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Over the last few decades, medical and surgical advances have led to a growing population of individuals living with congenital heart disease. The challenges of this condition can reach beyond physical limitations to include anxiety, depression and post-traumatic stress disorder. To date, these psychological outcomes have been neglected; yet, they need not be inevitable. The factors contributing to these difficulties are considered here, drawing on current evidence and neuropsychological theories including the novel application of polyvagal theory. Suggestions for developing psychologically informed medical and social care to improve mental health, wellbeing and recovery and influence policy and training are proposed (See supplemental material for video abstract). [ABSTRACT FROM AUTHOR]

Currently, self-report measures are the primary assessment tool for anxiety disorders. Since they have some limitations, alternative measurements, such as language-based measures, are worth investigating. This paper explores which language markers signal anxiety in fictitious stories written in response to four Thematic Apperception Test (TAT) cards. Participants (n = 492) from a non-probabilistic convenience sample were asked to write a short story next to each TAT card after completing the Generalized Anxiety Disorder-7. We used RoLIWC2015 to conduct the text analysis and applied the LASSO method to identify which language markers predict anxiety. The results showed that the respondents scoring high on anxiety also tend to use more words expressing negative emotions, and fewer words expressing positive emotions. Moreover, their language contained a higher frequency of words that implied semantic differentiation (i.e., but, else) and a lower frequency of words indicating leisure. In conclusion, this paper aims to shed new light on the multimethod assessment of anxiety, mainly focused on specific language signatures as reliable predictors of anxiety symptoms. Further research using more extensive text data is recommended to discover more linguistic markers and improve prediction accuracy. [ABSTRACT FROM AUTHOR]

Negative, destructive, and abusive behaviors in romantic relationships can vary from explicit kinds of abuse and aggression to more subtle and seemingly innocuous slights against or ways of treating a partner. However, regardless of the severity or explicit nature, these behaviors all, to one extent or another, reflect acts of invalidation, disrespect, aggression, or neglect toward a partner, and could be considered maltreatment of a partner. The current paper proposes the term partner maltreatment as a broad overarching concept, which was used to facilitate a meta-analytic synthesis of the literature to examine the associations between attachment insecurity (i.e., attachment anxiety, attachment avoidance) and perpetration of partner maltreatment. Additionally, this paper situated partner maltreatment within an attachment-based diathesis-stress perspective to explore the moderating role of stress. Five databases were systematically searched for published and unpublished studies that examined the direct association between perpetrator's adult attachment orientation and perpetration of partner maltreatment behaviors. We synthesized effect sizes from 139 studies (N = 38,472) and found the effect between attachment insecurity and acts of partner maltreatment varied between r =.11 to.21. Our findings provide meta-analytic evidence to suggest that attachment insecurity is a significant individual vulnerability factor (diathesis) associated with partner maltreatment; and that when individuals with an insecure attachment orientation experience stress, the tendency to perpetrate partner maltreatment is typically heightened. The findings of this meta-analysis provide empirical evidence for the importance of considering and addressing contextual factors, especially stress, for those individuals and couples seeking therapy for partner maltreatment. [ABSTRACT FROM AUTHOR]

Autistic children experience higher levels of anxiety than their peers. Making appropriate diagnoses of anxiety disorders and providing effective treatment for these children is particularly difficult. Inconsistent evidence suggests that levels of anxiety in autistic children are related to intellectual functioning. We provide the first meta-analysis of this evidence. A systematic search identified 49 papers for review. These papers included measures of anxiety and intelligence quotient in 18,430 autistic children. Studies employing correlations showed evidence of a significant relationship between intelligence quotient and anxiety in autistic children: children with higher intelligence quotient scored higher on measures of anxiety. Studies directly comparing groups of autistic children with and without intellectual disability also supported this conclusion. Most studies employing other designs also supported this finding. Employing a quality assessment framework identified common threats to validity. Many studies used measures of anxiety that were not validated across the samples they measure. This was most notable for those autistic children with an intellectual disability. It is vital that future research determines whether the identified relationship between intelligence quotient and anxiety reflects something important in the mechanism for anxiety in autistic children, or quantifies the lack of sensitivity of our measures of anxiety across different groups. Autistic children often experience higher levels of anxiety than their peers. It can be difficult to diagnose and treat anxiety disorders in autistic children, in part because of the high degree of variability in their underlying abilities and presentations. Some evidence suggests that autistic children with higher intelligence (as measured by intelligence quotient) experience higher levels of anxiety than autistic children with lower intelligence. However, the evidence is inconsistent, with other papers not finding a difference or finding higher levels of anxiety in autistic children with lower intelligence. In this article, we review existing literature to see whether autistic children with higher intelligence quotients have higher anxiety than autistic children with lower intelligence quotients. A systematic search of the literature was conducted which identified 49 papers on the topic. The methods of all the papers were reviewed using an objective quality assessment framework. When combining the data statistically, there was evidence that autistic children with higher intelligence quotients are more anxious than autistic children with lower intelligence quotients. The quality review raised common weaknesses across studies. Most importantly, few studies used measures of anxiety that have been shown to be valid for children with very low intelligence quotients. Similarly, many studies used measures of anxiety that have not been shown to be valid for autistic children. These factors are important because autistic children and those with low intelligence quotient may experience or understand anxiety differently. Future research should use fully validated measures to test whether high intelligence quotient is associated with high levels of anxiety in autistic children. [ABSTRACT FROM AUTHOR]

Death and dying are woven throughout the work of home care aides, and yet the care they provide at the end of life (EOL) remains poorly understood. This is due in part to the multiple circumstances under which aides provide EOL care. In this paper, we elucidate the EOL care experiences of aides working in home care agencies in New York City. We conducted in-depth interviews with 29 home care aides, and we analyzed these data using inductive, team-based methods. Our findings show that aides may not be aware of or accept a client's EOL status, and they may avoid EOL care. These conditions shape EOL care, and we detail the committed forms of care aides provide when they are aware and accepting. We recommend improved training, support systems, and policy change to enhance aides' contributions to EOL care, while protecting aides' health and well-being. [ABSTRACT FROM AUTHOR]

Statistical knowledge is widely used in academia; however, statistics teachers struggle with the issue of how to reduce students' statistics anxiety and enhance students' statistics learning. This study assesses the effectiveness of a "one-minute paper strategy" in reducing students' statistics-related anxiety and in improving students' statistics-related achievement. Participants were 77 undergraduates from two classes enrolled in applied statistics courses. An experiment was implemented according to a pretest/posttest comparison group design. The quasi-experimental design showed that the one-minute paper strategy significantly reduced students' statistics anxiety and improved students' statistics learning achievement. The strategy was a better instructional tool than the textbook exercise for reducing students' statistics anxiety and improving students' statistics achievement. [ABSTRACT FROM AUTHOR]

