Search Results (18,270)

Background: In adolescents and young adults (AYAs) with cancer, the importance of patient-centered research outcomes is increasingly acknowledged and there is a need for consensus on the most relevant outcomes. This review provides a comprehensive overview of outcomes relevant to AYAs with cancer in order to develop an AYA-specific core outcome set (COS) as part of the European project STRONG-AYA. Methods: A literature search was conducted to identify relevant articles in five databases. Each article was reviewed by two independent researchers, using Rayyan (an online tool) to screen articles by their title/abstract and then by their full text. Subsequently, the data were extracted using a predefined, tailored extraction framework. Results: In total, 17,301 articles were screened, of which 1631 were included in the analyses. Registry studies (52.9%) were the most used study type. Well-represented continents were North America (50.3%) and Europe (27.8%). Of the five core areas, functioning (47.0%) and epidemiology (44.9%) were covered most often, followed by physiological/clinical (42.4%), resource use (6.1%), and adverse events (4.5%). The outcome domains that were represented the most include mortality/survival (43.1%), delivery of care (23.4%), outcomes relating to neoplasms (22.7%), and emotional functioning/well-being (19.2%). Conclusions: This literature review provides a foundation for the development of an AYA-specific COS for improving the relevance and efficiency of measuring outcomes, the pooling of (international) research data, and the value of care for current and future AYAs with cancer. Finalization and refinement of the COS should be a priority for future research. Full article

Although worry is a normal cognitive process experienced by adolescents, for a significant number, it can reach intense and uncontrollable levels. If left untreated, these worries can lead to significant mental health problems that are maintained into adulthood. Adolescents with neurodevelopmental disorders (NDDs) may be more prone to cognitive biases (that precede worry) and therefore highly vulnerable to worry. Limited research has examined worry in adolescents with NDDs; however, most studies have focused on measuring anxiety. The present research administered an instrument specifically developed to measure worry to 404 10 to 16-year-old mainstream school-aged adolescents, 204 (123 males, 81 females) of whom had a formally diagnosed NDD. A measure of depressive symptoms was also administered. Confirmatory factor analysis revealed a satisfactory fitting model for worry. Multivariate analysis of variance revealed no interaction effects or main effect for worry according to NDD/non-NDD status. There were, however, main effects for sex, with females scoring significantly higher than males on worry about academic success and the future; worry about peer relationships; combined worry score; and depressive symptoms. The findings of this study offer psychologists and educators a brief validated measure of worry that is suited to mainstream school adolescents with or without NDDs. The wider implications of the findings in the context of education and intervention for students with NDDs are discussed. Full article

This study aims to examine context-specific post-migration stress factors and their differential impacts on the mental health of Syrian refugee women resettled in Houston, Texas, and urban communities in Jordan. A cross-sectional survey investigated sociodemographic and health-related conditions, psychological distress and coping (Perceived Stress Scale [PSS]), mental health-related symptomatology (Self-Report Questionnaire [SRQ]), conflict-related psychological distress (Afghan Symptom Checklist [ASC]), and post-migration stress (Refugee Post-Migration Stress Scale [RPMS]). Linear regression models examined factors associated with post-migration stress and mental health outcomes. A total of 127 Syrian refugee women participated in the study. Participants were in their mid-30s (mean age = 34.79 ± 11.2 years), married (66.9%), and reported low levels of education (44.8% below high school), low employment (27.2%), and elevated financial strain (91% below the poverty line). Jordan-based refugees exhibited higher scores on mental distress measures compared to their Houston-based counterparts; specifically more elevated psychological distress (p < 0.001), symptomatology (p < 0.001), and conflict-related distress (p < 0.001). Syrian refugee women in Houston reported higher social strain, while those in Jordan experienced greater financial hardship and barriers to accessing healthcare services. Mental distress among Syrian refugee women is influenced by specific post-migration stressors that vary by resettlement location. Targeted interventions are necessary to improve mental health outcomes in this population. Full article

