The associations between anxiety, depression, and the prognosis of COPD remain uncertain. The present study aims to investigate the associations of anxiety and depression with 30-day readmission rates and acute exacerbations of COPD (AECOPD). Four databases were searched to identify relevant studies published before 13 March 2024. Studies that report on the impact of anxiety and depression on the prognosis of AECOPD were included. The pooled effect size and its 95% confidence interval (CI) were calculated using a random effects model. The primary outcomes were 30-day readmission and AECOPD within the first year after discharge in COPD patients. Of the 5,955 studies screened, 14 studies were included in the analysis. Patients with anxiety had a higher risk of AECOPD within the first year after discharge compared to those without anxiety (HR: 2.10, 95% CI: 1.28-3.45, p = 0.003). Patients with depression also had a higher risk of AECOPD within the first year after discharge (HR: 1.36, 95% CI: 1.10-1.69, p = 0.004). Similar results were observed in the associations of anxiety and depression with 30-day readmission. Our results suggested that anxiety and depression were associated with an increased risk of 30-day readmission and AECOPD in patients with COPD.

Chronic obstructive pulmonary disease (COPD) induces an imbalance in T helper (Th) 17/regulatory T (Treg) cells that contributes to of the dysregulation of inflammation. Exercise training can modulate the immune response in healthy subjects.

We aimed to evaluate the effects of exercise training on Th17/Treg responses and the differentiation of Treg phenotypes in individuals with COPD.

This randomized controlled trial included 50 individuals with severe or very severe COPD who were allocated to the Exercise or Control groups. The Exercise group underwent eight weeks of aerobic and muscle strength training, whereas the Control group received usual care. The primary outcome was the change in the phenotypic characteristics of Tregs and Th17 profile differentiation in systemic inflammation.

Exercise training increased the frequency of total and activated Tregs and decreased the frequency of Th17 cells in between-group comparisons. Additionally, Th17/Treg responses were moderately correlated with improvements in the six-minute walking test, muscle strength of the upper and lower limbs, and daily life physical activity levels.

Exercise training improved functional exercise capacity, muscle strength, and physical fitness, which was associated with a decrease in the Th17 inflammatory response and an increase in Treg cell phenotypes immunosuppressive activity.

Esophagectomy is a primary curable treatment and a highly challenging procedure for esophageal cancer (EC) survivors. EC survivors experience various unmet needs. This study is aimed to assess unmet needs, health-related quality of life (HRQOL), and psychological distress of postoperative EC survivors.

A multicenter cross-sectional study was conducted between December 2023 and March 2024 across 28 hospitals in northern China. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, Hospital Anxiety and Depression Scale, and Supportive Care Need Survey - Short Form 34 were utilized to assess the HRQOL, anxiety, depression, and unmet needs.

A total of 357 postoperative EC survivors were recruited, with a mean age of 63.42 years. Approximately 14.6% exhibited borderline anxiety, and 17.9% showed borderline depression. Unmet needs were highest in health information and patient care domains. HRQOL was lower in global health, social, and physical functions post-surgery. Fatigue, appetite loss, insomnia, and financial difficulties were common. Dysphagia, dry mouth, reflux, and choking negatively impacted HRQOL. Multivariable regression analysis indicated that anxiety and depression levels were higher, and HRQOL was lower in those one week to six months post-surgery compared to one-week post-surgery.

EC survivors experience significant psychological distress and reduced HRQOL up to six months post-surgery. Dysphagia and unmet needs are prevalent. Compared to immediate post-surgery, EC survivors experienced higher levels of anxiety and depression, and lower level of HRQOL in six months. Future research should focus on developing individualized care strategies to provide optimal support.

Burnout is caused by long term psychosocial stress and has, besides the fatigue and mental health burden, been associated with increased risk of adverse physical health, such as for example type 2 diabetes. This study aims to investigate the glucose and insulin levels in individuals with stress related burnout, by assessing these metabolic markers in response to a standard oral glucose tolerance test (OGTT). 38 cases with burnout (13 men and 25 women) and 35 healthy controls (13 men and 22 women) in the age 24-55 were included in the study. The burnout group overall did not differ from healthy controls in glucose or insulin levels during the OGTT. However, the burnout cases who reported more severe burnout symptoms exhibited significantly higher levels of both glucose and insulin levels during the OGTT compared to burnout cases reporting lower severity of symptoms. Furthermore, the group of burnout cases who reported symptoms of depression exhibited higher insulin levels during OGTT compared to the burnout cases without depressive symptoms. The observed higher levels in the burnout cases with most severe symptoms indicate an increased diabetic risk in these patients and it may be of importance to follow glucose and insulin levels in individuals with more severe symptoms of burnout i.e. to perform an OGTT.

Uncontrolled COPD has been associated with reduced health-related quality of life, activity impairment, and increased use of healthcare resources. However, limited research is available on the factors associated with poor disease control in COPD patients. This study aimed to explore the factors associated with poor disease control in patients with COPD. The current cross-sectional study was conducted on patients with COPD who attended outpatient respiratory clinics at two major hospitals in Jordan. Information about disease and medication-related characteristics was collected through patient interviews and medical files. Validated instruments, including the 4-item medication adherence scale and the hospital anxiety and depression scales, were used to assess medication adherence, anxiety, and depression among the study participants. COPD severity was assessed using the GOLD classification criteria. Ordinal regression analysis was conducted to explore the variables associated with poor COPD control. In total, 702 patients participated in the study, with a median (interquartile range) age of 68 years (58-77). According to the GOLD report, most of the participants were in the B group (low risk/high symptoms; 40.2%), followed by the D group (high risk/high symptoms; 28.2%). Older age, higher depression scores, and a higher number of prescribed medications were associated with poorer COPD control, while not receiving LAMA (long-acting muscarinic antagonists) was associated with better control. Future mental health care initiatives should address the prevalence of depression symptoms in COPD patients and manage them effectively to improve COPD control and prevent further complications, with special attention to older patients, those receiving multiple medications, and those using LAMA.

