mental health disorder using machine learning and natural language processing techniques. During each iteration, user feedback from psychiatrists and patients are incorporated into the iterative design process. A survival of the fittest approach is also used to assess the continuation or removal of a specialized mental health chatbot in each generational design. We anticipate that our unique and novel approach can be used for the development of conversational mental health agents with the ultimate goal of designing a smart chatbot that delivers evidence-based care and contributes to scaling up services while decreasing the pressure on mental health care providers. [ABSTRACT FROM AUTHOR]

In 2020, the spread of the COVID-19 epidemic has attracted global attention. As a large-scale group that is receiving higher education, college students also show greater mood swings. How to reduce the psychological harm of anxiety to college students is a problem that needs to be solved urgently. Based on this, this paper proposes an evaluation model for the anxiety level of college students in different regions under the influence of COVID-19. First of all, the general influence index of college student's anxiety level is obtained by correlation analysis. Secondly, the logical OR of the double quantization variable precision fuzzy set model and the degree fuzzy rough set model is used to establish the evaluation model of the anxiety level of college students under the influence of COVID-19. Finally, used big data, the idea of fuzzy upper and lower approximation, combined with the principle of maximum membership in fuzzy set theory, achieved the quantitative ranking of the anxiety levels of college students in different areas. The research shows that when the accuracy of decision-making is 45%, the anxiety level of the township college students group and the provincial capital or municipality college students group is higher. When the accuracy of decision-making is 65%, the anxiety level of the provincial capital or municipality college students group is higher than others. [ABSTRACT FROM AUTHOR]

BACKGROUND: Anxiety is a prominent disabling non-motor neuropsychiatric complication of Parkinson's disease (PD). Pharmacological treatments for PD and anxiety have drug interactions and negative side effects. Therefore, non-pharmacological interventions such as exercise has been proposed to reduce anxiety in people with PD (PwP). OBJECTIVE: This systematic review aimed to explore the relationship between physical exercise and anxiety in PwP. METHOD: Four databases (PubMed, Embase, Scopus, Ebscohost) were searched without date restrictions. English randomized control trials (RCT) including adults with PD, exposed to physical exercise interventions with anxiety as an outcome variable, were included. Quality was assessed by means of an adapted 9-point PEDro scale. RESULTS: Five of the identified 5547 studies met the inclusion criteria. Sample size ranged between 11–152 participants, totaling 328 participants with majority being male. PD stage ranged from early to moderate, with disease duration ranged between 2.9 and 8.0 years. All studies measured anxiety at baseline and post-intervention. On average studies scored 7/9 (76%) on the PEDro scale. CONCLUSION: There is insufficient evidence to support or refute the effect of exercise on anxiety in PwP due to noted limitations of included studies. There is an urgent need for high-quality RCTs on physical exercise and anxiety in PwP. [ABSTRACT FROM AUTHOR]

Background: Individuals with traumatic brain injury (TBI) often develop sleep disorders post-injury. The most common one is insomnia, which can exacerbate other post-injury symptoms, including fatigue, impaired cognition, depression, anxiety, and pain. Cognitive Behavioral Therapy for Insomnia (CBT-I) is a manualized treatment that effectively treats insomnia with secondary effects on cognition, mood, and pain in various populations., Objective: This paper reviews the use of CBT-I for three participants with TBI of different severities., Methods: Pre- and post-treatment assessments of insomnia, fatigue, depression, anxiety, and pain were conducted. Mood was further assessed at follow-up. Minimal clinically important difference (MCID) scores derived from the research literature were used to establish clinically meaningful symptom improvement on self-report questionnaires., Results: The reduction in insomnia severity scores for all three participants were not large enough to be considered a clinically significant improvement following CBT-I, although trends toward improvement were observed. However, all participants showed clinically significant reductions in anxiety at post-treatment; the effects persisted for 2 participants at follow-up. Reductions in depression symptoms were observed for 2 participants at post-treatment, and treatment effects persisted for 1 participant at follow-up. One participant endorsed clinically significant improvements in fatigue and pain severity., Conclusions: We conclude that CBT-I may provide secondary benefits for symptoms commonly experienced by individuals with TBI, especially mood disturbances.

BACKGROUND: Systemic Lupus Erythematosus (SLE), or lupus, is a chronic autoimmune disorder. Individuals with lupus face unique psychosocial and emotional challenges such as living with the unpredictability of the disease, symptoms such as fatigue, pain and depression, anxiety, cognitive problems, and coping with stress. OBJECTIVE: This article attempts to shed light on the role that lupus plays in the lives of college students in their academics and other unique psychosocial needs. METHOD: The author uses a single case study method based on the lived experience of a student with lupus. The method adopted is used as a means to provide anecdotal information about specific areas to consider when providing services to students living with this condition. RESULTS: Findings from this one case study identified some of the accommodations available to help students in higher education that may even vary for two students with same diagnosis of lupus. CONCLUSIONS: The paper presents some of the innovative strategies that can be used by practitioners while working with these students in higher education. These strategies can provide helpful support for students with lupus with the recommended academic accommodations. [ABSTRACT FROM AUTHOR]

Subjective memory complaints (SMC) are a criterion in many definitions of mild cognitive impairment (MCI). However, there is controversy over whether this is useful and appropriate, as previous research has suggested that SMC may be a function of mood problems such as anxiety and depression. This paper aimed to establish the relationship between MCI and mood in older people and to investigate the role that SMC play in the relationship. Structured interviews were conducted with community dwelling older people in Wales to collect information regarding cognitive functioning, mood, and well-being. A widely-used algorithm was used to categorize 3,173 participants into three groups: not cognitively impaired, MCI including SMC (MCI), and MCI without SMC (MCIW). The odds of experiencing anxiety or depression were calculated for each cognitive group. Participants with MCI had increased odds of experiencing symptoms of both anxiety and depression, but the odds were not changed for participants in the not cognitively impaired or MCIW categories. A mediation analysis was performed on the whole sample using cognition as a dichotomous variable, grouped using an age-, education-, and gender-adjusted median cut off point. This showed that SMC partially mediated the relationship between anxiety and cognition, and depression and cognition. Mood problems may be related to SMC rather than objective cognitive impairment, as only participants with MCI that included SMC showed increased odds of experiencing anxiety and depression. SMC are likely to play a mediating role in the relationship between mood and cognitive functioning. [ABSTRACT FROM AUTHOR]