Background/Objectives: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a complex neuroimmunological disorder with limited treatment options. Despite the widespread use of Dietary Supplements (DSs) among ME/CFS patients to alleviate fatigue and associated symptoms, evidence remains inconclusive. This systematic review aims to provide an updated synthesis of the efficacy of DS interventions and explore possible mechanisms underlying their therapeutic effects. Methods: This systematic review was conducted according to PRISMA guidelines. Several databases (Ebsco Host, PubMed, Scopus, Google Scholar) were used for the systematic search, which was based on the broad search terms ME/CFS and DS with a focus on publications between 1994 and 2024. The primary outcome was fatigue, with additional considerations including psychological well-being, physical activity, and biochemical markers. Two independent researchers screened the studies for eligibility in a multi-stage process and assessed quality and bias using Cochrane’s risk of bias tools (RoB-2, ROBINS-I). Results: Fourteen studies (N = 809) of heterogeneous designs were included, showing a high risk of bias, mostly due to missing data and selection bias. While some interventions (L-carnitine and guanidinoacetic acid, oxaloacetate, CoQ10–selenium combination, NADH and NADH-CoQ10 combination) showed significant reductions in fatigue, methodological limitations, like small sample sizes and missing data, prevent firm conclusions. Mixed results were reported for secondary outcomes like cognitive function and inflammatory markers. Six studies noted adverse effects, including nausea and insomnia. Conclusions: Though some DSs showed potential in reducing fatigue in ME/CFS, methodological limitations and inconsistent results hinder definitive conclusions. Future research should improve diagnostic criteria and include more diverse populations. Full article

Objectives: Informed by implementation science, this exploratory study examined the capabilities, opportunities, and motivations of Australian mental health clinicians (N = 38) associated with the implementation of exposure and response prevention (ERP) for youth (i.e., children and adolescents) with obsessive-compulsive disorder (OCD). It also explored how the capabilities and motivations of mental health clinicians untrained in ERP for youth (i.e., typical clinicians; n = 25) differed from clinicians experienced in the use of ERP for youth (i.e., experienced clinicians; n = 13). Methods: Questionnaires were administered to the entire sample alongside observational role-plays, which assessed observed adherence and competence delivering ERP against published best-practice standards among available participants. Results: In the whole sample, the reported time dedicated to implementing ERP was associated with a range of factors relating to capabilities, opportunities, and motivations to implement ERP. Experienced clinicians had greater knowledge, adherence, competence, and self-reported confidence using ERP and fewer negative beliefs about ERP relative to typical clinicians. They also intended to dedicate greater time to implementing within-session ERP for youth and reported greater within- and between-session time spent doing so compared to typical clinicians. The time intended to dedicate to implementing between-sessions ERP did not significantly differ between the clinician groups. Conclusions: In summary, compared to typical clinicians, experienced clinicians appeared to possess greater levels of capabilities and motivations to implement ERP for youth with OCD. Future research examining barriers and facilitators of ERP implementation in community settings and identifying effective strategies to improve it would benefit service provision and, ultimately, outcomes for youth. Full article

Interventions taking place on the land are culturally well aligned for Native peoples, as they are often developed by the community and incorporate traditional knowledge, values, and practices. However, research on the effectiveness and characteristics of such programs is lacking. This scoping review examined outdoor and land-based prevention interventions for Indigenous adolescents ages 10–25 in the United States and Canada to identify program characteristics such as origination, aims, activities, duration, evaluation methods, and outcomes. Over three-fourths (77%) of the 153 programs identified were community-derived. The programs were principally strength-based and promoted protective factors for general wellbeing. The most common delivery format was short camps. Nearly all programs (97%) included an element of culture. The activities most often seen were recreation (84%), subsistence living (65%), and Elder knowledge sharing (63%). Thirty-three studies measured outcomes and included quantitative, qualitative, and mixed method study designs. Studies found positive impacts on participants’ self-esteem and mental health; connections to culture, cultural pride, and identity; and connections to community including peers and Elders. The literature on outdoor and land-based prevention interventions for Indigenous youth is growing rapidly. Understanding program components is a first step to identifying the elements critical to effective programs for Indigenous youth. Full article

Background/ Objectives: Despite the high estimated prevalence and the documented impact of caregiving on children, there is no systematic process to identify or study caregiving youth in the healthcare setting. The aim of this study was to pilot screening in school-based clinics to identify caregiving youth and their associated mental health outcomes. Methods: From March 2021 to March 2022, ninth- to twelfth-grade students were surveyed regarding caregiving and validated mental health screeners during intake at three Title 1 school-based health clinics in Miami, FL. Results: Thirty-nine percent of participants self-identified as caregivers. The most common caregiving tasks were cleaning (n = 20, 50%), keeping company (n = 19, 48%), shopping/cooking (n = 14, 35%), dressing (n = 13, 33%), mobility support (n = 12, 30%), and medical support (n = 11, 28%). Compared to their non-caregiving counterparts, caregiving youth had higher scores on mental health screeners, and caregivers were more likely to endorse clinically significant levels of depression (p = 0.050). Conclusions: Screening in the healthcare system was effective at identifying caregiving youth in school-based clinics whose mental health may be impacted by caregiving responsibilities. Pediatricians should actively screen for both caregiving and mental health concerns. Future studies are needed to ensure the caregiving screening tool is reliable and valid for broad-scale provider use. Full article