Fibromyalgia (FM) is a syndrome characterised by chronic and widespread musculoskeletal pain that is often accompanied by psychological distress. Another psychological aspect associated with FM is metacognition. Metacognition is a process that enables a person to understand themselves and others in terms of intentional mental states. The aim of the present study was to investigate the relationship between metacognitive functioning, psychological distress and pain intensity in a sample of FM patients.

Sixty-one females with FM were asked to complete the following questionnaires after signing informed consent: the pain intensity item of the Fibromyalgia Impact Questionnaire-Revised (FIQ-R), the Hospital Anxiety and Depression Scale (HADS), and the Metacognitive Functions Screening Scale (MFSS-30).

The pain intensity item of the FIQ-R was negatively associated with metacognitive abilities (MFSS-30) and positively related to psychological distress (HADS total). The mediation analysis showed that the HADS total score mediated the relationship between the MFSS total score and the pain intensity item of the FIQ-R. This result suggests that reduced metacognitive abilities were associated with higher levels of psychological distress, which in turn were associated with greater pain intensity.

These findings have important clinical implications. The suggestion of a psychological intervention targeting metacognitive processes could reduce the degree of psychological distress and consequently the intensity of pain.

The endogenous opioid system is thought to play a role in the placebo antidepressant response. A recent trial comparing the rapid antidepressant effects of ketamine versus placebo in surgical patients, some of whom were on chronic opioid therapy, revealed a substantial placebo effect. This finding provided an opportunity to test the hypothesis that opioid agonist exposure interacts with placebo antidepressant responses.

This post hoc analysis utilized data from a previously reported randomized, anesthesia-blinded, placebo-controlled trial of intravenous ketamine in depressed patients undergoing routine surgery. Mixed-effects models were used to determine whether baseline opioid use influenced antidepressant responses to the trial interventions, as measured by the Montgomery-Åsberg Depression Rating Scale (MADRS) over 1 to 14 days post-treatment.

The analysis showed that baseline opioid use significantly reduced post-treatment depression severity in patients who received placebo, but not in those who received ketamine. This reduction was independent of baseline depression severity, baseline pain intensity, and ethnicity. Additionally, there was negligible correlation between postoperative pain intensity and depression severity.

This post hoc analysis was conducted on a small sample, and the findings need to be confirmed by prospective controlled studies.

Opioid use at baseline attenuated the placebo antidepressant response independently of pain in depressed patients who received the study treatment under general anesthesia for routine surgery. The antidepressant response was preserved in opioid users who received intravenous ketamine.

The combination of antidepressant and antipsychotic medication is an effective treatment for major depressive disorder with psychotic features ('psychotic depression'). The present study aims to identify sociodemographic and clinical predictors of remission of psychotic depression treated with combination pharmacotherapy and determine the accuracy of prediction models.

Two hundred and sixty-nine participants aged 18 to 85 years with psychotic depression were acutely treated with protocolized sertraline plus olanzapine for up to 12 weeks. Three cross-validated machine learning models were implemented to predict remission based on 74 sociodemographic and clinical variables measured at acute baseline. The optimal model for each method was selected by the average fold C-index. Based on the performance of each method, grouped elastic net (cox) regression was chosen to examine the association of each predictor with remission of psychotic depression.

Of the 269 participants, 145 (53.9 %) experienced full remission of the depressive episode and psychotic features. Multivariable models had 65.1 % to 67.4 % accuracy in predicting remission. In the grouped elastic net (cox) regression model, longer duration of index episode, somatic or tactile hallucinations, higher burden of comorbid physical problems, and single or divorced marital status were independent predictors of longer time to remission. A higher number of lifetime depressive episodes and peripheral vascular or cardiovascular disease were predictors of shorter time to remission.

Future research needs to determine whether the addition of biomarkers to clinical and sociodemographic variables can improve model accuracy in predicting remission of pharmacologically-treated psychotic depression.

Up to 25 % of expectant fathers may experience anxiety symptoms, with potential adverse consequences for themselves and their families. This study developed a psychometrically sound measure of pregnancy-related anxiety for fathers, addressing a current gap in research and practice for psychological scales that specifically assess men's fears, worries, and concerns specific to pregnancy. An item pool encompassing men's pregnancy-related concerns and worries was generated based on findings from a systematic review (Dabb et al., 2023). Following expert panel review, 95 items were evaluated within the framework of the Rasch measurement model, using data from 292 expectant fathers (Mage = 29.9 years, SD = 5.55) from Australia (N = 146) and the USA (N = 146). The resultant 33-item unidimensional scale demonstrated good fit, no evidence for differential item functioning, sound levels of targeting, and excellent internal consistency reliability. The new Paternal Pregnancy-related Anxiety Scale (PPrAS) is a comprehensive measure of pregnancy-related anxiety for expectant fathers, with usefulness in both clinical and research contexts.

This study co-designed and feasibility tested a novel psychoeducational intervention delivered online to carers of patients with heart failure (HF) and examined the potential impact on carer-related outcomes.

The HEart faiLure carer support Programme (HELP) was co-designed with carers and healthcare professionals at a large University hospital. This intervention comprises an information booklet and six psychoeducational support group sessions delivered online by a multidisciplinary team. A convergent mixed-method design examined the feasibility, acceptability, and potential impact of HELP. Carers of patients with HF were recruited in the United Kingdom (UK) via clinical teams along with printed and online advertisements. Quantitative measurements included carer-related outcomes (carer burden, carer preparedness, quality of life, anxiety, depression, stress, and social support) and feasibility assessments (recruitment rates, attrition, and intervention usefulness). Focus groups conducted post-intervention qualitatively investigated the acceptability of HELP. Data was collected at baseline, 6 weeks post-intervention, and 3 months post-intervention. Quantitative and qualitative data were analyzed with descriptive and thematic analysis, respectively. The results were integrated to generate a holistic understanding of the findings.

51 carers were eligible and 22 (43 %) provided consent. Of those 22, 18 (89 %) participated and 12 (67 %) completed all intervention sessions. Participants highly rated the usefulness of the intervention via a feedback questionnaire (4.7 ± 0.59 out of 5, overall) and positive changes were found across the following carer-related outcomes: anxiety, depression, caregiver burden, stress, preparedness, and social support. Data integration generated three key findings: (1) Improved carer preparedness and knowledge, (2) Support from group environment, and (3) Emotional support and personal wellbeing.