Parkinson's disease (PD) is characterized by motor symptoms, but focused and extensive research in the last years has provided new knowledge in the field of non-motor symptoms. Non-motor symptoms include neuropsychiatric symptoms such as depression, anxiety, psychosis, apathy, impulse control disorders, and occur in the majority of patients with PD. They are associated with impaired quality of life for patients and relatives, additional deterioration of function and increased use of health resources. Medical and surgical therapies commonly used for treatment of PD can induce or worsen such symptoms. This paper discusses the epidemiology, clinical features and treatment approaches for neuropsychiatric symptoms (NPS) in PD in the perspective of clinical practice and management. The prevalence rates of various NPS are high, various demographic, clinical and treatment related variables have shown to be associated with higher risk of NPS. Randomized controlled trials of pharmacological and non-pharmacological treatments of NPS in PD are sparse. Current evidence supports tricyclic antidepressants as efficacious treatment of depression in PD and antipsychotic clozapine as efficacious choice for psychosis. Further studies to evaluate various other management strategies of NPS in PD are required. Neuropsychiatric symptoms in PD should be considered an integral part of the disease; hence a multidisciplinary approach is essential to improve the overall outcome of PD also through raised awareness and enriched knowledge on NPS. [ABSTRACT FROM AUTHOR]

Background: Cognitive assessment of older adults typically includes symptom reports and objective evaluations. However, there is often poor agreement between these measures. Cultural norms, stress, and anxiety may also influence cognitive self-appraisal and performance. Little research describes how other factors affect the self-report/objective test discrepancies noted in the literature. Objective: This study investigated whether the disparity between subjective cognitive concerns and objective cognitive performance is related to measures of anxiety and stress in older Black and African American adults. Methods: Telephone screenings were administered to 206 older adults (ages 64–94) during the first year of the pandemic. Demographic data, objective memory (Telephone Interview for Cognitive Status [TICS-m]), an adaptation of the subjective memory measure, the Cognitive Change Questionnaire, emphasizing executive functioning in everyday life [CCQ-e]), Generalized Anxiety Disorder-7 (GAD-7), and Perceived Stress Scale-4 (PSS4) were measured. Metacognition Discrepancy Index (MDI) was calculated from the standardized residual after regressing TICS-m on CCQ-e scores to quantify the discrepancy between cognitive self-appraisal and objective cognitive functioning. Results: Neither GAD-7 nor PSS-4 moderated the relationship between TICS-m and CCQ-e, and TICS-m scores weakly predicted subjective CCQ-e scores (F(1, 197)=4.37, p = 0.038, R2 = 0.022). The MDI correlated with stress and anxiety (rs = 0.294, 0.396, ps < 0.001). Conclusion: Discrepancies exist between objectively measured and self-evaluated cognition. Elevations in stress and anxiety are associated with greater overestimation of cognitive difficulties relative to objective performance. Pandemic-related stressors may have worsened anxiety and diminished self-appraisal of cognitive abilities for some individuals, while others may remain reluctant to acknowledge impairments. Social and emotional factors are meaningful considerations in assessing cognitive difficulties. [ABSTRACT FROM AUTHOR]

BACKGROUND: It is well established that environmental factors can have impact upon an injured person's recovery and return-to-work outcomes. To date, there has been no cohesive model to provide theoretical understanding of the way in which these divergent factors combine to create disability behaviours. OBJECT: Development of a conceptual model for understanding the development of disability behavior. METHODS: Interpolation from existing neuroplasticity theory to observed behaviors and studies of behavior in the workers' compensation environment, including existing research concerning predictors for disability. RESULTS: The paper describes a conceptual model for understanding instances of disability that are not necessarily attributable to physical harm. Preliminary testing provides support for the model.CONCLUSIONS: Factors that contribute to the formation of a neural network supporting the behavior of learned disability are described. From that description, intervention methods to prevent or resolve so-called "needless disability" are discussed. [ABSTRACT FROM AUTHOR]

Background: Dementia is one of the pathologies that has increased the most among the older population (mainly Alzheimer's disease), and it has a direct impact on the quality of life (QoL), cognitive performance, and health of these patients. Family functionality can play a role in this QoL if these patients are not institutionalized. Objective: To analyze the role of family function in the QoL and health perception of non-institutionalized dementia patients, as well as related variables such as anxiety, depression, optimism, or pessimism. Methods: Cross-sectional study with a sample of 54 patients diagnosed with some type of dementia, non-institutionalized, or in outpatient care, from different centers in the province of Valencia (Spain). The EQ-5D, MMSE, Apgar Family or general health, and Goldberg anxiety and depression questionnaires were utilized. Results: The correlation of the Apgar Family with the General Health Questionnaire-new onset problems variable (GHQ) and Chronicity and General Health Questionnaire-chronic problems (CGHQ) of the Goldberg Quality of Life questionnaire was statistically significant and negative (GHQ r = –0.310; p = 0.034. CGHQ r = –0.363; p = 0.012); as well as between Apgar Family and Anxiety-Depression (r = –0.341; p = 0.020). The correlation of the Apgar Family with the Life Orientation Test-Pessimism variable (LOT) was statistically significant and negative (r = –0.270; p = 0.061). Finally, severe dysfunction of Apgar Family has a negative correlation with self-perception of health (p = 0.036 B = –16.589) determined by the Visual Analogue Scale (VAS). Conclusion: Family functionality directly influences anxiety, depression, optimism, and pessimism. This could explain why family function is related to the QoL of patients and their self-perception of health. [ABSTRACT FROM AUTHOR]

Background: People with mild cognitive impairment (MCI) need to prevent the further decline of their cognitive functions, and one way to do so is by learning a foreign language. Objective: This study describes the development of a protocol for a novel, non-pharmacological intervention for people with MCI that seeks to prevent or reduce cognitive decline by teaching English through songs. Methods: The development of this protocol follows a mixed-methodology approach, consisting of three stages: 1) development of the protocol of the intervention, 2) a randomized controlled trial study with two arms over six months that includes an intervention group and a control group, and 3) the evaluation of the protocol by trainers. In the second stage, we recruited a total of 128 people with MCI from the five participating countries of this study (Greece, Spain, Croatia, Slovenia, and Italy). This educational program will assess three main outcomes after 6 months of the English Lessons with the Use of Songs for People with Mild Cognitive Impairment (E.L.So.M.C.I.) workshops. Results: Our primary outcome will hopefully be an improvement in general cognition in the intervention group compared to the control group from baseline to 6 months follow-up. Secondary outcomes include a decrease in participants' anxiety and depression and an improvement in their quality of life. Development of English language skills is the last outcome. [ABSTRACT FROM AUTHOR]