Drawing on ethnographic fieldwork on young white-collar women training bodies after work in Shanghai, I demonstrate that core muscles serve as visual indexes of discipline and hard-work, and that women create social spaces to collectively cultivate such dispositions. The socially sanctioned value of core muscles is connected to the discourse of 'having it all' increasingly popular among professional women in corporate, urban China. This paper elaborates on how bodily training transposes dispositions of work ethics beyond the workplace and on women's anxieties about their bodies at the intersection of productive and reproductive demands from the society. This paper builds on and critiques existing approaches to the body, and attends not only to the woman's body at the intersection of production and reproduction but also to the social aspect of bodily training in spaces between home and work. [ABSTRACT FROM AUTHOR]

Lacan's seminars are a treasure trove of innovative psychoanalytic explorations. In Seminar X, Anxiety, he takes up this Freudian theme and explores a number of interrelated ideas: castration, the difference between the sexes, two different forms of acting out, and what he terms his only original theoretical contribution: the object a and its "various incidences." The object a is described here in detail, especially in relation to Lacan's argument that analysts who are women have a freer relationship to their desire and the countertransferences it spawns than do men. Lacan discussed Lucia Tower's classic paper, "Countertransference," in light of these notions. This essay is a close reading of Lacan's close reading of Tower, whose account, he says, must be approached in all its "innocence and freshness." [ABSTRACT FROM AUTHOR]

Summary: The quality of the helping relationship is experienced when theories and principles are enacted in practice. Here, the people social workers seek to serve are able to decide whether the practice they experience is useful. One way that social workers can enhance the quality of the relationships they develop is to 'start where the person is at'. In order to explore what this phrase means in and for effective social work practice, this paper revisits Martin Buber's articulation of the I/thou relationship seeking to shed light on the notion of personhood in this value-based profession. Two participants, within a larger research project exploring the experiences of social workers in the Australian child welfare field, independently used the language of personhood to refer to the way they conceptualised the process of engaging with people. Both were referring to enacting the transcendent value of each person in terms of a practice philosophy. These personal narratives inspired the authors to move away from the usual professional discourse about the skills involved in relationship building and instead reflect on their own practice in order to capture something philosophical about caring relational processes. Revisiting humanistic conceptualisations of the helping relationship such as the I/thou has the potential to discourage practitioners from seeing relationships as transactional. This has particular significance in practice contexts characterised as risk-averse, austere or involuntary, and/or where people may be feeling anxious, stressed and/or simply unheard. Contemporary implications for social work practice are discussed. [ABSTRACT FROM AUTHOR]

Background: People with an advanced progressive illness and their caregivers frequently experience anxiety, uncertainty and anticipatory grief. Traditional approaches to address psychological concerns aim to modify dysfunctional thinking; however, this is limited in palliative care, as often concerns area valid and thought modification is unrealistic. Acceptance and Commitment Therapy is a mindfulness-based behavioural therapy aimed at promoting acceptance and valued living even in difficult circumstances. Evidence on its value in palliative care is emerging. Aims: To scope the evidence regarding Acceptance and Commitment Therapy for people with advanced progressive illness, their caregivers and staff involved in their care. Design: Systematic scoping review using four databases (Medline, PsychInfo, CINAHL and AMED), with relevant MeSH terms and keywords from January 1999 to May 2023. Results: 1,373 papers were identified and 26 were eligible for inclusion. These involved people with advanced progressive illness (n = 14), informal caregivers (n = 4), palliative care staff (n = 3), bereaved carers (n = 3), and mixed groups (n = 2). Intervention studies (n = 15) showed that Acceptance and Commitment Therapy is acceptable and may have positive effects on anxiety, depression, distress, and sleep in palliative care populations. Observational studies (n = 11) revealed positive relationships between acceptance and adjustment to loss and physical function. Conclusion: Acceptance and Commitment Therapy is acceptable and feasible in palliative care, and may improve anxiety, depression, and distress. Full scale mixed-method evaluation studies are now needed to demonstrate effectiveness and cost-effectiveness amongst patients; while further intervention development and feasibility studies are warranted to explore its value for bereaved carers and staff. [ABSTRACT FROM AUTHOR]

Introduction: Reminiscence therapy (RT), which engages individuals to evoke positive memories, has been shown to be effective in improving psychological well-being in older adults suffering from PTSD, depression, and anxiety. However, its impact on brain function has yet to be determined. This paper presents functional magnetic resonance imaging (fMRI) data to describe changes in autobiographical memory networks (AMN) in community-dwelling older adults. Methods: This pilot study used a within-subject design to measure changes in AMN activation in 11 older adults who underwent 6 weeks of RT. In the scanner, participants retrieved autobiographical memories which were either recent or remote, rehearsed or unrehearsed. Participants also underwent a clinical interview to assess changes in memory, quality of life, mental health, and affect. Findings: Compared to pretreatment, anxiety decreased (z = −2.014, p =.040) and activated significant areas within the AMN, including bilateral medial prefrontal cortex, left precuneus, right occipital cortex, and left anterior hippocampus. Conclusion: Although RT had subtle effects on psychological function in this sample with no evidence of impairments, including depression at baseline, the fMRI data support current thinking of the effect RT has on the AMN. Increased activation of right posterior hippocampus following RT is compatible with the Multiple Trace Theory Theory (Nadel & Moscovitch, 1997). [ABSTRACT FROM AUTHOR]

This paper examines the impact of messages about sexual danger women receive from parents, peers, media, school officials, and past victimization on fear of stranger and acquaintance rape. Analyzing survey data for 630 undergraduate women, we find that parental warnings, internalized mean world view, university crime alerts, and being more prone to anxiety are significant predictors of fear of rape across models, while effects of media and victimization are limited. When high and low proneness to anxiety subgroups are considered separately, numerous differences emerge. Results suggest the need to include formal measures of anxiety in future fear of crime research. [ABSTRACT FROM AUTHOR]

This paper argues that the allure of conspiracy theories lies in their evolutionary origins, specifically in our capacity to communicate unrepresented threats. Drawing on threat-detection psychology and error management theory, it posits that these theories serve as adaptive responses to perceived threats and social coalition-building, rather than as flaws in reasoning. [ABSTRACT FROM AUTHOR]