HELP delivery to carers of patients with HF is feasible and potentially provides emotional support and empowerment in their caring role.

HELP will advance to implementation testing across the UK to inform large-scale adoption in routine clinical practice.

Despite typically more pronounced cognitive and mental health issues in progressive disease courses of multiple sclerosis (PMS), rehabilitation research in this subgroup is rare. The efficacy of two non-pharmacological interventions with positive results from prior investigations was therefore examined in PMS specifically.

Persons with PMS (pwPMS) received either computerized cognitive training (BrainStim), standardized cognitive-behavioral group sessions (Metacognitive Training [MaTiMS]), or a combination of both in an ambulatory setting. Neuropsychological assessment was conducted before and after the four-week intervention.

37 participants (13 with primary/24 with secondary PMS, meanage = 52.87, SDage = 7.11, meanEDSS = 4.02, SDEDSS = 1.35) entered analyses. The BrainStim group improved in immediate and delayed verbal memory, recognition, verbal working memory, and perceived cognitive deficits while experiencing increased anxiety post-intervention. MaTiMS participants reported high program satisfaction and less cognitive difficulties at retest. The Combination group performed better in immediate and delayed verbal memory, and in information processing speed after training. Descriptive data further indicated positive effects on anxiety and depression in the MaTiMS and Combination group.

While objective cognitive performance improved when explicitly trained, psychoeducative sessions contributed to subjective mental health. The combination of both approaches is thus suggested, considering the specific needs of pwPMS treated in an ambulatory setting.

The aim of our study was to find out the effects of pulmonary rehabilitation (PR), which was applied to patients with coronavirus disease 2019 (COVID-19) both during their stay in the intensive care unit and also after discharge, on dyspnea, daily living activities, anxiety, depression, and quality of life.

The study was conducted using a randomized, pretest, posttest, follow-up, and control group interventional study design. The data were collected from patients between June and August 2021. A total of 60 patients with COVID-19 in the intensive care unit, including 30 in the intervention and 30 in the control group, were included randomly in the study. The patients in the intervention group were started PR at home and continued with telerehabilitation.

Pulmonary rehabilitation applied to patients diagnosed with COVID-19 both during their stay in the intensive care unit and following discharge had a positive effect on patients' dyspnea, daily living activities, anxiety, depression, and quality of life.

It was found that PR applied both during the intensive care unit stay and at home by using the telerehabilitation method decreased anxiety, depression, and dyspnea in patients with COVID-19 and affected the quality of life and daily living activities positively. Continuing PR, which was applied to acute respiratory patients in the hospital and with telerehabilitation at home, can ensure the integrity of care and treatment.

Uncontrollable anger is a debilitating consequence of acquired brain injury (ABI). This proof-of-concept study investigated the preliminary efficacy of an emotion regulation intervention for managing post-ABI anger. A secondary objective was to determine which participant characteristics were related to intervention gains. With a pre-post intervention design and three-month follow-up, there were five individually administered meetings on Zoom, over a four-month period. 24 adults who had sustained an ABI were enrolled. Participants were mostly males, from 24 to 85 years old. A series of one-way repeated-measures ANOVAs were conducted to determine the intervention's efficacy, and Spearman's rho bivariate correlations for the association between participant characteristics and intervention gains. Significant differences were observed in external anger from baseline to post-treatment; there were no further changes from post-treatment to follow-up. Of the participant characteristics, only readiness to change and anxiety were correlated. The proposed intervention presents a brief, feasible, and preliminary efficacious alternative for regulating post-ABI anger. Intervention gains are associated with readiness to change and anxiety, which has important implications for clinical delivery.

There is a high prevalence of neuropsychiatric sequelae in post-COVID syndrome, most commonly chronic fatigue, the mechanisms of which remain poorly understood. As altered function of the reward system has been suggested as a causal factor, we aimed to distinguish whether reward processing or task-unspecific cognitive operations are impaired in post-COVID syndrome. Our cohort study included 24 patients diagnosed with post-COVID syndrome and 24 demographically matched healthy controls. Questionnaire assessment of neuropsychiatric symptoms and socio-demographic variables, the Monetary Incentive Delay Task during an fMRI scan, and pupillary measurements were performed. In addition to clinical neuropsychiatric symptoms, participants in the post-COVID group demonstrated significantly slower task performance compared to healthy controls, although the function of behavioral reward circuits appeared unimpaired. However, the influence of rewarding cues on post-COVID patients increased significantly over time during task performance, correlating with temporally delayed activation of the left frontal gyrus and increased activity in task-unspecific brain regions in post-COVID patients. Furthermore, slower reaction times on the task were associated with a lower pupil diameter and a higher pupillary unrest index. This study proposes that post-COVID syndrome is a process that may not affect reward processing, but leads to neural hypoarousal and temporally altered brain activity in frontal and task-unspecific brain regions.

Recent evidence has identified four distinct eating profiles in 3-5-year-old children in the UK: avid, happy, typical, and avoidant. Among these profiles, children with avid eating behaviour exhibit high responsiveness to food cues, emotional eating, fast eating speed, and low responsiveness to fullness, posing risks for overeating and higher adiposity. Despite the implications, there is limited research on how avid eating manifests and impacts parents' behaviour and wellbeing. This study aimed to report the frequency of children's avid eating behaviour and explore its associations with child demographics, child temperament, home environment, parental feeding practices, and parental wellbeing. This study collected data via Ecological Momentary Assessment from 109 parents of a 3-5-year-old child identified as having an avid eating profile through a latent profile analysis of parents' reports of their children's eating behaviour. Using baseline and momentary data, the novel findings revealed that children with avid eating frequently requested food, especially snacks, with higher occurrences during weekends. Older children and boys showed higher probabilities of avid eating. High surgency in children correlated with more frequent food requests, while greater effortful control in children related to fewer eating occasions. Parents of children with higher probability of avid eating reported higher stress, depression, and anxiety, as well as frequent food requests from their child. Additionally, food insecurity was linked to increased food requests, suggesting a complex interplay between food availability and eating behaviour. The study underscores the need for targeted interventions to support parents in managing children's avid eating behaviour and improving overall family wellbeing.