BACKGROUND: Sinus floor elevation and immediate dental implantation are commonly performed to treat dentition defects in elderly patients. Targeted cognitive behavioral interventions (CBI) during the perioperative period can reduce pain and anxiety as well as improve sleep quality. This can lead to improvements in patient cooperation during follow-up treatment and enhance the overall efficacy of the surgery. OBJECTIVE: The study aimed to investigate the impact of a cognitive behavioral intervention method on perioperative pain, anxiety, and sleep quality in elderly patients undergoing sinus floor elevation and immediate dental implantation. METHODS: Forty patients who required the treatment at the Stomatology Clinic in our hospital between December 2018 and December 2022 were enrolled in this randomized controlled trial. The patients were randomly divided into two groups: a control group (n = 20), which received conventional treatment and care during the perioperative period, and an intervention group (n = 20), which received comprehensive behavioral intervention in addition to the conventional treatment and care during the perioperative period. The perioperative anxiety, pain, and sleep quality of the patients in both groups were evaluated. Anxiety was assessed using the Self-Rating Anxiety Scale (SAS), sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), and pain was measured using the visual analog scale (VAS). RESULTS: No statistically significant differences in SAS and PSQI were observed between the two groups at the initial visit; the values were significantly higher than those measured postoperatively. The SAS scores and PSQI of patients on days 0 and 7 post-surgery in the intervention group were significantly lower than those in the control group (P < 0.05). CONCLUSION: Perioperative cognitive behavioral intervention can effectively improve anxiety, postoperative pain and sleep quality in elderly patients who have undergone sinus floor elevation and immediate dental implantation, thereby reducing the incidence of complications. [ABSTRACT FROM AUTHOR]

BACKGROUND: Cognitive deficits have been defined in patients with bilateral and unilateral vestibular loss. OBJECTIVE: To investigate cognitive functions in patients with episodic vestibular disorders. METHODS: Nineteen patients with Meniere's disease (MD), 19 patients with vestibular migraine (VM) and 21 age and education matched healthy controls were studied. Mini Mental State Examination assessing global mental status, Reading Span Test and the Stroop Test evaluating working memory, cognitive processing, reading comprehension and attention, Trail Making Test and Benton's Judgment of Line Orientation Test investigating visual processing, visuospatial skills, processing speed were used. Beck depression and anxiety inventories were given to evaluate the emotional status. RESULTS: Cognitive test results of the MD and VM patients were not significantly different from the healthy controls (p > 0.05) as well as Beck depression scores (p = 0.14). Beck anxiety scores showed significant difference (p = 0.003). VM patients had significantly higher scores than the healthy controls (p = 0.002) on pairwise comparisons. The scores of the MD patients did not reach statistical significance (p = 0.15). CONCLUSION: Episodic vestibular disorders like MD and VM without inter-ictal vestibular deficits do not seem to be associated with cognitive impairment. Patients with VM have significantly higher anxiety scores than the healthy controls and MD patients. [ABSTRACT FROM AUTHOR]

Background: Cognitive behavioral therapy (CBT) reduces anxiety symptoms in patients with Parkinson's disease (PD). Objective: The objective of this study was to identify changes in functional connectivity in the brain after CBT for anxiety in patients with PD. Methods: Thirty-five patients with PD and clinically significant anxiety were randomized over two groups: CBT plus clinical monitoring (10 CBT sessions) or clinical monitoring only (CMO). Changes in severity of anxiety symptoms were assessed with the Parkinson Anxiety Scale (PAS). Resting-state functional brain MRI was performed at baseline and after the intervention. Functional networks were extracted by an Independent Component Analysis (ICA). Functional connectivity (FC) changes between structures involved in the PD-related anxiety circuits, such as the fear circuit (involving limbic, frontal, and cingulate structures) and the cortico-striato-thalamo-cortical limbic circuit, and both within and between functional networks were compared between groups and regressed with anxiety symptoms changes. Results: Compared to CMO, CBT reduced the FC between the right thalamus and the bilateral orbitofrontal cortices and increased the striato-frontal FC. CBT also increased the fronto-parietal FC within the central executive network (CEN) and between the CEN and the salience network. After CBT, improvement of PAS-score was associated with an increased striato-cingulate and parieto-temporal FC, and a decreased FC within the default-mode network and between the dorsal attentional network and the language network. Conclusion: CBT in PD-patients improves anxiety symptoms and is associated with functional changes reversing the imbalance between PD-related anxiety circuits and reinforcing cognitive control on emotional processing. [ABSTRACT FROM AUTHOR]

BACKGROUND: Parkinson's disease (PD) caregivers, particularly in Latin America, may experience high levels of affiliate stigma due to their association with a person having a disability. The most common measure used of this construct in the literature, the Affiliate Stigma Scale, was validated using non-standard and questionable methods. OBJECTIVE: The purpose of this study was to investigate the factor structure and psychometric properties of the Spanish version of the Affiliate Stigma Scale with PD caregivers in Mexico using more widely accepted psychometric approaches including confirmatory and exploratory factor analyses (CFAs, EFAs). METHODS: A sample of 148 PD caregivers from Mexico completed this measure, as well as indices of caregiver burden and anxiety. RESULTS: Initial CFAs revealed that the data did not fit either the originally proposed one-factor or three-factor structures. An EFA was then conducted which was unable to discern any factor structure. Upon instituting a stepwise removal alpha-if-item-deleted process, a 5-item Affiliate Stigma Scale Spanish Short Form was retained with an adequate Cronbach's alpha, good convergent validity, and a Short Form CFA generally indicating adequate fit. CONCLUSIONS: The new Spanish Affiliate Stigma Scale Short Form holds promise for more appropriately measuring affiliate stigma likely in general but particularly in Spanish and among PD caregivers. The Short Form can assist not only in assessing levels of caregiver affiliate stigma, but in creating novel interventions to help support caregivers and decrease stigma. [ABSTRACT FROM AUTHOR]

BACKGROUND: The Indigenous workforce in Canada is challenged by a history of Euro-Canadian colonialism that has presented deleterious health outcomes, including those in the workplace. OBJECTIVE: The aim of this study was to describe the mental health of Indigenous workers in the workplace. METHODS: We used the Canadian Community Health Survey (CCHS) between 2015 to 2016. Data were analyzed using the Public Use Microdata Files to profile the workplace mental health characteristics of First Nation Canadians (n = 6,297) and Canadians (n = 84,155). We utilized secondary data analysis design. The analyses included descriptive statistics (e.g., means and standard deviations) of self-reported mood disorders (depression, bipolar, mania, dysthymia), anxiety (phobia, OCD, panic) and occupational factors (e.g., demographic, days off work due to an acute mental health condition, job type, and job stress) in indigenous peoples living off-reserve and other Aboriginal settlements in the provinces. RESULTS: We examined the indigenous cohort between the ages of 18–64 who were employed. The sample was 53.1% male, married (34.8%), and obtained a post-secondary diploma or university degree (57.9%). The study reported statistically significant gender and age differences across mood and anxiety disorders (p < 0.05), job stress (p < 0.05) and workload (p < 0.05). CONCLUSION: To the best of our knowledge, this is the first study to describe the work profile of indigenous populations in Canada across various occupational mental health (e.g., mood disorders, anxiety) and demographic (e.g., age, education attainment) outcomes. [ABSTRACT FROM AUTHOR]