Since 2017, 518 journalists have been attacked while covering protests (U.S. Press Freedom Tracker, 2021) which is one of the most dangerous places to be as a journalist in the United States (Sterne & Peters, 2017). Despite the volatile climate around journalists as they cover increasingly dangerous protests (Luqiu, 2020), there is minimal understanding as to the effect of these events on them (Talabi, et al., 2021). Furthermore, there is a gap in the hostility literature examining harassment that journalists face in the field. Through a survey of U.S. journalists, this study finds that covering protests causes journalists mental and emotional health concerns, which influences how they view their journalistic roles. Furthermore, the effects of positive and negative encounters at protests affected journalists personally, depending on who the perpetrator was (protestor or law enforcement)—influencing everything from PTSD and anxiety to intentions to leave journalism. The paper ultimately underscores the need for news organizations to make sure journalists not only are safe, but also feel safe, when reporting in the field. [ABSTRACT FROM AUTHOR]

Introduction: This study explores the association between self-perceived personal and community changes due to COVID-19 and health among vulnerable primary care patients experiencing multiple chronic conditions. Methods: Between September 2017 and February 2021, we obtained data from 2,426 primary care patients managing multiple chronic conditions from across the United States. We assessed the relationship between self-perceived personal and community changes due to COVID-19 and change in health measured by the PROMIS-29 mental and physical health summary scores, GAD-7 (anxiety), andPHQ-9 (depression), and DASI (functional capacity) adjusting for relevant demographic, neighborhood characteristics, and county covariates. Results: After adjustment, self-perceived personal and community changes due to COVID-19 were associated with significantly worse mental health summary scores (ß = -0.55; 95% Confidence Interval (CI) = -0.72, -0.37), anxiety (ß = 0.28; 95% CI = 0.16, 0.39), depression (ß = 0.35; 95% CI = 0.22, 0.47), and physical health summary scores (ß = -0.44; 95% CI = 0.88, 0.00). There was no association with functional capacity (ß = - 0.05; 95% CI = -0.16, 0.05). Discussion: Among adults managing multiple chronic conditions, self-perceived personal and community changes due to COVID-19 were associated with health. This vulnerable population may be particularly susceptible to the negative effects of COVID-19. As we do not know the long-term health effects of COVID, this paper establishes a baseline of epidemiological data on COVID-19 burden and health among primary care patients with multiple chronic conditions. [ABSTRACT FROM AUTHOR]

Test anxiety is common and may lead to a range of negative outcomes, including poor exam performance. Therefore, it is important to explore psychological predictors of test anxiety. In this paper, we examined whether intellectual humility can predict test anxiety. In Study 1, college students (N = 181) completed an intellectual humility measure with four subscales and two different measures of test anxiety. In Study 2 (N = 196), a community sample recruited from an online workforce completed the same measures. In both studies, we found that intellectual humility was negatively related to test anxiety, such that higher intellectual humility predicted lower test anxiety. Specifically, Study 1 demonstrated a negative correlation between intellectual humility and the Sarason Test Anxiety Scale; Study 2 confirmed this negative relationship with both the Sarason and Westside test anxiety scales. We also found that this relationship was largely driven by the intellectual humility subscale of Independence of Intellect and Ego. Additionally, these results were present even when controlling for key demographic factors. These findings highlight intellectual humility's role in predicting exam anxiety and offer a potential avenue for intellectual humility to be leveraged into interventions to decrease exam anxiety in the future. [ABSTRACT FROM AUTHOR]

Survivors of intimate partner violence (IPV) are at heightened risk of sustaining a brain injury (BI). Problematically, a high overlap between BI and trauma symptoms leads to difficulties in identifying when an IPV-related BI has occurred. This paper investigated differences in symptom reports between survivors with (n = 95) and without (n = 42) probable IPV-related BI. Chi-squared analyses isolated a constellation of symptoms found to be specifically associated with BI status. These symptomatic markers may assist professionals in discerning BI from other comorbid conditions present in IPV, and thus help survivors access BI-specific treatments and resources. [ABSTRACT FROM AUTHOR]

Palliative care involvement is common among patients with gynecologic cancers related to delayed diagnosis and symptom burden. Physical symptoms such as pain, nausea, and weakness can be managed with analgesics, antiemetics, nutrition, and physical therapy. Psychiatric side effects like anxiety disorders, however, are harder to capture. Associations among palliative care, anxiety assessment, and intervention in this population are not well studied. This could be related to lack of psychiatric-specific education in medical, nursing, and continuing palliative education programs. Palliative guidelines suggest systematically addressing psychiatric aspects of care in each patient encounter. Prior to intervention, providers must first properly assess anxiety. In this paper, development and validity of three instruments designed to measure clinical anxiety will be reviewed, including National Comprehensive Cancer Network Distress Thermometer, State-Trait Anxiety Inventory Form Y1, and Beck Anxiety Inventory. Conclusions will be drawn regarding reliability and validity of each tool, and recommendations will be made based on respective psychometric properties. [ABSTRACT FROM AUTHOR]

This paper responds to critics of Reinhold Niebuhr by exploring two themes important for locating his views on cruelty's emergence in modern society. The first relates to his basic insight into the relationship between individual morality and group loyalty and solidarity. Niebuhr provides a sophisticated argument for such group dynamics in his work, issued in Moral Man, Immoral Society, as well as his essays on race. These also form the basis for his second thematic argument regarding cruelty, the role of 'righteousness' as it relates to security and insecurity. Niebuhr's views on race, I argue, need to be considered more broadly as an example of his views on groups, power, and cruelty. The paper concludes with some modest proposals for thinking about combatting cruelty via Niebuhr's counsel. [ABSTRACT FROM AUTHOR]

The COVID19 pandemic highlighted the need for remote diagnosis of cognitive impairment and dementia. Telephone screening for dementia may facilitate prompt diagnosis and optimisation of care. However, it is not clear how accurate telephone screening tools are compared with face-to-face screening. We searched Cochrane, MEDLINE, Embase, Web of Science, PubMed and Scopus for all English language papers published between January 1975 and February 2021 which compared telephone screening for dementia/mild cognitive impairment and an in-person reference standard, performed within six-weeks. We subsequently searched paper reference lists and contacted authors if data were missing. Three reviewers independently screened studies for inclusion, extracted data, and assessed study quality using an adapted version of the Joanna Briggs Institute's critical appraisal tool. Twenty-one studies including 944 participants were found. No one test appears more accurate, with similar validities as in-person testing. Cut-offs for screening differed between studies based on demographics and acceptability thresholds and meta-analysis was not appropriate. Overall the results suggest telephone screening is acceptably sensitive and specific however, given the limited data, this finding must be treated with some caution. It may not be suitable for those with hearing impairments and anxiety around technology. Few studies were carried out in general practice where most screening occurs and further research is recommended in such lower prevalence environments. [ABSTRACT FROM AUTHOR]