Background and Objective: to test a model aimed at delving into the psychological processes that lead to hopelessness in Spanish nurses two years after a stressful work situation. The model proposed starts with the anxiety experienced at the beginning of the COVID-19 pandemic and includes cognitive fusion and emotional exhaustion, evaluated six months after the end of the confinement, as possible contributing factors to development of hopelessness. Design: prospective study with three data collection periods, May to June 2020 (period 1), January to April 2021 (period 2), April to July 2022 (period 3). Materials and Methods: The sample (n = 131 Spanish nurses) was selected by non-probabilistic convenience sampling. The inclusion criteria were as follows: being female, over 18 years of age, and working as a nurse in direct contact with COVID-19 patients. Results: The model proposed was statistically significant (B = 0.34, SE = 0.07, t = 5.15, p < 0.001, 95% CI = [0.21, 0.47]), contributing to the explanation of 28% of the variance of hopelessness, finding that the direct anxiety–hopelessness effect was equally significant (B = 0.19, SE = 0.08, t = 2.46, p = 0.014, 95% CI = [0.04, 0.34]). An effect of anxiety on cognitive fusion and on emotional exhaustion was observed. In turn, cognitive fusion had a significant effect on emotional exhaustion but not on hopelessness. Finally, emotional exhaustion had a significant effect on hopelessness. In this final model, years of experience had a significant effect (p = 0.004) on hopelessness. Conclusions: Cognitive fusion and emotional exhaustion are shown to be relevant psychological processes upon which to intervene to contribute to the improvement of the mental health of nurses regarding the COVID-19 pandemic. Full article

Background/Objectives: International guidelines recommend the use of orthoses in subjects with cerebral palsy (CP), even though there is limited evidence of their effectiveness. Little is known about their effectiveness in children and adolescents with other types of neuromotor disability. Methods: The review protocol was recorded on the PROSPERO register (CRD42024509165) and conformed to the PRISMA guidelines. The inclusion criteria were any type of ankle–foot orthoses (AFOs); pediatric subjects with any non-acquired neuromotor disease; any type of outcome measure regarding gait performance; controlled studies; and those in the English language. Screening, selection, risk of bias assessment, and data extraction were performed by a group of independent researchers. Results: Fifty-seven reports were included, with most regarding CP; three involved subjects with Charcot–Marie–Tooth disease or Duchenne dystrophy. Nine were RCTs. A meta-analysis was performed for studies including subjects with CP. The meta-analysis demonstrated the effectiveness of AFOs in increasing stride length (MD −10.21 [−13.92, −6.51]), ankle dorsiflexion at IC (MD 9.66 [7.05, 12.27]), and peak ankle DF in stance (MD 5.72 [2.34, 9.09]) while reducing cadence (MD 0.13 [0.06, 0.17]) and the energy cost of walking (MD −0.02 [−0.03, −0.00]). The peak ankle power generated at push-off was significantly increased with flexible AFOs compared to rigid AFOs (MD 0.38 [0.30, 0.46]), but it decreased with both compared to walking barefoot or with shoes (MD −0.35 [−0.49, −0.22]). Evidence regarding DMD and CMT was limited but suggested opting for individualized flexible AFOs, which preserved peak ankle power generation. Conclusions: AFOs improve gait performance in CP. Flexible AFOs are preferable because they preserve the peak ankle power generated at push-off compared to rigid AFOs. Full article

Psilocybe cubensis, a widely recognized psychoactive mushroom species, has played a significant role in both historical and modern therapeutic practices. This review explores the complex interplay between genetic diversity, strain variability and environmental factors that shape the biosynthesis of key psychoactive compounds, including psilocybin and psilocin. With many strains exhibiting substantial variability in their phenotypic characteristics and biochemical content, understanding and documenting this diversity is crucial for optimizing therapeutic applications. The review also highlights advances in cultivation techniques, such as submerged fermentation of the mycelium, and innovative analytical methodologies that have improved the precision of compound quantification and extraction. Although there is limited scientific information on P. cubensis due to nearly four decades of regulatory restrictions on psychedelic research, recent developments in genetic and biochemical studies are beginning to provide valuable insights into its therapeutic potential. Furthermore, this review emphasizes key knowledge gaps and offers insights into future research directions to advance the cultivation, scientific documentation of strain diversity, regulatory considerations and therapeutic use of P. cubensis. Full article