Depending on the characteristics of the cancer and the specific treatment required, each type of cancer comes with a unique set of challenges in the psychological wellbeing of women. This research work mainly focuses on Ovarian cancer since the it is one of the 5 th leading cancers among women. As per the statistics of 2021, by the American Cancer Society, 21,410 women would be diagnosed with ovarian cancer and 13,770 women might die from ovarian cancer. Both physically and psychologically, ovarian cancer presents several challenges. To control the growth of the tumour, multiple treatments are required. The psychological issues in women with ovarian cancer is mainly due to "loss of femininity" that affects them while they proceed through the phases of diagnosis, treatment and recurrence. Psychological factors associated with both, having ovarian cancer and being at risk are considered in this study. In the proposed work, PHQ 9 and GAD 7 are the tools used to measure depression and anxiety among women who are undergoing treatment for ovarian cancer. The data, collected with the help of these tools, is analysed using the popular Machine Learning algorithms such as k-Nearest Neighbour (kNN), Random Forest, Support Vector Machine (SVM), Artificial Neural Network etc. The results of Machine Learning algorithms are then compared with Mamdani and Sugeno fuzzy inference models. The Sugeno fuzzy inference system outperformed in comparison to all other models, with an accuracy of 96.2% for depression and 98.83% for anxiety, followed by Mamdani fuzzy inference system giving 94.3% accuracy for depression and 96.7% for anxiety. The performance is then compared with the linear SVM which obtained an accuracy of 91.52% for depression and 93.78% for anxiety. The analysed performance of the data using computational algorithms are compared with that of expert clinical psychologists. The severely affected women are advised to visit a psychiatrist. [ABSTRACT FROM AUTHOR]

Background: Fear of progression (FoP) is a reactive, conscious concern about chronic disease progression and its consequences which may limit quality of life substantially. Only one study has examined FoP in Parkinson's disease (PD), showing the second highest FoP scores among chronic diseases. Objective: To examine FoP prevalence and to exploratorily analyze determinants of FoP in PD. Methods: Within a multicenter cross-sectional study, 120 PD inpatients (age: 64.45±9.20; 60.8% male; UPDRS-III: 28.86±16.12) were examined with the FoP questionnaire (FoP-Q; max. 20 points). Stepwise multiple linear regression analysis examined sociodemographic, clinical, and (neuro-) psychological determinants of FoP. Results: With a mean FoP-Q score of 8.08±2.17, 63.0% of the patients were classified with moderate FoP and 17.6% with dysfunctional (i.e., severe) FoP. The highest scores were shown for the subscale 'loss of autonomy'. Increased levels of anxiety, less self-efficacy, female gender, current employment, and lower health literacy were identified as significant determinants associated with FoP. Conclusion: With more than 80% of patients showing moderate to dysfunctional FoP, it must be regarded as a frequent symptom in PD, which needs to be further understood and addressed in clinical practice. Clinical parameters like PD duration and severity were no determinants for FoP, indicating that FoP awareness must be considered by professionals at all disease stages. [ABSTRACT FROM AUTHOR]

The article examines the consequences of Laser and taping applications on pain, flexibility, anxiety, depression, functional status and quality of life in patients with fibromyalgia syndrome. Topics discussed include the effectiveness of conventional treatments for controlling pain and maximizing function in fibromyalgia and the search for evidence for various physiotherapy applications. Decreased pain severity in activity, anxiety level, and enhanced quality of life is mentioned.

BACKGROUND: It is important to determine nurses' levels of knowledge, health-protective practices for work and social life, and mental health states at the beginning of the COVID-19 pandemic to combat the pandemic and minimize further problems. OBJECTIVES: To determine the relationships between knowledge levels, health-protective practices, and anxiety among nurses during the COVID-19 pandemic. METHODS: This cross-sectional study was carried out with the online participation of 605 nurses in Turkey. The researchers prepared a questionnaire form to evaluate the participants' knowledge of COVID-19 and their awareness and health-protective behaviours in work and social life. The mental health statuses of the participants were assessed with the Generalized Anxiety Disorder (GAD-7) questionnaire. RESULTS: Most of the participants (87.8%) had high levels of knowledge of COVID-19, while 28.8% had severe levels of anxiety disorder. The use of alcohol-based hand disinfectants (88.2%) and the use of N95 or N99 masks (88.5%) were the least frequently practiced protective behaviours at work, while in social life, a healthy and balanced diet (61.6%), social distancing (72.8%), and paying attention to one's sleep pattern (77.3%) were the least frequently practiced protective behaviours. Older age (41–50 years), higher education (master's degree) and having a work experience of 10 years or more were determined to increase the knowledge levels of the participants about COVID-19 (p < 0.001). Anxiety levels were higher in those with a history of mental illness (p < 0.001). CONCLUSIONS: Determining the knowledge levels, health-protective practices, and anxiety levels of nurses who are struggling in the frontlines in the field of health during the pandemic period can make a great contribution to the management of different current epidemics and pandemics and future ones by showing the areas in which nurses need to be empowered. [ABSTRACT FROM AUTHOR]

BACKGROUND: Health care providers (HCPs) and health care students experience a huge amount of stress due to high workloads and pressure to perform and are likely to develop anxiety, depression and burnout. OBJECTIVE: The objective was to carry out an umbrella review of systematic and narrative reviews on the effectiveness of mindfulness-based interventions in reducing stress and improving well-being in HCPs and health care students. METHODS: Systematic and narrative reviews that examined the impact of mindfulness-based interventions on HCPs and healthcare students' perceived stress were identified through a systematic search of three electronic databases: PubMed, Scopus and Web of Science. RESULTS: Fifteen articles were included in the analysis: eleven systematic and four narrative reviews. Studies' quality varied from critically low to high. The different interventions showed positive results in reducing stress in both HCPs and students, with mindfulness-based stress reduction (MBSR) course having the major impact. CONCLUSIONS: MBSR techniques and other mindfulness based interventions resulted to be potentially effective in reducing stress. However, despite the vast amount of data collected by the studies and the promising results, several limitations affected the validity of the studies. Therefore, more research that considers the critical aspects of this field is required, in order to provide more reliable results. [ABSTRACT FROM AUTHOR]

BACKGROUND: As millions of teachers have been forced to rely upon remote teaching due to the closure of schools during the COVID-19 pandemic. It is particularly important to understand the extent to which teacher's psychological wellbeing has been affected by this global health crisis. OBJECTIVE: The aim of this comprehensive systematic review and meta-analysis was twofold: 1) ascertain the prevalence of stress, anxiety, depression among teachers during the COVID-19 outbreak; 2) identify the associated factors of these psychological wellbeing domains of the teachers. METHODS: Academic Search Premier, Eric, PsycInfo, Scopus, and Web of Science were searched for articles published from December 2019 and July 2021, using search terms including "COVID-19" "anxiety" "depression" "stress", and "teachers". RESULTS: This study included 54 studies synthesising data from 256,896 teachers across 22 countries. The meta-analysis showed higher prevalence of stress (62.6%, 95% Confidence Interval [CI]: 46.1–76.6), compared to anxiety (36.3%, 95% CI: 28.5–44.9) and depression (59.9%, 95% CI: 43.4–74.4) among teachers. Teachers' experiences of these psychological issues were associated with various socio-demographic and institutional factors, including gender, nature of online teaching, job satisfaction, teaching experience, and the volume of workload. Additionally, several protective factors, such as regular exercises and provision of technical support for online teaching, reduced teachers' negative psychological experiences. CONCLUSION: There is a need for authorities to formulate educational policies to improve teachers' wellbeing at the time of global crisis. Special attention should be paid to assist female teachers in overcoming physical and mental stressors. [ABSTRACT FROM AUTHOR]