The present series of studies aimed to develop and provide initial validation of the Ease of Imagery Questionnaire (EIQ)-a measure assessing ease of imaging different positive and negative imagery content reflective of valence and engaging or disengaging in adverse situations. Five studies were conducted to collectively examine the questionnaire's factor structure and concurrent validity. Study 1 (N = 336) and Study 2 (N = 207) informed the development of 16 items of the EIQ, with a four-factor structure supported in Studies 3 (N = 219), 4 (N = 135), and 5 (N = 184) using confirmatory factor analysis. Study 3 also supported concurrent validity with significant bivariate correlations (p < .05) with the similar Sport Imagery Ability Questionnaire subscales, while studies 4 and 5 demonstrated criterion validity in the EIQ's prediction of challenge and threat appraisal tendencies, perceived stress, stress mindset, and anxiety and depressive symptoms. Overall, the EIQ demonstrates a replicable four-factor structure and appears to assess ability to image content associated with positive and negative emotions as well as demanding stress-evoking situations.

Hypertensive retinopathy (HR) is known to have effects on the brain's function. This neuroimaging investigation aimed to evaluate alterations in functional network connectivity and the topological properties of brain networks in in patients with HR.

The study involved twenty patients with HR and forty-one healthy controls (HC), all of whom underwent resting-state functional MRI scans. Independent component analysis and graph theory analysis were calculated to identify functional connectivity and topological property abnormalities between the two groups.

Compared to HC, patients with HR demonstrated increased internetwork functional connectivity. Furthermore, these patients showed increased intranetwork functional connectivity within the right precuneus of the default mode network. Graph theory analysis revealed that both groups demonstrated a small-world topology. However, significant differences were observed in global and regional network metrics in HR patients compared to HC.

These findings highlight the alterations in functional connectivity and topological properties of brain networks in patients with HR, offering valuable insights into the potential neural mechanisms underlying their condition.

Depression is a common mental disorder that significantly impacts global well-being. Although stress is a major contributor to depression, not all stress leads to depressive outcomes due to differences in stress perception. Understanding the neural mechanisms of stress perception may help identify biomarkers for targeted interventions to alleviate stress-related depression.

This study included 113 participants. Each participant completed a Verbal Fluency Task (VFT) while undergoing functional near-infrared spectroscopy (fNIRS) to monitor brain activity. Oxyhemoglobin (Oxy-Hb) concentration data were analyzed using Matlab, and PROCESS v4.1 to examine neural mechanisms connecting stress perception and depression.

Correlation analysis showed a significant negative association between depression severity and Oxy-Hb concentration in several brain regions, including the bilateral dorsolateral prefrontal cortex (DLPFC), bilateral Broca's area (BA), right frontal pole (FP), and right orbitofrontal cortex (OFC). Mediation and moderation analyses revealed that the bilateral DLPFC serves as a key mediator in the relationship between stress perception and depression, with the supplementary motor area (SMA) acts as a moderator. Functional differentiation was observed, with the left DLPFC and left SMA influencing the effect of nervous on depression, and the right DLPFC and right SMA influencing the effect of uncontrolled on depression.

The bilateral DLPFC and SMA play critical roles in mediating and moderating stress perception's impact on depression, suggesting these regions as potential targets for interventions in stress-related depressive disorders.

Psychedelics are gaining renewed attention, especially through the practice of microdosing, where low doses are taken regularly. Microdosing lysergic acid diethylamide (LSD) and psilocybin is used by both healthy individuals and those with mental health conditions to improve daily functioning, reduce anxiety, and enhance mood and cognition. However, there is limited information about the side effects of this practice. This review aimed to collect and characterize the side effects of psychedelic microdosing.

We conducted a systematic review of original papers from PubMed, Web of Science, and Scopus (accessed August 03, 2024) that reported side effects of microdosing LSD and psilocybin. Non-English papers, non-original studies, studies without typical microdosing doses, or those lacking descriptions of side effects were excluded. Our methodology has been developed in accordance with PRISMA guidelines. Because side effects were assessed heterogeneously in these papers, we did not perform a bias evaluation.

We included 31 studies, 15 of which we classified as laboratory studies with higher quality evidence, and 14 studies with lower quality evidence, as well as 2 clinical cases. Side effects were typically dose-dependent, mild, and short-lived. Common adverse effects included increased blood pressure, anxiety, and cognitive impairment.

This review is limited by the heterogeneity in reporting side effects and the short duration of many studies. Future studies should transparently and systematically present a description of side effects.

This study investigated the prospective association of serum interleukin-1 beta (sIL-1β) and brain-derived neurotrophic factor (sBDNF) with 12-week antidepressant treatment outcomes in patients with depressive disorders. We analyzed baseline levels of sIL-1β and sBDNF in 1,086 patients participating in a naturalistic, stepwise antidepressant treatment study. Remission was defined by a Hamilton Depression Rating Scale score of ≤7 at 12 weeks. Logistic regression, adjusted for sociodemographic and clinical covariates, was used to assess the relationships between biomarker levels and treatment outcomes. Higher sIL-1β levels were significantly associated with non-remission at 12 weeks in patients with lower sBDNF levels, while in patients with higher sBDNF levels, sIL-1β did not significantly impact remission outcomes. The interaction between sIL-1β and sBDNF significantly associated with remission status, even after adjusting for confounders. The study suggests the significant role of the interplay between inflammatory and neuroplastic systems in influencing antidepressant treatment outcomes. These findings underscore the potential of integrating biomarker profiles to enhance personalized antidepressant strategies, advancing treatment precision in depressive disorders. Future research should focus on elucidating the dynamic mechanisms behind these biomarker interactions to further refine models that assess treatment responsiveness and develop targeted therapeutic interventions.