In this paper, I elucidate how lived space is transformed in social anxiety disorder. The cognitive–behavioral framework that dominates the field conceptualizes the disorder as an intrapsychic dysfunction and sidelines concrete experience. The omnipresent sense of threat as it expresses itself "out there" in the patient's experiential world thus remains unexplored. Looking to first-person descriptions of social anxiety, I argue that the felt presence of the Other constantly threatens the patient's sense of autonomy and ownership of the places they inhabit. They experience others violating the boundaries of their intimate spaces and banishing them from public spaces. These experiences point to an altered mode of inhabiting space I term intersubjective overdetermination. The patient is condemned to live in the space of the Other. I compare this conceptualization to the commonplace cognitive–behavioral account. I end by discussing the treatment implications of this account of socially anxious lived space. [ABSTRACT FROM AUTHOR]

Objective: Previous research in various countries has found that employment–family trajectories characterized by early or single motherhood, or weak ties to employment, are associated with poor well-being among older women. Our paper explores whether this differs (1) in France, characterized by a high female employment rate and supportive family policies; (2) across dimensions of well-being. Method: We used the Health and Occupational Itinerary survey to identify 10 common patterns of employment–family trajectories (derived from multi-channel sequence analysis) and analysed their association with six indicators of well-being in 2010 (N = 2882 50–78 years old women). Results: Continuous full-time employment is associated with better well-being, except for women who had a first child around 24 years old, who reported increased anxiety and lack of support. Discussion: Employed mothers' well-being seems to be protected in a context of family friendly policies, but we identified one group with lower well-being, which merits further study. [ABSTRACT FROM AUTHOR]

Background: The treatment of anxiety and depressive symptoms following acquired brain injury is complex and more evidence-based treatment options are needed. We are currently evaluating the BrainACT intervention; acceptance and commitment therapy for people with acquired brain injury. Rationale: This paper describes the theoretical underpinning, the development and content of BrainACT. Acceptance and commitment therapy focuses on the acceptance of feelings, thoughts and bodily sensations and on living a valued life, without fighting against what is lost. Since the thoughts that people with acquired brain injury can experience are often realistic or appropriate given their situation, this may be a suitable approach. Theory into practice: Existing evidence-based protocols were adapted for the needs and potential cognitive deficits after brain injury. General alterations are the use of visual materials, summaries and repetition. Acceptance and commitment therapy-specific adaptions include the Bus of Life metaphor as a recurrent exercise, shorter mindfulness exercises, simplified explanations, a focus on experiential exercises and the monitoring of committed actions. The intervention consists of eight one-hour sessions with a psychologist, experienced in acceptance and commitment therapy and in working with people with acquired brain injury. The order of the sessions, metaphors and exercises can be tailored to the needs of the patients. Discussion: Currently, the effectiveness and feasibility of the intervention is evaluated in a randomised controlled trial. The BrainACT intervention is expected to be a feasible and effective intervention for people with anxiety or depressive symptoms following acquired brain injury. [ABSTRACT FROM AUTHOR]

Due to the unique challenges of the COVID-19 pandemic and the rapid spread infection, healthcare providers caring for these patients are experiencing high levels of anxiety and stress. This can be overwhelming, resulting in mental anguish and loss of productivity during a period when the demand for healthcare is high. Medical facilities need to adopt and quickly enact evidence-based practices that are designed to keep their workforce resilient. Successful implementation of a new practice during a pandemic is challenging. This paper describes how the Medical Association of Georgia is adapting and using "Diffusion of Innovation Science" techniques to formulate their guidelines and help Georgia's medical facilities implement evidence-based practices during the pandemic. [ABSTRACT FROM AUTHOR]

The pandemic of Covid-19 at the global level cannot be underestimated. Arab world including Saudi Arabia is affected with the pandemic of Covid-19. More importantly, the surge of the numbers of infected individuals in Iran has brought fear and anxiety in the whole region in general and Saudi Arabia in particular. Several studies have investigated the prevalence of the virus in different countries from various perspectives. Nonetheless, little focus is given to academic research on health challenge of the virus resulting to fear and anxiety in the recent time in the context of Saudi Arabia. This study primarily aims at exploring the health effect of Covid-19 in Saudi Arabia despite the fact that, the World Health Organization (WHO) has clamored for preventive measures in addressing global health effect of the virus. The methodology of the study is systematic literature review (SLR) and content analysis of the secondary data on health impact of Covid-19 and preventive measures against its transmission in the country are critically analyzed. The results of secondary data of the study indicated that a number of confirmed cases, active cases and deaths in Saudi Arabia manifested negative impact of Covid-19 on citizens' health especially fear and anxiety despite the fact that records have showed steady recovered cases in the country. More specifically, the findings indicated that, health impact of Covid-19 are as follows namely: fear or anxiety, negative attitude among health workers and women in health workforce. Similarly, Saudi Arabia has put in place various preventive measures such as: preventive measures against transmission of Covid-19 which are as follows: institutional preparedness and strengthening mechanism, curfews and lockdowns and suspension of activities and order of social distancing. In conclusion, this paper has lucidly highlighted the health effect of Covid-19 and safety measures against the transmission of Covid-19 have been elaborated in the context of Saudi Arabia. It is thereby suggested that, the outcome of this study can be helpful to the health workers and policymakers in the country to be acquainted with the magnanimity of the novel coronavirus as well as putting effective safety mechanisms in place in curtailing the spread of Covid-19 in Saudi Arabia. [ABSTRACT FROM AUTHOR]