BACKGROUND: Persistent Postural-Perceptual Dizziness (PPPD) is a chronic functional disorder which interferes with the way individuals experience their personal, social and work life. OBJECTIVE: To study the impact of disease duration in PPPD on the quality of life (QOL), dizziness handicap and mental health on the patients. METHODS: A prospective study comparing the EQ-5D for QOL, Dizziness Handicap Inventory (DHI) and DASS-21 between 27 patients with PPPD and 27 of those who have recovered from an acute vestibular event. Similar parameters between PPPD patients with symptoms less than one year and more than a year were compared. RESULTS: The PPPD patients were predominantly females and middle-aged with significantly higher DHI scores (mean 48.3 + 25.7, p = 0.00002), higher total mean scores in the DASS-21 (mean 21.6 + 13.7, p = 0.009) and poorer QOL with mean EQ-5D VAS of 67.9 + 17.3 (p < 0.00001). PPPD patients with symptoms for more than a year had significant increase in physical handicap (p = 0.041) as well as anxiety levels (p = 0.008). CONCLUSIONS: PPPD is predominantly seen in females and middle-aged which significantly reduces the QOL, increases dizziness handicap and increases depression, anxiety and stress levels. The increase in duration of illness further increases the anxiety levels and physical handicap. [ABSTRACT FROM AUTHOR]

The article presents a study which examined the effectiveness of art therapy and artistic engagement in addressing the anxiety and stress of COVID-19 patients and their treatment teams in Kolkata, India. Among the various art and performance activities during the study are drawing, poetry, music, and theatre. Also mentioned are the factors leading to stress and anxiety like fear of death and isolation, and the effectiveness of art as a tool to improve relisience of patients and their carers.

BACKGROUND: The likelihood of infection with SARS-COV-2 (COVID-19) in the dental office is considered high. OBJECTIVES: Assessing the impact of the COVID-19 on dental practices and anxiety levels in risk group Brazilian dentists. METHODS: A cross-sectional study was performed using an online questionnaire. The data obtained were analyzed using the IBM SPSS 25.0 software (Pearson's Chi-square association test, multivariate logistic regression, and Poisson multiple regression), with subsequent calculation of the odds ratio at a 95% confidence interval, with a significance level of 5%. RESULTS: Responses of 578 dentists distributed in all regions of Brazil were collected. Most of the dentists were female, with an average age of 35. Of the participants, 23.4% were part of the increased risk group for COVID-19. The professionals who belonged to the increased risk group had a greater chance of not feeling prepared to perform consultations (OR = 1.67) and were not performing any procedures during the pandemic (OR = 2.03). Belonging to the increased risk group did not influence anxiety levels among the dentists. The factors associated with increased anxiety were being female, being younger, working in the southeastern region of the country, being afraid of contracting COVID-19 while working, and being concerned for one's professional future. CONCLUSIONS: The pandemic has had a negative impact on the professional practice of individuals at risk, but the level of anxiety was like professionals who were not part of the increased risk group for COVID-19. [ABSTRACT FROM AUTHOR]

BACKGROUND: Early studies have revealed the psychological effects of the COVID-19 outbreak on healthcare workers (HCWs). Burnout and psychological outcomes of different medical professions during the pandemic have not yet been addressed. OBJECTIVE: The study aimed to investigate the burnout, depression, anxiety, and psychological distress levels of HCWs, and to determine the predictive factors of burnout in different professions of frontline HCWs during the pandemic. METHODS: This cross-sectional study included 253 HCWs (79 physicians, 95 nurses, and 79 other-HCWs). The Maslach Burnout Inventory, Beck Depression Inventory, Beck Anxiety Inventory, and Impact of Event Scale-Revised, and Sociodemographic Form were used. RESULTS: Emotional exhaustion was significantly higher in physicians and nurses than in other frontline HCWs. While depersonalization was significantly higher in physicians than nurses / other HCWs, levels of avoidance, hyperarousal and intrusion were found to be higher in other HCWs / nurses than physicians. Depression was the most effective predicting variable for burnout, following age, quarantine, supervisor's/team leader's attitude, hyperarousal and avoidance. CONCLUSIONS: It has been observed that depending on the uncertainty and life risk of the pandemic in HCWs involved in the treatment of COVID-19, physicians who are the decision-making authorities in the treatment process used more depersonalization than nurses and other HCWs. Nurses and other-HCWs had significantly higher distress symptoms than physicians. Both future research and psychosocial services should address those with high depressive symptoms as a potentially fragile subgroup for burnout among HCWs, and investigate and develop evidence-based interventions that can provide mental well-being, and prevent burnout. [ABSTRACT FROM AUTHOR]

BACKGROUND: Persistent Postural Perceptual Dizziness (PPPD) is a newly defined condition which was added to the International Classification of Vestibular Disorders in 2017. Little is known about its impact on patients. OBJECTIVE: The goal of this study was to analyze the symptomology, epidemiology and impact of PPPD on patients. METHODS: A retrospective chart review was done to identify patients who attended the Multidisciplinary Dizziness Clinic (MDC) and were diagnosed with PPPD. Responses to demographic questions, health-related quality of life surveys and several well-validated questionnaires commonly used to assess dizziness severity were analyzed. RESULTS: One hundred patients were diagnosed with PPPD between March 2017 and January 2019, of which 80%(80/100) were females. The average Dizziness Handicap Index score was 60.3±19.0. Responses to the Patient Health Questionnaire classified 53 patients (53/99;53.5%) as moderately to severely depressed. Sixty-four patients (64/100;64.0%) were minimally or mildly anxious according to the Generalized Anxiety Disorder scale. The average Vertigo Symptom Scale score was 24.1/60. The average Situational Vertigo Questionnaire score was 2.00. Forty-nine (49/100;49.0%) patients had migraine symptoms according to the Migraine Screen Questionnaire. CONCLUSIONS: In conclusion, patients with PPPD display important handicap and an elevated risk of depression, anxiety and migraines. [ABSTRACT FROM AUTHOR]