The aim of this review was to identify the type, content, and effectiveness of psychological parenting interventions for parents of children with intellectual disabilities to enhance child behavior and/or parental well-being. A systematic search yielded 21 studies involving 1825 participants. Studies were evaluated according to intervention content, pre- and post-treatment and follow-up effect sizes, and risk of bias. We categorized the interventions into those targeting 'Child or interaction' (child behavior, interaction and learning, understanding disability), and those targeting 'Parent' (parental well-being) or both themes. All these interventions had positive effects on parental well-being or child behavior. Parental outcomes were improved by interventions targeting 'Parental well-being', as well as 'Child or interaction'. Child behavior showed improvements in programs focusing on 'Child or interaction', and in a mindfulness-based parental well-being program. During follow-up, most effects were sustained or further increased, but some studies showed no improvements over the control group.

Despite advancements in medical technology and early cancer detection, many colorectal cancer (CRC) survivors report unmet care needs after completion of their cancer treatment that compromise their quality of life (QoL). Previous studies on the care needs of cancer survivors have yielded inconsistent results, and few studies have been conducted on survivors of CRC in Taiwan or on predictors of their unmet care needs.

The purpose of this study was to examine the unmet care needs, psychological distress, and QoL of Taiwanese CRC survivors ( n = 100) as well as to assess the mean differences by sociodemographic characteristics in their unmet care needs and other related predictors after treatment completion.

This cross-sectional study using a purposive sampling method was conducted at a regional hospital in northern Taiwan between October 2019 and February 2020. The measurements used in this study included Chinese Cancer Survivors' Unmet Needs, Hospital Anxiety and Depression Scale, and European Organization for Research and Treatment Quality of Life Questionnaire-Core 30 and Quality of Life Questionnaire-Colorectal Cancer Module 29. The independent t test and one-way analysis of variance were employed to assess sociodemographic differences in unmet care needs, and multivariate linear regression was used to identify significant predictors.

More than half of the participants (63.2%) reported at least one unmet care need, with the highest categories including information needs ("signs and symptoms of cancer recurrence" 31.7% and "information related to health promotion" 31.7%), "medical care needs" ("managing health with the medical team" 13.9%), and "physical/psychological effect needs ("concerns about cancer recurrence" 23.8%). Also, 7%-57% of the participants experienced differing degrees of distress symptoms including fatigue, intestinal and urogenital dysfunctions, and anxiety or depression. The results of the univariate analyses showed unmet needs to differ significantly by age ( p = .021), employment status ( p = .007), and chronic disease status ( p = .025). The findings revealed being of older age (β = 0.23, p = .049), being employed (β = 0.26, p = .014), and having a lower functional level (β = -0.31, p = .012) to be associated with significantly higher levels of unmet care needs, collectively accounting for nearly 27.3% of the variance (adjusted R2 = .273).

CRC survivors continue to experience unmet care needs and various forms of physical-psychological distress for an average of almost 2 years after their completion of CRC treatment. The findings of this study may assist healthcare providers in identifying the major risk factors that interfere with survivor care needs following treatment, thus facilitating the development of timely interventions to mitigate the impact of cancer on this vulnerable population.

While previous studies have suggested a potential link between greenspace and semen quality, the effect of greenspace exposure on sperm kinematics, as well as the impact of greenspace estimation scales, remains underexplored.

This study aimed to examine the association between greenspace exposure and sperm kinematics, and to determine whether this relationship varies across different greenspace estimation scales.

We conducted a retrospective longitudinal study of 5025 semen measurements from 1674 sperm donors recruited by the Sichuan Provincial Human Sperm Bank (SHSB) between June 2019 and December 2021. Greenspace exposure was estimated using the Normalized Difference Vegetation Index (NDVI) for four buffer zones (250 m, 500 m, 1,000 m, and 2000 m) centred on the geocoded residential addresses. Linear mixed-effects models and restricted cubic spline models (knots = 4) were used to assess the associations between greenspace exposure and both conventional semen parameters and sperm kinematic parameters across all buffer zones.

A non-linear association between NDVI-500m and progressive motility was observed for conventional semen parameters (P non-linear = 0.018). For sperm kinematics, NDVI-500m could be associated with multiple kinematic measures (VCL: % change = 1.81, 95% CI: 0.72, 2.91; VAP: % change = 2.57, 95% CI: 1.46, 3.70; VSL: % change = 3.37, 95% CI: 2.11, 4.66; LIN: % change = 1.51, 95% CI: 0.82, 2.21; STR: % change = 0.83, 95% CI: 0.44, 1.23; WOB: % change = 0.69, 95% CI: 0.35, 1.04; BCF: % change = 1.82, 95% CI: 0.97, 2.68), and significant non-linear associations were found between NDVI-500m and LIN (P non-linear = 0.011), STR (P non-linear = 0.015), WOB (P non-linear = 0.012), and ALH (P non-linear <0.001). Regarding the impact of greenspace estimation scales, smaller buffer zones exhibited stronger non-linear relationships for conventional semen parameters, whereas larger buffer zones revealed more pronounced non-linear relationships for sperm kinematics. There was a stable and significant linear association between greenspace exposure and sperm kinematics during the 70-90 days before ejaculation (spermatocytogenesis). PM2.5 and PM10 attenuated the negative effect of greenspace exposure on IM at a buffer scale of 250 m, while enhanced the positive effect of greenspace on kinematics at all scales.

Greenspace exposure were significantly associated with sperm kinematics, with the strength and nature of these associations varying by buffer scale. 70-90 days before ejaculation (spermatocytogenesis) was the window of susceptibility for greenspace exposures at all buffer scales. As PM2.5 and PM10 increased, increasing levels of greenspace can improve sperm kinematics more significantly. These findings support the beneficial effect of greenspace on male fertility, and underscore the importance of considering greenspace buffer zones in urban planning to optimize health benefits effectively.

To analyze the effect of two 16-week interventions with jazz dance and concurrent training compared to a control group on anxiety, depression, stress, mood, and the perspective of aging in menopausal women, after 1-month, post-intervention, and at the 6-month follow-up.