Balancing academic responsibilities and work commitments poses significant challenges for students in built environment (BE) programs, often leading to compromised well-being and academic difficulties. This study examines the causal effects of balancing work–study responsibilities on students’ health, well-being, and academic outcomes, addressing critical gaps in the literature. A positivist research approach was employed, with data collected via an online survey of 253 undergraduate BE students from Australian universities. The survey assessed academic and work stressors, health, mental well-being, coping strategies, and academic outcomes. Statistical analyses, including one-sample t-tests, factor analysis, and path analysis, were used to analyse the data. The findings reveal that BE students experience severe stress and moderate levels of anxiety and depression, significantly impacting their academic performance. Common health issues include fatigue and sleep disturbances. Work–study conflict and performance anxiety were identified as the strongest predictors of negative health outcomes, with maladaptive coping strategies amplifying these effects. These results underscore the urgent need for institutional interventions, such as flexible learning options, enhanced mental health services, and industry partnerships to alleviate work–study conflicts. Encouraging adaptive coping mechanisms and providing targeted support can help mitigate adverse effects, promoting improved academic performance and well-being among BE students. These findings can be generalised to students in other academic disciplines and countries, as similar work–study challenges and their associated impacts are observed globally. Full article

Background/Objectives: Depressive disorders are diagnosed using categorical definitions provided by DSM-5 and ICD-11. However, categorization for diagnostic purposes fails to account for the inherently dimensional nature of depression. Artificial categorization may impede research and obstruct the achievement of optimal treatment outcomes. Methods: The current study utilized a Canadian historical dataset called the National Population Health Survey (NPHS) to explore a simple alternative approach that does not depend on categorization. The NPHS collected complete data from 5029 participants through biannual interviews conducted in 1994–2010. Data collection included the K6 Distress Scale as well as the Composite International Diagnostic Interview Short Form for Major Depression. Data from the National Population Health Survey (NPHS) were used to quantify vulnerability to depressive symptoms through longitudinal K6 Distress Scale assessments. Variability of symptoms across this dimension of apparent vulnerability was quantified using ordinal regression, adjusting for age and sex. Results: Predicted probabilities from these models were used in simulations to produce a visualization of the epidemiology and to explore clinical implications. Conclusions: Consideration of these two dimensional factors (estimated overall level of vulnerability to depression and variability over time) is already a component of clinical assessment and is also accessible to repeated measurement in settings adopting measurement-based care. More formal consideration of these elements may provide a complementary approach to categorical diagnostic assessment and an opportunity for greater personalization of care and improved clinical outcomes. Future studies should validate these findings in diverse clinical settings to ensure their applicability in real-world contexts. Full article

Background/Objectives: Ischemic heart disease (IHD) is a major cause of morbidity and mortality worldwide, and it is frequently associated with depression, which can negatively impact both clinical outcomes and quality of life. The relationship between IHD and depression is complex, with gender differences influencing the severity of depression and willingness to seek psychological support. This study aims to evaluate the prevalence and severity of depression in IHD patients using the Depression Assessment in Ischemic Heart Disease Questionnaire (DA-IHDQ) and to explore gender differences in depression severity and help-seeking behavior. Methods: This cross-sectional study involved 103 patients diagnosed with IHD (62 males, 41 females), with data collected from two general practice clinics in Arad, Romania, between November 2023 and November 2024. Participants completed the DA-IHDQ, a self-developed questionnaire designed to screen for depression in IHD patients. The questionnaire categorizes depression severity into four grades: minimal to no depression, mild depression, moderate depression, and severe depression. The study also assessed participants’ interest in receiving psychological support. Descriptive and inferential statistical analyses were performed, and the psychometric properties of DA-IHDQ, including its reliability (Cronbach’s α = 0.957) and diagnostic accuracy (sensitivity = 90.0%, specificity = 98.8%), were evaluated. Results: Mild depression was the most common grade in both male and female IHD patients, while severe depression was the least prevalent. Males had a higher overall frequency of depression, with more cases of mild depression, whereas females had a higher proportion of moderate and severe depression. Additionally, males demonstrated significantly lower interest in psychological or psychiatric help, while females showed greater willingness to seek mental health support. The DA-IHDQ exhibited strong internal consistency and high diagnostic accuracy in identifying depressive symptoms in IHD patients. The DA-IHDQ exhibited strong internal consistency and high diagnostic accuracy in identifying depressive symptoms in IHD patients. Conclusions: The findings highlight the high prevalence of depression in IHD patients and the gender disparities in mental health engagement, emphasizing the need for targeted psychological interventions. The DA-IHDQ demonstrated strong psychometric properties and could serve as an effective screening tool for depression in IHD care. The DA-IHDQ demonstrated strong psychometric properties and could serve as an effective screening tool for depression in IHD care. Future research should explore the barriers to help-seeking among male IHD patients and develop gender-sensitive strategies to improve access to mental health services. Full article