BACKGROUND: This study is the second leg of a two-leg project. In the first leg, the effect of the COVID-19 pandemic on healthcare workers (HCWs) was investigated in the period between the first case in Turkey and the arrival of the first case in the hospital. OBJECTIVE: In this second leg, three months after the first evaluation, we aimed to investigate whether psychological effects of COVID-19 such as stress, anxiety, depression, and sleep quality have been changed on HCWs. METHODS: This was a 3-month observational study. 169 hospital staff who participated in the first leg of the study were reached and asked to participate in the second leg evaluation in Gaziantep University Medical Faculty Hospital.110 HCWs accepted to participate. Impact of Event Scale (EIS-R), Depression Anxiety Stress Scale (DASS-21), and Pittsburgh Sleep Quality Index (PSQI) were used to assess in both two legs. Paired Sample T-test was used for comparison of normally distributed variables. Wilcoxon test was used for the comparison of abnormally distributed variables. SPSS 22.0 software was used in the analysis of variables. RESULTS: Of the HCWs with an average age of 33.9±6.6 years, 59% (65) were males. There was no significant difference between the two legs in terms of IES-R, DASS-21, and PSQI scales. CONCLUSION: This study suggests that the psychological effects of the COVID-19 pandemic on HCWs started with the pandemic, before the arrival of the first case in the hospital. Also, these psychological effects continued similarly without significant change after the initiation of direct contact with COVID-19 patients and even after the increase in COVID-19 patients in a hospital which in they work. [ABSTRACT FROM AUTHOR]

AIM: To determine the effects of a structured, moderate-intensity, early cardiac rehabilitation (CR) program on physical function and psychological wellbeing in patients following aortic root replacement. MATERIALS AND METHODS: Patients were randomly assigned to either an 8-week (24 sessions) cardiac rehabilitation (CR) program, 4 to 6 weeks after aortic root replacement using the Bentall procedure, or to an age- and sex-matched control group undertaking no structured exercise. Physical function (via exercise treadmill test (ETT)) and psychological wellbeing (assessed via DASS-21 and SF36) were assessed before and following 8-weeks of CR. RESULTS: 30 patients (15 in the control (mean age: 37±10 years) and 15 in the intervention group (mean age: 38±11 years)) completed the 8-week CR programme and no adverse events were reported over the intervention period. In the CR group, all sub-components of the SF-36 and DASS-21 increased (all P < 0.05), showing an overall improvement in psychological wellbeing following the intervention. Distance walked on the ETT (improved significantly following 8-weeks of CR (490±167 m v 659±141 m; Λ improvement = 169 m; P < 0.05). There were no changes in physical function and psychological wellbeing in the controls (P > 0.05). A significant group-by-time interaction effect was evident for physical function and all sub-components of the SF-36 and DASS-21 (all P < 0.05) highlighting significant improvements in outcomes in the CR group compared to controls. CONCLUSIONS: This small sample, aerobic-based, moderate-intensity CR is safe and effective, and can be tolerated only 4–6 weeks after complex aortic root replacement surgery. [ABSTRACT FROM AUTHOR]

BACKGROUND: Torn between the decision to return to school classrooms or continue holding online classes during COVID-19, teachers around the world feel great uncertainty. OBJECTIVE: Bearing in mind that the study of mental health during the pandemic is of great importance for vulnerable categories, and given the role of teachers in society, the aim of this research is to assess teachers' concerns and anxiety before the start of the school year, and also to examine the factors related to them and propose measures in line with the results. METHODS: The study was conducted as a cross-sectional study before the start of the 2020/2021 school year. The research sample consisted of 286 teachers. For the purposes of this research, a special questionnaire was constructed consisting of a general questionnaire and a Generalized Anxiety Disorder 7-item scale (GAD-7). RESULTS: The strongest predictor of a teacher's answer that they were concerned about the reopening of schools was their concern for their own life and health and for the life and health of their family members, followed by the amount of information received about COVID-19, and, finally, older age. Only 2% of teachers had mild anxiety. CONCLUSIONS: This research indicated that it is necessary to examine in more detail the degree of teachers' concern and its impact on their functionality and work process. It is also necessary to repeat the research on the mental health status of teachers and implement procedures in the form of a regular screening program of the mental health status of teachers or implement procedures of support in concern management. [ABSTRACT FROM AUTHOR]

Background: Cognitive training (CT) may have benefits for both healthy older adults (HC) and those with early cognitive disorders [mild cognitive impairment (MCI) and dementia]. However, few studies have qualitatively evaluated home-based, computerized CT programs.Objective: We present the qualitative arm of a feasibility randomized controlled trial evaluating a CT program for HC and people living with MCI or dementia.Methods: Participants underwent semi-structured interviews after 12 weeks of CT. Where possible, participants were interviewed with their carers. The interview schedule and analysis were underpinned by the health belief model. Interviews were audio-recorded, transcribed, open-coded, and categorized into themes. The analytical framework was developed, and themes were condensed under five major categories: benefits, barriers, threat, self-efficacy, and cues to action.Results: 37 participants underwent interviews. CT was feasible and acceptable to participants. Benefits included: enjoyment, improved awareness, benchmarking cognitive function, reassurance of abilities and giving back control. Barriers were more prevalent among those with dementia: problems with technology, frustration, conflict between patients and carers, apathy and lack of insight, anxiety or low mood, and lack of portability. HC and MCI perceived the severity of dementia risk as high, partially mitigated by CT. Participants living with dementia valued a more individualized approach to training, accounting for baseline characteristics.Conclusion: CT was a feasible intervention for HC and people living with dementia and MCI. Benefits were present, but the identified barriers need to be addressed for CT to be implemented successfully. [ABSTRACT FROM AUTHOR]

Background: While most intervention studies conducted with dementia family caregivers have focused on depressive symptoms as the main outcome, no study has analyzed the effects of an intervention on comorbid clinical presentations of depressive and anxious symptomatology.Objective: The aim of this study was to examine the association between clinical depressive and anxious symptomatology at baseline and treatment responses of dementia family caregivers using samples from two randomized intervention trials with the same pre-post design.Methods: Specifically, the effects on depressive and anxious comorbidity of three intervention conditions (Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), and a control group (CG)) were analyzed. Participants were 130 dementia family caregivers. In addition to sociodemographic variables, depressive and anxious symptomatology were measured.Results: Caregivers with clinical depressive and anxiety comorbid symptoms at baseline recovered less well from depressive symptoms after CBT (45.45%) and ACT (47.72%) interventions than caregivers with non-comorbidity (100% recovery in both treatments). No significant association between comorbidity and treatment responses on depression was found for the control group. Regarding anxiety, among participants with comorbidity at baseline, 36.36% of caregivers in CBT and 30.9 % in the ACT group recovered from anxiety symptoms after treatment, compared to 6.45% in the control group. Similar results were obtained regarding those caregivers who recovered both from clinical depressive and anxiety symptoms and showed comorbidity at baseline.Conclusion: Caregivers that show comorbid depressive and anxiety symptoms at baseline may benefit less from interventions than caregivers who do not show comorbidity. [ABSTRACT FROM AUTHOR]