70 post-menopausal women (53.19 ± 3.39 years) randomized into 3 groups:intervention group with Jazz Dance (JD); intervention group with Concurrent Training (CT), and Control Group (CG). Both interventions lasted 16 weeks, with 60-min classes, JD with a frequency of two weekly classes, and CT three times a week. The intensity of the JD was progressive and according to the frequency of beats per minute of the songs. In CT, the aerobic an initial intensity of 60% of HRmax, reaching 90%, and resistance the volume of sets and loads increased progressively throughout the intervention. Questionnaires related to symptoms of anxiety and depression (Hospital Anxiety and Depression Scale); stress (Perceived Stress Scale); mood (Brunel Mood Scale); and aging perspective (Sheppard Inventory) were applied. Intention-to-treat (ITT) and protocol adherence analysis were performed.

In the protocol analysis, the JD showed improvements in anxiety and depressive symptoms after 1-month, which remained at the follow-up. The TC presented reduced anxiety and depressive symptoms after 16 weeks, which also remained at the follow-up. Considering stress, the CT showed improvements at all times and the JD post-intervention. As for mood, the CT presented reduced anger, mental confusion, and fatigue only after 1-month, and both exercise groups presented increased vigor at all times.

Both interventions were beneficial, however dance showed immediate results for anxiety and depression, and concurrent training for stress. Considering mood, concurrent training was more effective for anger, mental confusion, and fatigue, while both interventions were effective for vigor.

Brazilian Clinical Trials Registry (REBEC) RBR - 87ndrv.

ClinicalTrials.gov identifier: NCT01437683..

Physical exercise is a non-pharmacological treatment that can bring positive changes to menopausal women experiencing physiological and hormonal changes leading to various physical and psychological symptoms. This study introduces the MenosPausa Mais Movimento Project protocol, aiming to compare the effects of Urban Dance and Functional Fitness with a control group on the physical and psychological well-being of postmenopausal women.

This study outlines a protocol for a three-arm randomized clinical trial involving two interventions (Urban Dance and Functional Fitness) lasting 12 weeks. The participants will be women in early postmenopause, aged between 40 and 59 years, assigned to three groups: (1) Urban Dance Intervention Group, (2) Functional Fitness Intervention Group, and (3) Control Group. Both interventions will consist of two weekly sessions lasting 60 min each. The outcomes to be assessed include physical aspects (body mass index, fat percentage, waist circumference, muscle strength, cardiorespiratory fitness, bone densitometry, sleep quality, urinary incontinence, sexual function, and follicle-stimulating hormone) as well as psychological aspects (stress, cognition, mood state, depressive symptoms, and anxiety). Data collection and analysis will be conducted during pre- and post-intervention periods.

The study is proposed with the aim of expanding the evidence related to the effects of different types of physical exercise in reducing and/or stopping symptoms resulting from menopause. The hypothesis is that women who perform the types of physical exercise will significantly improve the symptoms investigated when compared to those in the control group, thus expanding the possibilities of non-pharmacological therapies to assist the work of health professionals, favoring the physical and psychological aspects of this population.

Tocilizumab, an IL-6 receptor antagonist, may prevent functional impairments in critically ill patients by attenuating the cytokine storm. This study investigated a potential effect of tocilizumab on preventing functional impairments in patients with severe coronavirus infection 2019 (COVID-19).

In a multicenter prospective observational study, patients with COVID-19 ≥ 20 years requiring mechanical ventilation admitted to the intensive care unit between April 2021 and September 2021 and discharged alive were followed for one year. A self-administered questionnaire on sequelae and functional impairments was mailed in August 2022, and data were collected. A multivariate logistic regression was used to assess the impact of tocilizumab on physical function, mental health, and Long COVID.

Of 157 analyzed patients, 41 received tocilizumab. The tocilizumab group had more severe illness, but a lower prevalence of physical impairment (17.1 % vs. 23.3 %, p = 0.41) and mental disorders (19.5 % vs. 39.7 %, p = 0.009) than the non-tocilizumab group. The prevalence of Long COVID was higher in the tocilizumab group (92.7 % vs. 80.2 %, p = 0.06), whereas fatigue/malaise was significantly lower (19.5 % vs. 37.1 %, p = 0.039). Adjusted odds ratios (95 % confidence interval) for physical impairment, mental disorders, and Long COVID with tocilizumab were 0.70 (0.2-2.1), 0.40 (0.16-1.01), and 2.94 (0.7-12.3), respectively, with no significant difference.

Tocilizumab was associated with a lower prevalence of physical impairment and mental disorders at 1 year in patients with severe COVID-19. Furthermore, Long COVID had a weaker impact on physical and cognitive functions.

Conditioned Pain Modulation (CPM) is a useful tool for testing the functionality of endogenous pain modulation. However, inconsistent results have been obtained in clinical populations, possibly due to the wide variety of CPM protocols used and the influence of demographic and psychological characteristics of the individuals assessed.

We tested the sensitivity and reliability of four commonly used CPM paradigms in a sample of 58 healthy participants. We also checked how these measures were related to Temporal Summation of Second Pain (TSSP), sociodemographic (age and sex) and psychological variables (anxiety and stress).

CPM results were influenced by the test stimulus used, with tests using pain pressure threshold (PPT) obtaining a greater number of responders (over 65%) and being the most sensitive (higher size effect: Cohen's d > 0.5). However, all measures showed excellent intrasession reliability, with strong agreement between the CPM magnitudes. CPM indices were not correlated with TSSP, age or sex, and the psychological scales did not differentiate CPM responders and non-responders.

Although the CPM indices showed good reliability, construction of a large database with standardized values for healthy individuals seems necessary for the use of CPM in clinical settings.

Anal slow waves (SW) and ultraslow waves (USW) have been documented previously, yet their significance remains uncertain. Our aims were to characterize the prevalence and features of SW and USW in healthy subjects and patients with constipation and to correlate them with clinical features and anorectal physiological testing.

Forty-three healthy female subjects and 83 female tertiary referral patients with constipation were included. High-resolution water-perfused manometry was performed. Retrospective blinded descriptive and quantitative analyses of manometric tracings were completed with a focus on SW and USW.