Introduction: Persistent postural-perceptual dizziness (PPPD) is a chronic functional vestibular disorder where there is persistent dizziness or unsteadiness occurring on most days for more than 3 months duration. Treatment recommendations for PPPD include vestibular rehabilitation therapy (VRT) with or without medications and/or cognitive behavioral therapy. Objectives: This paper is a pilot study designed to compare the effects of Bal Ex as a home-based VRT on the quality of life (EQ-5D), dizziness handicap (DHI) and mental health (DASS-21) against hospital-based VRT. Design: This was an assessor-blinded, randomized controlled pilot study where PPPD patients were randomly selected to undergo Bal Ex, the home-based VRT (intervention group) or hospital-based (control group) VRT. The participants were reviewed at 4 weeks and 12 weeks after the start of therapy to assess the primary endpoints using the subjective improvement in symptoms as reported by patients, changes in DHI scores, DASS-21 scores and EQ5D VAS scores. Results: Thirty PPPD patients successfully completed the study with 15 in each study group. Within 4 weeks, there were significant improvements in the total DHI scores as well as anxiety levels. By the end of 12 weeks, there were significant improvements in the DHI, DASS-21 and EQ5D. The degree of improvement between Bal Ex and the control was comparable. Conclusion: VRT is an effective modality in significantly improving quality of life, dizziness handicap, depression, and anxiety levels within 3 months in PPPD. Preliminary results show Bal Ex is as effective as hospital-based VRT and should be considered as a treatment option for PPPD. [ABSTRACT FROM AUTHOR]

This article considers artistic engagements with string figure performance and collection as 'imaginary' articulations of digital media. As an object of anthropological inquiry, the string figure emerges in 1888 with a short paper by Franz Boas. Encouraged by more mainstream publications by Caroline Furness Jansen (2008) and Kathleen Haddon (1930), over the course of the 20th century the string figure would become a model through which largely western writers and artists have explored both the anxieties and dreams of ideal, embodied and networked communication technologies. The present article explores, specifically, the collecting projects and films of Harry Smith in the 1960s and 1970s; the video-performance piece of 1974, titled String Games: Improvisations for Inter-City Video, by the interdisciplinary artist Vera Frenkel; and the string figure exhibit at David Wilson's Museum of Jurassic Technology in Culver City, California. Through a media-archeological lens, the history of string figure fascination takes shape as a repository of dreams about (digital) communication, which, it is additionally suggested in a final section, might yet allow for the expansion and enlargement of conceptions of both digitality and media. [ABSTRACT FROM AUTHOR]

Background: This paper describes findings from research conducted on students who participated in a service-learning course in South Africa. Objective: The study aimed to understand how participants constructed their experiences of service-learning and to interrogate their emotional investments in these constructions. Method: Data were collected and analyzed using a psychosocial methodology, consisting of discursive and psychoanalytic readings of interview transcripts, reflective journal entries, and researcher field notes. Results: The discursive findings focus on how participants employed liberal traditional learning discourses to construct service-learning as linear resulting in subject positions that reinforced prejudices and the power structures supporting these. A psychoanalytic reading of the data suggests that participants invested in these constructions to defend against their own anxiety related to uncertainty and guilt about privilege in an unfamiliar context. Conclusion: Students invest in liberal traditional discourses of service-learning for defensive reasons, which can be understood as arising from the intersubjective and social context in which the service-learning takes place. Teaching Implications: Recognizing prejudice as emanating from anxiety generated by the affective work required for service-learning means thinking creatively about how to both contain and allow this affective work to take place in service-learning activities. [ABSTRACT FROM AUTHOR]

The 2002 paper "Does 5-HT restrain panic? A tryptophan depletion study in panic disorder patients recovered on paroxetine" by Bell and colleagues - reprinted in this issue of the Journal - reports on a study undertaken in the halcyon days of David Nutt's Psychopharmacology Unit at the University of Bristol, England. In this invited commentary authors of the original work discuss the impact of this paper on the field of acute tryptophan depletion research (especially in the field of clinical anxiety disorders) and the development of disorder-specific anxiogenic provocations over the past decade. [ABSTRACT FROM AUTHOR]

This paper examines a method which can be used by instructors pursuing innovative methods for language teaching, which expands learners' motivation in second language learning. Computational thinking (CT) is a problem-solving skill which can motivate students' English language learning. Designing a learning activity which integrates CT into English language learning has been considered in only a few academic studies. This study aimed to explore whether integrating CT into English language learning can be useful for improving learners' motivation and performance. The method of "present, practice, and produce" was applied as a method of presenting computational thinking in the English language learning classroom. Fifty-two elementary school students (52) participated in the experimental study. Following an experimental design, data were collected and analyzed from a combination of knowledge test scores, storytelling, motivation, and anxiety surveys. The experimental results indicate that the CT strategy improves students' language learning and raises their motivation in the two dimensions of extrinsic and intrinsic goal orientation. These results imply the positive effect of CT strategy on strengthening problem-solving skills of students participating in digital storytelling and increases their motivation and performance in English language learning. [ABSTRACT FROM AUTHOR]

The hospitalization and the unfamiliar experiences of patients in interventional radiology procedures cause a moderate to high levels of anxiety. This study was aimed to evaluate the anxiolytic effect of Cananga odorata essential oil (COE) aromatherapy in unexperienced patients hospitalized for interventional neuroradiology (INR) procedures. Forty-four patients admitted for their first INR procedure were randomly divided into COE and placebo control groups. COE or distilled water was dropped onto 2 pieces of mulberry paper and attached to the participant's gown at the shoulder level overnight. The main outcomes were observed from the morning salivary cortisol levels and salivary alpha-amylase activity after intervention. The Thai version of Spielberger State-Trait Anxiety Inventory (STAI) and the vital signs (blood pressure and heart rate) were also assessed before and after COE intervention as the secondary outcome. The demographic and baseline data of both groups did not show any significant difference. After intervention, COE group had a significantly lower salivary alpha-amylase activity than placebo control group. The post-intervention scores of Trait (STAI-T) and State (STAI-S) anxiety were significantly less than those of baseline in both groups. Interestingly, the COE group had a greater percentage reduction on STAI-T after intervention than placebo control group. No significant difference was observed in other outcomes. In addition, the salivary alpha-amylase activity was weak but showed significant correlation with STAI anxiety scores. This study indicates that COE aromatherapy reduces the saliva alpha amylase activity and STAI-T anxiety in unexperienced patients hospitalized for INR procedures. [ABSTRACT FROM AUTHOR]

Oppression refers to systemic discrimination where the injustice targets or disproportionately impacts specific groups of people. The Trauma Symptoms of Discrimination Scale (TSDS) is a self-report measure designed to assess the traumatizing impact of discrimination broadly by measuring anxiety-related symptoms of trauma due to discriminatory experiences. This may include symptoms arising from racism, homophobia, sexism, poverty, or other forms of marginalization. Almost all studies of the TSDS have examined its use in marginalized ethnoracial groups, primarily African Americans. This paper will extend prior work to help us better understand racial trauma across groups by reporting and comparing TSDS mean scores across ethnoracial identities in a diverse national sample (n = 923). It also explores trauma with other marginalized identities and demographic dimensions, including gender, sexual minority/LGBQ status, education, and income. The relationship of TSDS scores to clinical psychopathologies are examined, including stress, depression, anxiety, and PTSD. We also examine the unique risks associated with intersectionality, and how having multiple marginalized identities may increase traumatization. Clinical implications and future directions are discussed. [ABSTRACT FROM AUTHOR]