Background: Normal aging is accompanied by cognitive deficiencies, affecting women and men equally. Aging is the main risk factor for Alzheimer's disease (AD), with women having a higher risk. The higher prevalence of AD in women is associated with the abrupt hormonal decline seen after menopause. However, other factors may be involved in this sex-related cognitive decline. Alterations in gut microbiota (GM) and its bioproducts have been reported in AD subjects and transgenic (Tg) mice, having a direct impact on brain amyloid-β pathology in male (M), but not in female (F) mice.Objective: The aim of this work was to determine GM composition and cognitive dysfunction in M and F wildtype (WT) and Tg mice, in a sex/genotype segregation design.Methods: Anxiety, short term working-memory, spatial learning, and long-term spatial memory were evaluated in 6-month-old WT and Tg male mice. Fecal short chain fatty acids were determined by chromatography, and DNA sequencing and bioinformatic analyses were used to determine GM differences.Results: We observed sex-dependent differences in cognitive skills in WT mice, favoring F mice. However, the cognitive advantage of females was lost in Tg mice. GM composition showed few sex-related differences in WT mice. Contrary, Tg-M mice presented a more severe dysbiosis than Tg-F mice. A decreased abundance of Ruminococcaceae was associated with cognitive deficits in Tg-F mice, while butyrate levels were positively associated with better working- and object recognition-memory in WT-F mice.Conclusion: This report describes a sex-dependent association between GM alterations and cognitive impairment in a mice model of AD. [ABSTRACT FROM AUTHOR]

BACKGROUND: The suicide of college students had been a social topic attracting people's attention, and the generation of suicidal ideation was an inevitable link in the psychological process of suicidal behavior. It was the focus of many researches whether the pressure of college students with suicidal ideation can be detected and relieved in time. OBJECTIVE: The study aimed to analyze the therapeutic effect of cognitive behaviour therapy on psychological stress, depression, and other negative emotions of college students with suicide ideation. METHODS: 114 people from 1,158 college students with suicide ideation in the Wuhan area were divided into an experimental group and a control group in this study. Students in the experimental group were given with the cognitive behaviour therapy, and students in the control group were not intervened in any way. The suicide ideation scale (despair, optimism, and sleep), psychological stress test rating, and self-reporting inventory (somatization, compulsion, interpersonal relationship, depression, anxiety, hostility, terror, delusion, and psychosis) were used to evaluate the objects in the pre-test stage, intermediate-test stage, and the tracking-test stage. The multivariate logistic regression was adopted to analyze the influencing factors of the suicide ideation of the college student. RESULTS: The suicide ideation of the college student was significantly positively correlated with the psychological stress, depression, interpersonal sensitivity, anxiety, and psychosis (P > 0.05); the total score of suicide ideation, despair, optimism, and sleep in the experimental group were lower than those in the control group (P < 0.05) in the intermediate-test stage and the tracking-test stage (P < 0.05); the psychological stress, depression, and anxiety of the college students in the experimental group in the intermediate-test and tracking-test stage were slighter than those in the control group (P < 0.05); the somatization, compulsion, and interpersonal relationship of students in the experimental group were significantly lower than those in the control group (P < 0.05). CONCLUSIONS: The psychological stress, depression, interpersonal sensitivity, anxiety, and psychosis were all risk factors for the college student to have suicide ideation. Negative emotions such as psychological stress, emotional depression, and anxiety of the college student with suicide ideation could be improved effectively by cognitive behaviour therapy, and the level of suicide ideation could be reduced finally. [ABSTRACT FROM AUTHOR]

Background: Psychological difficulties such as anxiety, depression, and irritability are common in Huntington's disease, even for premanifest individuals. However, very little evidence exists of psychological approaches to manage this distress. We have conducted a feasibility study with an embedded qualitative component to investigate the possibility of using mindfulness-based cognitive therapy (MBCT) and present here the findings from the qualitative data. Objective: To investigate the experience of premanifest individuals learning and practising mindfulness through completing a course of MBCT. Methods: Twelve premanifest individuals completed a course of MBCT and attended three follow up reunion meetings over the following year. Eleven participants agreed to be interviewed post-course and ten participants one year post-course about their experience of the course and any impact on their lives. Seven participants nominated a friend or relative (supporter) to be involved in the research, of whom six agreed to be interviewed post-course and two at one year about the impact of the course on the participants. Data were analysed using reflexive thematic analysis. Results: Four themes were constructed from the data: 1) A meeting of minds: the group facilitating learning and support; 2) Mindfulness is hard, but enables more effective emotional management; 3) Mindfulness can change the relationship with self and others; and 4) Benefiting from mindfulness: the importance of persistence. Conclusion: The participants who completed the course found it beneficial. Some participants reported reductions in psychological distress, a greater sense of calm and better emotion regulation, with some of these positive changes also noticed by supporters. MBCT is worthy of further investigation for this population. [ABSTRACT FROM AUTHOR]

Background: Caring for someone with dementia is associated with negative and positive experiences. There is little evidence based on large datasets.Objective: To present data around the experience of caring for someone with dementia, to identify support (emotional and practical) needs, and inform future service provision.Methods: A mixed-methods study embedded in the Promoting Activity, Independence and Stability in Early Dementia (PrAISED) Randomized Controlled Trial. We administered questionnaires on strain, quality of life (QoL), and perceived health to 301 caregivers and assessment of cognitive performance, depression, anxiety, and disability in activities of daily living to 301 participants with dementia. Data were analyzed through descriptive and modelling statistics. A subsample of 20 patient-caregiver dyads were qualitatively interviewed. Data around caregivers' experience of providing care were extrapolated and analyzed through inductive thematic analysis.Results: There were significant negative associations between caregiver strain and QoL (p < 0.01) and between caregiver age and QoL (p < 0.01), and significant positive associations between caregiver strain and disability (p < 0.01), cognitive impairment (p < 0.01), depression (p < 0.05), and anxiety of the person with dementia (p < 0.05). Older caregivers reported a lack of support, reinforced by their reluctance to seek help. All caregivers reported contradictory emotions associated with caring and accumulation of strain over time.Conclusion: While there is recognition that it is essential to support caregivers, dedicated intervention programs, and support strategies to respond to the needs of older caregivers are still needed. [ABSTRACT FROM AUTHOR]