Background and Objective: Adolescents’ mental health, including depression and anxiety, represent a global public health problem. However, there is a paucity of data on depression and anxiety among adolescents in Sudan. Therefore, the current study aimed to investigate the prevalence and associated factors for depression and anxiety among adolescents in Northern Sudan. Methods: This school-based cross-sectional study was conducted at randomly selected schools from August to September 2022 in Almatamah, River Nile State, Sudan. Sociodemographic and clinical data were collected using a face-to-face questionnaire. Depression and anxiety were measured using the questionnaire tools of the Patient Health Questionnaire (PHQ-9) and the General Anxiety Disorder (GAD-7), respectively. Univariate and multivariate binary analyses were performed to determine the associated factors of depression and anxiety using the adjusted odd ratios (AOR) and 95.0% confidence interval (CI). Results: Of 384 adolescents, 178 (46.4%) and 206 (53.6%) were boys and girls, respectively. The median (interquartile range [IQR]) of age was 15.1 (14.0–16.3) years old. Of the total adolescents, 311 (81.0%), 42 (10.9%), 20 (5.2%), 7 (1.8%), and 4 (1.0%) had no, mild, moderate, moderate to severe, and severe depression, respectively. Of the total, 31 (8.1%) adolescents had moderate or severe depression (depression score ≥ 10). In multivariable binary analysis, female gender (AOR = 5.35, 95% CI 1.67–17.09) and anxiety (AOR = 25.98, 95% CI 7.68–87.90) were associated with increased odds of depression; there was no association between age, father’s education, and BMI for age Z-score and depression. Of the 384 adolescents, 320 (83.3%), 47 (12.2%), 11 (2.9%), and 6 (1.6%) had no mild, moderate, and severe anxiety, respectively. Of the total, 17 (4.4%) had moderate and or severe anxiety (anxiety score ≥ 10). In multivariable logistic regressions, while family history of mental disorder (AOR = 6.31, 95% CI 1.36–29.27), being anemic (AOR = 3.95, 95% CI 1.19–13.12), and depression (AOR = 29.03, 95% CI 7.52–112.05) were associated with increased odds of anxiety; there was no association between age, gender, father’s occupation, and BMI for age Z-score and anxiety. Conclusions: The findings indicate that 1 in 10 adolescents in Northern Sudan experiences at least one mental disorder, encompassing depression, anxiety, or a combination of both. Notably, female adolescents are at a higher risk for depression, while factors such as a family history of mental disorders and anemia significantly contribute to anxiety levels. To address these pressing mental health concerns, it is imperative to implement inclusive and holistic programs that incorporate nutritional support, integrate mental health education into school curricula, and introduce community-based interventions aiming to enhance mental well-being among all adolescents, irrespective of gender. Full article

Background/Objectives: Shift work schedules and mental and physical workloads affect the sleep homeostasis of nurses, increasing the risk of occupational injuries. This study aimed to investigate the relationship between sleep disturbances caused by shift schedules and the occurrence of needlestick and sharps injuries (NSIs) among nurses, considering significant worker and occupational factors. Methods: A total of 348 nurses from five hospitals of Santiago de Guayaquil, Ecuador, participated in this cross-sectional survey. Data on sociodemographic and occupational characteristics, work schedules, and NSI incidents during the previous six months were collected. Emotional status, sleepiness, and insomnia symptoms were assessed using validated questionnaires. Additionally, nurses with night shifts (fixed or rotating) were specifically assessed to estimate the relationship between NSIs and insomnia or sleepiness symptoms related to these types of shift work using logistic regression analyses. Results: Nurses whose schedule included night shifts showed a higher prevalence of NSIs than those with other shifts (33.2% vs. 29.0%; p < 0.05). High levels of depression, anxiety, and stress were associated with having had an NSI in the previous six months. Logistic regression showed that female sex (adjusted odds ratio, aOR 4.62, 95% CI: 1.65–12.97), less experience in the current clinical setting (aOR 3.12, 95% CI: 1.46–6.57), the use of psychotropic drugs (aOR 4.46, 95% CI: 1.51–13.17), and insomnia and sleepiness symptoms due to shift work (aOR 2.61, 95% CI: 1.15–5.91) increased NSI risk among nurses with night shifts. Conclusions: There is an acute need to explore the complex relationship between sleep troubles linked to shift work schedules, occupational factors, and the risk of occupational injuries and propose preventive strategies for enhancing nurses’ sleep health and workplace safety. Full article