BACKGROUND: The purpose of this paper is to provide a preliminary evaluation of treatment outcomes, retention and client satisfaction following a 12-week combined cognitive behavioural therapy (CBT) and motivational enhancement therapy (MET) group treatment for cannabis use disorder (CUD) delivered in an outpatient setting. Implementation of the program is also described. METHODS: A retrospective observational cohort study was conducted using data collected from medical records and self-report assessments. Participants were treatment-seeking cannabis users at the Centre for Addiction and Mental Health, Toronto. Cannabis use, cannabis-related problems, craving, withdrawal symptoms, self-efficacy for remaining abstinent, depression and anxiety were assessed pre- and post-treatment. Treatment retention was calculated by inspecting clinic attendance records, and client satisfaction was evaluated using an anonymous feedback survey. Potential predictors of treatment outcomes and retention were investigated in exploratory analyses. RESULTS: Cannabis use was lower and days of abstinence higher post-treatment (vs pre-treatment). Post-treatment improvements in can-nabis-related problems, craving, withdrawal symptoms, self-efficacy and mood were also observed. Completion of group treatment (≥75% of sessions attended) was 57% and moderate levels of treatment satisfaction were reported. CONCLUSIONS: This study provides preliminary evidence that a 12-week combined CBT and MET treatment for cannabis use disorder delivered in a novel group setting improves cannabis use outcomes. Potential predictors of reduced cannabis use and retention were identified. Future controlled studies are warranted, and strategies for increasing retention should be explored. [ABSTRACT FROM AUTHOR]

The hospitalization and the unfamiliar experiences of patients in interventional radiology procedures cause a moderate to high levels of anxiety. This study was aimed to evaluate the anxiolytic effect of Cananga odorata essential oil (COE) aromatherapy in unexperienced patients hospitalized for interventional neuroradiology (INR) procedures. Forty-four patients admitted for their first INR procedure were randomly divided into COE and placebo control groups. COE or distilled water was dropped onto 2 pieces of mulberry paper and attached to the participant's gown at the shoulder level overnight. The main outcomes were observed from the morning salivary cortisol levels and salivary alpha-amylase activity after intervention. The Thai version of Spielberger State-Trait Anxiety Inventory (STAI) and the vital signs (blood pressure and heart rate) were also assessed before and after COE intervention as the secondary outcome. The demographic and baseline data of both groups did not show any significant difference. After intervention, COE group had a significantly lower salivary alpha-amylase activity than placebo control group. The post-intervention scores of Trait (STAI-T) and State (STAI-S) anxiety were significantly less than those of baseline in both groups. Interestingly, the COE group had a greater percentage reduction on STAI-T after intervention than placebo control group. No significant difference was observed in other outcomes. In addition, the salivary alpha-amylase activity was weak but showed significant correlation with STAI anxiety scores. This study indicates that COE aromatherapy reduces the saliva alpha amylase activity and STAI-T anxiety in unexperienced patients hospitalized for INR procedures. [ABSTRACT FROM AUTHOR]

Social psychological theories provide useful tools for identifying interpretive processes that affect individual mental health outcomes. In this paper, we use the affect control theory of self (ACT-Self) to examine the relationship between depressive symptoms and global feelings about the self—self-sentiments—that are evoked by the constellation of identities, traits, moods, characteristics, and roles we hold and have held. We examine this relationship in two separate longitudinal studies conducted with undergraduates (N = 147) and doctoral students (N = 178) at a university in the Southeastern U.S., which employ different measures of depressive symptoms (the Center for Epidemiological Studies Depression Scale and Depression, Anxiety, and Stress Scale Short Form, respectively). We present key findings about links between depressive symptoms and evaluation (goodness), potency (powerfulness), and activity (liveliness). First, evaluation negatively predicts depressive symptoms at follow-up in both samples; activity predicts symptoms among undergraduates, and potency predicts symptoms among doctoral students. Second, respondents in both samples with self-sentiments closer to cultural sentiments for "depressed" report more depressive symptoms at follow-up. Third, evaluation gains over time predict less Wave 2 depressive symptoms in both samples; potency gains also predict symptoms among doctoral students. Finally, Wave 1 depressive symptoms—and increases in depression over time—predict lower levels of evaluation and potency in both samples. [ABSTRACT FROM AUTHOR]

This paper endeavors to portray the narratives of a group of female undergraduate students, in Saudi Arabia, studying during the Covid-19 pandemic. Data collection occurred in March 2021, at which time students had been in online classes for a year and had experienced several curfews as well as a total lockdown. Students answered open-ended questions and wrote a reflection about how they experienced the pandemic. The majority of the participants reported sleep disturbances, depression, anxiety, and social isolation, identifying their family as the most important source of support during this time. Others tried to cope using their own resources. The study highlighted the need for increased awareness among faculty, education leaders and policy-makers about the psychological effects of lockdown and social isolation. There is a requirement for more support services for those affected by anxiety, depression, and regular follow-up after the pandemic ends to explore the long-term consequences. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effects of rTMS on drug craving, depression, anxiety, sleep, and cognitive function in methamphetamine (MA) dependent individuals. Data sources and methods: Randomized controlled trials (RCTs) of rTMS interventions for MA-dependent patients were searched through PubMed, Embase, Cochrane Library, Web of Science, Chinese National Knowledge Infrastructure (CNKI), Wanfang database, Chongqing Vipers (VIP) and China Biomedical Literature Database (CBLD). The included literature was statistically processed using Revman 5.4, and STATA 16.0 for sensitivity and bias analysis. Results: A total of 13 papers were included, and the results of the meta-analysis showed that rTMS was effective in reducing craving scores (SMD = −1.53, 95%CI:−2.08 ∼ −0.98, p < 0.00001), improving depression (SMD = −0.32, 95%CI:-0.58 ∼ −0.07, p = 0.01) and sleep scores (WMD = −1.26, 95%CI:−2.26 ∼ −0.27, p = 0.01), but had no effect on anxiety scores (SMD = −0.42, 95%CI:−0.88 ∼ 0.03, p = 0.07); in terms of cognitive function, there were improvements in the international shopping list task (ISL), Groton maze learning task (GML) and continuous paired association learning task (CPAL), except for no effect on the social emotional cognition task (SEC) and two back task (TWOB). Subgroup analysis showed significant differences in the effects of different intervention period on craving in MA-dependent individuals. Conclusion: rTMS was effective in reducing MA dependent individuals' cravings, alleviating depressive symptoms, improving sleep quality and language learning, collaborative learning and executive skills. Due to the small sample size of this study, a large number of RCTs are needed to validate this. [ABSTRACT FROM AUTHOR]