SW were present in 58% of healthy subjects and 62% of constipated patients (p = 0.72) yet USW were seen almost exclusively in constipated patients (27% vs. 2% health; p < 0.0001). Frequencies and mean amplitudes of SW and USW were similar in both groups. Anal resting and squeeze pressures were higher in patients with SW compared to those without (p < 0.001, p = 0.004, respectively). Patients with USW had higher anal resting pressure and shorter duration of sustained squeeze compared to those without (p < 0.001 for both). There was a trend for less obstetric injury in constipated patients with USW compared to those without (23% vs. 48%; p = 0.05).

While SW were common in both constipated and healthy subjects, USW were almost exclusively observed in constipated patients. Some correlations were observed with other anorectal physiology parameters such as high resting anal pressure with both SW and USW. Formal definitions for SW and USW are proposed. Further research into the clinical significance of these waves is warranted.

Chronic dizziness is common in older adults, yet frequently occurs without a clear cause ('idiopathic dizziness'). Patients experience subjective unsteadiness with minimal objective imbalance, potentially related to small vessel disease. Here we examine the hypothesis that this syndrome is associated with disrupted cortical processing of postural instability.

EEG and postural sway were recorded in 33 older adults with chronic, idiopathic dizziness (Age, Mean = 77.3 years, SD = 6.4, 61 % female) and 25 matched controls (Age, Mean = 76.9 years, SD = 6.0, 56 % female). EEG was time-locked to spontaneous instances of postural instability and analysed via time-frequency decomposition.

Significant between-group differences in EEG were observed during the early phase of postural instability (p < 0.05, cluster-corrected). Whilst controls exhibited broadband increase in EEG power across sensorimotor areas, dizzy patients displayed suppressed beta activity (19-24 Hz). Contrary to predictions, these differences did not relate to small vessel disease markers (rs < 0.05, ps > 0.720) but to fear of falling (r = -0.44, p = 0.001).

Previous work implies that suppressing cortical beta enhances the relay of sensory information. We therefore propose that the modulation in beta EEG observed in patients reflects an anxious, top-down strategy to increase sensitivity to instability, which paradoxically causes persistent feelings of subjective imbalance.

These results identify associations between idiopathic dizziness and disrupted sensorimotor beta activation during postural instability. Cortical beta during imbalance may be a possible biomarker of chronic, idiopathic dizziness in older adults and/or fear of falling.

To investigate the effects of customized web video-based vestibular rehabilitation in patients with chronic vestibular hypofunction.

This study is a randomized controlled trial.

The dizziness specialty clinic.

The participants were diagnosed with chronic vestibular hypofunction.

The study used a randomized controlled trial design, in which participants were randomly assigned to either the customized web video-based vestibular rehabilitation or booklet-based vestibular rehabilitation in a 1:1 ratio.

Patients were assessed at three time points: before-intervention (baseline), post-intervention completion (6 wk), and follow-up (12 wk). The primary outcome was the Dynamic Gait Index (DGI), the secondary outcome was the Dizziness Handicap Inventory (DHI), and tertiary outcomes included other functional and psychological assessments.

The baseline characteristics of the patients were comparable between the two groups. Statistical analysis revealed a significant time effect for the DGI score ( p < 0.0001). Comparing the post-intervention and follow-up assessments to the baseline assessment, the customized web video-based VR group showed a significant increase in the DGI score. Time × group interaction effects were observed ( F = 5.739, p < 0.01). Both groups showed decreased DHI_total scores when comparing the postintervention and follow-up assessments to the baseline assessment. No serious adverse events were reported during intervention period.

The present study demonstrated that customized web video-based VR improved DGI compared with booklet-based VR, and the intervention effect was maintained at 6-week follow-up. Additionally, the findings suggested that both interventions improve to a similar extent DHI. Therefore, vestibular rehabilitation with motion visualized by video may be more effective than that with still image by booklet.

To investigate the correlation between laryngopharyngeal reflux (LPR) and psychological distress in a sample of adult Italian patients.

LPR was assessed using the Reflux Symptom Index (RSI), Reflux Finding Score (RFS), and 24-hour impedance-pH monitoring. Psychological distress was evaluated with the following clinical tools: the Hospital Anxiety and Depression Scale (HADS), the Hamilton Anxiety Rating Scale (HAM-A), the Hamilton Depression Rating Scale (HAM-D), the Impact of Event Scale-Revised (IES-R), the Insomnia Severity Index (ISI), and the Perceived Stress Scale-10 (PSS-10). Associations between RSI, RFS, and psychological scores were analyzed.

A total of 45 patients with LPR (Study Group, SG) and 29 healthy volunteers (Control Group, CG) were included in the study. Psychological assessments revealed significant differences between the CG and SG, except for the ISI. The HAM-A score was 6.79 ± 6.5 in the CG versus 9.53 ± 5.8 in the SG (p = 0.025), with similar results for the HADS (p = 0.029). For the HAM-D, mean scores in both groups were below the threshold for mild depressive symptoms, though SG scores were just below the cut-off (CG: 4.86 ± 5.1; SG: 6.89 ± 4.1; p = 0.010). The PSS-10 indicated mild to moderate perceived stress, with significantly higher scores in the SG (CG: 13.90 ± 5.5; SG: 21.62 ± 8.1; p = 0.000). RSI scores were positively correlated with HAM-D, HADS, and HAM-A scores.

Psychological distress is significantly higher in LPR patients compared to healthy controls. These preliminary findings suggest that psychological factors should be considered in the management of LPR.

Pain in hand osteoarthritis (OA) is evaluated with repeated pain questionnaires. It is unclear whether these questionnaires adequately capture changes in pain recalled by patients. This study investigated whether changes on pain questionnaires (real-time evaluation) correspond to recalled pain.

Data from hand OA patients from the HOSTAS cohort (four one-yearly) and HOPE trial (one six-week interval) were used. Pain was measured with the Australian/Canadian hand Osteoarthritis Index (AUSCAN, range 0-20) and a recall question (how is the pain compared with your last visit). Changes in AUSCAN pain were categorized into improved (≤-1), stable or worsened pain (≥1) and compared with the recall question using Cohen's kappa and percentage agreement. We determined concordance between measurement methods, and investigated associations of mental well-being and illness perceptions with concordance using generalized estimating equations (GEE).