BACKGROUND: As an unexpected environmental factor causing significant economic, financial, and health challenges for everyone, it is no wonder that COVID-19 presents significant employment-related worries for people with chronic health conditions and disabilities. OBJECTIVE: The purpose of this study was to explore whether higher levels of functional limitations are associated with worry about job loss for individuals with disabilities and chronic conditions. METHODS: Data for this study were collected to understand the effects of COVID-19 on individuals with disabilities and chronic conditions. A total of 219 employed participants were extracted from a total of 269 individuals with disabilities and chronic conditions. The mean age among participants was 37.83 (SD = 10.97). RESULTS: Our hierarchical logistic regression analysis revealed that (a) demographic variables were not associated with worry about job loss in the first block, (b) perceived COVID-19 stress (AOR = 2.90, p < 0.001) was correlated with worry about job loss in the second block, and (c) functional limitations (AOR = 1.06, p < 0.001) were positively correlated with worry about job loss in the third block. Overall, the entire model containing all predictor variables in three blocks explained 23% (Nagelkerke R2) of the variance in worry about job loss. CONCLUSIONS: This study contributes to the disability and vocational rehabilitation literature by examining the relationship between functional limitations and worry to lose jobs in people with disabilities. [ABSTRACT FROM AUTHOR]

BACKGROUND: Anxiety is a common neuropsychological sequela following traumatic brain injury (TBI). Cognitive Behaviour Therapy (CBT) is a recommended, first-line intervention for anxiety disorders in the non-TBI clinical population, however its effectiveness after TBI remains unclear and findings are inconsistent. OBJECTIVE: There are no current meta-analyses exploring the efficacy of CBT as an intervention for anxiety symptoms following TBI, using controlled trials. The aim of the current study, therefore, was to systematically review and synthesize the evidence from controlled trials for the effectiveness of CBT for anxiety, specifically within the TBI population. METHOD: Three electronic databases (Web of Science, PubMed and PsycInfo) were searched and a systematic review of intervention studies utilising CBT and anxiety related outcome measures in a TBI population was performed through searching three electronic databases. Studies were further evaluated for quality of evidence based on Reichow's (2011) quality appraisal tool. Baseline and outcome data were extracted from the 10 controlled trials that met the inclusion criteria, and effect sizes were calculated. RESULTS: A random effects meta-analysis identified a small overall effect size (Cohen's d) of d = –0.26 (95%CI –0.41 to –0.11) of CBT interventions reducing anxiety symptoms following TBI. CONCLUSIONS: This meta-analysis tentatively supports the view that CBT interventions may be effective in reducing anxiety symptoms in some patients following TBI, however the effect sizes are smaller than those reported for non-TBI clinical populations. Clinical implications and limitations of the current meta-analysis are discussed. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Approximately 20% of patients are not satisfied following Total knee arthroplasty (TKA). The ability to identify patients at risk of poor outcomes in the early-postoperative period following TKA could inform the development of targeted treatments with the ability to improve outcomes for these patients. This prospective cohort study aimed to identify early post-operative, prognostic factors for patients experiencing dissatisfaction and poor outcomes at 12-months post TKA. METHODS: Patients (n = 185) were recruited from TKA waiting lists at a single site, completed measures of pain intensity, neuropathic pain, anxiety, depression, generic and disease specific health related quality of life (HRQoL), satisfaction and expectations, at discharge from hospital; three weeks post-surgery and again at 1 year. ROC curve analysis identified which variables best predicted patients experiencing dissatisfaction (VAS < 5/10) and poor outcomes (Western Ontario and McMaster Universities Arthritis Index (WOMAC)<40) at 12-months. RESULTS: The strongest prognostic factors for dissatisfaction were low HRQoL (EQ5D3L) at both day of discharge (AUC = 0.812) and three weeks post-surgery (AUC = 0.810), and high pain levels (WOMAC pain sub-scale) at 3-weeks post-TKA (AUC = 0.796). The strongest prognostic factors for poor outcomes were poor function (WOMAC function sub-scale) at three weeks post TKA (AUC = 0.815); low HRQoL (EQ5D3L) at three weeks post-TKA (AUC = 0.783) and high levels of pain (WOMAC pain sub-scale) at 3 weeks post-TKA (AUC = 0782). Anxiety and depression at 3-weeks were also prognostic factors for dissatisfaction (AUC = 0.629 & AUC = 0.686) and poor outcomes (AUC = 0.632 & 0.713) at 12-months. CONCLUSION: This single site cohort study suggests that patients with low HRQoL, high pain levels, poor function, anxiety, and depression in the first three weeks following TKA are at risk of dissatisfaction and poor outcomes at one-year post-surgery. [ABSTRACT FROM AUTHOR]

BACKGROUND: Stress is an acknowledged element of the medical profession; how cultural backgrounds may affect the perception of stress is understudied. OBJECTIVE: This study aimed to examine the stress-related experiences of British South Asian medical students and junior doctors, and to explore their coping mechanisms. METHODS: Semi-structured interviews were conducted with five participants at various stages of medical training. All participants reported stress, anxiety or depression and were of a British South Asian heritage. RESULTS: An Interpretative Phenomenological Analysis was undertaken and three master themes were identified. These themes follow a narrative journey. The first theme was Individualism and External Reasoning, and referred to the factors that influenced participants career choices - both internal (e.g. a sense of self-efficacy) and external (e.g. prior exposure to the medical career). Secondly, Stress and Vulnerability examined the stress the participants experienced as a result of either internal stressors (e.g. perfectionism) or external stressors (e.g. social comparison). The last theme, Perseverance and Coping, referred to the coping strategies that participants developed to deal with aforementioned stressors, which varied from self-harm to visualisation. CONCLUSIONS: The choice to pursue a medical career was based on self-efficacy, prior exposure, and the perceived prestige of the vocation. Stressors and related coping mechanisms varied within the cohort, depending on social, environmental, and psychological circumstances. Whilst stress management interventions should take a personalised approach, considering individual cultural backgrounds; the systemic factors within medical training that directly lead to stress have to be addressed rather than merely acknowledged. [ABSTRACT FROM AUTHOR]

BACKGROUND: Antidepressants are much used and have been tested for many conditions. OBJECTIVE: To investigate the type of diagnoses in placebo-controlled trials apart from depression and anxiety. METHODS: This was a systematic review. RESULTS: We downloaded 5471 records from PubMed and excluded 3017 that contained depression or anxiety. After exclusion of non-eligible studies, meta-analyses and reviews, and records that were unclear, 1273 records remained. We counted 214 unique diagnoses, of which the most common were abuse of drugs or substances (227 records), pain or neuropathy (170), obesity (125), other eating disorders (45), obsessive compulsive disorder (66), sexual dysfunction (41), gastrointestinal disorders (40), menopausal symptoms/hot flashes (36), premenstrual dysphoric disorder (27), urinary incontinence (21), post-traumatic stress disorder (38), schizophrenia (31), dementia or cognition problems (25), insomnia (19), ADHD (17), autism spectrum disorders (14), and stroke or traumatic brain injury (15). CONCLUSIONS: Trials of antidepressants may be driven mainly by commercial interests, focusing on prevalent diseases and everyday problems. No one can live a full life without experiencing several of the problems for which these drugs were tested. Antidepressants, sometimes called happy pills, could be seen as the modern version of Aldous Huxley's soma pill intended to keep everyone happy in the "Brave New World". [ABSTRACT FROM AUTHOR]