In Part 1 of this UK-based study, across four timepoints between March and October 2020, autistic children and young people showed higher levels of parent-reported depression and anxiety symptoms than those with other special educational needs and disabilities. In this study, we draw on qualitative data from 478 parents/carers of autistic pupils and those with other special educational needs and disabilities to conduct a longitudinal qualitative content analysis examining stability and change in the mental health of these young people, and their parents/carers, during the first 6 months of the COVID-19 pandemic. Worry and psychological distress were dominant categories at all timepoints and we noted that, in line with quantitative findings, worry in autistic pupils stayed stable over time but decreased for those with other special educational needs and disabilities. The third dominant category was wellbeing and we saw evidence that removing demands, especially the demand to attend school, was a driver of wellbeing for a significant minority of pupils, particularly autistic pupils, and their parents/carers. Overall, we observed no differences in mental health experiences between the two groups of parents, also mirroring quantitative findings. We know that autistic children and young people, and their caregivers, are at increased risk of mental ill health. We asked whether the first 6 months of COVID-19 exacerbated that risk, and whether the implications were different for autistic pupils and their caregivers, than for those with other special educational needs and difficulties. In a linked paper, we found that caregivers of autistic pupils reported higher levels of depression and anxiety symptoms in their children than parents of children with other special educational needs and difficulties (Toseeb & Asbury, 2022). For pupils with other special educational needs and difficulties, their parent-reported anxiety symptoms eased over time while remaining high throughout for autistic pupils. There were no differences in mental health and wellbeing between caregivers of autistic pupils and those with other special educational needs and difficulties. Here, we used parents' written descriptions of their own and their child's mental health during the first 6 months of COVID-19 to explore these linked findings in greater depth. We identified strong evidence of worry and distress for all, but most prominently autistic children and young people. Our finding that worry and distress declined over time for pupils with other special educational needs and difficulties, but not for autistic pupils, was supported and we observed a few differences between caregivers. We also found evidence of wellbeing throughout the sample, and examples of some (mainly autistic) pupils benefitting from a reduction in demands (e.g. going to school). This has implications for our understanding of the school experience for autistic pupils. Findings suggest that the mental health of autistic children and young people may have been disproportionately affected during the first 6 months of COVID-19 and that careful consideration of optimal support, from both health and education perspectives, is vital. [ABSTRACT FROM AUTHOR]

Social support has a positive impact on quality of life (QoL) in neurotypical older adults and young autistic adults, but the association for older autistic adults is unclear. Autistic adults (n = 388; mean age = 40–83 years) were recruited via Simons Powering Autism Research for Knowledge (SPARK) Research Match. Participants completed questionnaires online querying demographic information, depression, and anxiety symptomatology, QoL (physical, psychological, social, environmental, and autism-specific) and social support (instrumental, subjective, and social interactions). Regression analyses examined whether different aspects of social support contributed to models explaining each domain of QoL. Models explaining QoL were significant. Subjective social support significantly contributed to the models for all aspects of QoL; social interactions contributed to the models for Physical and Psychological QoL, whereas instrumental support contributed to models for social, environmental and autism-specific QoL. Social support is an important contributor to the QoL of middle-aged and older autistic adults, after accounting for demographic factors and depression. Further studies are required to understand whether age-related changes in social support and QoL are the same for autistic as non-autistic older adults in order to identify and implement appropriate support. Social support can take many forms, such as practical help, time spent socially with others, or the satisfaction with personal relationships. Social support is known to affect quality of life (QoL) in both non-autistic older and autistic young adults. QoL reflects how satisfied an individual is with their life either overall or in a certain area. We know little about middle-aged and older autistic adults' experiences of social support or QoL. In this study, 388 adults aged 40–83 years old, completed online questionnaires asking about background such as age and sex, depression and anxiety symptoms, QoL (physical, psychological, social, environmental, and autism-specific), and different types of social support. Even after taking into account background, depression, and anxiety, social support was important for individuals' QoL. To our knowledge this is the first paper to examine the relationship between social support and QoL in middle-aged and older autistic adults. Improving social support may have a significant impact on the QoL of older autistic adults. Future studies should examine whether age-related changes in social support (size, content, and arrangement of social networks) that are common in non-autistic aging, also occur among older autistic adults. [ABSTRACT FROM AUTHOR]

This paper is the biography of a failed infrastructural project: that of building a Romanian seaport and of linking it to the mainland via a canal and/or a railway. It details its rich life, its initiators and partisans, but also its (mostly foreign) contenders; "born" in the early 1860s in a certain geopolitical, economic or infrastructural environment, the initiative morphed in the coming years in close connection and in direct competition with complementary or rival projects. While the plan of having an "independent" Romanian Black Sea port remained central to the Jibrieni project, most of its other infrastructural components were continuously reimagined, so as to fit into the Romanian government's priorities and – with them – into the extremely dynamic transportation map of Central and Eastern Europe in the 1860s–1870s. [ABSTRACT FROM AUTHOR]

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Objective: To determine the prevalence of common mental disorders among older Australians included in the Health In Men Data Linkage Study and compare those with the results of the 2020–2021 National Study of Mental Health and Wellbeing (NSMHW). Method: We used longitudinal record linkage to estimate the prevalence of mental disorders from age 65 years in a random sample of 38173 Australian men aged 65–85 years living in the Perth metropolitan region. Outcome was the proportion of participants affected by depressive episodes or dysthymia, bipolar disorder, anxiety disorder, psychotic disorder and alcohol use disorder. Results: Prevalence estimates for participants aged 65–69, 70–74, 75–79, 80–84 and ≥85 years were 0.9%, 2.0%, 3.6%, 5.8% and 12.6% for depressive, 0.2%, 0.3%, 0.4%, 0.4% and 0.7% for bipolar, 0.1%, 0.5%, 1.3%, 2.2%, 6.9% for anxiety, 0.2%, 0.4%, 0.5%, 0.4% and 0.6% for psychotic and 1.2%, 1.7%, 2.1%, 2.2% and 4.2% for alcohol use disorders. Conclusions: In contrast to the NSMHW, our data indicate that the prevalence of depressive and anxiety disorders increases with age, particularly among the older old. We conclude that the NSMHW should not be relied upon to guide planning or policies to address the mental health needs of older Australians. [ABSTRACT FROM AUTHOR]