Of 708 intervals from HOSTAS (307 patients, 82% women, mean age 61.0 years, mean AUSCAN 9.1), AUSCAN changes and recall were concordant in 42% (Cohen's kappa 0.13). There was concordance in 47% of 86 intervals (Cohen's kappa 0.14) from the HOPE trial (86 patients, 80% women, mean age 63.5, mean AUSCAN 10.7). The most frequent recall answer was worsened pain in the HOSTAS (60%), improved pain in the HOPE trial (76%). In both studies, AUSCAN pain most frequently improved. Depression and anxiety showed no association with concordance.

Changes in repeatedly measured AUSCAN pain often differ from the recalled course of pain over the same period. This has profound implications for evaluating patient-reported pain in clinical trials.

Previously, we reported that an inpatient multimodal occupational rehabilitation program (I-MORE) was more effective than outpatient Acceptance and Commitment Therapy (O-ACT) in reducing sickness absence and was cost-effective over a 24-month period. Here we present 7-years of follow-up on sick leave and the cost of lost production.

We randomized individuals aged 18-60, sick-listed due to musculoskeletal or mental health disorders to I-MORE (n = 82) or O-ACT (n = 79). I-MORE, lasting 3.5 weeks, integrated ACT, physical training, and work-related problem-solving. In contrast, O-ACT mainly offered six weekly 2.5 h group sessions of ACT. We measured outcomes using registry data for days on medical benefits and calculated costs of lost production. Our analysis included regression analyses to examine differences in sickness absence days, logistic general estimating equations for repeated events, and generalized linear models to assess differences in costs of lost production.

Unadjusted regression analyses showed 80 fewer days of sickness absence in the 7-year follow-up for I-MORE compared to O-ACT (95% CI - 264 to 104), with an adjusted difference of 114 fewer days (95% CI - 298 to 71). The difference in costs of production loss in favour of I-MORE was 27,048 euros per participant (95% CI - 35,009 to 89,104).

I-MORE outperformed O-ACT in reducing sickness absence and production loss costs during seven years of follow-up, but due to a limited sample size the results were unprecise. Considering the potential for substantial societal cost savings from reduced sick leave, there is a need for larger, long-term studies to evaluate return-to-work interventions.

Engaging family members in patient care in the intensive care unit (ICU) is a recommended practice by critical care societies. However, there are currently no validated tools to measure family engagement in the ICU setting. The objective of this study was to validate the FAMily Engagement (FAME) tool in the ICU.

The FAME study was a multicenter prospective cohort study of family members of ICU patients in 8 Canadian ICUs. Family members completed the FAME questionnaire during the ICU stay. The FAME questionnaire comprised 12 items that assessed various domains of family engagement behavior. FAME scores were reported in a 0-100 scoring system with higher scores indicating increased care engagement. Following hospital discharge, we assessed associations between the FAME score and family satisfaction with care and mental health (anxiety and depression). The internal consistency (reliability), convergent validity, and predictive validity of the FAME tool were evaluated.

There were 269 family members (age 56.8 ± 15.1; 68.4 % women) included in the analysis. The most common relationships to the patient were spouse/partner (40.5 %) and daughter/son (33.8 %). The overall mean FAME score was 77.7 ± 14.8. The FAME score had high internal consistency (Cronbach's α = 0.83) and the tool demonstrated convergent and predictive validity. The FAME score was associated with family satisfaction, but not with mental health outcomes.

The FAME tool demonstrated reliability, convergent, and predictive validity in this multicenter ICU cohort. The FAME tool could be used to evaluate the effectiveness of family engagement interventions.

Dependency and self-criticism are two dimensions of personality vulnerability to depression, whereas efficacy is a dimension of personality resilience. The aim of this study was to examine the unique role of these personality dimensions in adaptation following a diagnosis of breast cancer, while controlling for the potentially confounding role of symptoms of depression and anxiety. Three adaptation outcomes were examined: Functioning, symptomatic load, and fatigue. Patients residing in Germany, diagnosed with breast cancer and comorbid depression, participated in a Randomized Clinical Trial (RCT) testing Supportive-Expressive Psychodynamic Psychotherapy (SEP; N = 78)) versus Treatment as Usual (TAU; N = 79). Assessments were made pre-treatment, at termination, and at 6-month follow-up. Analyses were conducted via General Linear Modelling (GLM). Pretreatment self-criticism prospectively predicted a rank-order decrease in functioning and a rank order increase in symptomatic load and fatigue. Dependency predicted an increase in breast symptoms. No effects were found for efficacy. Self-criticism may complicate adaptation to breast cancer. Implications for early detection and illness management are discussed.

This paper examines demographic, structural, and syndemic variables to map facilitators and barriers to accessing pre-exposure prophylaxis (PrEP) among gay, bisexual, and other men who have sex with men (GBM) in the three largest cities in Canada, Vancouver, Toronto, and Montreal. Focusing on factors in the later stages of the PrEP cascade, this study first performed a logistic regression analysis and reports adjusted odds ratios, then entered statistically significant social indicators into a network analysis to profile the interrelated and sometimes mutually reinforcing social conditions that shape inequitable access to PrEP among Canadian GBM. Barriers to accessing a gay-friendly health care provider (HCP) and financial barriers remain primary nodes associated with inequitable PrEP access. These two nodes are, in turn, linked to other social indicators: experiencing stigma from an HCP, being less likely to be out to an HCP (most common among bisexual and queer men), and not being able to find an HCP accepting of their sexuality (most common among Indigenous, Black, and some other GBM of colour). The cost of PrEP was also a barrier, especially for less educated and un- or under-employed GBM, as well as newcomers to Canada, who more often lacked insurance for medications. These findings point toward the importance of having a primary HCP and finding an HCP who is culturally competent regarding the sexualities of gay and bisexual men, queer and trans people. These barriers may also explain other social inequities experienced by Black, Indigenous, and other GBM of colour, and by people who do not have health insurance that covers all or most of the cost of PrEP. This pattern of inequitable access to PrEP points toward the urgency of providing universal access without financial barriers (currently available in some Canadian provinces but not others) and supporting access points with a reputation for welcoming GBM in their full diversity.