Objectives: Quality of life, mental wellbeing, and physical function deteriorate among women with breast cancer. Tai Chi is a moderate form of exercise that may be effective in improving the mental and physical wellbeing, therefore, the quality of life of women with breast cancer. This protocol paper outlines a trial to determine the therapeutic effects of a Tai Chi programme on breast cancer management. Methods: The study will be an interventional, single-blind, double-armed, randomized, and controlled trial involving a 12-week Tai Chi programme for women with breast cancer. Forty participants aged 18 years and above who are diagnosed with breast cancer from the general community will be recruited. All participants will be randomized to either a Tai Chi programme or a waiting list control group. The Tai Chi programme will involve 12 weeks of group Tai Chi sessions, with 45 min per session, twice a week. The primary outcome will be potential improvements to the quality of life, and secondary outcomes will be potential improvements in mental wellbeing (anxiety and depression), and physical function (pain, flexibility, obesity, and vital signs). These outcomes will be assessed via self-administered online assessments and physical examinations pre-and post-intervention. Linear mixed modelling will be used to assess changes in outcomes. Discussion and dissemination: Tai Chi is a safe, easy to learn, inexpensive, and low-intensity exercise with increasing popularity worldwide. If the intervention improves the quality of life in women with breast cancer, this study will build research capacity and increase awareness of the potential for Tai Chi to empower patients and engage them in self-management of breast cancer symptoms. Research findings will be disseminated to the public, health professionals, researchers, and healthcare providers through conference presentations, lay summaries, and peer-reviewed publications. [ABSTRACT FROM AUTHOR]

Death anxiety has been linked to several psychopathological conditions. However, the causes, comorbidity, and differential diagnosis of death anxiety is unexplored. This paper stands out by identifying common predictors of death anxiety and exploring the potential of death anxiety as a predictor for other psychological conditions. The paper reports the findings of four consecutive studies that involved a total of 2291 conveniently selected participants including 861 men and 1430 women. We focused on clarifying both the predictors of death anxiety and the psychopathological consequences emerging from it. Our findings established depression, anxiety, stress, fear of aging, and reduced life satisfaction as predictors of death anxiety. Psychosocial illness, sleep disturbances, aggression, and daily hassles were established as the adverse outcomes of death anxiety. Fear of aging was the most significant predictor of death anxiety and daily hassles emerged as the most significant adverse consequence of death anxiety. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has affected various facets of health. While mental health became a major concern during the COVID-19 outbreak, the impact on the migrants' mental health has still been neglected. The purpose of this study was to examine the COVID-19 outbreak's impact on the mental health of immigrants in South Korea. Methods: A total number of 386 immigrants in South Korea participated in this quantitative cross-sectional study. The standardized e-questionnaire, including the General Anxiety Disorder (GAD-7) scale, was used to measure the anxiety level. Logistic regression analysis was performed to find out the determinants of anxiety disorders among immigrants. Results: The prevalence of severe anxiety among immigrants was found to be 47.2%. Female immigrants (28.6%) had a lower anxiety disorder than males (71.4%). Immigrants who were married, living alone, had a low income, had a history of health problems were suffered from moderate to severe anxiety. Immigrants who were unemployed (OR 2.302, 95% CI = 1.353–3.917) and lost their jobs due to the COVID-19 outbreak (OR 2.197, 95% CI = 1.312–3.678) have a higher anxiety disorder. Immigrants aged over 30 years were found to suffer from a high level of anxiety (OR 2.285, 95% CI = 1.184–4.410). Relief support from the government was significantly associated with anxiety disorder among immigrants (p < 0.01, OR = 3.151, 95% CI = 1.962–5.061). Conclusion: With very limited studies on immigrants' mental health during the COVID-19 pandemic, this paper provides scientific research evidence of the COVID-19 outbreak's impact on the mental health of migrants. Our study has consequences for implementing integrated psychological interventions and health promotion strategies for the well-being of immigrants' mental health. [ABSTRACT FROM AUTHOR]

Exposure-based therapies are the gold standard treatment for anxiety disorders, and recent advancements in basic and clinical research point to the need to update the implementation of exposure. Recent research has highlighted the importance of transdiagnostic factors such as anxiety sensitivity (AS), or fear of anxiety-related sensations. Elevated AS is common among all anxiety disorders and contains three dimensions, or expectancies, that can be used to guide treatment. Recently, treatments directly targeting AS have shown potential in reducing symptoms of anxiety. In addition, inhibitory learning theory (ILT) provides an alternative explanation of exposure processes based on basic learning research. ILT extends the current framework by accounting for renewal of fear, which is important given the substantial number of individuals who experience a return of symptoms following treatment. The current paper will provide an overview of ILT and discuss several ILT techniques that can be used to target AS. These two converging bodies of research hold strong potential for optimizing treatment for anxiety. [ABSTRACT FROM AUTHOR]

This paper reviewed mediators of psychological well-being among healthcare workers responding to pandemics. After registration on PROSPERO, a systematic review was performed in four databases and 39 studies were included. Worse mental health outcomes, such as stress, depressive symptoms, anxiety and burnout were related to demographic characteristics, contact with infected patients and poor perceived support. Self-efficacy, coping ability, altruism and organisational support were protective factors. Despite limitations in the quality of available evidence, this review highlights the prevalence of poor mental health in healthcare workers and proposes target mediators for future interventions. [ABSTRACT FROM AUTHOR]

Objectives: This review examined the currently available evidence of the association between liver encephalopathy and mood/anxiety disorders.Method: English-language studies using the keywords "hepatic encephalopathy," "depression," and "anxiety" were searched through PubMed, Medline, Cochrane Library, and PsycINFO databases. A total of 135 articles were considered for this review, of which 9 were qualitative and quantitative research papers regarding depression and anxiety in hepatic encephalopathy (HE).Results: There is a significant discrepancy between the research method of the studies and their outcomes. The number of studies suggesting a relationship between HE and mood/anxiety disorders is slightly higher than that of studies with opposite results; however, based on the current evidence, it is difficult to conclude a significant association between these two conditions.Conclusion: More longitudinal studies that include face-to-face psychiatric assessments are required to highlight any possible association between depressive/anxiety disorders and HE. [ABSTRACT FROM AUTHOR]